Health officials in the United States are expressing concern over a recent increase in cases of syphilis in newborns and are urging efforts to prevent the spread of the sexually transmitted disease. This includes promoting testing for millions of women and their partners who are of childbearing age.
The Centers for Disease Control and Prevention reported that in 2022, there were over 3,700 infants born with congenital syphilis. This number is 10 times higher than it was a decade ago and shows a 32% increase from 2021. Additionally, syphilis resulted in 282 stillbirths and infant deaths, which is almost 16 times more than the number of deaths in 2012.
According to CDC officials, the number of cases in 2022 was the highest in over three decades. Additionally, in over half of the instances of congenital syphilis, the mothers tested positive during pregnancy but did not receive appropriate treatment.
Despite repeated warnings by public health agencies, the increase in congenital syphilis is linked to a rise in primary and secondary cases of syphilis in adults, according to officials from the CDC. Additionally, medical providers are facing challenges in obtaining benzathine penicillin injections, which is the primary treatment for congenital syphilis, due to shortages in supply.
Dr. Laura Bachmann from the CDC stated that it is evident that there are issues at hand and that changes need to be made. She emphasized the need for extraordinary actions to be taken in order to combat this devastating epidemic.
The government entity desires for healthcare professionals to initiate treatment for syphilis as soon as a pregnant woman receives a positive test result, rather than waiting for further confirmation. They also aim to increase transportation options to ensure women can receive timely treatment. Additionally, the CDC recommends that rapid tests be accessible in various settings, such as emergency rooms, needle-exchange programs, and correctional facilities, in addition to traditional medical offices and STD clinics.
Government officials once again recommended that women who are sexually active and of childbearing age, as well as their partners, should undergo testing for syphilis if they reside in a county with high rates of the infection. A recent map and definition from the CDC revealed that 70% of adults in the United States live in an area with high rates of syphilis. This equates to potentially tens of millions of individuals, as estimated by the Associated Press using data from the government.
The guidelines from the CDC are simply suggestions; there is no additional federal funding being provided to state and local health departments for the purpose of increasing testing or improving access. Certain state health departments have expressed concerns about their limited resources for treatment and prevention, but Illinois recently announced that it would establish a phone line for healthcare professionals to aid with record retrieval, consultation, and mandatory reporting.
Syphilis is a bacterial infection that for centuries was a common but feared sexually transmitted disease. New infections plummeted in the U.S. starting in the 1940s when antibiotics became widely available and fell to their lowest mark in the late 1990s. By 2002, cases began rising again, with men who have sex with other men being disproportionately affected, though the STD is spreading among several demographics.
In congenital syphilis, moms pass the disease on to their babies, potentially leading to death of the child or health problems for the child like deafness, blindness, and malformed bones. Case rates have been rising across racial and ethnic groups.
According to Dr. Mike Saag, a specialist in infectious diseases at the University of Alabama at Birmingham, syphilis can go undetected in women because its diagnosis requires a blood test. Not all women experience painless sores, wart-like lesions, or other noticeable symptoms.
The Centers for Disease Control and Prevention (CDC) has consistently advised that pregnant women undergo testing for syphilis during their initial prenatal appointment. However, limited availability of prenatal care, particularly in rural regions of the United States, can pose challenges. According to the CDC, almost 40% of congenital syphilis cases reported last year were among mothers who did not receive prenatal care.
In the case of a syphilis diagnosis during pregnancy, administering a single penicillin injection can eliminate the risk of transmission to the baby. However, medical professionals caution that the further along in the pregnancy you are, the greater the chance of needing multiple injections, all of which must be completed at least 30 days prior to delivery.
Dr. Nina Ragunanthan, an OB/GYN at the Delta Health Center in Mound Bayou, Mississippi, shared that some of her patients on a three-shot regimen have missed a shot due to various reasons such as transportation, job, or child care issues. This interruption in treatment can result in incomplete treatment.
Additionally, health officials in the United States have informed the AP that the limited availability of syphilis treatments has made it challenging to decrease the number of cases. While non-pregnant patients can use the antibiotic doxycycline to treat syphilis, there is concern that the required 14- to 28-day treatment period may be difficult for individuals to complete, resulting in incomplete treatment and continued infection.
Pfizer is the nation’s sole supplier of the penicillin shot. Earlier this year, company officials said it was in short supply because of increased demand. Pfizer also said the shortage may not be resolved until next year.
The Centers for Disease Control and Prevention (CDC) stated that the lack of supply did not impact the reported cases of congenital syphilis in 2022. Additionally, despite the shortage, the CDC is not aware of any patients experiencing difficulty in receiving their necessary vaccinations.
Hunter provided an update from Atlanta.
The AP Health and Science Department is funded by the Science and Educational Media Group of the Howard Hughes Medical Institute and the Robert Wood Johnson Foundation. The AP is solely responsible for all of its content.