Congenital syphilis circumstances, the place syphilis transfers to an unborn baby throughout being pregnant, have risen by over 1,000 percent to three,761 circumstances in 2022 from 334 in 2012. Because congenital syphilis is quickly preventable with a $10 blood take a look at and a shot of penicillin, every case represents a failed public well being system. 

Lower-income international locations all through the world like Cuba and Thailand have been licensed as having eradicated congenital syphilis, but charges within the United States preserve growing.

Research has proven that circumstances of congenital syphilis are pushed by the lack of syphilis testing in pregnant women and the absence of timely treatment. Social components counsel that pregnant girls put at elevated threat are girls of shade, poor, have a historical past of latest substance use or psychological well being points and restricted entry to prenatal care. Those points usually are not significantly new and have at all times been related to ailments like syphilis. Yet up to now, efficient public well being applications supported routine testing and early remedy that resulted within the management of an infection and the close to absence of congenital syphilis.

Several latest system components make the remedy of maternal syphilis, the precursor to congenital syphilis, tougher, together with an ongoing shortage of injectable penicillin. There is just one producer of injectable penicillin within the U.S., Pfizer, and with a restricted demand and return on funding in comparison with blockbuster medication like these for weight reduction or erectile dysfunction, there may be little monetary incentive to extend manufacturing.

There are new Food and Drug Administration-cleared rapid point-of-care diagnostic tests that may very well be deployed in hospitals, emergency departments and different neighborhood settings like jails or substance use remedy applications and even be included in street-based drugs and homeless outreach actions. However, the adoption of these assessments has been gradual as a consequence of a lack of expertise or promotion and ongoing funding constraints.

While many public well being officers and docs agree that the current situation is a crisis, federal management has been reluctant to contemplate the rise in congenital syphilis a public well being emergency.  Officials state that there’s public well being emergency “fatigue” approaching the heels of the monkeypox and COVID-19 emergencies in addition to considerations about whether or not the 1,000 % enhance really represents a nationwide emergency. Many consultants strongly disagree, nevertheless, and are calling for the declaration of a public health emergency now.

Section 319 of the Public Health Service Act authorizes the secretary of well being to declare a public well being emergency based mostly on an emergent situation or when important outbreaks exist. Such a declaration would enable for the quick use of reserve funds, the acceleration of tips and suggestions for syphilis testing amongst females of reproductive age in quite a lot of settings, quicker authorization of latest assessments, expanded procurement of speedy syphilis assessments and doubtlessly using the Defense Production Act to extend the availability of injectable penicillin. It would additionally create centered management and a monitored technique to deal with the difficulty.

More than 10 years in the past, congenital syphilis was recognized as a global downside however one with little advocacy. Dead and chronically debilitated infants can’t converse up for themselves and moms of newborns with syphilis are extremely stigmatized. Stillbirths, a serious end result of maternal syphilis, are one of the stigmatized circumstances worldwide.

Society should converse up for the rights of pregnant girls and the well being of newborns. In 2024 we shouldn’t be dealing with continued will increase in congenital syphilis, a scourge of prior generations.  

We have the instruments to forestall and management syphilis. Do we have now the desire? The time to declare congenital syphilis a nationwide public well being emergency is now.

Jeffrey D. Klausner, MD, MPH, is a USC professor of medication and public well being, a former Centers for Disease Control and Prevention medical officer and a former San Francisco metropolis and county deputy well being officer.