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Congenital Syphilis Cases in United States Reach 20-Year High

A new report from the CDC underscores the need for all pregnant women to receive early prenatal care that includes syphilis testing at their first visit.

The number of congenital syphilis cases reported in the United States has more than doubled since 2013, according to a new Sexually Transmitted Disease Surveillance Report that was recently released by the Centers for Disease Control and Prevention (CDC).

These record-breaking numbers emphasize the need for all pregnant women to receive early prenatal care, which should include getting tested for syphilis at their first visit, according to the CDC. Pregnant women who are thought to be at high risk of infection should receive follow-up testing.

“To protect every baby, we have to start by protecting every mother,” Gail Bolan, MD, director of the CDC’s Division of STD Prevention, stressed in a recent statement. “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.”

According to the report, cases of congenital syphilis have increased from 362 reported in 2013 up to 918 just 4 years later, in 2017; this is the highest number of cases recorded in 20 years.

From 2016 to 2017 alone, the CDC notes a 21% increase in syphilis infections in women during that same time period (from 1.9 cases per 100,000 women in 2016 to 2.3 per 100,000 women in 2017). During that same time period, rates of congenital syphilis increased by 44%, going from 16 cases per 100,000 live births in 2016 to 23 per 100,000 live births in 2017. The CDC notes a 21% increase of syphilis infections in women during that same time period (from 1.9 cases per 100,000 women in 2016 to 2.3 per 100,000 women in 2017).

In order to reverse the resurgence of these cases, pregnant women should visit their health care providers as soon as possible during pregnancy to be tested for the infection, according to the CDC. In fact, authors of a recent JAMA article reinforced recommendations made by the US Preventative Services Task Force calling from early screening for syphilis in all pregnant women.

“There is convincing evidence that the benefits of early detection and treatment of syphilis in pregnant women are substantial, namely curing the infection and preventing harmful pregnancy outcomes including fetal and neonatal death,” authors of the study write. “Treatment earlier in pregnant is more effective than later; therefore, screening is recommended early in pregnancy.”

For pregnant women who may be at increased risk of infection, getting tested only at the first prenatal visit may not be enough. The CDC recommends that they should also get tested for syphilis in the third trimester and at delivery.

In an effort to reduce the increasing number of congenital syphilis infections, the CDC is working on strengthening local prevention systems and their ability to identify pregnant women with syphilis and treat them as early as possible for their infections.

They are also compiling research dedicated to the identification of the different factors that may have contributed to the surge in cases in the United States; they plan on using this data to inform preventive programs.

Through partnerships and organizations, the CDC is working to boost awareness of the problem in hopes that more pregnant women will receive early prenatal care, and thus, early treatment if needed.