Mableton to rearrange Cobb Board of Health, officials worried about congenital syphilis

Feb. 17—MARIETTA — The composition of the Cobb Board of Health will change with the creation of the new city of Mableton, public health officials said this week.

The board, which manages the Cobb portion of Cobb and Douglas Public Health, met for its monthly meeting Thursday. It also heard from Rachel Franklin, CDPH director of epidemiology, about the state of various diseases in the county, including a concerning rise in congenital syphilis.

From Marietta to Mableton

CDPH Deputy Director Lisa Crossman told the MDJ that, under state law, the mayor of the largest city in Cobb is automatically appointed to the board, and also gets to appoint a Cobb citizen to serve.

For decades, that city has been Marietta. Mayor Steve "Thunder" Tumlin serves on the board, as does W. Wyman Pilcher III, who Tumlin appointed.

But the new city of Mableton, created when voters approved incorporation in a referendum last November, means Marietta will be the county's second largest city.

Mableton is estimated to have roughly 77,500 residents; Marietta's population is roughly 61,500. The election of Mableton's mayor is set for March 21.

"I wanted to thank you personally, both the mayor and Wyman, for all the years of service," said Dr. Janet Memark, director of CDPH. "You've just been such a huge help and supporter of public health. We will miss you, we're not letting you go yet."

Pilcher said it had been his pleasure to serve more than 18 years on the board.

Lisa Cupid, chair of the Cobb Board of Commissioners, Cobb Schools Superintendent Chris Ragsdale and Marietta Schools Superintendent Grant Rivera also serve on the board by virtue of their respective positions.

The three other posts are appointed by the Cobb Board of Commissioners, and are to include a currently practicing medical doctor, a member to represent the county's "needy, underprivileged or elderly community," and a member to represent an advocacy group or the county's healthcare consumers. Those three positions are respectively held by Dr. Paula Greaves, a Wellstar Health System doctor of obstetrics and gynecology, Dr. Carol Holtz (who serves as chair of the board), a nursing professor at Kennesaw State University, and Pete Quinones, CEO of Metro Atlanta Ambulance.

'A huge issue of congenital syphilis'

CDPH's Rachel Franklin told the board bad news about congenital syphilis and tuberculosis, but good news when it comes to flu, mpox (formerly known as monkeypox) and COVID-19.

Congenital syphilis occurs when a pregnant woman passes on her infection to her baby.

"Georgia, we have a huge issue of congenital syphilis," Franklin said.

Syphilis is curable with antibiotics. But if not detected, it can cause lasting damage. When passed from mothers to infants, it can cause babies to have a low birth weight, or result in stillbirth.

Prior to 2021, there were a "couple dozen" cases statewide. In 2021, 93 babies were born with syphilis, Franklin said. About a dozen of those were in Cobb and Douglas counties, resulting in two stillbirths.

The infections are especially affecting Hispanic and African-American women, Franklin said.

"A lot of it is prenatal care. They're not getting prenatal care, and they're showing up at the (emergency department) to deliver and there's nothing you can do, because you have to get the penicillin 30 days before they deliver," she said.

Memark said that hopefully, the federal COVID money CDPH received to address prenatal care will help curb the problem.

The Board of Commissioners recently allocated $3.67 million to a CDPH program, partnering with Wellstar, to provide prenatal care to uninsured women.

The syphilis issue is part of a larger trend in increasing transmission of sexually transmitted infections, per Franklin. Areas in Cobb with higher HIV rates also see higher syphilis rates.

"All the STIs are going up, especially syphilis and gonorrhea have seen the biggest climb. It's very frightening stuff," she said.

Franklin added that her staff was alarmed to see, for the first time in more than 15 years, cases of young teen girls with primary and secondary syphilis.

"That just doesn't happen," Franklin said. "Like, you might have chlamydia, you might have gonorrhea. ... Some of it is a matter of, unfortunately, trafficking or being with older men, some of it is the men going back and forth between males and females, and they're more high risk."

The board discussed working with community groups to spread awareness of the issue, and provide recommendations on preventing infection.

Franklin said that tuberculosis is "not slowing down either." CDPH has seen five cases this year. In 2022, there were 18 cases in Cobb.

"A couple of these cases are from our refugees from Venezuela. And unfortunately, we've also been seeing the Ukrainian refugees for a year now, and we just got our first case from that population as well," she said.

Some refugees are showing up to local hospitals very sick and malnourished, Franklin said.

CDPH is working on identifying resources to help people who are infected.

Good news

The U.S. public health emergency for mpox ended Jan. 31.

(The World Health Organization changed the name of monkeypox to mpox in November 2022.)

Cases in Georgia have declined significantly, Franklin said, adding that vaccines "helped tremendously."

Georgia has seen nearly 2,000 cases of the virus. Franklin said the people who contracted mpox were overwhelmingly men.

"And the majority of those were Black males, especially between the ages of 20 and 40," she added.

Mpox was primarily seen in what public health officials call the "MSM" population — men who have sex with men.

In Cobb and Douglas counties, there were only two mpox cases in December and one in January.

Influenza is also on the decline. This year, the U.S. had an early flu season, starting in August and September and spiking in October and early November. Cases have declined since then, though Franklin cautioned that flu season continues through April.

"It was a bad flu season, especially coupled on top of COVID and other respiratory bugs going around. But the spike actually didn't get as high as some of our previous flu seasons, it was just so unusual, because it was so early," Franklin said.

COVID transmission in Cobb has been in the medium category, as classified by the Centers for Disease Control and Prevention, but is now back in the low category.

Cobb didn't see a large winter surge this year, Franklin said.

"Compared to the last two winters that we had with COVID, this was a great winter," she said.

People continue to die from COVID, primarily the very ill and elderly, Franklin said.

Transmission and the severity of infections has declined because of "the immunity that we have in the population between the vaccine coverage, the previous infections, the vaccines are still working against the particular sub lineages of omicron that are circulating," Franklin said.

President Joe Biden plans to end the national COVID public health emergency on May 11, more than three years after the pandemic hit.

"So I think we can celebrate. Obviously, COVID will be around like flu is, and the vaccines will change because of that. But hopefully the large pandemic response can shift after May 11," Franklin added.