Practice Practice Pointer

Investigating the pregnant woman exposed to a child with a rash

BMJ 2012; 344 doi: (Published 26 March 2012) Cite this as: BMJ 2012;344:e1790

Re: Investigating the pregnant woman exposed to a child with a rash

I partially agree with Dr. Peter J Flegg. Humans are the sole natural host of syphilis. The disease is most common in Sub-Saharan Africa, South and Southeast Asia, and South America though it has declined in developed countries including USA1,2. The diagnosis of syphilis beyond early infancy (among children) raises concerns for possible child sexual abuse, although progression of congenital syphilis may account for some cases2. At this juncture , I shall highlight (as stated in my previous response as well) that the pregnant woman can acquire the infection from other age groups too and not necessarily from a child.


1, Philipot R. Future directions for STIs and sexual health in Asia-Pacific region: 2002-2020. In : Kumar B, Gupta S, editors, Sexually transmitted infections. 1 st ed. Elsevier: New Delhi; 2005. p. 18-26.

2, Woods CR. Syphilis in children: congenital and acquired. Semin Pediatr Infect Dis. 2005 Oct;16(4):245-57.

Competing interests: No competing interests

14 April 2012
Neeru Gupta
Scientist E
KK Jani, Shalini Singh.
Indian Council of Medical Research
Ansari Nagar, New Delhi-110029