PRO/EDR> Syphilis – USA (14): (AK) congenital, rising incidence, 2022


A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases

Date: Thu 22 Jun 2023
Source: Anchorage Daily News [edited]

A rise in syphilis cases in Alaska in recent years has led to a record
number of cases of the often deadly disease being passed from mothers
to babies during pregnancy, according to a new state health report.

“We saw an upward trend,” said Riley Fitting, an epidemiology fellow
with the Alaska Department of Health and the lead author on the new
report, which tracks congenital syphilis cases in Alaska between 2018
and 2022.

While just one case was reported in 2018, 12 cases were reported in
2022. A total of 26 cases were detected during that 5-year period, the
report said.

Congenital syphilis is defined as a syphilis case that’s passed from a
mother to her baby during a pregnancy. If it is not detected and
treated in the 1st trimester, the health impacts on the baby can be
dire, said Dr. Joe McLaughlin, Alaska’s state epidemiologist.

It can cause miscarriage, stillbirths, low birth weight, severe
anemia, jaundice, blindness and deafness, meningitis and skin rashes.
Untreated syphilis in pregnant people results in infant death in up to
40% of cases, McLaughlin said.

In many of the cases reported in Alaska, the mothers had a number of
risk factors, Fitting said. “One thing we found was that prenatal care
visits were either absent or limited for a lot of cases,” he said.
Many of the mothers in the cases also reported substance misuse and
housing instability.

Fitting and McLaughlin said this week that the concerning rise in
congenital syphilis is part of a broader state and national trend of
sharply increasing rates of syphilis as well as other sexually
transmitted infections (STIs), including chlamydia and gonorrhea in
recent years.

During 2021, 442 cases of non-congenital syphilis were reported in
Alaska, up drastically from 33 cases in 2017. McLaughlin said the rise
in syphilis cases and other STIs is linked to a change in sex habits
among adults, as well as a lack of awareness and education.

“I think when people think about syphilis, they think of this as being
a disease of the past,” McLaughlin said. “But we really have seen a
large resurgence of syphilis cases in Alaska and across the country.”
He cited a shift toward remote health care visits during the COVID-19
pandemic as a factor in the increase as well. “A lot of work was being
done through telemedicine, and that really is a hindrance to STI
screenings,” McLaughlin said.

The increased popularity of dating apps is also a factor, he said.
“There are more people who are having multiple sexual partners through
the widespread availability of dating and sex-seeking apps
nationally,” he said. “These apps are really making it easy for people
to find anonymous sexual partners, and that is a contributor
nationally to the increase in STIs.”

Fitting and McLaughlin said that in order to address the concerning
trend, increasing prenatal STI screenings and health care for
high-risk mothers was very important. “In some cases, people really
can’t afford to go get prenatal care and really don’t know how to
access health care that is affordable. So that’s a barrier,”
McLaughlin said.

Alaskans can access free or reduced health care through local public
health centers. In Anchorage, the city health department provides
sliding scale fees based on need, as does the Anchorage Neighborhood
Health Center.

Alaskans can also visit for free STI screening kits
mailed to their homes.

[Byline: Annie Berman]

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