Congenital Syphilis: Upsurge in Number of Babies Affected

Congenital Syphilis: Upsurge in Number of Babies Affected

Science Department Staff

September 2019

Globally, syphilis is one of the most prevalent sexually transmitted diseases, with approximately 6 million new cases each year.¹ Syphilis is a complex disease, associated with a series of stages and various symptoms. It is known to be the “great imitator” as it can mimic other diseases.² Not being able to adequately identify a syphilis infection based on symptoms alone can be detrimental to the health of an individual especially an expecting mother and her unborn baby.

When an expecting mother has an untreated syphilis infection, her baby is at risk for contracting congenital syphilis. In 2017, the Sexually Transmitted Disease Surveillance Report revealed an alarming finding—918 babies were born with congenital syphilis.³ This unsettling information verifies that syphilis was passed from a mother to her child during her pregnancy. Imagine a woman who’s unknowingly infected with syphilis. She doesn’t know to get tested because she isn’t experiencing any symptoms. She continues to embrace her pregnancy, carrying her child for 9 months all while looking forward to bringing a new life into the world. Then, when the baby is ready to meet the world, that world turns upside down because syphilis has met the baby in the womb before it even had a chance to meet the world. Discovering congenital syphilis after a baby is delivered is too late. Untreated syphilis in pregnant women results in infant death in up to 40 percent of cases.⁴ The recent surge in congenital syphilis cases has generated a critical demand for more than just one initial prenatal test for syphilis in expecting women.

Knowing how syphilis transmits from a mother to her baby is essential to protecting their health. During pregnancy, the bacteria can cross the placenta of the mother and infect the fetus while in the womb.⁴ Even after an initial test for syphilis, the mother is still at risk for infections throughout the pregnancy. One risk is the lack of partner testing and treatment. The expecting mother and her sex partner should be tested and treated for syphilis to avoid reinfection.⁵ Consider an expecting mother getting treatment for syphilis and her partner’s status remains unknown. The partner doesn’t receive testing or treatment, but she and her partner are still sexually active during her pregnancy. Even though she received treatment for syphilis, she can get re-infected if she and her partner have not both been treated and cleared of syphilis. More importantly, this reinfection would also affect her baby, putting it at risk for congenital syphilis.

The second way a baby can acquire congenital syphilis is during birth. The bacteria can expose itself to the baby in the birth canal.² Some babies survive the infection, and some don’t. Symptoms of congenital syphilis may or may not be present, but if left untreated, the baby can develop serious health complications in as little as a few weeks.⁴ The most detrimental outcomes for a baby with congenital syphilis is being born stillborn, dying from the infection, or experiencing irreversible health complications that affect the baby’s development.⁶ It’s quite common to presuppose that most babies will be born healthy without any complications. But being born with congenital syphilis can put a baby at risk for various complications, depending on the stage and duration of the infection. In early onset of congenital syphilis symptoms can include runny nose, body rashes, enlarged liver or lymph nodes, infections of the kidneys, bones, heart, lungs and eyes. Late onset of congenital syphilis affects the development of facial features (prominent forehead and jaw, wide-spaced teeth, and saddle nose condition), loss of hearing, cornea scarring, and deformed bones (bowing of the shins and arthritis in the knees).^2,6 These outcomes are disheartening to even envision for a newborn as congenital syphilis is a treatable and preventable disease.¹ It is vital that the gaps for testing and treating congenital syphilis be addressed to eradicate negative health consequences for newborns.

Taking measures to prevent congenital syphilis is the preeminent approach to save babies. In the field of public health, avoiding the risk of infection is termed primary prevention. For those who are sexually active, a mutually faithful, life-long relationship with an uninfected partner is the healthiest choice. An additional measure to prevent this disease is to know about syphilis and whether is it prevalent in your community.⁵ Seek education specific to your risks factors and make sure you understand the transmission routes of congenital syphilis.

When people are educated about this disease, they can make informed decisions to help protect babies. There are also secondary prevention options. Timely testing and treatment can prevent congenital syphilis. If a mother receives timely testing and treatment early in her pregnancy, the chances of delivering a stillborn baby or a baby with developmental complications is greatly reduced if not eliminated. Penicillin therapy has a 98 percent effective rate and is the only sure way to prevent mother-to child- transmission.⁴ Even with treatment, it is important to note that there is the possibility of reinfection. A pregnant woman and her sex partner should both be tested and treated to avoid reinfection.⁵ Another prevention approach is to talk to your healthcare provider about your risk factors. Whether you are carrying a child or not, having a discussion with your doctor about protection from syphilis is a preventative measure that can help an unborn child.

Globally, congenital syphilis is the second leading cause of preventable stillbirth.¹ Congenital syphilis affects our most vulnerable population– babies. In order to effectively address the burden, one test and one conversation for syphilis is not enough for the damage it can cause if it is not treated. Staying educated and linked to care for testing and treatment is key in helping your community combat the negative health outcomes babies experience from congenital syphilis.

References

1. “WHO Publishes New Estimates on Congenital Syphilis.” World Health Organization, 5 Mar. 2019, www.who.int/reproductivehealth/congenital-syphilis-estimates/en/.
2. Grimes, Jill. “Congenital Syphilis.” Sexually Transmitted Diseases: An Encyclopedia of Diseases, Prevention, Treatment, and Issues, 2:I-Z, ABC-CLIO,LLC, 2014, pp. 598, 603-606.
3. Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance 2017. Atlanta: U.S. Department of Health and Human Services; 2018. Available at: https://www.cdc.gov/std/stats17/2017-STD-Surveillance-Report_CDC-clearance-9.10.18.pdf
4. “STD Facts – Syphilis (Detailed).” Centers for Disease Control and Prevention, cdc.gov/std/syphilis/stdfact-syphilis-detailed.htm.
5. “A Devastating Surge in Congenital Syphilis: How Can We Stop It?” Medscape, 14 Jan. 2019, www.medscape.com/viewarticle/907183?src=par_cdc_stm_mscpedt&faf=1.
6. “Sexually Transmitted Diseases (STDs).” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, Reviewed January 2017, cdc.gov/std/syphilis/stdfact-congenital-syphilis.htm.