In 2014, the rate of babies born with syphilis in the US hit its highest point more than a decade, according to a report from the US Centers for Disease Control and Prevention. Syphilis, which is on the rise, can be fatal for infants.
Last year, 458 babies were born with syphilis, up from 334 cases in 2012 — a 38 percent increase. And because of syphilis, 25 pregnancies resulted in stillbirths last year, and eight infants died within a month of delivery. This could have been prevented if women had received adequate prenatal care; according to the CDC, about 22 percent of the women who transmitted syphilis to their fetus last year didn’t receive prenatal care of any kind.
458 BABIES WERE BORN WITH SYPHILIS IN 2014
More than 56,000 people were infected with syphilis, a sexually transmitted infection, in 2013. People who are infected sometimes develop sores and rashes, whereas others end up with eye infections, which can lead to blindness; but some people don’t have symptoms at all. For infants, the disease’s risks are even more pronounced: a child who’s infected as a fetus can develop health problems like cataracts, deafness, bone deformities, or seizures — and not all of these appear right away. That’s why the CDC is keeping tabs on “congenital syphilis,” the term used to designate the kind of syphilis that newborns get. If federal officials can figure where these infections are taking place — and why — they might be able to curb their rise.
One of the most striking revelations from the CDC’s report is a sudden change in the rate of infections. Between 2008 and 2012, congenital syphilis was declining, says Virginia Bowen, an epidemiologist at the CDC and a co-author of the study — and that change mirrored a decline in new syphilis infections among women. But the trend didn’t carry over to the two following years. Instead, researchers noticed a “really sharp increase” in congenital syphilis, Bowen says — “and it kind of undid all the good work we had seen in the previous five years.”
The CDC doesn’t know why this change occurred, but the rise in congenital syphilis seems to be linked to a general increase in syphilis infections among the general population. “We are seeing a nationwide increase in syphilis among everyone, so some of that translates into babies with syphilis,” Bowen says.
That isn’t the only factor, however. The CDC’s study shows that one-fifth of women who passed the infection to their fetus didn’t receive any prenatal care. And of the women who did receive care, many received it late or received poor care, Bowen says. “So maybe they don’t get at test at all for syphilis, or maybe they aren’t well connected to care and only show up once and never come back so nobody got a change to treat them.” That’s a big problem, because women who are pregnant are supposed to get tested for syphilis at least once. And the treatment that can help women recover from the disease can also be used to ensure that kids are born healthy.
To address these gaps, the CDC wants health departments across the country to focus more on women. That means that if a woman is diagnosed with syphilis, clinics and hospitals should find out if she’s pregnant. The CDC also wants hospitals to make sure that women who are at high risk for syphilis — women who live in high risk areas or who have personal risk factors, such as not using condoms or engaging in drug use — don’t leave the hospital after giving birth without being checked for the disease. Finally, the CDC wants health departments to prioritize women when they call people who have just been diagnosed to find out how they became infected. “We think these recommendations could prevent women from slipping through the cracks,” Bowen says.
People who are diagnosed with syphilis are treated with penicillin. For women who are newly infected, a single dose can drastically decrease a child’s likelihood of being born with the disease. “That’s the beauty of it,” Bowen says. “If you can find the woman and you can diagnose and treat her, her baby will be born syphilis free 98 percent of the time.”