Congenital syphilis spikes across New Mexico

Rick Nathanson
Albuquerque Journal
Darkfield micrograph of Treponema pallidum, the germ that causes syphilis.

Physicians and other medical officials on Monday were ordered to step up screenings of pregnant women for syphilis in order to arrest a dramatic spike in congenital syphilis in newborns that has been reported over the past two years.

"Prior to 2018, one or two cases of congenital syphilis were reported yearly to the state," said Dr. Christopher Novak, medical director for the New Mexico Department of Health's public health division.

Then, in 2018, New Mexico recorded 15 cases per 100,000 women of childbearing age, roughly 15 to 44, who had syphilis; of those women, 10 gave birth to babies with congenital syphilis.

The preliminary 2019 numbers more than doubled to 37 cases per 100,000 women of childbearing age, with 23 babies born with congenital syphilis.

The CDC reports that syphilis in newborns is on the rise with Texas topping the list for number of cases.

At least two newborns reportedly died as a result.

The state now has the eighth-highest rate of congenital syphilis in the nation, the DOH said.

It is among the sexually transmitted diseases and infections that must be reported to the state. The others include gonorrhea, HIV, hepatitis C and B, and chlamydia, which is the most common, Novak said.

To combat the rising rate of congenital syphilis, the DOH has ordered that pregnant women statewide be tested in their first and third trimesters, and again at delivery.

A simple blood test can detect it; however, women with syphilis often have no symptoms or mild symptoms that mimic other health problems, and half of babies born with it "don't have any symptoms right away," Novak said. "That's why screening is so important."

Untreated, syphilis can result in a lengthy list of conditions, including neurological and cardiac problems, eyesight and hearing loss, enlarged organs and bone deformations, as well as developmental delays in newborns.

The good news is that the bacterium that causes syphilis responds well to antibiotics, typically penicillin, "and it's 100% effective in treating congenital syphilis if treated in time," Novak said. "The earlier we catch it, the less damage the bacteria can cause."

Researchers are investigating to determine what the underlying causes are for the increase in congenital syphilis. What is known are some of the mothers' risk factors, said Dr. Abraham Lichtmacher, chief of women's services for Lovelace Health System. They include women who failed to get prenatal care or didn't get it until later in pregnancy, those who have been incarcerated, have a history of substance abuse, exchanged sex for resources, have had multiple sex partners and who experienced homelessness.

With the exception of prenatal care, these risk factors also apply to men.

New Mexico is not alone in recording an increased rate of syphilis and congenital syphilis. It is a national trend that has been going on for several years, Lichtmacher said.

According to the CDC, the rate has ticked up every year since its historic low in about 2000 or 2001.

In the case of congenital syphilis, "the problem is now we're seeing patients who were exposed to it after their initial screening test," Lichtmacher said. "They became exposed during the pregnancy, so unless you retest or rescreen the patient, you may not be aware they've become exposed to it."

Although men and women of any age group are susceptible to syphilis, "sexually transmitted infections are still more prevalent in the younger population," he said.

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