Health officials warn again about concerning upticks in newborn syphilis

Rising rates of syphilis and newborn syphilis are not letting up in Pennsylvania, said state and local health officials at a news conference at the Wilkes-Barre Health Department on Monday.

Acting state Secretary of Health Dr. Debra Bogen urged for more awareness about syphilis as well as more available testing and treatment to prevent the spread. She referenced a report released by the U.S. Centers for Disease Control and Prevention on Friday, which highlighted multiple missed opportunities to effectively prevent and treat the sexually transmitted infection, contributing to nearly 90% of congenital syphilis cases seen last year.

Congenital syphilis occurs when a pregnant person who is positive for the infection passes it on to their unborn child, which can lead to multiple complications.

More than 10 times as many congenital syphilis cases were reported nationwide in 2022 compared to 2012, according to the CDC report. Also from 2021 to 2022 alone, congenital syphilis cases increased by 31.7%.

Across the commonwealth, the state department of health confirmed that 31 infants have had newborn syphilis in 2023 so far, from 16 Pennsylvania counties across the state.

Last year, 39 Pennsylvania infants were confirmed with the infection, the highest number since 1990, when there were 17 infants, according to the state department of health.

And in Allegheny County, while syphilis cases decreased by 16% since 2021, the overall trend still represents an increase, with 63 early syphilis cases documented in 2013 versus 285 in 2022. Black residents in Allegheny County also face a rate that is 10 times higher than their white counterparts.

Symptoms of syphilis can include sores and skin rashes around the mouth and genitals, as well as more generalized illness symptoms, such as fever, swollen lymph nodes, sore throat, headaches and fatigue. Syphilis that goes untreated can damage the nerves, brain, heart, liver and other organ systems. Babies born with syphilis can develop skeletal abnormalities, blindness and deafness, or can die. The CDC report showed that 6% of congenital syphilis cases in 2022—or 231 babies—led to stillbirths.

Kady McGlynn, Wilkes-Barre City health associate director of personal health, said at the news conference that public health officials in Luzerne County have noticed a rise last year in syphilis cases, a trend that continues to tick upward.

"Already for the first 10 months of this year, it's much more of a significant rise than we were fearing," she said. While they typically handle a few cases, they have already seen "a number of cases" in the first 10 months of 2023.

"We must increase awareness among all residents," Dr. Bogen said at the conference. "We want people to know that there are simple tests to diagnose syphilis, and treatments available to cure syphilis across the lifespan."

According to the CDC report, missed opportunities include a lack of testing, late identification of the infection, a lack of treatment, inadequate treatment, and gaps in data used to identify opportunities for testing and treatment.

The report also showed that about half of cases studied had no prenatal care at all, meaning they likely missed opportunities to get tested for syphilis while pregnant. The CDC has updated its recommendation that pregnant people get tested three times during gestation as opposed to just once.

"You can acquire the infection across pregnancy," said Dr. Bogen. "And people can have very mild symptoms and not know they have it." Symptoms can also be mild and mirror other illnesses.

"I do think some of this is really about access to care, and getting people to prenatal care," said Dr. Bogen.

In addition to announcing a Health Alert Network Advisory to health care providers across the commonwealth this past May, the state health department and Wilkes-Barre City Health collaborated to mail out 600 letters to OB-GYNs and family practitioners outlining congenital syphilis testing and treatment recommendations, as well as partner management to reduce spread.

It also unveiled a billboard campaign to increase awareness and reduce stigma of the illness. Ms. McGlynn said the team intends to repeat the billboard campaign this December, as well as expand direct outreach and training to health care providers about the severity of the illness.

"We're hoping to also educate providers at these in-services about comprehensive testing, so including syphilis testing, among testing for all other STDs, not just singular testing," said Ms. McGlynn. "You miss a lot of opportunities to prevent syphilis when you just test for one type of STD."

"For individuals who test positive for syphilis, please seek treatment immediately and let your partners know to get tested too," said Dr. Bogen.

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