Using an Email Alert to Improve Identification of Pregnancy Status for Women With Syphilis-Florida, 2017-2018

Congenital syphilis can be prevented if syphilis is treated early in pregnancy. Identifying women with syphilis who are pregnant facilitates prioritization for follow-up. In 2016, Florida reported 1062 female syphilis cases, aged 15 to 44 years, and 160 (15%) cases were missing pregnancy status. The Florida Department of Health developed a system-generated weekly email notification sent to local program staff for all female syphilis investigations with unknown pregnancy status. We describe the outcome of these efforts to reduce unknown pregnancy status among women with syphilis.

Review of the frequency and outcomes (reduction in investigations flagged and change in pregnancy status variable) of the first email notification (October 2, 2017) were compared with subsequent notifications through June 25, 2018. In addition, we reviewed pregnancy status of reported female syphilis cases (age, 15-44 years) from 2013 to 2018.

The first email notification listed 76 investigations with unknown pregnancy status. This number decreased to 40 in 1 week and to 22 by 1 month. The decreased volume continued through June 2018 (n = 13). Of the original 76 investigations, 3 women were pregnant, and 38 (50%) were determined to meet the syphilis case definition (including 1 who was pregnant). In 2017, pregnancy ascertainment for female syphilis cases reached 98%.

Focused efforts using email notification to obtain pregnancy status improved ascertainment in large sexually transmitted disease (STD) programs with minimal effort. Most but not all women with unknown pregnancy status were identified as not pregnant.