LOS ANGELES — Under the afternoon sun, Maggie Tran stopped one person after another on a hectic stretch of Skid Row, asking if they knew a particular woman.
No one seemed to recognize the name she repeated at tent after tent as she made her way along the block. "She could have a whole different name out here," one person replied. "Do you have a picture?"
Tran shook her head before heading back to her SUV, disappointed but undeterred. It's rare for Tran to find the people she's looking for right away.
As a public health investigator, she searches for clues: An emergency contact number listed by a patient during a clinic visit. An old address saved in a database. The location of a homeless encampment where outreach workers found a particular person in the past.
Then she heads to the streets. Her job at the Los Angeles County Department of Public Health is to track down a crucial set of patients who slipped away from the health system: women of childbearing age who have tested positive for syphilis, a sexually transmitted disease that can cost newborns their lives.
Cases of syphilis have skyrocketed in L.A. County and across the country, with devastating results. Left untreated in adults, it can damage organs and infiltrate the brain, possibly leading to dementia and blindness. Men have suffered at higher rates than women, but a rise in cases among women has spurred particular alarm because newborns infected in utero can be stillborn or suffer enduring medical issues.
The disease can be stopped with antibiotics if detected and treated in time. Yet last year, L.A. County reported 136 cases of infected newborns — up from just four a decade earlier — including 13 that resulted in stillbirth.
Across the U.S., the number of such congenital syphilis cases reported annually among newborns ballooned from 335 in 2012 to 3,761 in 2022. The syphilis surge resulted in 231 stillbirths and 51 infant deaths last year in what one official called "an unacceptable American crisis."
Tran is part of an L.A. County effort to turn those numbers around. Whenever someone tests positive for syphilis, the results must be reported to the county. Some patients are easily reached, but others cannot be found by public health nurses.
Those are the women whom Tran and her colleagues on the syphilis special investigation team are seeking. Finding them is crucial: Last year, 88% of congenital syphilis cases across the U.S. might have been averted with timely testing and adequate treatment, researchers at the Centers for Disease Control and Prevention concluded.
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