NEW YORK — Alarmed by yet another jump cases of syphilis in newbornsU.S. health officials are calling for stepped-up prevention measures, including encouraging millions of women of childbearing age and their partners to get tested for the sexually transmitted disease.
More than 3,700 babies will be born with congenital syphilis in 2022, 10 times more than a decade ago and a 32% increase from 2021, the Centers for Disease Control and Prevention announced Tuesday. Syphilis caused 282 stillbirths and infant deaths, almost 16 times more than the deaths in 2012.
The 2022 tally is the highest in more than 30 years, CDC officials said, and in more than half of congenital syphilis cases, mothers tested positive during pregnancy but were not properly treated .
The increase in congenital syphilis comes despite repeated warnings from public health agencies and is linked to increases in primary and secondary cases of syphilis in adults, CDC officials said. It is also increasingly difficult for medical providers to obtain injections of benzathine penicillin – the main medical weapon against congenital syphilis – due to supply shortages.
“It’s clear that something is not working here, that something needs to change,” said Dr. Laura Bachmann of the CDC. “This is why we are calling for exceptional measures to address this heartbreaking epidemic”
The federal agency wants medical providers to begin syphilis treatment as soon as a pregnant woman first tests positive, rather than waiting for confirmatory tests, and to expand access to transportation to so that women can receive treatment. The CDC also called for rapid tests to be made available beyond doctors’ offices and STD clinics, to places such as emergency rooms, needle exchange programs and prisons.
Federal authorities have again advised sexually active women of childbearing age and their partners to get tested for syphilis at least once if they live in a county with high rates. According to a new map and definition from the CDC, 70% of American adults live in a county with high rates. That’s likely tens of millions of people, according to an Associated Press estimate based on federal data.
The CDC recommendations are just that; no new federal money flowing to state and local health departments to strengthen testing or access. Some state health departments have already said they are at their wit’s end when it comes to treatment and prevention, although Illinois announced last week that it was opening a hotline for health care providers. health in order to help them search for records, consult and assist with mandatory reporting.
Syphilis is a bacterial infection that has been a common but feared sexually transmitted disease for centuries. New infections fell in the United States starting in the 1940s, when antibiotics became widely available, reaching their lowest level in the late 1990s. In 2002, cases began to rise again, as men with sex with other men being disproportionately affected, although the STD spreads among several demographic groups.
In congenital syphilis, mothers pass the disease to their babies, which can lead to the death of the child or health problems such as deafness, blindness and bone defects. Case rates have increased among racial and ethnic groups.
Dr. Mike Saag, an infectious disease expert at the University of Alabama at Birmingham, said syphilis can be “a silent infection” in women because it is difficult to diagnose without a blood test: not everyone gets it. has no painless sores, wart-like lesions or the like. visible symptoms.
The CDC has long recommended that all pregnant women be tested for syphilis during their first prenatal visit, but poor access to prenatal care – primarily in rural areas of the United States – can make this difficult. Nearly 40% of congenital syphilis cases last year involved mothers who did not receive prenatal care, the CDC said.
If syphilis is diagnosed early in pregnancy, the risk of passing it to the baby can be eliminated with a single injection of penicillin. But experts say the later you get pregnant, the more likely you’ll need multiple injections, and they should be given at least 30 days before delivery.
“I’ve had patients who were on a (three-injection) regimen and then missed an injection,” said Dr. Nina Ragunanthan, an obstetrician-gynecologist at Delta Health Center in Mound Bayou, Mississippi. “So they’re trying to get vaccinated, but if they don’t get all three shots in a row, because of transportation issues, employment issues, child care issues, all kinds of reasons that prevent them from coming back, they don’t I don’t finish their treatment.
Additionally, vaccine shortages are making it difficult to reduce syphilis numbers, health officials across the United States told the AP. Patients who are not pregnant can use the antibiotic doxycycline to treat syphilis, but health officials worry that the 14- to 28-day treatment time frame is difficult to meet, leaving infected people uncured. .
Pfizer is the country’s only supplier of penicillin injection. Earlier this year, company officials said there was insufficient supply due to increased demand. Pfizer also said the shortage may not be resolved until next year.
The CDC said the shortage did not affect the number of congenital syphilis cases in 2022 and that, despite the shortage, it was not aware of any patients not receiving the vaccines they needed.
Hunter reported from Atlanta.
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