Canadian Public Health Laboratory Network (CPHLN) Diagnostic Recommendations for Neurosyphilis in Canada

Eight provinces and territories are currently experiencing syphilis outbreaks in Canada, with the national rate of infectious syphilis increasing significantly from 5.1 per 100,000 population in 2011 to 36.1 per 100,000 population in 2022. Neurosyphilis refers to infection of the central nervous system by Treponema pallidum, which may occur at any stage. It is to be expected that along with the syphilis outbreak, a concomitant rise in neurosyphilis cases will occur. It is important to note that Canadian national surveillance data on neurosyphilis is not currently published as it is inconsistently reported and often lumped in with secondary and tertiary syphilis rates. Future surveillance efforts must focus on properly identifying these cases to quantify the scope of the problem. This article summarizes Canadian Public Health Laboratory Network guidelines for neurosyphilis diagnosis.