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News From the Centers for Disease Control and Prevention
July 28, 2020

Dramatic Increase in US Congenital Syphilis Cases

JAMA. 2020;324(4):328. doi:10.1001/jama.2020.11652

A nearly 4-fold increase in US congenital syphilis cases between 2013 and 2018 underscores many missed opportunities to prevent the disease, the CDC reported.

Centers for Disease Control and Prevention

Congenital syphilis occurs if a pregnant woman with untreated syphilis passes Treponema pallidum infection to her infant. The infection can cause stillbirth, miscarriage, or lifelong physical or neurological problems in surviving infants.

Although a prenatal course of penicillin can prevent congenital syphilis, the CDC reported that cases in the US have increased by 261%, from 362 in 2013 to 1306 in 2018. Nearly 90% of the cases occurred in southern or western states. Infants born to black or Hispanic mothers accounted for about 70% of the cases reported in 2018.

Failures in basic prenatal care practices are driving the dramatic increase in congenital syphilis cases, the report suggested. In 30.7% of the cases, the researchers found that pregnant women received a timely diagnosis but weren’t adequately treated. Adequate treatment was defined as completing a penicillin-based regimen that was started at least 30 days before delivery. In addition, 28% of cases were linked with delayed prenatal care and 11% were due to identification of seroconversion less than 30 days before delivery. These patterns of failed care varied by geographic region, pointing to the need for targeted interventions, the authors wrote.