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November 07, 2023
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‘Crisis’: Congenital syphilis increasing at ‘heartbreaking rate’

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Key takeaways:

  • Cases of congenital syphilis increased more than 10-fold over a decade.
  • Nearly nine in 10 cases last year could have been prevented.

Cases of congenital syphilis increased more than 10-fold between 2012 and 2022, the CDC reported Tuesday in another warning about the worsening epidemic of sexually transmitted infections in the United States.

“The congenital syphilis crisis in the United States has skyrocketed at a heartbreaking rate,” Debra Houry, MD, MPH, the CDC’s Chief Medical Officer, said in a press release. “New actions are needed to prevent more family tragedies. We’re calling on health care providers, public health systems, and communities to take additional steps to connect mothers and babies with the care they need.”

IDC1123Bachmann_Graphic_01
Data derived from McDonald R, et al. MMWR Morb Mortal Wkly Rep. 2023;doi:10.15585/mmwr.mm7246e1.

Over the course of almost a decade, there has been a continued increase in the three nationally reportable STIs in the U.S. — chlamydia, gonorrhea and syphilis — including a large spike in cases of congenital syphilis that has alarmed experts.

The number of reported congenital syphilis cases in the U.S. increased 755% from 335 in 2012 to 2,865 in 2021, and has only continued to rise.

According to new data reported Tuesday by CDC researchers, there were 3,761 cases reported last year — a more than 1,000% increase over 2012. These included 231 stillbirths and 51 deaths.

According to the researchers, 88% of cases could have been prevented with timely testing and treatment during pregnancy.

“The consequences of these missed opportunities can be devastating, but these data also point us toward solutions,” Laura Bachmann, MD, MPH, FIDSA, FACP, Chief Medical Officer in CDC’s Division of STD Prevention, said during a press briefing.

“First, we ask health care providers to remember that the job doesn't end at testing,” Bachmann said. “Over half of newborn syphilis cases in 2022 happened when people tested positive for syphilis during pregnancy yet did not receive timely and complete treatment. To address this gap, CDC is encouraging providers to consider using rapid syphilis testing and presumptive treatment with the first positive test for patients who may face barriers to regular high-quality prenatal care.”

Equality of care is also a must, Houry said during the call, and could have a “profound effect.”

“These efforts must reach people where they are so that every mother and baby get the support they need to stay healthy. Truly reversing these trends will require increased focus and resources [of] already strained public health systems,” Houry said. “Health care and public health systems are scrambling to prevent moms and babies from slipping through the cracks any way they can. To truly address this epidemic, we need better infrastructure and new tools to prevent STIs.”

References:

McDonald R, et al. MMWR Morb Mortal Wkly Rep. 2023;doi:10.15585/mmwr.mm7246e1.

U.S. syphilis cases in newborns continue to increase: A 10-times increase over a decade. https://www.cdc.gov/media/releases/2023/s1107-newborn-syphilis.html. Published Nov. 7, 2023. Accessed Nov. 7, 2023.