NEW YORK – Alarmed by another rise in syphilis cases among newborns, U.S. health officials are calling for enhanced prevention measures, including encouraging millions of women of reproductive age and their partners to get tested for the sexually transmitted disease. Sexual intercourse.
More than 3,700 babies will be born with congenital syphilis in 2022 — 10 times more than a decade ago and a 32% increase from 2021, the Centers for Disease Control and Prevention said Tuesday. Syphilis has caused 282 stillbirths. and infant deaths, nearly 16 times more than in 2012.
CDC officials said the 2022 count was the largest in more than 30 years, and in more than half of congenital syphilis cases, mothers tested positive during pregnancy but did not receive appropriate treatment.
CDC officials said the rise in congenital syphilis comes despite repeated warnings by public health agencies, and is linked to a rise in primary and secondary syphilis cases in adults. It is also becoming increasingly difficult for medical providers to obtain injections of benzathine penicillin — the main medical weapon against congenital syphilis — due to supply shortages.
“It’s clear that something is not working here, and something has to change,” said Dr. Laura Bachman of the CDC. “That is why we call for exceptional measures to address this tragic epidemic.”
The federal agency wants medical providers to begin syphilis treatment when a pregnant woman first tests positive, rather than waiting for a confirmatory test, and to expand access to transportation so women can get treatment. The CDC also called for rapid testing to be made available beyond doctors’ offices and STD clinics to places such as emergency rooms, needle exchange programs and prisons.
Federal officials again advised sexually active women of reproductive age and their partners to get tested for syphilis at least once if they live in a county with high rates. According to the CDC’s new map and definition, 70% of U.S. adults live in a county with high rates. That number likely reaches tens of millions of people, according to an Associated Press estimate based on federal data.
The CDC recommendations are just that; There is no new federal money going to state and local health departments to boost testing or access. Some state health departments have already said they are overwhelmed when it comes to treatment and prevention, though Illinois announced last week it would start a phone line for health care providers to assist with records searches, consultations and assistance with mandatory reporting.
Syphilis is a bacterial infection that for centuries was a common but feared sexually transmitted disease. Rates of new infections in the United States declined starting in the 1940s when antibiotics became widely available and fell to their lowest level in the late 1990s. By 2002, cases began to rise again, with men who have sex with other men disproportionately affected, despite the prevalence of sexually transmitted diseases among many population groups.
In congenital syphilis, mothers transmit the disease to their babies, which may result in the death of the baby or health problems for the baby such as deafness, blindness, and bone deformity. Case rates have increased among racial and ethnic groups.
Syphilis can be a “silent infection” in women because it’s difficult to diagnose without a blood test — not everyone gets painless sores or wart-like lesions, said Dr. Mike Sage, an infectious disease expert at the University of Alabama at Birmingham. Visible symptoms.
The CDC has long recommended that all pregnant women should be tested for syphilis at their first prenatal visit, but poor access to prenatal care — largely in rural areas of the United States — can make that difficult. Nearly 40% of congenital syphilis cases last year were in mothers who did not get prenatal care, the CDC said.
If syphilis is diagnosed early in pregnancy, the risk of transmitting it to the baby can be eliminated with a single penicillin injection. But experts say the later in pregnancy, the more likely you are to need several doses, and they should be completed at least 30 days before giving birth.
“I’ve had patients who were on the (three-dose) regimen and then missed one dose,” said Dr. Neena Raghunanthan, an obstetrician-gynecologist at Delta Health Center in Mound Bayou, Mississippi. “So they’re trying to get their doses, but if they don’t get three doses in a row, because of transportation issues, because of work issues, child care issues, or any number of reasons that prevent them from coming back, they won’t do it.” “Do not complete their treatment.”
In addition, vaccine shortages make the task of reducing the number of syphilis patients difficult, health officials across the United States told the AP. Non-pregnant patients can use the antibiotic doxycycline to treat syphilis, but health officials worry that the 14- to 28-day treatment schedule is difficult to complete, leaving those infected without recovery.
Pfizer is the country’s only supplier of the penicillin injection. Earlier this year, company officials said there was a shortage in supply due to increased demand. Pfizer also said the shortage may not be resolved until next year.
The CDC said the shortage has not affected 2022 congenital syphilis case numbers, and that despite the shortage, it is not aware of patients not getting needed doses.
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Hunter reported from Atlanta.
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