Syphilis skyrockets in newborns | MedPage today


New data from the CDC shows no slowdown in 2020 in the discouraging multi-year trend towards a rapid rise in rates of neonatal syphilis.

In 2020, the number of cases reached 2,022, according to Virginia B. Bowen of the CDC, PhD, MHS, and colleagues writing in a New England Journal of Medicine letter.

This follows increases every year since 2012, when only around 300 cases of neonatal syphilis were reported – an almost 7-fold increase in just 9 years.

While around 2,000 cases still represent a tiny fraction of all births – of which there were around 3.6 million in 2020 – the trend is concerning as it reflects a similar increase in syphilis infections among women. of childbearing age. Bowen and his colleagues noted that the cases have spread geographically, at least, at an astonishing rate. Only a quarter of US counties reported cases of syphilis among young women in 2010; in 2019, that figure was 50%.

More generally, these data are part of a boom in “traditional” sexually transmitted infections (STIs), including chlamydia and gonorrhea as well as syphilis. Compared to 2015, CDC data for 2019 shows the following:

  • Chlamydia: up 19%
  • Gonorrhea: up 56%
  • Adult syphilis: up 74%

“Social inequalities often lead to inequalities in health and, ultimately, manifest themselves in disparities in health,” the agency said in releasing the figures. “Historically, health disparities have persisted because access to and systematic use of quality health care, including prevention and treatment of STIs, has not been equitably distributed.

The CDC went on to say that some populations – racial / ethnic minorities, young adults and adolescents – are less able than others to access STI prevention services.

As a result, “racial and ethnic minorities had rates of STIs several times higher than whites. [in 2019], and youth aged 15 to 24 made up significant proportions of reported cases in all groups. Rates were also high among sexual minorities, especially gay and bisexual men.

“It is important to note that these disparities are little explained by differences in sexual behavior and rather reflect differential access to quality sexual health care, as well as differences in characteristics of the sexual network,” the CDC added. . The latter, the agency explained, simply means that in communities with a high prevalence of infection, the chances of meeting an infected sexual partner are higher, regardless of the particular sexual acts involved.

On congenital syphilis, Bowen and her colleagues called for more attention to the prevention and treatment of STIs in women of childbearing age.

“The implementation of strategies that reduce the perinatal transmission of [HIV] … has been associated with a decline in annual perinatal HIV cases from about 1,760 in 1991 to less than 40 in 2019, “the group wrote.” A similar commitment of resources could reduce or eliminate congenital syphilis. “

  • John Gever was editor-in-chief from 2014 to 2021; he is now a regular contributor.

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