The number of US babies born with syphilis has nearly quadrupled in 5 years

• Of the 1,870 babies with congenital syphilis in 2019, nearly two-thirds were Black or Hispanic.
• The disease caused 94 stillbirths and 34 deaths in 2019, an uptick from 2018.
• Congenital syphilis can be prevented with screening and antibiotics.

Newborn deaths from congenital syphilis are on the rise in the US, according to a new Centers for Disease Control and Prevention STD report.

Syphilis is a bacterial infection - characterized by a sore on the genitals, rectum, or mouth - that typically spreads through sex, according to the Mayo Clinic. Congenital syphilis occurs when a pregnant woman with syphilis passes off the infection to her baby during pregnancy.

In 2019, 1,870 babies were born with congenital syphilis, a 291% increase from 2015. In 2013, congenital syphilis occurred 9.2 times out of every 100,000 births, and now, the number has sharply risen to 48.5 cases every 100,000 births.

"Rising congenital syphilis is an unacceptable situation in America for a country that has this amount of resources and wealth," David Harvey, executive director of the National Coalition of STD Directors, told Insider. "Every failure of a baby born with syphilis is a sentinel public health failure."

Experts are surprised by this trend. They said the rise is likely tied to insurance coverage, as women without health insurance delay seeking prenatal care in time for detection and treatment for syphilis.

Dr. Edward Hook, a professor of medicine and STD prevention expert at the University of Alabama at Birmingham, also said the rise may be because of the ongoing drug use epidemic. Pregnant women with drug use dependence may be less likely to engage with the healthcare system, and therefore more likely to go undiagnosed.

Other congenital infections have been trending down, but syphilis is different

Harvey finds the rise surprising, given that other mother-to-child infections have decreased.

While chlamydia, gonorrhea, and syphilis rates are at an all-time high for six years in a row, cases of perinatal infections have been tumbling. Perinatal HIV rates, for example, have dropped from 141 in 2014 to 65 in 2018.

Of the babies born with congenital syphilis in 2019, nearly two-thirds were either Black or Hispanic. "This is one more example of people having unequal access to health care," Harvey said.

In the same group, there were 94 stillbirths and 34 deaths in 2019, up from 79 stillbirths and 15 deaths in 2018. In general, 40% of babies born with congenital syphilis may be stillborn or die.

Congenital syphilis can be prevented with a screening test and treatment

Surviving newborns with congenital syphilis may develop permanent health issues like deformed bones, meningitis, or severe anemia. These symptoms may develop a few weeks or years after birth.

Although congenital syphilis can be prevented with antibiotics, 40% of the cases occurred because a mom did not receive treatment despite a timely syphilis diagnosis. 36% of cases occurred because a mom did not get timely prenatal care.

The CDC recommends all pregnant women get tested for syphilis during their first prenatal visit. But if women are in communities with high rates of syphilis and are likely to be infected, they recommend getting tested twice during the third semester and using condoms.