THURSDAY, July 12, 2001 (HealthDayNews) -- The number of babies born with syphilis in the United States dropped sharply in the closing years of the last decade, new government figures show.
The rate of congenital syphilis fell to 13.4 per 100,000 live births in 2000, a decline of almost 52 percent since 1997. Rates of the potentially deadly infection dropped among almost all racial and ethnic groups, though wide disparities between blacks, whites and Hispanics persist.
At the same time, there was a marked decrease in the rate of primary and secondary syphilis among women of childbearing age, from six per 100,000 to 3.7 per 100,000. Those infection rates closely track the trends for congenital syphilis.
Health officials say the decrease more than met the goal for 2000 of bringing down the caseload of congenital syphilis to 40 per 100,000 live births. They attribute most of the improvement to an initiative begun in 1997 to eliminate the disease. In fact, as has been reported recently, overall syphilis rates are at their lowest level since reporting on them began.
"These data are extremely encouraging," says Dr. Judy Wasserheit, director of the sexually transmitted disease prevention program at the Centers for Disease Control and Prevention, which released the report today.
Wasserheit says the CDC would like to eradicate syphilis in the United States by 2005, wiping out all but sporadic and easily controlled outbreaks of the disease. "Eliminating syphilis in the United States would be a landmark achievement," she says. It would also save approximately $1 billion a year in treatment costs and improve maternal and child health in the process.
Babies who contract syphilis from their mothers while in the womb or during delivery can suffer severe complications, including birth defects, deafness, brain damage and skeletal deformities. As many as 40 percent of the infants whose mothers' syphilis goes untreated during pregnancy will die.
A single dose of penicillin is ample to treat the infection in a pregnant woman. But limited access to good prenatal care, gaps in screening, lack of health care insurance, and other social and economic factors allow many infected women, particularly the poor and minorities, to escape notice.
Black babies are 33 times more likely than white infants to be born with syphilis, the study found, with respective rates of 49.3 and 1.5 cases per 100,000 live births. Hispanics were second to African-Americans, with 22.6 cases per 100,000 live births.
However, both blacks and Hispanics saw significant falloffs in congenital infection, of about 60 percent and 33 percent, respectively. Only Native Americans saw an increase in congenital syphilis in 2000, but that consisted of a single case.
The overwhelming majority of the country's 529 cases of congenital syphilis were concentrated in the South and in a few urban areas. Indeed, 95 percent of the 155 counties surveyed reported no cases at all in 2000, officials say.
Dr. George Counts, who head the CDC's syphilis elimination efforts, says this narrow geographic distribution, and the declining caseload, make his program's target "a feasible goal."
Yet the "cornerstone" of the eradication effort is diagnosis and treatment of pregnant women, and budget cutbacks in community health initiatives, particularly in the South and urban areas, threaten that aim.
What To Do
The CDC recommends that doctors test all pregnant women for syphilis at least once. But those at higher risk for the disease should be screened once early in their term, once in the last three months of pregnancy, and once at delivery. The agency also suggests testing women who deliver a stillborn baby after 20 weeks of gestation, because stillbirth is a possible indication of infection.
For more on syphilis, try the National Institute of Allergy and Infectious Diseases, or the American Medical Association.
