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December 24, 2022

Babies are being born with syphilis in Pennsylvania at the highest rate in 32 years

State health officials say expectant mothers can protect their unborn children by getting prenatal care and being tested for the disease

Children's Health STDs
Congenital Syphilis Pennsylvania Jimmy Conover/Unsplash

Pennsylvania has seen an uptick in congenital syphilis cases in 2022, putting the rate at the highest level since 1990. In Philadelphia, there have been at least 22 confirmed cases of the disease in babies.

The rate of babies born with syphilis in Pennsylvania has spiked prompting health officials to issued a reminder about the importance of  prenatal care and getting tested for the disease early in pregnancy

Congenital syphilis occurs during pregnancy when the bacterial infection is transmitted to the baby. Syphilis in unborn children can cause miscarriages, stillbirths, premature births, low birth weight, and death. Mothers can pass the disease on to their fetuses if they become infected during pregnancy from infected partners.

There have been 22 cases of congenital syphilis in Philadelphia as of November, and 12 confirmed cases across the rest of Pennsylvania. In recent years, nationally about 7% of babies born with the disease have died. Newborns who survive face problems, like brain and bone problems, blindness, and organ damage, according to the U.S. Centers for Disease Control and Prevention.

"Congenital syphilis can be a painful disease that is dangerous for the overall health of babies," Dr. Denise Johnson, Pennsylvania's acting secretary of health, said. "It also is preventable. We need to educate people about the importance of testing for syphilis throughout the pregnancy in order to stop children from being born with the disease and to reduce the number of stillbirths." 

The number of cases this year is the most in Pennsylvania since 1990, officials said. That year, there were 17 confirmed cases. The state has seen what health officials call a "disturbing" trend during the last five years, with more than 39 confirmed cases of congenital syphilis since 2018. These numbers exclude Philadelphia, which tracks its own data and also has had a substantial rise in cases recently. 

Syphilis testing should occur three times during pregnancy, the Philadelphia Department of Public Health recommends.

Congenital syphilis is curable, and the disease is treated using antibiotics, the same way as it is among adults who aren't pregnant. However, treating congenital syphilis after a child is born can be more difficult. 

While using penicillin to treat syphilis carries little risk, delivering the antibiotic to a baby often involves a lumbar puncture, which is painful for the child. Treatment after birth also means keeping the baby in the hospital for 10 days at a time that is particularly important forming family bonds, according to Kaiser Health News

Babies who are undiagnosed or untreated for congenital syphilis can develop meningitis, skin rashes, severe anemia, enlarged liver and spleen, and other health complications. 

Since the disease can cause morbidity and other long-lasting impacts, Pennsylvania is one of 43 states that requires syphilis screenings early during pregnancy.

"Pregnant patients need to understand that syphilis can be treated and cured with antibiotics," Johnson said. "If anyone tests positive for syphilis during pregnancy, they should seek treatment right away. We hope that by openly talking about this issue, we can reduce stigma surrounding syphilis testing and ultimately increase the number of health child births across the state." 

Health providers should screen all pregnant people for syphilis at the first prenatal visit, during the third trimester, and at delivery, officials said.

Symptoms of syphilis in adults change depending on stage of the disease, according to the Minnesota Department of Health. Though the initial infection may be undetectable, symptoms become apparent between 10 and 90 days after exposure. 

People may get painless, open sores in their mouths, on their genitals or on their anus — typically at the place where the disease entered the body. Untreated a person can then develop rashes, a fever, swollen glands, lesions, and fatigue. If still not treated, syphilis can result in damage to a person's brain, heart, eyes and nerves. 

In the early 2000s, syphilis cases were at all-time lows in Pennsylvania and the United States. Cases were so low that in October 1999, the CDC pushed to eliminate the disease entirely, releasing an 84-page report on eradicating syphilis from the United States through community health initiatives and rapid outbreak response. 

The plan did not work and the number of people diagnosed with the disease began to climb again in 2011, particularly in men who have sex with men. In 2018, Philadelphia saw an increase in syphilis numbers among intravenous drug users.

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