Congenital Syphilis Epidemiology, Prevention, and Management in the United States: A 2022 Update

Area of Science:

• Public Health
• Infectious Diseases
• Neonatal Medicine

Background:

• Congenital syphilis (CS) has seen a dramatic increase in the US over the last decade, challenging its prior status as a near-eliminated infection.
• This resurgence necessitates a thorough evaluation of contributing factors and an update of current prevention and management strategies.

Purpose of the Study:

• To examine the current epidemiology, screening, and management of perinatal and congenital syphilis in the US.
• To review the pathogenesis, clinical features, and contributing factors to the rise in CS cases.
• To identify areas for future research and intervention.

Main Methods:

• A structured narrative review of CS data reports, peer-reviewed literature, and state health department guidelines over the past two decades.
• Focused search criteria on CS treatment, prevention, and prenatal health disparities.
• Analysis of geographical trends, state laws on maternal syphilis testing, and potential causes for increased incidence.

Main Results:

• Significant geographical disparities and disproportionate rates of CS among certain racial groups have been identified.
• Gaps in prevention, timely diagnosis, treatment, and management of perinatal syphilis and CS contribute to rising cases.
• Current screening and management guidelines require updates to address the re-emergence of this pathogen.

Conclusions:

• The re-emergence of congenital syphilis as a significant neonatal pathogen requires heightened awareness among healthcare providers.
• Addressing health disparities and strengthening public health infrastructure are crucial for effective prevention and control.
• Increased federal funding for targeted interventions and research in vulnerable populations is essential to curb the rising rates of CS.