STD Awareness: What Does “Congenital Syphilis” Mean?

Treponema pallidum, the bacteria that causes syphilis

Treponema pallidum, the bacteria that causes syphilis

Congenital syphilis, for centuries a leading cause of infant mortality, is often thought of as an antique affliction, relegated to history books — but it is on the rise again. Between 2012 and 2014, there was a spike in congenital syphilis rates, which increased by 38 percent and are now the highest they’ve been in the United States since 2001. As of 2014, the last year for which we have data, more babies were born with syphilis than with HIV.

The word “congenital” simply means that the baby was born with syphilis after being infected in the womb. When an expecting mother has syphilis, the bacteria that cause the disease can cross the placenta to infect the fetus — and will do so 70 percent of the time. As many as 40 percent of babies infected with syphilis during pregnancy will be stillborn or will die soon after birth. It can also cause rashes, bone deformities, severe anemia, jaundice, blindness, and deafness. Congenital syphilis is especially tragic because it’s almost completely preventable, especially when expecting mothers have access to adequate prenatal care and antibiotics. Penicillin is 98 percent effective in preventing congenital syphilis when it is administered at the appropriate time and at the correct dosage.


More babies are being born with syphilis — but this trend can be reversed with wider access to prenatal care.


Incidence of congenital syphilis is growing across all regions of the country, but rates are highest in the South, followed by the West. Rates have also been increasing across ethnic groups, but, compared to white mothers, congenital syphilis rates are more than 10 times higher among African-American mothers and more than 3 times higher among Latina mothers, illustrating the need to increase access to prenatal care for all expecting mothers — and to ensure that this prenatal care is adequate.

Anyone receiving prenatal care should be screened for syphilis at their first visit, and some pregnant people — including those at increased risk or in areas where congenital syphilis rates are high — should be screened a second time at the beginning of the third trimester and again at delivery. Continue reading

The 26th Amendment at 45: Bringing More Voters to the Fight for Reproductive Rights

Image of a button showing support for a lower voting age from the Smithsonian National Museum of American History

When the question of same-sex marriage went before the Supreme Court in the summer of 2013, it was clear that millennials, the nation’s youngest adults, had already reached their verdict; 66 percent were in favor of recognizing it, putting them among the most supportive demographic groups in the U.S.

That same year, millennials were in the spotlight in another fight for social justice. Refusing to accept their university’s mishandling of sexual assault reports, two survivor activists at the University of North Carolina at Chapel Hill fought back with federal complaints. Their activism turned up the pressure on their institution and evolved into the founding of the organization End Rape on Campus, or EROC, a networked movement against sexual assault that linked survivor activists and other advocates for change on college campuses throughout the U.S. Following EROC’s founding, supportive faculty formed Faculty Against Rape, or FAR, bringing the movement to more stakeholders in campus communities.


Young voters have the power to shape political futures.


Jennings Randolph, a Democratic member of Congress from 1933 to 1947 (and later a senator from 1958 to 1985), said the nation’s youth “possess a great social conscience, are perplexed by the injustices in the world and are anxious to rectify those ills.” With that faith in the collective power of young Americans, Randolph made it his mission, beginning in 1942, to introduce legislation that would lower the voting age to 18. Historically it had been 21. His hopes, though, would not be realized until decades later, in the 1970s.

The United States entered the 1970s bearing the toll of what became one of the longest and most unpopular wars in its history. By the time the Vietnam War ended in 1975, 2.5 million Americans had served in the conflict, a quarter of them because of the draft. More than 58,000 of them lost their lives. Continue reading

STD Awareness: Gonorrhea, Women, and the Pre-Antibiotic Era

Penicillin, the first cure for gonorrhea, was developed for mass production in the 1940s.

Penicillin, the first reliable cure for gonorrhea, was mass produced in the 1940s.

It’s Women’s History Month, a time to reflect on the achievements of women worldwide — like Margaret Sanger, Rosalind Franklin, and Florence Nightingale, or contemporary heroes like Wangari Maathai. But it may also be a time to examine some of the sadder aspects of womanhood, including the increased burden gonorrhea imposes on women. While gonorrhea is no picnic for anyone, it wreaks the most havoc in female reproductive tracts. In fact, before antibiotics, gonorrhea was a leading cause of infertility — one 19th century physician attributed 90 percent of female infertility to gonorrhea. Not only that, but the effects of gonorrhea could seriously reduce a woman’s overall quality of life.


