Perspective

CDC: Congenital syphilis cases more than double since 2013

A recent CDC report highlighted an alarming rate of congenital syphilis cases among infants in the United States. According to the agency, the rate of infection has increased by 153.3% since 2013.

This is the highest number of congenital syphilis cases reported in 20 years, the agency said. The increase is occurring amid a rise in cases seen among U.S. women of reproductive age, and it outpaces an overall increase in STDs in the U.S., which has experienced a record 2.3 million cases nationwide in 2017. The CDC reported that a 24.9% increase in syphilis cases was observed among women between 2016 and 2017.

“When passed to a baby, syphilis can result in miscarriage, newborn death and severe lifelong physical and mental health problems,” Jonathan H. Mermin, MD, MPH, director of the CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, said in a press release. “No parent should have to bear the death of a child when it would have been prevented with a simple test and safe treatment.”

The researchers wrote that the increase in congenital syphilis cases began in 2013 — the first spike in cases reported since 2008. Between 2013 and 2017, the annual number of congenital syphilis cases increased from 362 to 918. Sixty-four of these cases resulted in syphilitic stillbirth, and 13 infants died. Most of the cases were reported in 37 states, especially Western and Southern states.

CDC infographic
Click to enlarge

The CDC said it is improving its support for states with a high burden of the infection, and they are researching why the surge has occurred to guide preventive measures. The agency is also partnering with community organizations like the March of Dimes to increase public awareness of risk factors.

The CDC urges that all pregnant women should be tested for syphilis at their first prenatal visit. For those at high risk for infection, the organization suggests that follow-up testing should be conducted. This recommendation is supported by the U.S. Preventive Services Task Force.

Additional research published by the CDC demonstrated that one in three women who gave birth to a baby with syphilis in 2016 were tested for the disease during pregnancy. They suggested that these women either became infected after the test was conducted or did not get treated in time.

Once syphilis is detected in pregnant women, it can be cured with antimicrobial therapy. However, if the infection is not treated, the woman has up to an 80% chance of transmitting syphilis to their child.

“To protect every baby, we have to start by protecting every mother,” Gail Bolan, MD, director of CDC’s Division of STD Prevention, said in the release. “Early testing and prompt treatment to cure any infections are critical first steps, but too many women are falling through the cracks of the system. If we are going to reverse the resurgence of congenital syphilis, that has to change.” – by Katherine Bortz

Resource:

CDC. Sexually Transmitted Disease Surveillance 2017. https://www.cdc.gov/std/stats17/2017-STD-Surveillance-Report_CDC-clearance-9.10.18.pdf. Accessed September 25, 2018.

A recent CDC report highlighted an alarming rate of congenital syphilis cases among infants in the United States. According to the agency, the rate of infection has increased by 153.3% since 2013.

This is the highest number of congenital syphilis cases reported in 20 years, the agency said. The increase is occurring amid a rise in cases seen among U.S. women of reproductive age, and it outpaces an overall increase in STDs in the U.S., which has experienced a record 2.3 million cases nationwide in 2017. The CDC reported that a 24.9% increase in syphilis cases was observed among women between 2016 and 2017.

“When passed to a baby, syphilis can result in miscarriage, newborn death and severe lifelong physical and mental health problems,” Jonathan H. Mermin, MD, MPH, director of the CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, said in a press release. “No parent should have to bear the death of a child when it would have been prevented with a simple test and safe treatment.”

The researchers wrote that the increase in congenital syphilis cases began in 2013 — the first spike in cases reported since 2008. Between 2013 and 2017, the annual number of congenital syphilis cases increased from 362 to 918. Sixty-four of these cases resulted in syphilitic stillbirth, and 13 infants died. Most of the cases were reported in 37 states, especially Western and Southern states.

CDC infographic
Click to enlarge

The CDC said it is improving its support for states with a high burden of the infection, and they are researching why the surge has occurred to guide preventive measures. The agency is also partnering with community organizations like the March of Dimes to increase public awareness of risk factors.

The CDC urges that all pregnant women should be tested for syphilis at their first prenatal visit. For those at high risk for infection, the organization suggests that follow-up testing should be conducted. This recommendation is supported by the U.S. Preventive Services Task Force.

Additional research published by the CDC demonstrated that one in three women who gave birth to a baby with syphilis in 2016 were tested for the disease during pregnancy. They suggested that these women either became infected after the test was conducted or did not get treated in time.

Once syphilis is detected in pregnant women, it can be cured with antimicrobial therapy. However, if the infection is not treated, the woman has up to an 80% chance of transmitting syphilis to their child.

“To protect every baby, we have to start by protecting every mother,” Gail Bolan, MD, director of CDC’s Division of STD Prevention, said in the release. “Early testing and prompt treatment to cure any infections are critical first steps, but too many women are falling through the cracks of the system. If we are going to reverse the resurgence of congenital syphilis, that has to change.” – by Katherine Bortz

Resource:

CDC. Sexually Transmitted Disease Surveillance 2017. https://www.cdc.gov/std/stats17/2017-STD-Surveillance-Report_CDC-clearance-9.10.18.pdf. Accessed September 25, 2018.

    Perspective
    Joseph A. Bocchini Jr.

    Joseph A. Bocchini Jr.

    The continuing dramatic rise in congenital syphilis cases in the U.S. over the past 4 years is a public health emergency that needs immediate increased attention from providers and public health authorities. As in the past, failure to identify infected pregnant women and inadequate treatment of syphilis before delivery are leading reasons for this worsening epidemic. Increased efforts to educate providers who care for women about the need for additional testing for syphilis at the beginning of the third trimester and at delivery in areas with a high prevalence of primary and secondary syphilis, prompt reporting of syphilis screening test results and initiation of treatment as soon as possible to enable completion of therapy at least 30 days before delivery will help reduce this epidemic.

    • Joseph A. Bocchini Jr., MD, FAAP
    • Professor and chairman, department of pediatrics
      Louisiana State University Health Sciences Center, Shreveport
      Infectious Diseases in Children Editorial Board member

    Disclosures: Bocchini reports no relevant financial disclosures.