Congenital syphilis cases in the United States have continued to rise since a 32% increase in cases was logged by the Centers for Disease Control and Prevention in 2021, with Texas seeing some of the highest numbers of all.
According to a report released in April by the CDC, 176,713 cases of congenital syphilis (CS) appeared nationwide in 2021 — the last year for which there is complete data available — compared to 133,954 in 2020.
Over the past decade, Dr. Robert McDonald from the CDC’s Division of STD Prevention, Surveillance, and Data Management reported a 700% increase in CS cases, according to CNN.
CS is a sexually transmitted infection (STI) that has a high chance of being passed from a mother to her unborn child if not treated at least 30 days before delivery. Since it is a bacterial infection, syphilis can be treated effectively with uninterrupted rounds of penicillin.
Yet when left untreated, the chances of a miscarriage or stillbirth run high. Infant mortality is also a considerable risk given that newborns with CS might suffer anemia, bone damage, an enlarged liver and spleen, nerve problems causing blindness or deafness, or other conditions.
In 2021, 220 stillbirths and infant deaths were reported across the U.S. in connection with CS.
Moreover, rates of STIs have seen a silent explosion between 2020 and 2021, with over 2.5 million cases logged by the CDC. While the public health authority points to the disruptions in healthcare seen during the pandemic as one reason for this increase, several factors are likely at play.
Some cases of STIs are asymptomatic or even mimic other illnesses, as in the case of syphilis.
Another possible contributing factor is the availability of STI screening.
For instance, a study published in January pointed out that rates of syphilis were six times higher among individuals insured by Medicaid compared to those with private insurance.
This is surprising in the case of expectant mothers and syphilis, given that Medicaid requires that they be tested in their first trimester.
Expectant mothers on Medicaid might forego prenatal STI screening due to barriers related to finding a physician that accepts it or an unfavorable reimbursement policy. Furthermore, Medicare coverage often doesn’t extend to their partners, who might be infected.
Regardless, the rise in the number of babies born with syphilis in Texas has become a concerning trend for doctors and public health investigators.
A report released in January from the Texas Department of State Health Services (DSHS) noted that the state had seen an increase in CS cases from 70 in 2016 to 1,246 in 2021.
This puts Texas at 182 CS cases per 100,000 live births, the fourth highest number recorded in the nation — a ranking tied with Mississippi. Only Arizona with 232.3, New Mexico with 205.7, and Louisiana with 191.5 surpassed this number.
The DSHS found that despite Texas’s heavy burden of the disease, many healthcare professionals are either unaware of or disregard the state’s requirement — Texas Health and Safety Code, Section 81.090 — to test all expectant mothers three times for syphilis. This includes tests in the first and third trimesters and again at delivery.
Cynthia Deverson is a researcher who reviews congenital syphilis cases in the Houston area for the state. She noted that both healthcare providers and patients don’t seem to know that syphilis is “still a thing,” according to the San Antonio News-Express.
“As someone who is reviewing actual cases and speaks to actual [patients], it has been astounding,” said Deverson, according to the San Antonio News-Express.
A lack of public awareness has also been linked to the incurable disease of fetal alcohol spectrum disorder, which leads to deformities and neurological impairments.
Many believe that this disorder is caused by an expectant mother consuming alcohol. However, as The Dallas Express reported, a recent study from Texas A&M University linked occurrences to the father’s drinking patterns prior to conception. Paternal alcohol consumption is especially believed to impact facial deformities.