Eight times as many babies were born with syphilis in Colorado in 2022 as in 2017, and while the numbers are still small, the public health community is racing to get the disease under control.
Untreated syphilis during pregnancy can cause miscarriages, stillbirth or infant death; premature birth; low birthweight; and disabilities, including deafness or blindness. Some babies appear healthy at birth, but get sick from congenital syphilis in the following weeks.
Colorado’s five-year increase, from four cases in 2017 to a preliminary count of 34 in 2022, is part of a nationwide trend — one that’s almost entirely preventable. State law requires that everyone get tested for syphilis, a sexually transmitted infection, during their first prenatal visit, and prompt antibiotic treatment can prevent complications.
“One case is one case too many,” said Lacy Mulleavey, prevention and field services program manager for the Colorado Department of Public Health and Environment. “We need to act quickly on this.”
The health department reported a preliminary count of 3,056 syphilis cases of all types in Colorado last year, which was about a 33% increase compared to the previous year.
Nationwide data for 2022 isn’t available yet, but cases rose 32% from 2020 to 2021, reaching more than 176,000. Congenital syphilis affected more than 2,800 babies in 2021 — an increase of almost one-third, and the highest rate since 1993. About 220 of those babies were stillborn or died in infancy.
From 2011 to 2015, rates of syphilis among women between 15 and 44 were relatively stable nationwide, but they began rising sharply in the second half of the decade. Some epidemiologists think the rise in infections among women reflects increases in injection drug use, as well as related factors that raise risk, like homelessness, HIV infection and trading sex for drugs or money.
While the majority of syphilis cases still affect men — particularly those who report they had male sexual partners — cases in women of reproductive age rose about twice as fast as overall cases, Mulleavey said. Some of the increase is due to a greater emphasis on testing, she said, because, until recent years, women generally weren’t screened for syphilis in the way they were for chlamydia and gonorrhea.
There’s a special emphasis on preventing and treating syphilis in women of reproductive age because of the potential harm to infants, but it’s also a serious threat to men, Mulleavey said.
Most people don’t develop serious complications until they’ve been infected for decades, but the bacteria can invade the nervous system at any point, particularly if a person has a compromised immune system, she said. Neurosyphilis can cause strokes and loss of hearing or vision.
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