A resurgence of syphilis in the United States has led to a dramatic spike in cases of the disease among newborns

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The rate of American babies born with syphilis has doubled in just four years – hitting a 20-year high, new CDC figures reveal.

Last year 918 newborns contracted the disease from their mothers, up from 362 in 2013, with the majority of cases concentrated in the South and the West, particularly California.

Disease – Syphilis – Report – Part – CDC

No other sexually-transmitted disease is spreading as far and as fast as syphilis, according to the report, part of the CDC’s annual assessment of STDs.

The spike in congenital syphilis mirrors the uptick in men and women contracting the condition nationwide, less than two decades after many thought the disease was all but eliminated.

Reasons – Rise – Drivers – Increase – Drug

The reasons for the rise are multifaceted but some of the biggest drivers include: the increase in illicit drug use, a mistrust of the health care system, and the drop in federally-funded sexual health programs, while some public health officials blame dating apps for pushing a culture of casual sex.

‘When passed to a baby, syphilis can result in miscarriage, newborn death, and severe lifelong physical and mental health problems,’ said Jonathan Mermin, MD, MPH, director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention.

The report found that in recent years, cases of syphilis among newborns — a condition known as congenital syphilis — more than doubled in the U.S., from 362 cases in 2013 to 918 cases in 2017.

The latter is the highest number of congenital syphilis cases reported in the U.S. in 20 years, according to the report, from the Centers for Disease Control and Prevention (CDC).

The rise parallels recent increases in syphilis rates among U.S. adults.

For nearly two decades, rates of the disease have increased among men, and rates are now rising among women as well. From 2016 to 2017, cases of syphilis increased 21 percent among U.S. women, the report said.

The five states were California, Arizona, Texas, Louisiana and Florida.

Congenital syphilis can lead to a number of complications, including miscarriage or premature birth, as well as blindness, deafness or even death in newborns, according to the CDC.

The report highlighted the need for all pregnant women to receive early prenatal care, including a syphilis test at their first pregnancy-related doctor’s visit.

“Early testing and prompt treatment to cure any infections are critical first steps, but too many women are falling through the cracks of the system,” Dr. Gail Bolan, director of the CDC’s Division of STD Prevention, said in a statement.

“If we’re going to reverse the resurgence of congenital syphilis, that has to change.”

Syphilis, which is caused by the bacterium Treponema pallidum, is a sexually transmitted disease, but it can also pass from mother to baby during pregnancy or delivery.

Risultati immagini per Treponema pallidum

If left untreated, a pregnant woman with syphilis has up to an 80 percent chance of passing the disease to her baby, the CDC said.

But the good news is that the infection is easily cured during pregnancy with the right antibiotics.

However, for some women, one test for syphilis during pregnancy may not be enough; the CDC report found that some pregnant women who initially tested negative for syphilis later acquired the infection after their first test.

For this reason, women who are at high risk for syphilis or who live in areas with higher rates of the disease should be tested at the first prenatal visit as well as during the third trimester and at delivery, the CDC said.

Anyone, including pregnant women, can lower their risk of syphilis by using condoms properly every time they have sex and by making sure that their partner has also been tested for syphilis, the CDC said.

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Syphilis is a bacterial STI caused by Treponema pallidum that results in substantial morbidity and mortality.

Syphilis is transmitted through sexual contact with infectious lesions of the mucous membranes or abraded skin, via blood transfusion, or transplacentally from a pregnant woman to her fetus. Untreated, the disease lasts many years and is divided into stages.

Early syphilis consists of primary syphilis, secondary syphilis and early latent syphilis, while late syphilis consists of late latent syphilis and tertiary syphilis (neurosyphilis, cardiosyphilis and gumma).

Primary syphilis classically presents as a solitary, painless chancre at the site of inoculation.
However, the primary chancre may go unnoticed by patients.

If untreated, the disease progresses to the secondary stage, characterized by generalized
mucocutaneous lesions affecting both skin, mucous membranes and lymphnodes.

The rash of secondary syphilis can vary widely and mimic other infectious and non-infectious conditions, but characteristically affects the palms and soles.

The symptoms and signs of secondary syphilis spontaneously resolve, even without treatment, and if left untreated, the patient enters the latent stage.
Latent syphilis is asymptomatic, characterized by positive syphilis serology with no clinical
manifestations. Latent syphilis is often divided into two phases: early latent syphilis is defined as infection for less than two years while late latent syphilis is the presence of the disease for two years or more.

Sexual transmission typically occurs during primary, secondary or early latent stage infections; however, mother-to-child transmission has been documented to occur in untreated cases several years after initial maternal infection.
Mother-to-child transmission of syphilis (congenital syphilis) is usually devastating to the fetus if maternal infection is not detected and treated sufficiently early in pregnancy.

The burden of morbidity and mortality due to congenital syphilis is high.

In 2012, an estimated 350 000 adverse pregnancy outcomes worldwide were attributed to syphilis, including 143 000 early fetal deaths/stillbirths, 62 000 neonatal deaths, 44 000 preterm/low-birth-weight babies and 102 000 infected infants.

Most untreated primary and secondary syphilis infections in pregnancy result in severe adverse pregnancy outcomes. Latent (asymptomatic) syphilis infections in pregnancy also cause serious adverse pregnancy outcomes in more than half of cases.
Mother-to-child transmission of syphilis is declining globally due to increased efforts to screen and treat pregnant women for syphilis.
Syphilis diagnosis is usually based on clinical history, physical examination, laboratory testing and sometimes radiology.
In most laboratory settings, the diagnosis is based upon serologic tests. These include treponemal tests that measure antibodies to infection (including Treponema pallidum haemagglutination assay [TPHA], Treponema pallidum particle agglutination assay [TPPA], fluorescent treponemal antibody absorbed [FTA-ABS]) and non-treponemal tests that are indirect markers measuring host immune response to infections (including rapid plasma reagin [RPR], Venereal Diseases Research Laboratory [VDRL], Toluidine Red Unheated
Serum Test [TRUST]).

Rapid treponemal tests for syphilis and dual HIV and syphilis tests are now available.

These tests will increase coverage for diagnosing syphilis.

 

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