DC-area doctor calls rise of syphilis in pregnant women across US ‘concerning’

Women giving birth in the U.S. are now three times more likely to have syphilis than they were in 2016, according to a new Centers for Disease Control and Prevention report.

“The increase in maternal syphilis has led to a concerning rise in congenital syphilis,” said Dr. Amy Banulis, an OB-GYN with Kaiser Permanente’s mid-Atlantic Group.

“Congenital syphilis” refers to when the disease is passed down through the mother to a newborn.

“Women who have untreated syphilis during pregnancy will transmit the infection to babies in about 50% to 70% of cases,” Banulis told WTOP. “It is currently estimated that 1 in every 1,300 live births is affected by congenital syphilis.”

The trend is one that Banulis said is alarming and perplexing the medical community, adding it isn’t sure what’s causing the rise.

”No one is sure exactly why, because syphilis rates have been declining overall since 1990,” she said.

But since the COVID pandemic, she said syphilis and certain other sexually transmitted infections like chlamydia and gonorrhea are on the rise.

Banulis said that with syphilis in particular, there was a rise noticed even before the pandemic.

“We know that syphilis in infants can cause severe, disabling, potentially life-threatening conditions,” Banulis said.

Syphilis can cause complications that include — but aren’t limited to — miscarriages, stillbirths, preterm birth and low birth weight babies. Babies to whom the disease is passed down can also have issues like bone deformities, severe anemia, blindness, deafness, meningitis and skin rashes.

“This can be a significant health concern, and can even lead to death,” Banulis said.

While Banulis said the cause of this trend is a mystery, the solution is simple: “All pregnant women, regardless of any risk factors, should be tested for syphilis early in pregnancy, ideally in the first trimester.”

If syphilis is detected, Banulis said it needs to be treated right away. The treatment, intramuscular penicillin, which she said is highly effective, will prevent infection from worsening in the mother and from being passed on to the baby.

“People worry, because of course, there are some women who are allergic to penicillin,” Banulis said. “But women can actually go through a desensitization process and still get the treatment that they need.”

At Kaiser Permanente, Banulis said she and her colleagues test again in the third trimester, to make sure there have been no changes.

”For women who do test positive for syphilis during pregnancy — those babies need to be tested for syphilis, even if they don’t have any symptoms after birth,” Banulis said.

That’s because syphilis, even if it doesn’t present in babies, can still be latent.

That goes for adults too, as syphilis can be latent in the body, meaning a person may have it and be a carrier, even if they don’t display signs of being infected, sometimes for years.

Banulis said the primary initial symptom of syphilis is a sore in the genital area — which can heal over. When that happens, the disease can become latent if it isn’t treated.

“We need to get away from risk-based testing,” Banulis told WTOP. “Everybody should get tested. There should be universal testing.”

Overall, she said safe sexual contact, and regular testing (as a preventive measure, not just a reactive one) will lead to the best outcomes.