New data released by the Centers for Disease Control and Prevention (CDC) shows that the number of babies born with syphilis in the United States has increased tenfold over the last decade. The report documents the rise from 2012-2022 and concludes that there were many missed opportunities for prevention, finding over 3,700 cases of congenital syphilis in 2022 alone, representing about a 30% increase from the year before.
While syphilis can be effectively treated during pregnancy, it can cause stillbirth, miscarriage, premature birth, infant death, bone malformations, blindness, deafness, and developmental delays if left untreated. In 2022, 231 stillbirths and 51 infant deaths were reported.
The increase in cases indicates that syphilis is spreading unchecked in much of the country, and also evidence of a breakdown in the public health infrastructure around maternal care, according to doctors and advocates who work in the field. The new report found that more than half of congenital syphilis cases last year were among people who had a positive test but never received adequate or timely treatment.
To address this crisis, the authors of the report recommend public health agencies and physicians increase efforts to reach pregnant people with timely testing and treatment, including broader testing of sexually active girls and women and their partners in areas with high syphilis rates. However, an ongoing shortage of the antibiotic used to treat syphilis has become a “significant problem,” forcing some healthcare providers to spend hours searching for reserves of the medication.
The upsurge in infant syphilis cases is sobering, but not surprising to those who work in public health and STI prevention. Rates of chlamydia and gonorrhea have ticked up steadily for years now, and syphilis is now at its highest level since the mid-1960s. Black, Hispanic, and American Indian/Alaskan Native mothers are eight times more likely to be affected than white mothers.
The report reveals that gaps in maternal care underlie the crisis, as close to 40% of the cases last year were among mothers who were not in prenatal care, indicating missed opportunities for testing. The CDC recommends increased use of rapid syphilis tests in urgent cares and emergency departments and that providers consider starting treatment immediately following a positive test if the person is likely to fall out of care.
