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Syphilis cases in newborn babies reach 20-year high, CDC says

Congenital syphilis cases -- when a mother passes syphilis onto her baby during pregnancy or delivery -- hav...

Posted: Sep 26, 2018 7:39 AM
Updated: Sep 26, 2018 7:39 AM

Congenital syphilis cases -- when a mother passes syphilis onto her baby during pregnancy or delivery -- have more than doubled in the United States since 2013, according to an report released Tuesday by the US Centers for Disease Control and Prevention.

Eight out of 10 pregnant women who have untreated syphilis will pass it onto their babies through the placenta and this can lead to stillbirth or death of a newborn in up to 40% of affected pregnancies, according to the CDC.

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The number of recorded cases swelled from 362 in 2013 to 918 in 2017, the report indicates. Five states -- Arizona, California, Florida, Louisiana and Texas -- account for 70% of the cases, according to the CDC. Additional cases were reported in 32 states, primarily Western and Southern states. The overall increase in congenital syphilis outpaces the national increase in sexually transmitted disease overall, the report indicated.

Diagnoses of primary and secondary syphilis, the most infectious stages of the disease, increased 76% in the US from 2013 to 2017, the CDC reports. Though rates of syphilis accelerated most among men, who accounted for more than 88% of infections in 2017, rates among women are also rising. The new report found 2.3 cases per 100,000 women in 2017, which rose from 1.9 cases diagnosed for every 100,000 women in 2016.

One in three women who gave birth to a baby with syphilis in 2016 did get tested during pregnancy, but either acquired syphilis after that test or did not get treated in time to cure the infection in the unborn baby, according to the CDC.

'Not surprising'

Dr. Pablo J. Sanchez, a principal investigator in the Center for Perinatal Research at The Research Institute at Nationwide Children's Hospital, said, "I am not surprised that congenital syphilis has increased because we have been seeing increasing cases of syphilis among women of child-bearing ages. So it's not surprising but it is of major concern."

Sanchez, who was not involved in the CDC report, explained that untreated syphilis in a pregnant woman not only leads to possible fetal death or "death in the first month of life from overwhelming infection" but it can also cause enlarged liver, enlarged spleen, rash, abnormal bone inflammation, and infections of the brain and of the eye in an infant.

"The majority of babies who are born to mothers with untreated syphilis look well at birth and that's why it's so important to screen women during pregnancy to detect the infection," said Sanchez, who is also a professor of pediatrics at The Ohio State University College of Medicine.

While some infected babies who go undetected at birth will develop signs of the disease in the first several months of life, some newborns will not develop any symptoms. Detection happens much later, usually around age 8 to 10 but up to 16 years old, when congenital syphilis affects other body organs causing hearing loss and eye problems, Sanchez explained.

"The good thing is if we are able to identify them -- even those who are asymptomatic-- and treat them in the newborn period, it seems like these babies do well," said Sanchez. He noted, though, that "we don't have a lot of information on the neurodevelopmental outcomes. That's the knowledge gap today."

The CDC recommends that every pregnant woman get screened early in her pregnancy so that she can get treated and prevent fetal infection and possible stillbirth. In areas or states where syphilis rates or congenital syphilis rates are high, women should get screened repeatedly -- at 28 to 32 weeks of pregnancy and at delivery, in addition to early-term screening.

"Repeated screening is important and imperative to be able to detect all cases of newborns who have been infected in utero," said Sanchez.

The treatment for a mother with syphilis is penicillin, which is curative and safe for both mother and fetus. In cases where the mother has not been treated or not adequately treated, then the baby can be treated either with a single shot of penicillin or a 10-day course of the common antibiotic. "That's curative and very safe," said Sanchez. "It's the standard of care."

Sanchez said congenital syphilis is a "major global public health problem," one that is on the rise not only in the US, but worldwide.

"Every case of congenital syphilis represents a failure of our public health and we need to ensure early and adequate prenatal care for all women and appropriate testing of women so that we can detect all babies and treat them appropriately," said Sanchez. "It sounds simple but unfortunately, it's not often done."

Mississippi Coronavirus Cases

Data is updated nightly.

Cases: 263023

Reported Deaths: 5752
CountyCasesDeaths
DeSoto17675191
Hinds16813331
Harrison14224204
Rankin11167219
Jackson10839190
Lee9050144
Madison8568168
Jones6668114
Forrest6177124
Lauderdale6097192
Lowndes5518120
Lafayette516298
Lamar503965
Washington4923125
Bolivar4104109
Oktibbeha405982
Panola384881
Pontotoc376258
Warren3674103
Monroe3671108
Union355663
Marshall355270
Neshoba3485154
Pearl River3468105
Leflore3111109
Lincoln305688
Hancock291862
Sunflower291475
Tate279662
Alcorn272354
Pike268981
Itawamba268063
Scott259648
Yazoo255256
Prentiss252553
Tippah249250
Copiah249049
Coahoma248054
Simpson242171
Leake237367
Grenada223272
Marion222073
Covington219973
Adams213671
Wayne212634
Winston207371
George204339
Newton199046
Attala196963
Tishomingo194161
Chickasaw189044
Jasper179538
Holmes171768
Clay165837
Tallahatchie156235
Stone151425
Clarke147262
Calhoun140822
Smith129226
Yalobusha122034
Walthall114337
Greene113529
Noxubee112926
Montgomery111636
Carroll106622
Lawrence106517
Perry104531
Amite101426
Webster96124
Tunica88821
Claiborne88325
Jefferson Davis88329
Benton85623
Humphreys84624
Kemper80520
Quitman7089
Franklin69917
Choctaw63213
Wilkinson59825
Jefferson56821
Sharkey45117
Issaquena1606
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Alabama Coronavirus Cases

Cases: 439442

Reported Deaths: 6657
CountyCasesDeaths
Jefferson644371007
Mobile31435569
Madison28158217
Tuscaloosa21492275
Montgomery19873332
Shelby19248132
Baldwin17128189
Lee13137107
Morgan12594142
Etowah12070181
Calhoun11496206
Marshall10420123
Houston8988164
Limestone832081
Cullman8257124
Elmore8183110
DeKalb7871107
Lauderdale7847107
St. Clair7808130
Talladega6445112
Walker6028183
Jackson599145
Colbert548694
Blount546286
Autauga535862
Coffee460764
Dale409685
Franklin374150
Russell354215
Chilton344373
Covington338580
Escambia334544
Tallapoosa3143109
Dallas312996
Chambers303470
Clarke298036
Pike262431
Lawrence253355
Marion253161
Winston233342
Bibb222348
Geneva210247
Marengo208231
Pickens199531
Hale184944
Barbour180538
Fayette177829
Butler173160
Cherokee165131
Henry159525
Monroe152021
Randolph145536
Washington141727
Clay129746
Crenshaw123745
Macon121937
Cleburne121525
Lamar119922
Lowndes114836
Wilcox107922
Bullock103328
Perry99918
Conecuh97822
Sumter90527
Greene77923
Coosa63418
Choctaw51924
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