Denmark reaches a decade without mother-to-child syphilis transmission

In Denmark, general practitioners offer free syphilis screening, usually during the first prenatal visit. Denmark has now gone 10 years without a single case of mother-to-child transmission since 2016, and WHO has officially recognized the country’s elimination of congenital syphilis.

The contrast with Europe is stark. Reported congenital syphilis cases nearly doubled, from 78 in 2023 to 140 in 2024, across 14 countries reporting data. Denmark has offered universal, free screening to pregnant women since 2010 as part of prenatal care. Between 2010 and 2024, 963,424 pregnant women were tested, corresponding to a 99% testing rate; treatment uptake among those who tested positive was close to 100%.

The mechanism is direct: screen during pregnancy, confirm an infection, then provide prompt antibiotic therapy. In Denmark, 1,720 pregnant women initially tested positive, but active infection was confirmed in only 10% (172) after additional testing. That combination matters because untreated congenital syphilis can lead to stillbirth, preterm birth, neonatal death or serious long-term complications.

The record is not without exceptions. Researchers counted five children with congenital syphilis among almost 900,000 live births from 2010 to 2024. Four cases occurred despite the screening approach: two women arrived in Denmark late in pregnancy, and two were infected late in pregnancy. A reporting irregularity delayed follow-up in the fifth case. At the same time, a model found Denmark’s overall syphilis incidence rising by a mean annual increase of around 6%, while the prevalence of confirmed active infection in pregnancy remained stable.

In practical terms, Denmark’s result gives pregnant women a free check embedded in ordinary prenatal care, while showing why early engagement and prompt treatment matter. It also shows why coverage alone is not enough for women who arrive late or become infected late. Denmark met the European Region’s elimination benchmarks ahead of schedule: fewer than 10 cases per 100,000 live births for 2025 and ≤1 case for 2030. The researchers say continued attention to vulnerable groups, high screening coverage and robust surveillance will be needed to sustain the result.