Babies born with syphilis in the US are at a 20-year high

Screening while pregnant is important.
Screening while pregnant is important.
Image: Reuters/Alex Lee
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This week, the US Centers for Disease Control (CDC) released it’s annual Sexually Transmitted Disease Surveillance report. One of the most striking findings in the report is the rapid rise of congenital syphilis—instances where a baby is born with the STI—in the US:

In general, the number of reported sexually transmitted infections (the term that indicates someone has contracted a pathogen, whether or not that potentially disease-causing microorganism actually causes a disease), is growing in the US. At a conference early this year, the CDC released preliminary data saying there were 2.3 million cases of chlamydia, gonorrhea, and syphilis reported in the US in 2017. All three STIs can go unnoticed because their symptoms are sometimes so subtle they’re overlooked. Although each of these infections can be cured with antibiotics, treatment requires testing to provide a proper diagnosis.

Instances of chlamydia and gonorrhea are both growing rapidly in the country, with cases increasing 22% and 67%, respectively, since 2013. But syphilis is the fastest-spreading STI in the US: identified cases of the infection have risen 76% since 2013.

Meanwhile, in 2017, there were 918 cases of congenital syphilis, higher than any year since 1997. Between 2016 and 2017, cases increased 43.8%. That can mostly be chalked up to pregnant women not receiving adequate testing or treatment for syphilis during their pregnancies; although not all mothers with syphilis pass the infection along to their children, it’s highly likely. Syphilis affects unborn babies and newborns differently than it does adults: up to 40% of fetuses who contract syphilis are stillborn, or don’t survive long after birth. Losing sight and hearing is another side effect of the infection, as are deformed bones and skin rashes.

The CDC recommends screening for syphilis at the beginning of pregnancy, at the start of the third trimester, and right before delivery. Ideally, if she tested positively for syphilis at any of these times, she could receive treatment before delivering. The recent CDC report found that a third of the women who delivered with syphilis did get tested for syphilis, but only at the beginning of their pregnancies. The fact that they still had syphilis when they gave birth suggests they either caught syphilis later on—and were not tested at the start of the third trimester or before delivery—or never received treatment.

Funding for the CDC’s STD prevention branch has decreased by 40% in the last 15 years, Edward Hook, an infectious-disease researcher at the University of Alabama told CNN earlier this year. This program works with local communities to increase public awareness about the importance of getting tested. Simultaneously, more than half of state and local funding for STI testing has also decreased, Hook said, which means that clinics available for testing may be understaffed or open for fewer hours, making it harder for people to come in for testing.

In addition, as Popular Science has pointed out, STIs are so heavily stigmatized in the US that people are often unwilling to use insurance to cover testing for fear that it will not be kept confidential. And paying out of pocket can make testing prohibitively expensive.

Correction, Sept. 28: A previous version of this article said that there were 917 cases of congenital syphilis in 2017. It was actually 918.