{"id":75649,"date":"2024-05-07T13:36:49","date_gmt":"2024-05-07T19:36:49","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/?p=75649"},"modified":"2025-03-03T12:59:53","modified_gmt":"2025-03-03T19:59:53","slug":"colorado-syphilis-emergency-triggers-additional-testing-for-pregnant-moms","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/colorado-syphilis-emergency-triggers-additional-testing-for-pregnant-moms\/","title":{"rendered":"Colorado syphilis \u2018emergency\u2019 triggers additional testing for pregnant moms"},"content":{"rendered":"<div style=\"margin-top: 0px; margin-bottom: 0px;\" class=\"sharethis-inline-share-buttons\" ><\/div><figure id=\"attachment_75652\" aria-describedby=\"caption-attachment-75652\" style=\"width: 640px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-75652\" src=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2024\/04\/30143029\/syphillis-pregnantwomansized.webp\" alt=\"Sharply higher rates of congenital syphilis in Colorado \u2013 a disease transmitted to baby during pregnancy \u2013 is the key driver in the state\u2019s action.\" width=\"640\" height=\"365\" \/><figcaption id=\"caption-attachment-75652\" class=\"wp-caption-text\">Sharply higher rates of congenital syphilis in Colorado \u2013 a disease transmitted to baby during pregnancy \u2013 is the key driver in the state\u2019s action. Photo: Getty Images<\/figcaption><\/figure>\n<p>A sharp increase in syphilis cases has led the state of Colorado to <a id=\"\" href=\"https:\/\/drive.google.com\/file\/d\/1yxs95JPtTnrrqzex168EBKi5600nIE3p\/view\" target=\"_blank\" rel=\"noopener\">declare<\/a> a <a id=\"\" href=\"https:\/\/www.cdc.gov\/syphilis\/about\/about-congenital-syphilis.html\" target=\"_blank\" rel=\"noopener\">congenital syphilis<\/a> epidemic effective April 25. It requires all health care facilities in the state \u2013 from clinics to major hospitals \u2013 to offer syphilis testing at least three times surrounding pregnancy: in the first and third trimesters and then at admission for delivery.<\/p>\n<p>State law already requires health care providers to do syphilis testing during the first trimester; a new <a id=\"\" href=\"https:\/\/leg.colorado.gov\/bills\/hb24-1456\" target=\"_blank\" rel=\"noopener\">bill<\/a> would require it in the third trimester also. The cost of the tests will be covered by insurers and Medicaid, state officials say.<\/p>\n<p>Pregnant women will be offered syphilis testing regardless of the type of appointment \u2013 an urgent care visit for a sprained ankle would apply.<\/p>\n<p>\u201cWe hope to save many babies from death and suffering,\u201d Colorado Gov. Jared Polis said at a news conference announcing the congenital syphilis epidemic.<\/p>\n<h2><strong>The dire consequences of congenital syphilis<\/strong><\/h2>\n<p>The vast majority of syphilis cases are spread through sexual contact. But congenital syphilis happens when the bacterial disease transfers from mother to fetus in utero. The disease brings roughly 40% mortality rates through late-term miscarriage, stillbirths, and deaths shortly after birth.<\/p>\n<p>The 60% of babies who survive can have bone damage, severe anemia, enlarged liver and spleen, jaundice, nerve problems causing blindness or deafness, meningitis, or skin rashes, <a id=\"\" href=\"https:\/\/www.cdc.gov\/sti\/about\/about-stis-and-pregnancy.html\" target=\"_blank\" rel=\"noopener\">according to<\/a> the U.S. Centers for Disease Control and Prevention.<\/p>\n<p>Good prenatal care usually catches syphilis cases, so congenital syphilis disproportionally impacts disadvantaged populations, particularly the incarcerated and among those experiencing homelessness.<\/p>\n<p>\u201cTreatment of mom during pregnancy can definitely help improve outcomes for babies,\u201d said <a href=\"https:\/\/www.uchealth.org\/provider\/helen-dunnington-md\/\">Dr. Helen Dunnington<\/a>, OB\/GYN medical director at <a href=\"https:\/\/www.uchealth.org\/locations\/uchealth-greeley-hospital\/\">UCHealth Greeley Hospital<\/a> and the hospital\u2019s medical director of Women\u2019s Services. \u201cIf untreated, then their baby is at more risk of having congenital syphilis. But if mom gets treated, then you can decrease that risk of vertical transmission.\u201d<\/p>\n<figure id=\"attachment_75653\" aria-describedby=\"caption-attachment-75653\" style=\"width: 200px\" class=\"wp-caption alignright\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-75653\" src=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2024\/04\/30143345\/Dunnington.Helen_.webp\" alt=\"Dr. Helen Dunnington\" width=\"200\" height=\"275\" \/><figcaption id=\"caption-attachment-75653\" class=\"wp-caption-text\">Dr. Helen Dunnington<\/figcaption><\/figure>\n<p>Congenital syphilis cases are typically treated with one or more injections of the antibiotic penicillin G benzathine (brand name Bicillin), which is <a id=\"\" href=\"https:\/\/www.statnews.com\/2023\/06\/22\/bicillin-syphilis-pfizer-penicillin-shortage\/\" target=\"_blank\" rel=\"noopener\">in short supply<\/a> nationwide.<\/p>\n<p>Dunnington says UCHealth is reserving the drug for syphilis cases. In addition, the U.S. Food and Drug Administration is temporarily <a id=\"\" href=\"https:\/\/www.cidrap.umn.edu\/sexually-transmitted-infections\/fda-temporarily-allows-import-french-firms-penicillin-syphilis\" target=\"_blank\" rel=\"noopener\">allowing the importation<\/a> of Extencilline, a French-made penicillin G benzathine formulation approved in other countries but not the United States.