Syphilis cases continue to rise in Wisconsin-affecting Babies, teens, and adults

DHS is calling on medical providers to increase syphilis screening and testing during pregnancy

The Wisconsin Department of Health Services (DHS) has issued a memo to health care providers in the state calling for increased awareness and testing for the sexually transmitted infection (STI) syphilis. Recently released 2022 surveillance data show a continued rise in cases in the state. Cases of syphilis increased 19% (1,608 to 1,916) from 2021 to 2022. Among those cases, congenital syphilis increased 81% (16 to 29) during this same time period. By comparison, Wisconsin had an average 0-2 congenital syphilis cases per year in the 2010s.

“These increases from pre-pandemic numbers are concerning, especially the increase in cases of congenital syphilis,” said DHS Chief Medical Officer for the Bureau of Communicable Disease and State Epidemiologist Dr. Ryan Westergaard. “Syphilis and congenital syphilis can lead to serious health complications, but they are preventable with simple screening, early detection, and treatment.”

Syphilis is caused by a type of bacteria known as Treponema pallidum that is spread through sexual contact. Congenital syphilis occurs when a pregnant person with syphilis passes the infection to their unborn child which can have serious impacts on an unborn baby. Before birth, syphilis can cause miscarriage, premature delivery, or low birth weight. Up to 40% of babies with congenital syphilis may be stillborn or die from the infection. At birth, a baby with a syphilis infection may not have signs or symptoms of disease. However, if the baby does not receive treatment right away, the baby may develop serious problems, such as cataracts, deafness, or seizures, it could also lead to death. Syphilis is treatable with antibiotics.

DHS encourages medical providers to increase syphilis testing of all individuals and especially pregnant people in all medical settings, including urgent care, emergency departments, and other non-traditional prenatal care settings. Pregnant people should undergo three syphilis screenings during their pregnancy: one during the first trimester, a second after 28 weeks of pregnancy, and a third at delivery. This is especially important since people with syphilis may not show symptoms.

“We found that a large number of congenital syphilis cases were due to a lack of syphilis testing, late testing during pregnancy, and a lack of prenatal care,” said DHS Syphilis Surveillance Coordinator Craig Berger. “Getting tested and treated early is critical to preventing congenital syphilis.”

The prevalence of syphilis highlights longstanding racial inequities observed across a wide range of health conditions. In 2022, over 65% of newborns with congenital syphilis were Black. Racial and ethnic disparities also persist among adults with syphilis. Black people are most affected by syphilis in general. Hispanic and Native American people are also disproportionately affected. It is important to understand that these higher rates are not caused by ethnicity or heritage, but by social conditions that are more likely to affect minority groups. Factors such as poverty, large gaps between the rich and the poor, fewer jobs, and low education levels can make it more difficult for people to stay sexually healthy.

“By addressing the root causes of these inequities, we can help those who are counting on us, including people who are pregnant and their children,” said DHS Chief Medical Officer for the Bureau of Community Health Promotion Dr. Jasmine Zapata.

Along with providing increased access to screening and treatment, other ways to protect people at risk for syphilis infection include increasing access and use of prenatal care services, assuring equitable housing and living conditions for all people in Wisconsin, improving access to mental health services, and building and maintaining trust between patients and health care providers.

The best way to protect babies from congenital syphilis is to get tested and treated. If you are pregnant, talk to a doctor or clinic near you to receive testing and treatment, if needed. For questions about syphilis, including reporting and surveillance in Wisconsin, visit the DHS sexually transmitted diseases webpage (www. dhs.wisconsin.gov/std/index.htm).