Congenital syphilis in the United States: highest number of cases since 1994

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By NewsDesk @infectiousdiseasenews

The Centers for Disease Control and Prevention (CDC) reported a total of 2,022 infants born in 2020 as of July 29, 2021, a number that already eclipses the 1,870 cases reported in 2019. This is a number that has not been seen in the United States in 27 years and the numbers will likely increase as the benchmark ends in a few months.

Image / CDC

Of the 2,022 infants born in 2020 who were identified and reported to the CDC as cases of congenital syphilis, 139 were reported as stillbirths or infant deaths, or about 7%.

How has congenital syphilis spread in the United States over the past decade? In 2010, only 29 states and the District of Columbia reported one or more cases of congenital syphilis. In 2019, 43 states and the District of Columbia reported one or more cases, the CDC reports.

Additionally, 32 states and the District of Columbia are already reporting increases in cases from 2019.

In 2010, a total of 846 US counties (27%) reported at least one case of syphilis in a woman of childbearing age; by 2019, the number of counties had grown to 1,568 (50%).

According to correspondence published Thursday in the New England Journal of Medicine:

Stopping community transmission of syphilis is the most effective way to prevent congenital syphilis; however, the identification and treatment of syphilis in pregnant women remains invaluable in preventing infant mortality and disability. The CDC recommends universal syphilis screening at the first antenatal visit, with repeat screening at 28 weeks gestation and delivery for women who live in areas of high morbidity or at increased individual risk.

Implementation of strategies that reduce perinatal transmission of human immunodeficiency virus (HIV) – including prevention of infection in women, increased prenatal testing, and advances in maternal treatment – has been associated annual decline in perinatal HIV cases from an estimated 1,760 in 1991 to less than 40 in 2019. A similar resource commitment could reduce or eliminate congenital syphilis.

Congenital syphilis is an infectious disease passed from an infected mother to her baby in the womb. Adults transmit syphilis through sexual contact, but mothers can pass the infection to their babies in the womb or during childbirth. The disease can cause miscarriage, stillbirth, death soon after birth, prematurity, and birth defects. A woman can be treated and cured of syphilis during pregnancy, but it is important that women are tested in time for the treatment to be effective. Babies who test positive for syphilis at birth should be treated immediately to avoid serious health problems.

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