Congenital Syphilis Cases Rise After Years of Decline

Rate in U.S. infants increases 23 percent from '05 to '08; primary and secondary syphilis cases also rise

FRIDAY, April 16 (HealthDay News) -- After declining between 1991 and 2005, the incidence of congenital syphilis (CS) in infants in the United States increased 23 percent from 2005 to 2008, according to data reported in the April 16 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

John R. Su, M.D., of the National Center for HIV, Hepatitis, STD, and TB Prevention in Atlanta, and colleagues reviewed cases reported to the CDC through the National Electronic Telecommunication System for Surveillance, plus a few mailed reports. Both CS and primary and secondary (P&S) syphilis are reportable illnesses in all 50 states and the District of Columbia.

The reviewers found that CS cases increased from 8.2 per 100,000 live births in 2005 to 10.1 per 100,000 births in 2008, a 23 percent increase. During approximately the same time period, there was a 38 percent increase in the P&S syphilis rate among females aged 10 years or older, from 0.8 per 100,000 in 2004 to 1.1 per 100,000 in 2007. In 2008, this P&S rate further increased to 1.5 per 100,000. Nearly all of the national increase in the CS rate from 2005 to 2008 was in the South, which had a 64 percent increase. The increase in CS cases also occurred primarily to children born to black mothers.

"The increase in the P&S syphilis rate from 1.1 per 100,000 females in 2007 to 1.5 in 2008 might portend a larger increase in the CS rate in 2009 and future years. The increase in the CS rate, the substantial burden of P&S syphilis among black women in the South, and the high case-fatality ratio associated with CS require that CS prevention be given high priority in areas with high syphilis morbidity and evidence of heterosexual syphilis transmission," the authors write.

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