Syphilis cases in newborns reach 20-year high, say officials

According to a report released Tuesday by the US Centers for Disease Control and Prevention, cases of congenital syphilis – when a mother passes syphilis to her baby during pregnancy or childbirth – have more than doubled in the USA.

According to the CDC, eight out of ten pregnant women with untreated syphilis pass it on to their baby via the placenta, which can lead to stillbirths or newborn deaths in 40% of affected pregnancies.

The number of registered cases has increased from 362 in 2013 to 918 in 2017, says the report. According to the CDC, five states – Arizona, California, Florida, Louisiana and Texas – account for 70% of cases. Additional cases have been reported in 32 states, mainly western and southern states. The overall increase in congenital syphilis exceeds the national increase in sexually transmitted diseases overall, the report says.

According to the CDC, diagnoses of primary and secondary syphilis, the most infectious stages of the disease, increased by 76% in the United States from 2013 to 2017. Although syphilis rates have accelerated most in men, which accounted for more than 88% of infections in 2017, rates for women are also increasing. The new report revealed 2.3 cases per 100,000 women in 2017, compared to 1.9 cases per 100,000 women in 2016.

According to the CDC, one in three women who gave birth to a baby with syphilis in 2016 underwent a pregnancy test, but either acquired syphilis after this test, or not been treated in time to cure the condition. infection in the unborn child.

& # 39; No wonder & # 39;

Dr. Pablo J. Sanchez, Principal Investigator at the Perinatal Research Center of the Nationwide Children's Hospital Research Institute, said, "I am not surprised that congenital syphilis has increased because we have There has been an increase in cases of syphilis among women. -Age of ages. This is not surprising, but it is a major concern. "

Sanchez, who was not involved in the CDC report, explained that untreated syphilis in a pregnant woman causes not only a fetal death or "death of the first month of life", but may also cause a liver hypertrophy, rash, abnormal bone inflammation, and infections of the brain and eyes in infants.

"The majority of babies born to mothers with untreated syphilis have a good appearance at birth and that is why it is so important to screen women during pregnancy to detect the infection," Sanchez said. , professor of pediatrics at Ohio State University College. of medicine.

While some infected babies who are not detected at birth will show signs of the disease during the first few months of life, some newborns will not develop any symptoms. Detection occurs much later, usually around the age of 8 to 10 but up to 16 years of age, when congenital syphilis affects other organs, causing hearing loss and eye problems, Sanchez explains.

"The good thing is that if we are able to identify them – even those who are asymptomatic – and treat them during the neonatal period, it seems like these babies are doing well," said Sanchez. He noted, however, that "we do not have much information on neurodevelopmental outcomes. It's the lack of knowledge today.

The CDC recommends that every pregnant woman be screened early in pregnancy for treatment and prevention of fetal infection and possible stillbirth. In areas or states where syphilis rates or congenital syphilis rates are high, women should be screened repeatedly – at 28 or 32 weeks of pregnancy and at birth, in addition to early detection.

"Repeated screening is important and imperative to detect all cases of infected infants in utero," said Sanchez.

The treatment for the mother with syphilis is penicillin, which is curative and safe for the mother and fetus. In cases where the mother has not been treated or has not been adequately treated, the baby may be treated with either a single penicillin injection or a 10-day antibiotic treatment. "It's healing and very safe," said Sanchez. "It's the standard of care."

Sanchez said congenital syphilis is a "major global public health problem," rising not only in the United States, but worldwide.

"Every case of congenital syphilis is a failure of our public health and we need to provide all women with timely and adequate prenatal care and appropriate testing to be able to detect all babies and treat them appropriately," Sanchez said. "It sounds simple, but unfortunately it's not often done."