Syphilis cases are on the rise in the U.S., with Mississippi reporting a staggering 1000% increase in infant hospitalizations due to congenital transmission of the disease since 2016, a study from the Centers for Disease Control and Prevention (CDC) has revealed.

The rate of syphilis has increased almost every year in all regions of the U.S. and within all age groups after a historic low in 2000 and 2001. There were 176,713 new cases of syphilis in 2021.

The CDC reported that out of the 367 infants hospitalized with congenital syphilis in Mississippi, 97.6% were newborns. More than 70% of them were African Americans, and 58.0% were residents of nonurban counties.

Syphilis is a sexually transmitted bacterial infection that typically starts as sores on the genitals, rectum or mouth. The infection spreads when a person comes in direct contact with the sores, known as chancre, during vaginal, anal or oral sex. The average incubation period or the time between contracting the bacteria and the first symptoms is 21 days.

Pregnant women with syphilis can transmit the infection to the unborn child through the placenta or during birth. The condition is called congenital syphilis.

CDC recommends screening pregnant women for syphilis and for other infections, including HIV, hepatitis B virus (HBV) and hepatitis C virus (HCV).

Signs of syphilis

The signs of syphilis depend on the stage of infection. The disease progression takes weeks, months or even years.

  • Preliminary syphilis is the first stage of infection, during which multiple painless, firm and round chancres appear at the sites at which bacteria enter the body. The sores may last for three to six weeks and progress to the next stage if the patient does not take treatment.
  • Secondary syphilis - In this stage, rashes appear on one or more areas of the body. They may not be itchy and may look like rough, reddish-brown spots when it appears on the palm of the hands and bottoms of the feet. Patients may also exhibit symptoms such as fever, headaches, weight loss, muscle aches, patchy hair loss, sore throat, swollen lymph nodes and tiredness. The symptoms might go away even without treatment but it results in progression of the disease to the next stage.
  • Latent Stage - It is the period of no signs that may last for many years. Sometimes, the symptoms never return after the latent stage, but the disease can also progress to the tertiary stage.
  • Tertiary stage - The infection is not contagious at this stage but begins to affect organs and can turn fatal. Around 15% to 30% of people with syphilis go into complications, when the infection is left untreated. Changes in vision, numbness, dementia and issues with muscle control are some of the common complications of the disease.

Complications in pregnancy

Untreated syphilis can cause complications in pregnancy, including miscarriage, stillbirth, development delays, nerve issues causing blindness or deafness, meningitis and seizures in newborns. The risk of stillbirth is 40% in cases of untreated syphilis. Infants with congenital syphilis are also at high risk of developing rashes, damage to bones, severe anemia, enlarged liver and spleen, and jaundice.

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