Arizona is officially in the midst of a syphilis outbreak that in 2018 claimed the lives of 10 infants. That’s the most babies to die of congenital syphilis in the state’s recent history. In addition to the 10 deaths, another 43 babies were born with syphilis, which can cause severe health problems.
The word “congenital” simply means the baby was born with syphilis after acquiring the infection in the womb. The bacteria that cause syphilis can cross the placenta to reach the fetus — and will do so in 80 percent of pregnancies in which syphilis is untreated. As many as 40 percent of babies infected with syphilis during pregnancy will be stillborn or will die soon after birth. The condition can also cause rashes, bone deformities, severe anemia, jaundice, blindness, and deafness. The good news is that congenital syphilis is almost completely preventable. When it is administered at the appropriate time and at the correct dosage, penicillin is 98 percent effective.
Prenatal care must include screening for syphilis, which can be cured with penicillin but can be deadly if not treated.
Syphilis used to be the most feared STD out there, but rates have been plunging since the discovery of effective antibiotics during the first half of the 20th century. By 2000, syphilis rates hit an all-time low, and many health experts thought the United States was at the dawn of the complete elimination of the disease. But it’s been making a comeback, and between 2013 and 2017 nationwide congenital syphilis rates more than doubled, with the number of affected babies at a 20-year high.
Areas in the southern and western United States have been especially hard hit. Arizona has the sixth-highest congenital syphilis rate in the country, after Louisiana, Nevada, California, Texas, and Florida. Our congenital syphilis rate doubled between 2016 and 2017 — in terms of sheer numbers, most of these cases originated in Maricopa County, but officials say it’s disproportionately affecting rural areas. Gila County, which is east of Phoenix and home to the old mining town Globe, has the highest syphilis rate in the state.
Prenatal care must be available to anyone who needs it. Pregnant people should be screened for syphilis at their first prenatal visit — which is required by Arizona law — and in January the Maricopa County Department of Public Health notified doctors that pregnant people should receive additional screening at the beginning of the third trimester and after giving birth. A significant number of mothers who gave birth to infants with congenital syphilis had actually been treated for syphilis in the first trimester, only to reacquire the infection later in their pregnancy — so that second screening in the third trimester could be the difference between life and death for some babies.
Syphilis isn’t the only STD gaining ground in Arizona. Gonorrhea and chlamydia rates are also climbing, mirroring the rise of syphilis. Here in Arizona, schools aren’t required to provide students with sex education — a missed opportunity for reminding young adults of the importance of protecting their sexual health. Sexually active people can protect themselves — and help ensure healthy pregnancies — by using condoms and dental dams, and getting tested for STDs with their partners. Without comprehensive sex education, people might not understand that STDs can be present even without symptoms, or know where they can be tested and treated.
Worldwide, the congenital syphilis burden is terribly heavy, highlighting the need for access to prenatal health care in every corner of the world — and STD testing and treatment for everyone, regardless of their ability to get pregnant. In 2016, there were 661,000 cases of congenital syphilis across the globe, causing more than 200,000 stillbirths and infant deaths. Luckily, international congenital syphilis rates have been declining — but, given how serious the condition is, they are still too high.
Congenital syphilis can be prevented at many levels, starting with comprehensive sex education in the schools, continuing with access to condoms and STD screening and treatment, and ending with competent, adequate prenatal care at every stage of pregnancy. A society that values the lives and health of everyone needs to come together to put policies in place that make these necessities a reality.
You can get tested for syphilis and other STDs at a Planned Parenthood health center, as well as other clinics, private health-care providers, and health departments. You can also drop by to ask questions about safer sex or to pick up condoms. Some Planned Parenthood health centers offer prenatal care, while others offer referrals to local resources.
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