Syphilis Uptick In Babies Prompts Statewide Awareness Campaign

Lilo H. Stainton | September 27, 2017 | Health Care
Infants infected with syphilis can be stillborn or suffer from a range of neurological and physical problems

Cathleen D. Bennett, Commissioner of the state Department of Health
New Jersey’s health officials launched a public and physician education campaign in response to a sudden rise in the number of babies born with syphilis, a potentially deadly infection that can easily be prevented if women are treated in advance of a delivery.

After three years of no reports of congenital, or infant, syphilis, in 2016 a dozen babies were born infected with the disease to Garden State women who then tested positive for the sexually transmitted disease.

“That is 12 too many,” state Department of Health Commissioner Cathleen D. Bennett said in announcing the “Protect Your Baby From Syphilis” campaign Tuesday.

To curb this trend, state officials partnered with medical associations and maternal-care providers to raise awareness on the need to get tested, and potentially treated, for the disease. Among other things, the campaign includes a social media effort using the hashtag #teSTD4baby and posters in six languages. The DOH is also reminding doctors of their responsibility to screen all patients for STDs, including pregnant woman.

Stillbirth and infant death

According to the federal Centers for Disease Control and Prevention, a woman who acquires the disease up to four years before getting pregnant has an 80 percent chance of passing it to her baby in utero; an infection in the fetus can lead to stillbirth or infant death in as many as four out of 10 cases. The bacteria can also lead to premature birth; result in low birthrate in full-term babies; and cause brain, nerve problems, and severe anemia, among other conditions.

An infected infant can be treated successfully if certain antibiotics are administered quickly; mothers who are treated at least a month before giving birth have almost no chance of passing on the disease.

Click to expand/close
After declining for nearly five years, syphilis has been on the rise nationwide since 2013 among many populations, including women of childbearing age, the CDC found; the rate of women infected is directly tied to the rate of congenital syphilis. By 2015 the national syphilis rate was 7.5 cases per 100,000 people – the highest since 1994 and a 67 percent jump from 2011.

New Jersey reported 4.2 cases per 100,000 in 2015, lower than all neighboring states and less than half of the New York rate. Nationwide, the syphilis infection rate in 2015 ranged from 15/100,000 in Louisiana and Puerto Rico to .09/1000,000 in Wyoming.

National action

This rise has prompted federal officials to take action on a national scale, including a CDC campaign to educate pregnant women and ensure doctors are doing their part. Some of that involves reminding them about an infection they might not have seen since medical school. If untreated in adults the disease can lead to vision and hearing loss, stroke, and other neurological problems.

“Because syphilis rates remained so low for so long, it’s likely that many of you have had limited, if any, experience with diagnosing and treating it. The issue is further compounded by a deteriorating public health infrastructure that features fewer health department clinics for the treatment of sexually transmitted infections,” Dr. Gail Bolan, the director of the division of STD prevention at the CDC, wrote to fellow physicians in July.

Gov. Chris Christie has been criticized for years for not funding woman’s healthcare services at the same levels they had been in the past — resulting in a $50 million loss to providers over eight years. Planned Parenthood and its allies have said those cuts have made it harder for the state to address the rising rate of STDS, which climbed 35 percent between 2009 and 2015 in the Garden State, and called on health officials to do more.

But the DOH has vehemently defended its work to sustain these services and address the rising STD rates. In December, the department launched “Get #TeSTD” to raise awareness about the increases in chlamydia, gonorrhea, and syphilis — the three most common STDs — which had reached record highs nationally. The campaign also reminded people that half of all sexually active people will get an STD by age 25, many of whom don’t receive treatment.

STDs and seniors

This was followed by #Never2old, an anti-STD campaign targeted at seniors that also involved distributing posters and other materials to senior centers statewide. While the CDC shows syphilis rates are increasing across all age groups — with the highest rise among those ages 24 to 29 — the disease jumped by nearly a third among Americans between 55 and 64 years old. (Rates are also impacted by race and sexual orientation, among other factors.)

The DOH’s new campaign, focused on congenital syphilis, was developed with input from community health workers who met during the summer with a DOH task force to develop the multipronged effort.

This included a letter from Bennett to healthcare providers, urging them to promote the campaign to patients who visit their office and to ensure staff is following proper guidelines; the letter was endorsed by the New Jersey Hospital Association, the New Jersey Primary Care Association, state chapters of national groups representing pediatricians, OB/GYNS, and family doctors, and maternal-health partnerships across the state.

The recommended treatments, based on advice from the American College of Obstetricians and Gynecologists, the CDC, and others, include frank talk about sexual activity with all pregnant patients; an STD screening on the mother’s first visit and at least one more, early in the third trimester; and immediate treatment with Penicillin G if syphilis is diagnosed. If this is administered at least a month before delivery, congenital syphilis will likely be prevented.

Among the 12 women who delivered infected babies last year in New Jersey, the DOH said many of the mothers received prenatal care at some stage but were exposed later in their pregnancy and then didn’t return for care until delivery or after the 30-day window in which treatment would have prevented congenital syphilis.