By NewsDesk @infectiousdiseasenews
New Hampshire state health officials issued a health alert Monday due to reports of the first congenital syphilis cases reported in six years and the rise in syphilis cases in the state.
Authorities report three infants with probable congenital syphilis have been born to New Hampshire (NH) residents from May 2018 through September 2019. These are the first congenital syphilis cases reported in NH since 2013.
In addition, the state has experienced a 96% increase in cases of infectious syphilis, from 54 cases reported in 2014 to 106 cases in 2018. This has resulted in a number of syphilis infections in pregnant women within the last couple of years.
Syphilis is increasing nationally with infections at a 20-year high. Since 2012, rates of congenital syphilis in the U.S. have steadily increased. From 2012 to 2017 there was a 153% increase in the rate of congenital syphilis nationally, which has paralleled increases in the rate of primary and secondary syphilis in women of reproductive age. Congenital syphilis is preventable with early diagnosis and treatment of infections in pregnant mothers.
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Syphilis is a sexually transmitted disease caused by the bacterium Treponema pallidum. Syphilis is divided into stages (primary, secondary, latent, and tertiary), with different signs and symptoms associated with each stage.
A pregnant woman can transmit syphilis to her child during any stage of syphilis and any trimester of pregnancy. However, the risk of transmission is highest if the mother has been infected recently. Syphilis infection during pregnancy increases adverse pregnancy outcomes including miscarriage, preterm birth, and stillbirth. Up to 40% of babies born to mothers with untreated syphilis may be stillborn or die in infancy.
Congenital syphilis can also cause other complications including hepatosplenomegaly, syphilitic rhinitis (“snuffles”), rashes, generalized lymphadenopathy, neurologic complications, blindness and deafness, skeletal abnormalities, facial deformity, hydrops fetalis.
NH health officials say all pregnant women should be screened for syphilis early in pregnancy, ideally at the time pregnancy is confirmed or the first prenatal visit.
Women at increased risk for syphilis (e.g. women diagnosed with a sexually transmitted disease during pregnancy; exchanging sex for drugs, money, or services; unprotected sex with multiple sex partners; a new sex partner; illicit drug use, etc.) should be retested early in the third trimester (28-32 weeks) and again at delivery.
Women who experience a stillbirth after 20 weeks of pregnancy should be tested for syphilis.
Appropriate treatment of syphilis in pregnant women as soon as possible during pregnancy dramatically decreases the rate of congenital syphilis.
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