Newborn syphilis cases at highest level in 30 years: CDC

Cases of newborn syphilis are rising rapidly in the U.S., and federal health officials are sounding the alarm and urging action. 

New data from the Centers for Disease Control and Prevention (CDC) show cases are at the highest level in at least 30 years. There were more than 3,700 infants born with syphilis in 2022, a tenfold increase over the past 10 years. 

Syphilis during pregnancy can lead to stillbirth, miscarriage, infant death and lifelong medical issues for both mother and baby. However, syphilis is easily preventable if people can be reached with screening and treatment.  

Benzathine penicillin G is the preferred treatment for syphilis during pregnancy, and it is currently in short supply. Pfizer, which is the only company manufacturing the drug, said it would take until at least the second quarter of 2024 to increase production enough to end the shortage.

Nearly 90 percent of newborn syphilis in 2022 might have been prevented with timely testing and treatment during pregnancy, CDC found. More than half of all cases last year were among people who tested positive for syphilis during pregnancy but did not receive adequate or timely treatment. 

The epidemic is hitting people from racial and ethnic minority groups the hardest. While newborn syphilis cases are increasing overall, babies born to Black, Hispanic, or American Indian/Alaska Native mothers were up to eight times more likely to have newborn syphilis in 2021 than babies born to white mothers, CDC said.  

Lack of timely testing and adequate treatment contributed to substantial proportions of cases in all geographic areas and in all racial and ethnic groups.  

“The congenital syphilis crisis in the United States has skyrocketed at a heartbreaking rate,” CDC chief medical officer Debra Houry said. “Already strained public health systems and the escalating STI epidemic have brought our nation to a tipping point with newborn syphilis. Health care and public health systems are scrambling to prevent moms and babies from slipping through the cracks any way they can.”  

CDC also recommended regular geographic-based screening to reduce stigma and biases associated with screening based on individual risk factors. For many people, their most significant risk factor is living in a community with high rates of syphilis, and much of the country is now considered to have high rates of spread.

Forty percent of newborn syphilis cases occurred among people who do not receive prenatal care. Every encounter a person has with a health care provider during pregnancy can be an opportunity for prenatal care and testing for syphilis, the agency recommended. This includes visits to emergency departments, syringe service programs, substance use treatment facilities, and maternal and child health programs. 

CDC said it is encouraging providers to consider using rapid syphilis testing and begin treatment with the first positive test for patients who may face barriers to regular high quality medical care.  

“By treating patients quickly rather than waiting for the results of a follow up test and requiring another visit, we can reduce some of the greatest hurdles to the care some others need,” said Laura Bachmann, chief medical officer in CDC’s STD prevention division.