Epidemic of congenital syphilis in US needs ‘concerted action’, says CDC - The Guardian

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New data shows cases of congenital syphilis have “skyrocketed” over the last decade, and that “concerted action” is needed to bring the epidemic under control, US public health authorities said.

Congenital syphilis happens when a pregnant person passes syphilis to their child. The devastating disease can lead to stillbirth, death or miscarriage, along with a long list of potential birth defects and disabilities.

In 2022, more than 3,700 babies were born with congenital syphilis, more than 10 times the number in 2012. The disease was nearly eradicated in the 1990s in the US, but came roaring back amid stagnant funding for sexually transmitted diseases.

“The congenital syphilis crisis in the United States has skyrocketed at a heartbreaking rate,” said Debra Houry, the Centers for Disease Control and Prevention chief medical officer , in a statement. “New actions are needed to prevent more family tragedies. We’re calling on healthcare providers, public health systems and communities to take additional steps to connect mothers and babies with the care they need.”

Nearly 90% of the cases of congenital syphilis might have been prevented. More than half of people who gave birth to infants with syphilis tested positive during pregnancy but did not receive adequate treatment. Nearly 40% were patients who did not receive prenatal care.

Cases where congenital syphilis could have been prevented are known as “missed opportunities”, with barriers that range from individual, such as untreated addiction, to systemic, such as a lack of basic prenatal care in rural communities.

The high level of syphilis cases in the US has also strained supplies of Bicillin, a long-acting form of penicillin and the only drug to treat syphilis known to be safe during pregnancy. Because of a shortage, public health authorities have been forced to shuffle supplies among clinics, even sending patients across town to get treatment in some cases.

In 2019, the US had the third-highest rate of syphilis among countries in the OECD, a group of countries with developed economies. However, as in many aspects of US life, the rates of syphilis are unequal. The south and south-west have rates of congenital syphilis comparable to some developing nations, whereas several New England states have gone years with fewer than five cases.

Additionally, Black, Latino and Native American people were eight times more likely to give birth to a child with syphilis. That increased risk represents the confluence of social, economic and political factors known as “social determinants of health”, which lead those with low incomes and people of color to have worse health outcomes overall.

“The congenital syphilis epidemic is an unacceptable American crisis. All pregnant mothers – regardless of who they are or where they live – deserve access to care that protects them and their babies from preventable disease,” said Jonathan Mermin, the director of the CDC’s national center for HIV, viral hepatitis, STD and TB prevention.

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