Overcrowded household, poor hygiene up risk of nonsexual syphilis infection in children

Children may acquire syphilis by nonsexual contact, with overcrowded and poor household conditions increasing the risks for nonsexual treponema transmission, suggests a study.

In addition, an infected member of the family or a caretaker are of particular risk to an infant due to certain practices like using saliva to moisten the rubber nipples of milk bottles or trying the food temperature before feeding the infants.

This prospective cohort study included 24 paediatric patients (mean age at diagnosis 4.2 years) who acquired syphilis by nonsexual contact. The investigators obtained demographics, clinical findings, post-treatment serology development, and general laboratory data.

After a careful medical and psychosocial evaluation of the children and their family, sexual transmission was ruled out.

All patients were from overcrowded households with poor hygiene conditions. Secondary syphilis skin lesions (79.2 percent) was the most common reason for consultations. After psychosocial assessment of children and their families, no sign of sexual abuse was found in any of the cases.

Of the 78 families and their cohabitants evaluated, 23 (29.5 percent) had a positive result for rapid plasma regain and treponemal test of hemagglutination; majority of these cases (60.9 percent) were asymptomatic. Symptomatic relatives, on the other hand, exhibited lesions of secondary syphilis.

A sustained fall on nontreponemal antibodies titre (rapid plasma regain) occurred after treatment, which became negative in six of 24 cases (25 percent) within 12 months post-treatment.

“Following evaluation, it was considered that sexual abuse was unlikely,” the investigators said. “[I]f examination and psychosocial evaluation do not support it, other ways of transmission must be considered.”