Newborn syphilis cases more than double in four years, reaching 20-year high

Reported cases of congenital syphilis – syphilis passed from a mother to her baby during pregnancy or delivery – have more than doubled since 2013, according to the annual Sexually Transmitted Disease Surveillance Report released Tuesday by the Centers for Disease Control and Prevention (CDC).

The data underscore the need for all pregnant women to receive early prenatal care that includes syphilis testing at their first visit and follow-up testing for women at high risk of infection.

Reported cases jumped from 362 in 2013 to 918 in 2017 – the highest number of recorded cases in 20 years. Cases were reported in 37 states – primarily Western and Southern states. The report notes that this surge parallels similar increases in syphilis among women of reproductive age and outpaces national increases in STDs overall.

“When passed to a baby, syphilis can result in miscarriage, newborn death, and severe lifelong physical and mental health problems,” said Jonathan Mermin, M.D., M.P.H., director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. “No parent should have to bear the death of a child when it would have been prevented with a simple test and safe treatment.”

Early and regular prenatal care essential for every pregnancy; one test may not be enough

To reduce the number of babies born with syphilis, it is critical for all pregnant women to visit a health care provider as soon as possible during every pregnancy and to be tested for syphilis. Without early and regular prenatal care, a pregnant woman may not know that she has syphilis and that her baby is at risk.

Syphilis during pregnancy is easily cured with the right antibiotics. If left untreated, a pregnant woman with syphilis has up to an 80 percent chance of passing it on to her baby.

“To protect every baby, we have to start by protecting every mother,” said Gail Bolan, M.D., director of CDC’s Division of STD Prevention. “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. If we’re going to reverse the resurgence of congenital syphilis that has to change.”

Recent CDC research shows that 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 and prevent adverse health outcomes.

CDC recommends that all pregnant women be tested for syphilis the first time they see a doctor about their pregnancy. But for many women, one test for syphilis may not be enough.

Women at high risk for syphilis or who live in high-prevalence areas should be tested not only at the first prenatal visit, but again early in the third trimester and at delivery. If sexually active, individuals can lower their risk of getting syphilis by being in a long-term, mutually monogamous relationship with a partner who has been tested for syphilis and using condoms the right way every time they have sex.

CDC is taking action to reduce congenital syphilis

CDC is working on multiple fronts to protect newborns and mothers from syphilis, including:

• Ramping up support for high burden states to strengthen local prevention systems and improve their ability to identify and treat pregnant women with syphilis.
• Researching factors contributing to the resurgence of congenital syphilis cases to inform prevention programs.
• Increasing awareness of congenital syphilis risk factors among pregnant women through partnerships with community organizations like March of Dimes.