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Congenital syphilis continues to rise at an alarming rate

Anna Maria Barry-Jester, Kaiser Health News on

Published in News & Features

One of the nation's most preventable diseases is killing newborns in ever-increasing numbers.

Nationwide, 1,306 infants acquired syphilis from their mother in 2018, a 40% rise over 2017, according to federal data released Tuesday. Seventy-eight of those babies were stillborn, and 16 died after birth.

In California, cases of congenital syphilis -- the term used when a mother passes the infection to her baby during pregnancy -- continued a stark seven-year climb, to 332 cases, an 18.1% increase from 2017, according to the federal data. Only Texas, Nevada, Louisiana and Arizona had congenital syphilis rates higher than California's. Those five states combined made up nearly two-thirds of total cases, although all but 17 states saw increases in their congenital syphilis rates.

The state-by-state numbers were released as part of a broader report from the Centers for Disease Control and Prevention tracking trends in sexually transmitted diseases. Cases of syphilis, gonorrhea and chlamydia combined reached an all-time high in 2018. Cases of the most infectious stage of syphilis rose 14% to more than 35,000 cases; gonorrhea increased 5% to more than 580,000 cases; and chlamydia increased 3% to more than 1.7 million cases.

For veteran public health workers, the upward trend in congenital syphilis numbers is particularly disturbing because the condition is so easy to prevent. Blood tests can identify infection in pregnant women. The treatment is relatively simple and effective. When caught during pregnancy, transmission from mother to baby generally can be stopped.

"When we see a case of congenital syphilis, it is a hallmark of a health system and a health care failure," said Virginia Bowen, an epidemiologist with the CDC and an author of the report.

 

It takes just a few shots of antibiotics to prevent a baby from getting syphilis from its mother. Left untreated, Treponema pallidum, the corkscrew-shaped organism that causes syphilis, can wiggle its way through a mother's placenta and into a fetus. Once there, it can multiply furiously, invading every part of the body.

The effects on a newborn can be devastating. Dr. Philip Cheng is a neonatologist at St. Joseph's Medical Center in Stockton, a city in San Joaquin County in California's Central Valley. Twenty-six babies were infected last year in San Joaquin County, according to state data.

The brain of one of Cheng's patients didn't develop properly and the baby died shortly after birth. Other young patients survive but battle blood abnormalities, bone deformities and organ damage. Congenital syphilis can cause blindness and excruciating pain.

Public health departments across the Central Valley, a largely rural expanse, report similar experiences. Following release of the CDC report Tuesday, the California Department of Public Health released its county-by-county numbers for 2018. The report showed syphilis, gonorrhea and chlamydia levels at their highest in 30 years, and attributed 22 stillbirths or neonatal deaths to congenital syphilis.

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