OHA sounds alarm on increasing number of congenital syphilis cases



PORTLAND, Ore (KOIN) — The Oregon Health Authority has issued a health alert to public health practitioners and health care providers about the urgent need to address the increasing number of congenital syphilis cases in the state.

According to the OHA, congenital syphilis is a disease that occurs when a pregnant person with syphilis passes the infection on to their baby during pregnancy and can be deadly.

There were no cases of congenital syphilis in 2013; in contrast, there were 19 cases in 2020 and, as of this alert, there have been 17 cases reported to OHA in 2021. The alert was issued last Thursday.

The action requests for providers and practitioners to treat all patients with signs or symptoms consistent with primary or secondary syphilis when they present for care.

However, they should not wait for the results of such tests to provide treatment, particularly among pregnant people, people experiencing homelessness and other people who have difficulty following up with medical care.

“Given the severe consequences of (congenital syphilis), every case is a sentinel event indicating that the healthcare system is not meeting the needs of marginalized and minoritized Oregonians,” said OHA in the alert. “We found that almost 40% of pregnant people who delivered an infant with (congenital syphilis) did not receive prenatal care.”

The alert added that pregnant people with syphilis likely have touchpoints with other providers, systems, and services during their pregnancy. Better coordination of these systems has the potential to avert cases of CS, according to the OHA.

While screening for the disease at delivery is common, the agency suggests that increased screening at first presentation to prenatal care and third trimester screening may prevent additional cases. New infections and re-infections during pregnancy make up almost one-fourth of cases in Oregon.

The alert said that starting and completing treatment for the disease can be challenging.

“For pregnant people diagnosed with late syphilis or syphilis of unknown duration, treatment requires three precisely timed injections of Bicillin LA at seven-day intervals initiated at least 30 days prior to delivery. Treatment may also require coordination with additional providers and health systems for timely initiation and completion of this multi-dose regimen,” explained OHA.

The agency also suggests for providers and practitioners to test people who exchange money or drugs for sex, people who use methamphetamine, heroin or cocaine by any route for syphilis when they present for care, including and especially in emergency rooms and urgent cares, jails or other carceral settings, and substance use disorder treatment facilities.

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