Infection
Congenital Syphilis Reaches ‘Dire Levels’ In U.S. Amid Antibiotic Shortage — Here’s What To Know
Nov
Topline
The number of syphilis cases in newborn babies has “reached dire levels” in the United States, the Centers for Disease Control and Prevention has warned, as cases of the once waning infection climb at an alarming pace amid shortages of crucial antibiotics used to treat it.
Key Facts
There has been a sharp surge in congenital syphilis cases in the U.S. in recent years, according to the CDC, with more than 2,000 cases documented in 2021, more than triple the number from 2017 and a 27-year high.
Congenital syphilis happens when a syphilis infection is passed from a mother to their unborn child during pregnancy .
It is a devastating disease that can lead to the death of the baby or miscarriage and a host of serious conditions including blindness, deafness, bone damage and brain and nerve problems.
Congenital syphilis is both preventable and treatable through testing and treatment for syphilis with antibiotics during pregnancy and the CDC says babies born with the infection should be treated with antibiotics “right away” to prevent them from developing serious health problems or even dying from the infection in the first weeks or years of life.
Health officials recommend all pregnant people should get tested for syphilis when expecting, ideally at the first prenatal visit (and during a future checkup if not), with repeat tests at the beginning of the third trimester and birth depending on the number of syphilis cases in the area and the person’s risk for contracting the infection.
Syphilis is a sexually transmitted infection that can have an array of symptoms like fever and sores—many people do not know they are infected—and aside from abstinence the best ways of reducing the risk of infection is to use barriers like condoms and dental dams the right way when having sex.
Key Background
Syphilis is one of the oldest known sexually transmitted infections. Throughout much of history, syphilis was heavily stigmatized and viewed as an incurable and ultimately fatal scourge that could cause painful sores and debilitating neurological issues like paralysis and blindness. The bacteria responsible for syphilis can have long latent periods in the body where it is still infectious but there are no signs or symptoms of infection. The advent of antibiotics transformed syphilis into an easily treatable disease—often just a single injection—and cases have previously reached such low levels in the U.S. that the CDC launched an initiative to eliminate it from the country. That mission ended in failure and despite the availability of tests and antibiotics, rates of syphilis have been rising around the world at an alarming rate for years. In the U.S., cases have risen unevenly, with poorer states like Mississippi seeing much higher rates of congenital syphilis than other parts of the country.
News Peg
U.S. efforts to combat syphilis—as well as the wider surge in STIs—have faced numerous setbacks in recent years and health experts are urging the Biden Administration to declare congenital syphilis a public health emergency. Health departments across the country have watched budgets stagnate over time and many programs were slashed after large amounts of federal funds for STI surveillance were scrapped as part of a debt ceiling deal. A key syphilis drug is also in very short supply with few signs of supplies returning to normal soon. This drug, the antibiotic Bicillin, is a common form of the first antibiotic ever synthesized, penicillin, and is the preferred medication for treating syphilis. Requiring just a shot or three, the drug is far more convenient than the next best alternative, doxycycline, which must be taken multiple times a day for weeks. It is also the only medication known to safely treat syphilis in pregnancy.
Big Number
7.1 million. That’s how many people between the ages of 15 and 49 acquired syphilis in 2020, the World Health Organization estimates. Most infections are “asymptomatic or unrecognized,” the WHO said, adding that gay men and other men who have sex with men are “disproportionately affected.”
Surprising Fact
The 1927 Nobel Prize in Physiology or Medicine was awarded to Austrian psychiatrist Julius Wagner-Jauregg for treating late-stage syphilis by infecting patients with malaria. The high fevers brought on by malaria would kill the syphilis-causing bacteria in the body and the malaria could then be treated with quinine. While malarial therapy was not without risk, at that time late-stage syphilis that had invaded the nervous system was a terminal condition.
Further Reading
Soaring congenital syphilis rates in US risk lives of thousands of babies (Guardian)
Penicillin Shortage Explained: Increased Syphilis Rates And Amoxicillin Shortage Fueled Crisis (Forbes)
Why syphilis is rising around the world (BBC)
