What to Know About the Rise of Congenital Syphilis in the U.S.

Prevent congenital syphilis with early screening.

In recent years, health experts have raised alarms about a troubling trend — the sharp increase in congenital syphilis cases across the United States. The disease, which occurs when syphilis is passed from a pregnant person to their baby during pregnancy or at birth, is largely preventable yet continues to claim young lives.

New York State officials recently reported three infant deaths from congenital syphilis in a single year, reflecting what public health leaders describe as a nationwide crisis. With cases reaching their highest levels in decades, it is crucial for the public to understand the risks, prevention methods, and actions needed to protect families.

This guide breaks down what congenital syphilis is, why cases are increasing, and the steps that can help drive rates down.

What is Congenital Syphilis?

Congenital syphilis occurs when a baby contracts syphilis from an untreated or inadequately treated parent during pregnancy or delivery.

• Syphilis basics: A sexually transmitted infection caused by the bacterium Treponema pallidum.
• Transmission: Passed through sexual contact and from mother to child in the womb.
• Treatment: Easily treatable with antibiotics when detected early.

Without treatment, syphilis can progress silently through different stages, sometimes for years, eventually harming multiple organs. When passed to infants, it can result in devastating outcomes, including death.

Why is Congenital Syphilis Dangerous?

The consequences for infants can be severe and lifelong. Some complications include:

• Miscarriage or stillbirth
• Low birth weight and premature birth
• Organ damage (liver, spleen, brain, nervous system)
• Bone deformities
• Developmental delays
• Blindness or deafness

One of the biggest challenges is that up to 70% of newborns with congenital syphilis show no symptoms at birth, making detection difficult. Without testing and treatment, the disease can surface months or years later with irreversible effects.

Why Are Cases Rising in the U.S.?

According to health officials, congenital syphilis cases have been steadily rising for over a decade. Several factors contribute to this troubling increase:

• Limited access to prenatal care: Some expectant mothers miss out on early screening.
• Healthcare barriers: Lack of insurance, transportation, or mistrust in the medical system.
• Missed opportunities for treatment: Even among those receiving prenatal care, delays in diagnosis and treatment are common.
• Widening disparities: Native American, Hispanic, Black, and Alaska Native communities report disproportionately high rates.

Despite progress in reducing other sexually transmitted infections, syphilis has made a strong comeback, underscoring systemic gaps in healthcare access and education.

How to Prevent Congenital Syphilis

The good news is that congenital syphilis is largely preventable. Experts emphasize several key strategies:

a. Prenatal Screening

• Pregnant women should be screened for syphilis at least three times:
1. At the first prenatal visit
2. In the third trimester
3. At delivery
• Early detection allows timely antibiotic treatment that can protect both mother and baby.

b. Expanding Access to Care

• Offering point-of-care testing can reduce delays, allowing same-day diagnosis and treatment.
• Community partnerships help reach underserved populations who may not otherwise access prenatal care.

c. Public Awareness

• Education about safe sex practices, such as consistent condom use, remains critical.
• Both men and women should be encouraged to get tested, reducing the chance of passing syphilis to partners or future children.

d. Policy and Health System Efforts

• State health departments, like New York’s, are mandating multiple screenings.
• Expanding Medicaid and insurance coverage for prenatal care can close gaps in care.

What You Can Do to Stay Informed and Protected

Preventing congenital syphilis requires action from both individuals and communities. Here are practical steps everyone can take:

• If you are pregnant: Ask your doctor about syphilis testing early and often.
• If you are planning a family: Get tested before pregnancy.
• If you are sexually active: Use protection and schedule regular STI screenings.
• As a community: Support outreach programs that bring healthcare to underserved neighborhoods.

Conclusion

The rise of congenital syphilis is a stark reminder that public health victories can be reversed if vigilance slips. Although the infection is centuries old and easily treatable, systemic barriers and lack of access to care continue to put families at risk.

The bottom line: congenital syphilis should not exist in today’s world. With education, widespread testing, and timely treatment, these tragic cases are preventable. Protecting the next generation begins with awareness, access to care, and commitment to ensuring that no baby is born with a disease that can be stopped before it starts.