Alarming number of babies born with syphilis prompts universal screening recommendation

Because of the increasing prevalence of syphilis in the St. Louis region and an alarming number of babies born last year with the sexually transmitted disease, city and county health officials are recommending all pregnant women get screened for the disease late in pregnancy and at delivery.

Across the state, zero to three babies are born a year with congenital syphilis, officials say. But last year, 10 babies were born with the disease. Six were in the urban areas of Kansas City and St. Louis.

The results are devastating, explained Dr. Hilary Reno, infectious disease expert at Washington University School of Medicine. Nearly 40 percent of exposed babies are stillborn, and other outcomes include blindness, deafness and bone deformities.

"The number is small, but the consequences of congenital syphilis are so severe, and the test is readily available and easy," Reno said. "Any case of congenital syphilis should have been prevented."

Missouri law already requires syphilis testing with a blood test for all pregnant women in the first trimester. Because women who remain sexually active during pregnancy can still contract the disease, local health officials are recommending testing again during the third trimester and at delivery.

Treatment involves one to three shots of penicillin. Those with penicillin allergies should be desensitized.

Between 2012 and 2016 in the city and county, Reno said, rates for early syphilis (within a year of infection, when the disease is most infectious) rose 86 percent - from 11.8 to 22 per 100,000 people. While most syphilis cases involve men, the number of women contracting it is increasing.

Rates have also increased nationwide. Cases of congenital syphilis rose 39 percent between 2012 and 2014, federal data show.

Early symptoms include a sore at the site of sexual contact that is not painful. The sore usually gets better, then a rash appears on the palms, soles and sometimes the trunk. The rash also goes away on its own. Because of these mild symptoms in the early and infectious stages, many people don't get tested.

"We are concerned we are going to miss women and not treat them early enough in pregnancy if we don't do this universal testing," Reno said.

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