With gonorrhea becoming more resistant to antibiotics, the CDC warns of a return to the pre-antibiotic era.


Gonorrhea is described by written records dating back hundreds of years B.C. Ancient Greeks treated it with cold baths, massage, “cooling” foods, and vinegar. In the Middle Ages, Persians might have recommended sleeping in a cool bed with a metal plate over the groin. A bit to the west, Arabs tried to cure gonorrhea with injections of vinegar into the urethra. Kings of medieval England might have had their gonorrhea treated with injections of breast milk, almond milk, sugar, and violet oil.

Although gonorrhea is as ancient an STD as they come, because women rarely have symptoms while men usually do, for much of history it was mostly discussed in terms of men. The name gonorrhea itself derives from the ancient Greek words for “seed flow” — gonorrhea was thought to be characterized by the leakage of semen from the penis. This confusion inspired many misguided notions throughout the millennia, such as the idea that almost all women carried gonorrhea and transmitted it to their unwitting male partners. Continue reading

“I Didn’t Want to Believe It”: Lessons from Tuskegee 40 Years Later

Located among longleaf pine and hardwood trees, low ridges, and broad floodplains, Tuskegee, Alabama, is a small town that’s been a big part of American history. Despite a modest population of less than 10,000 people, Tuskegee has been able to boast many notable residents who have made names for themselves in everything from sports to the arts. Among them have been the Tuskegee Airmen, the first African American Air Force unit, which served during World War II, and Rosa Parks, the icon of the civil rights movement, who sparked the Montgomery bus boycott in 1955.


The Tuskegee syphilis experiment, conducted from 1932 to 1972, examined the natural progression of untreated syphilis in poor, rural black men — without their informed consent.


Tuskegee, though, is also remembered for one of the worst chapters in the history of medical research. Forty years ago, in 1972, newspapers revealed the story of a syphilis study that was callous in its deception of research participants, and damaging, even today, in the distrust it sowed among black Americans. The study had started another 40 years prior, in 1932, when the United States Public Health Service (USPHS) needed to rescue a financially troubled syphilis intervention in Macon County, Alabama. The intervention was first established in partnership with a Chicago-based philanthropic organization, but its future was uncertain when the organization’s funds dried up during the Great Depression.

Syphilis, the sexually transmitted disease caused by the bacterium Treponema pallidum, was the subject of conflicting scientific hypotheses at the time, including the hypothesis that the disease behaved differently in blacks and whites. Interested in testing those hypotheses and faced with disappearing funds for treatment, the USPHS turned its project into a study of untreated syphilis. Also influencing the decision was the fact that the USPHS was discouraged by the low cure rate of the treatments at the time, mercury and bismuth. But by the mid-1940s, penicillin was in use as a proven treatment for syphilis. In spite of that medical advance, the USPHS withheld treatment from a total of 399 infected patients by the time the study ended in 1972. Continue reading

STD Awareness: Sexually Transmitted Diseases and Pregnancy

Every month since January 2011, we’ve been sharing installments of our STD Awareness series, and each month, we’ve encouraged you to protect yourself from sexually transmitted diseases (STDs) by using dental dams and condoms. But what if you’re trying to get pregnant? In that case, you’re probably not using condoms! However, it is very important that partners know their STD status — being screened and treated for STDs prior to pregnancy is a good idea for your health, and can protect your future baby.


If you and a partner are trying to get pregnant, you might consider being screened for STDs together.


When present during pregnancy, certain STDs can have negative health effects for you or your future baby (including preterm labor, stillbirth, low birth weight, pneumonia, certain infections, blindness, and liver disease), especially if they are not cured or treated in time. Receiving prenatal care can help prevent these problems, so it is important to be screened and treated for STDs prior to or early in your pregnancy.

During pregnancy, the immune system undergoes changes, which are probably necessary to ensure that the body doesn’t reject the fetus — normally, the immune system recognizes non-self cells as potential pathogens and attacks. These immune system changes might make a pregnant person more susceptible to disease. Latent viral infections, like genital warts or herpes, might come out of dormancy. Additionally, anatomical changes lead to a larger exposed area of the cervix, which is potentially more vulnerable to initial infections. Continue reading