CDC raises alarm over syphilis in newborns. Here's why it's an ongoing crisis in Arizona

Stephanie Innes, Arizona Republic
Updated ·5 min read
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A "rapidly accelerating epidemic" of syphilis in newborns across the U.S. last year left 32 Arizona babies dead, and both local and federal health officials are calling for stepped-up awareness and testing amid a rising caseload.

Officials with the U.S. Centers for Disease Control and Prevention on Tuesday raised the alarm about the number of potentially deadly cases of syphilis among newborn U.S. babies, which, according to newly released preliminary data, increased more than tenfold between 2012 and 2022.

"This is an outcome of increasing syphilis cases in the United States and the missed opportunities to test and treat mothers for syphilis during pregnancy," CDC chief medical officer Dr. Debra Houry told reporters. "Syphilis cases in newborns have reached concerning levels. ... CDC is urgently calling attention for the need for health care providers, public health systems and communities to step up their efforts to address newborn syphilis."

In Arizona, the problem is particularly acute. State data shows the number of babies born with syphilis went from 17 in 2016 to 219 last year, which was a nearly thirteenfold increase over seven years. CDC data from 2021 showed Arizona leading the nation for its rate of syphilis in newborns.

State-specific data for 2022 from the CDC, including state rankings of newborn syphilis rates, is expected to be released sometime in early 2024. But preliminary state data from the Arizona Department of Health Services paints a bleak picture, showing worsening syphilis numbers between 2021 and 2022, when the number of newborn syphilis cases jumped from 182 to 219, and the number of babies who died from syphilis more than doubled from 14 to 32.

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Syphilis is a bacteria that can cross the placenta and infect unborn babies. Cases that are passed onto unborn babies during pregnancy are often referred to as congenital syphilis. When caught early enough, syphilis can be successfully treated with antibiotics. That's why it's important to get tested, especially during pregnancy.

The level of congenital syphilis, as well as syphilis in the general population, is "very high," and Arizona is likely to once again be in the top spot for its range of congenital syphilis when state-specific data is released for 2022, said Dr. Melanie Taylor, an infectious disease physician and medical epidemiologist with the Maricopa County Department of Public Health in Phoenix.

Maricopa County, which is Arizona's most populated county, has about half of the state's congenital syphilis deaths and infants of color are disproportionately affected, Taylor said.

In Arizona, state data shows about 30% or 10 of the 32 babies who died from congenital syphilis were American Indian or Alaska Natives, and slightly more than one-third were Hispanic.

"The issue is really access and uptake of prenatal care for the purposes of congenital syphilis prevention," Taylor said. "There are other behavioral risk factors related to substance use and abuse, unstable housing and concerns for retribution for someone using substances who is pregnant, whereby some people may not want to seek the care that is available."

Even if babies don't die from syphilis, they may still suffer serious health consequences, including bone damage, severe anemia, jaundice, skin rashes, meningitis, blindness and hearing loss. And they likely will spend the first 10 days of their lives in the hospital to clear the infection. Syphilis can lead to miscarriages, which are not reflected in the congenital syphilis data.

More than 3,700 babies in the U.S. were born with syphilis in 2022, the new CDC data says. The increase in newborn syphilis follows rising syphilis cases among women of reproductive age combined with social and economic factors that create barriers to high-quality prenatal care and ongoing declines in prevention infrastructure and resources, according to the CDC.

The CDC's latest report on congenital syphilis found that:

  • Nearly 90% of newborn syphilis in 2022 might have been prevented with timely testing and treatment during pregnancy.

  • More than half of newborn syphilis cases in 2022 were among people who tested positive for syphilis during pregnancy but did not receive adequate or timely treatment.

  • Nearly 40% of newborn syphilis cases were among mothers who were not receiving prenatal care.

Both federal and Arizona health officials say the next step in bringing down syphilis numbers is to connect with more pregnant individuals and people of childbearing age outside of sexually transmitted infection clinics to meet them where they are, whether it's through community health workers, substance misuse treatment venues or emergency departments.

"What we found through our ob/gyn partners is that they are screening 100% of the mothers that come into their clinics, 100%. But if over half the women who become sick and have syphilis never seek prenatal care, then all of our interventions will not reach that patient," Taylor said. "So where we are working now is to try and seek places where pregnant women seek care for non-pregnancy related concerns. "

Individual-level barriers to getting prenatal care may include lack of insurance and substance use disorder, while system-level barriers may include systemic racism and limited health care access, CDC officials said.

While newborn syphilis cases are increasing overall, babies born to Black, Hispanic, or American Indian/Alaska Native mothers were up to eight times more likely to have newborn syphilis in 2021 than babies born to white mothers, CDC research has found. Federal officials say the disparities stem from decades of deeply entrenched social determinants of health — where people live, learn, work, play, and age — that create obstacles to quality health care.

Syphilis in newborns: Arizona leads the nation for its rate of syphilis in newborns. Here's why

Reach health care reporter Stephanie Innes at Stephanie.Innes@gannett.com or at 602-444-8369. Follow her on X, formerly known as Twitter @stephanieinnes.

This article originally appeared on Arizona Republic: Why syphilis in newborns in an ongoing crisis in Arizona