Spike In Syphilis in the U. S. Among Newborns Driven By Broader Epidemic

The U. S. Central Valley has seen an unprecedented spike in congenital syphilis over the last few years. It’s part of an overall rise in syphilis and other sexually transmitted diseases across California and the nation. California’s rate of syphilis among newborns is the second highest in the US after Louisiana, and the state ranks third after Louisiana and Georgia for syphilis among women, according to the CDC.

Health officials are encouraging people to “know their sexual health status” by getting tested for other STDs at the same time they are tested for HIV. The state health departments in the U. S. is working with night clubs and with health providers around the state to increase testing.

Health professionals fear rates could rise even further if President Donald Trump and the Republican Congress repeal the Affordable Care Act and people lose access to reproductive health care.

Neonatologist Gurvir Khurana had only read about it in textbooks. Seeing it in real life has been a shock: baby after baby born severely anaemic, lungs filled with fluid, bodies covered with rashes. Some only lived minutes; others died within days or weeks.

The cause: congenital syphilis.

“It’s been an absolute explosion,” said Khurana, who works at four hospitals in California’s Central Valley. “It’s just spreading very, very quickly. Kern County has a huge public health problem on its hands.”

They are all born to mothers with syphilis. Many of the mothers arrive at the hospital to give birth never having had prenatal care, unaware they have the disease — let alone that they could pass it along to their unborn babies. The infants who survive carry an elevated risk of long-term health problems.

“STD rates aren’t going just to stop,” said Natasha Felkins, a health educator for Planned Parenthood in Bakersfield, the central city in Kern County. “When health coverage goes away or when things are cut, we are going to see numbers increase and that’s going to affect all of us.”

Across the U.S., sexually transmitted diseases are at an all-time high, according to the CDC. The rate of syphilis among women increased 27 percent from 2014 to 2015, and congenital syphilis raised by 6 percent. Preliminary data show the trend continued into 2016, with syphilis among women rising another 21 percent and congenital syphilis 4 percent.

The rise is worrisome, especially given that syphilis had almost disappeared by about 2000, said Gail Bolan, director of the CDC’s division of sexually transmitted disease prevention.

“There was a great hope for syphilis elimination in the United States,” Bolan said. “Unfortunately, our national data now show that syphilis is thriving.”

Bolan said CDC officials are closely monitoring the epidemic of syphilis around the nation, urging states to explore the roles of poverty, limited health care access, drugs and incarceration and to address those factors. They are watching with particular concern the spike in cases among women and encouraging more testing, treatment and education.

“Rises in women, especially women of reproductive age … are a bellwether for when we are going to start seeing more congenital syphilis,” Bolan said.

Health officials attribute the problem to poverty, drug use that leads to risky sexual behaviour, and lack of awareness of the risks of HIV, syphilis and other STDs. Also to blame, they say, are changes in sexual behaviour, including reduced condom use and a tendency to have more partners.

As Anna Gorman from Kaiser Health News, "At the federal level, CDC officials say the rise in syphilis and other STD cases is due in part to budget cuts in state and local STD programs that have resulted in diminished access to care."