<\/p>\n<h2><strong>Syphilis case counts are skyrocketing<\/strong><\/h2>\n<p>Colorado saw 50 congenital syphilis cases in 2023, up from 32 cases in 2022 and seven cases in 2018. Even the 2018 figure represented a big jump: Just 15 Colorado cases were reported in total from 2003 through 2017. That\u2019s 10 fewer than the number of cases reported so far this year, which, without intervention, is on track to reach 100 to 150 cases in 2024, says Scott Bookman, the state health department\u2019s senior director for public health readiness and response.<\/p>\n<p>\u201cWe are experiencing a national crisis regarding syphilis and congenital syphilis, and we are part of that in Colorado,\u201d Bookman said.<\/p>\n<p>Syphilis testing is a start, but it must be followed up with better health care options for pregnant women, says <a href=\"https:\/\/www.uchealth.org\/provider\/michelle-barron-md-infectious-disease\/\">Dr. Michelle Barron<\/a>,\u00a0senior medical director of infection prevention and control for UCHealth\u00a0and a\u00a0professor of medicine and infectious diseases\u00a0at the\u00a0University of Colorado School of Medicine.<\/p>\n<p>A significant proportion of Colorado moms whose babies had congenital syphilis got no prenatal care, she says. Barron says it\u2019s probably no coincidence that the recent rise in cases coincided with the coronavirus pandemic.<\/p>\n<p>\u201cI think it\u2019s a direct reflection of public health resources being channeled into Covid during the pandemic at the expense of other disease interventions,\u201d she said. \u201cMany people are behind on or don\u2019t have access to routine health maintenance screening visits which could help detect cases.&#8221;<\/p>\n<h2><strong>Three stages of syphilis<\/strong><\/h2>\n<figure id=\"attachment_75654\" aria-describedby=\"caption-attachment-75654\" style=\"width: 630px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-75654\" src=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2024\/04\/30143656\/CO-syphilis-cases-April-2024-scaled.webp\" alt=\"Congenital syphilis cases, the focus of the epidemic declaration, are up more than sevenfold in Colorado since 2018. Courtesy of the Colorado Department of Public Health and Environment.\" width=\"630\" height=\"358\" \/><figcaption id=\"caption-attachment-75654\" class=\"wp-caption-text\">Congenital syphilis cases, the focus of the epidemic declaration, are up more than sevenfold in Colorado since 2018. Courtesy of the Colorado Department of Public Health and Environment.<\/figcaption><\/figure>\n<p>Syphilis manifests in <a id=\"\" href=\"https:\/\/www.cdc.gov\/syphilis\/about\/\" target=\"_blank\" rel=\"noopener\">three main stages<\/a>. Primary syphilis comes after initial infection, with painless open sores that last three to six weeks. Untreated, it can soon become secondary syphilis, which typically brings skin rashes and can come with fever, muscle aches, fatigue, patchy hair loss, and other symptoms.<\/p>\n<p>If still untreated, tertiary syphilis can develop after a latent period (that is, no symptoms at all) that can last for years or even decades. Tertiary syphilis develops in about 35% of untreated patients and can come with serious neurologic, heart, eye, ear, and other problems.Many don\u2019t realize they are at risk, and they may not have any obvious symptoms, so screening is an important aspect of detection and allows for treatment, Barron says.<\/p>\n<p>Treatment for primary syphilis typically involves one injections of penicillin G benzathine\u00a0 antibiotic; secondary and latent syphilis usually takes three injections with at most nine days between injections, Dunnington says.<\/p>\n<p>\u201cOtherwise, you have to start over, so really having that follow-up to come back and get your next injection is important,\u201d she says. Tertiary syphilis generally requires hospitalization and intravenous antibiotics.<\/p>\n<p><a href=\"https:\/\/www.cdc.gov\/sti-statistics\/?CDC_AAref_Val=https:\/\/www.cdc.gov\/std\/statistics\/2022\/default.htm\">U.S. syphilis cases<\/a> peaked in the 1940s before plunging with the introduction of antibiotics, but they\u2019re up nationally from about 114,000 cases in 2018 to 204,000 in 2022, the last year national data is available. The rate of increase is much higher in Colorado. The 3,266 cases in 2023 were triple that of 2018. Gay and bisexual men account for <a href=\"https:\/\/www.cdc.gov\/sti-statistics\/county-level-syphilis-data\/\">nearly half<\/a> of cases and women for about a quarter of them.<\/p>\n<p>Dunnington stressed the importance of women and their partners understanding the risks of congenital syphilis and the importance of being tested. That can take courage, she says.<\/p>\n<p>\u201cThere\u2019s a lot of stigma around sexually transmitted infections, and so it\u2019s about not being afraid to seek out testing,\u201d she said. \u201cAs health care providers, we\u2019re here to help support them.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"<p>A sharp increase in syphilis cases has led the state of Colorado to declare a congenital syphilis epidemic effective April 25. It requires all health care facilities in the state \u2013 from clinics to major hospitals \u2013 to offer syphilis testing at least three times surrounding pregnancy: in the first and third trimesters and then [&hellip;]<\/p>\n","protected":false},"author":23,"featured_media":75652,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[8],"tags":[4010,212],"class_list":["post-75649","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-news","tag-pregnancy-childbirth-and-newborn-care","tag-womens-care"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.4 (Yoast SEO v27.4) - 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