News from the U.S. Department of Health and Human

Services (HHS) Office of the Assistant Secretary for Health (OASH) Region 5

What is congenital syphilis (CS)?

Congenital syphilis (CS) is a disease that occurs when a mother with syphilis passes the infection on to her baby during pregnancy. Learn more about syphilis.

Almost 9 in 10 cases of newborn syphilis in 2022 might have been prevented with timely testing and treatment during pregnancy.

More than half were among people who tested positive for syphilis during pregnancy but did not receive adequate or timely treatment.

Nearly 40 percent were among mothers who were not in prenatal care.

One of the biggest risk factors for syphilis for some people is where they live. According to previous CDC data, in 2021, more than 70 percent of the U.S. population lived in counties considered to have high rates of syphilis among reproductive-age women (above the Healthy People 2030 target).

How can CS affect a baby?

CS can have major health impacts on your baby. How CS affects your baby’s health depends on how long you had syphilis and if — or when — you got treatment for the infection.

CS can cause:

• Miscarriage (losing the baby during pregnancy)
• Stillbirth (a baby born dead)
• Prematurity (a baby born early)
• Low birth weight
• Death shortly after birth

Babies born to women with untreated syphilis may be stillborn, or die from the infection as a newborn.

For babies born with CS, CS can cause:

• Deformed bones
• Severe anemia (low blood count)
• Enlarged liver and spleen
• Jaundice (yellowing of the skin or eyes)
• Brain and nerve problems, like blindness or deafness
• Meningitis
• Skin rashes

These outcomes can be prevented through appropriate screening and treatment.

In 2022, lack of timely testing and adequate treatment contributed to almost 90% of congenital syphilis cases in the United States, including substantial proportions of congenital syphilis cases in all U.S. Census Bureau regions and among all racial and ethnic groups.

U.S. syphilis cases reach highest levels since the 1950s, creating a critical public health need

More than 3,700 cases of congenital syphilis were documented among newborns in 2022–more than 10 times the number diagnosed in 2012.

If untreated, syphilis can seriously damage the heart and brain and can cause blindness, deafness, and paralysis. When transmitted during pregnancy, it can cause miscarriage, lifelong medical issues, and infant death.

In response to the surging number of syphilis and congenital syphilis cases nationwide, the U.S. Department of Health and Human Services (HHS) is taking action to slow the spread with a focus on those most significantly impacted. Through the establishment of the National Syphilis and Congenital Syphilis Syndemic (NSCSS) Federal Task Force, the Department is utilizing its agencies, its expertise, and its stakeholder network to respond to the U.S. syphilis and congenital syphilis epidemic. The actions of the Task Force leverage federal resources to reduce rates, promote health equity, engage impacted communities and direct resources to support those most impacted.

HHS Announces Department Actions to Slow Surging Syphilis Epidemic

CDC’s 2022 STI Surveillance Report underscores that STIs must be a public health priority

Congenital syphilis rates are rapidly increasing in the United States and are at the highest level in at least 30 years (4). Barriers to congenital syphilis prevention are multifactorial, including those at the patient level, such as substance use and insurance status, and those at the system level, such as structural inequities, limited access to health care, and medication shortages (5,8,16,17,20). Addressing patient and system-level barriers to accessing testing, treatment, and care could help prevent congenital syphilis. Improvements in timely testing and appropriate treatment of syphilis through tailored strategies at local and national levels will help control the congenital syphilis epidemic in the United States. Vital Signs: Missed Opportunities for Preventing Congenital Syphilis — United States, 2022 | MMWR (cdc.gov)

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About Our Office

Within the U.S. Department of Health and Human Services (HHS), the Office of the Assistant Secretary for Health (OASH) Regional Offices perform essential functions on behalf of the HHS Secretary, the Assistant Secretary for Health (ASH), the Surgeon General (SG), and in collaboration with other HHS Operating Divisions. In Region 5, we work to protect and promote the health of all communities within the six Great Lakes states of IL, IN, MI, MN, OH, and WI. Learn more about OASH Region 5 here: https://www.hhs.gov/ash/about-ash/regional-offices/region-5/index.html