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We welcome all comments and suggestions for improving future publications. The report Syphilis in Canada, Technical Report on Epidemiological Trends, Determinants and Interventions is primarily based on surveillance data submitted to the Canadian Notifiable Disease Surveillance System (CNDSS) by provincial and territorial health authorities and also presents data published in provincial and territorial surveillance reports as well as information from the scientific literature and from the grey literature including media releases and international reports. Syphilis is a notifiable disease in Canada. It presents evidence on the current trends in rates of syphilis infection in Canada, associated risk factors, and some interventions that were implemented in response to the increase in cases of syphilis in Canada. This report was developed in response to the current rise of syphilis rates in Canada. The purpose of this report is to provide information to the public health sector, to clinicians and to policy makers about trends in syphilis cases and infection rates in Canada. The Centre for Communicable Diseases and Infection Control at the Public Health Agency of Canada (PHAC) is pleased to present the report: Syphilis in Canada, Technical Report on Epidemiological Trends, Determinants and Interventions. Appendix H: Number of cases and rates of congenital syphilis, rates of infectious syphilis among women aged 15 вЂ“ 39 and rates of infectious syphilis among females, 1993-2018.Appendix G: Rates of reported cases of infectious syphilis by province/territory and by sex in Canada, 2009-2018.Appendix F: Rates of reported cases of infectious syphilis per 100,000 population by age group and sex in Canada, 2009-2018.Appendix E: Proportion of cases by syphilis stage overall and by sex in Canada, 1991-2017.Appendix D: Rates of infectious syphilis per 100,000 population by sex in countries of the Organization for Economic Co-operation and Development, 2008-2017.Appendix B: Case definitions of syphilis used in Canada.Appendix A: Clinical algorithm for syphilis staging and treatment.6.2 Screening: Methods to increase access and uptake.Interventions and policy for syphilis prevention and control 5.5 Addressing Congenital Syphilis in Canada: Potential solutions.5.4 Comparison of recent trends in Canada to those of other countries.5.3 Factors associated with Canadian trends.5.2 Epidemiological situation across Provinces and Territories.

5.1 Congenital syphilis trends in Canada over the past 25 years.Congenital syphilis: Trends, determinants and response 4.3 Proximate determinants of syphilis in Canada.4.2 Underlying determinants of syphilis in Canada.4.1 Proposed conceptual framework of the determinants of infectious syphilis.Determinants and risk factors of syphilis in Canada 3.2 Current epidemiological situation across provinces and territories.3.1 Historical and recent national rates of syphilis in Canada.Epidemiological trends of syphilis in Canada, 2009-2018 2.2 Burden of the disease on those affected.1.2 Infectious syphilis staging and clinical manifestations.1.1 The origins of syphilis and means of transmission.Syphilis: Natural history, diagnosis and treatment Organization: Public Health Agency of Canada

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