An 'unacceptable American crisis': Cases of babies with syphilis reach staggering numbers

The Centers for Disease Control and Prevention is sounding the alarm amid an “unacceptable American crisis”: Syphilis is surging in newborns.

A report published Tuesday found cases have increased dramatically in recent years, showing more than 3,700 babies were born with syphilis in 2022. That’s more than 10 times the number of cases in 2012 and the highest rate reported in 30 years, officials said.

The agency is demanding that the health care system take action to prevent this infectious disease, noting that the report found nearly 90% of cases in 2022 could have been prevented with timely testing and treatment of the babies' mothers during pregnancy.

More than half the cases occurred among people who had tested positive for syphilis during pregnancy but didn’t receive adequate or timely treatment. Nearly 40% of the babies were born to mothers who were not in prenatal care.

“Despite repeated warnings and calls to action, the congenital syphilis crisis in the United States has skyrocketed at a heartbreaking rate,” said CDC Chief Medical Officer Dr. Debra Houry. “We’re calling on health care providers, public health systems and communities to take additional steps to connect mothers and babies with the care they need.”

Syphilis is a sexually transmitted infection that can be treated with antibiotics. Congenital syphilis is when a mother with syphilis passes the infection to her baby during pregnancy. It can cause miscarriage, stillbirth, premature birth, low birth weight or death shortly after birth, according to the CDC.

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The CDC released new guidance in July for providers prescribing Bicillin, the only antibiotic approved to treat syphilis in pregnant people, amid a drug shortage due to increased demand, recommending other antibiotic treatments for people who aren't pregnant to preserve doses. Health officials said during a press briefing Tuesday that the Bicillin shortage hasn't prevented patients from accessing the drug.

Babies can also be treated for syphilis with antibiotics, but health experts warn infants need to be treated right away or they can develop serious health problems, including deformed bones, severe anemia, jaundice, blindness or deafness, meningitis and developmental delays, among other problems.

While newborn cases are rising overall, research shows babies born to Black, Hispanic, American Indian and Alaskan Native families were up to eight times more likely than white people to have congenital syphilis in 2021.

Experts say this problem goes beyond providers and it should also include public health strategies, community health workers, case managers, patient navigators and disease intervention specialists to address gaps in marginalized communities.

“The congenital syphilis epidemic is an unacceptable American crisis,” said Dr. Jonathan Mermin, director of the CDC’s National Center for HIV, Viral Hepatitis, STD and TB Prevention. “Our nation should be proactive and think beyond the OB/GYN’s office and bridge prevention gaps.”

The CDC says it’s important to test and treat syphilis during pregnancy in settings such as emergency departments, syringe service programs, prisons and jails and maternal and child health programs.

In addition to working with community health workers, the agency is also urging health care providers to start syphilis treatment right away after a positive rapid test during pregnancy instead of waiting for secondary results and screening for syphilis before pregnancy in counties with high rates.

“It’s so simple to identify this and treat it,” said Dr. Natalie Neu, a pediatric infectious disease expert at Columbia University Irving Medical Center, who is unaffiliated with the CDC study.  

“If we can remove this stigma that surrounds sexually transmitted infections and evaluate people and treat them in a nonjudgmental, nonthreatening environment, we’ll do better for women and babies," she said.

Send tips to Adrianna Rodriguez at adrodriguez@usatoday.com.

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