Cases Of Congenital Syphilis Research Articles

Syphilis in Ottawa: An evolving epidemic.

The incidence of infectious syphilis in Canada has declined throughout the latter decades of the last century; however, in Ottawa, an upsurge in new cases began in 2001. The local epidemic continues to involve predominantly gay, bisexual and other men who have sex with men (gbMSM), but in recent years, has expanded further into heterosexual populations. This has coincided with an increase in the number of pregnant women testing positive for syphilis on antenatal screening. The aim of this study is to understand the changing epidemiology in infectious syphilis cases diagnosed in Ottawa to strengthen primary care management and public health response. Surveillance data from the Ontario Ministry of Health were used to describe the evolving epidemiology of infectious syphilis in the Ottawa region from 2010 to 2019, including a comprehensive chart review of cases from 2015-2019. The number of cases of infectious syphilis in Ottawa rose from 50 cases in 2010 to 171 cases in 2019. These rates were consistently high among males, and increased from 10.9/100,000 in 2010 to 30.9/100,000 in 2019. The rates among females, in comparison, increased from 0.4/100,000 in 2010 to 3.2/100,000 in 2019, with corresponding increases during antenatal screening (with no congenital syphilis cases to date). As the syphilis epidemic continues to evolve in Ottawa, ongoing surveillance plays a crucial role. Public health resources must address the needs of populations already impacted but at the same time be flexible enough to respond to changes in trends and support clinicians providing care to populations where the epidemic is emerging.

Rising syphilis rates in Canada, 2011-2020.

Syphilis rates are of public health concern in Canada, with multiple jurisdictions reporting outbreaks over the past five years. The objective of this article is to describe trends in infectious and congenital syphilis in Canada 2011-2020. Routine surveillance of syphilis is conducted through the Canadian Notifiable Disease Surveillance System (CNDSS). In response to rising rates of syphilis, all provinces and territories (P/Ts) have also submitted enhanced surveillance data on infectious syphilis to the Public Health Agency of Canada through the Syphilis Outbreak Investigation Coordinating Committee (SOICC) starting in 2018. Descriptive analyses of CNDSS and SOICC surveillance data 2011-2020 by age, sex, pregnancy status, male sexual orientation and P/Ts were performed. The national rate of infectious syphilis increased from 5.1 per 100,000 population in 2011 to 24.7 per 100,000 population in 2020.The rates increased in almost all P/Ts, with the Prairie provinces reporting the greatest relative increases from 2016 to 2020 (more than 400%). Rates in males were consistently higher than rates in females over the past 10 years; however, from 2016 to 2020, rates among females increased by 773%, compared with 73% among males. Although the proportion of cases who self-identify as gay, bisexual and other men who have sex with men decreased from 54% to 38% between 2018 and 2020, they still represent a high proportion of cases (according to data from eight P/Ts). From 2016 to 2020, rates of infectious syphilis increased in every age group, especially in females aged 15-39 years. Confirmed early congenital syphilis cases for 2020 increased considerably from prior years, with 50 cases reported in 2020, compared with 4 cases in 2016. Infectious and congenital syphilis rates are a growing concern in Canada and the nature of the syphilis epidemics across Canada appears to be evolving, as evidenced by recent trends. More data and research are needed to better understand the drivers associated with the recent changes in the epidemiology of syphilis in Canada.

Stochastic Petri net model describing the relationship between reported maternal and congenital syphilis cases in Brazil

IntroductionSyphilis is a sexually transmitted disease (STD) caused by Treponema pallidum subspecies pallidum. In 2016, it was declared an epidemic in Brazil due to its high morbidity and mortality rates, mainly in cases of maternal syphilis (MS) and congenital syphilis (CS) with unfavorable outcomes. This paper aimed to mathematically describe the relationship between MS and CS cases reported in Brazil over the interval from 2010 to 2020, considering the likelihood of diagnosis and effective and timely maternal treatment during prenatal care, thus supporting the decision-making and coordination of syphilis response efforts.MethodsThe model used in this paper was based on stochastic Petri net (SPN) theory. Three different regressions, including linear, polynomial, and logistic regression, were used to obtain the weights of an SPN model. To validate the model, we ran 100 independent simulations for each probability of an untreated MS case leading to CS case (PUMLC) and performed a statistical t-test to reinforce the results reported herein.ResultsAccording to our analysis, the model for predicting congenital syphilis cases consistently achieved an average accuracy of 93% or more for all tested probabilities of an untreated MS case leading to CS case.ConclusionsThe SPN approach proved to be suitable for explaining the Notifiable Diseases Information System (SINAN) dataset using the range of 75–95% for the probability of an untreated MS case leading to a CS case (PUMLC). In addition, the model’s predictive power can help plan actions to fight against the disease.

Gaps in the congenital syphilis prevention cascade: qualitative findings from Kern County, California

BackgroundCongenital syphilis is preventable through timely access to prenatal care, syphilis screening and treatment of pregnant women diagnosed as infected. In 2018, California had the second highest number of congenital syphilis cases in the United States (U.S.), a nearly twofold increase in cases since 2014. This study assessed gaps in preventing congenital syphilis in the high morbidity region of Kern County, California.MethodsBetween May 2018 and January 2019, we conducted five focus group discussions with pregnant/postpartum women and ten semi-structured interviews with prenatal care providers in Kern County. Focus group and interview data were recorded, transcribed, and analyzed to identify emergent themes pertaining to facilitators and barriers at each step (prenatal care, syphilis screening and treatment) in the congenital syphilis prevention cascade.ResultsGaps in congenital syphilis prevention discussed in focus group discussions with pregnant/postpartum women were related to limited prenatal care access, social-, economic-, and cultural-barriers, and substance use and co-occurring intimate partner/domestic violence. The gaps identified from interviews with prenatal care providers included social economic vulnerabilities of pregnant women and stigma and shame around the vulnerabilities, distrust in medical system, prenatal substance use, limited prenatal substance use disorder treatment facilities, and inadequate provider training on context-specific congenital syphilis management strategies. Gaps in partner notification, screening and treatment for syphilis were brought up by pregnant/postpartum women and prenatal care providers.ConclusionsCongenital syphilis continues to increase in Kern County and throughout the U.S. In high syphilis morbidity areas, comprehensive and tailored public health approaches addressing setting-specific gaps in prenatal screening and treatment are needed.

The severity of congenital syphilis in an unscreened newborn in the delivery room

Syphilis, despite all the use of Health Policies to minimize its occurrence, for various reasons, continues to affect pregnant women, newborns, and children. The objective of this work is to report a case of congenital syphilis with late diagnosis in a teaching hospital. It is a disease of easy diagnosis and treatment, with a historical reduction after the discovery of penicillin in the 40's. However, in the 21st century this pathology has returned to a significant growth, with this, the lack of attention is highlighted. pre- and post-natal care for the screening and diagnosis of the disease. In order to treat the child in advance, many times, even before the symptoms appear. This work seeks to report a case of late diagnosed congenital syphilis, showing the damage caused by the disease and emphasizing the importance of screening, diagnosis, and treatment.

A case of congenital syphilis despite a negative maternal serological test for syphilis at early gestation

A case of congenital syphilis despite a negative maternal serological test for syphilis at early gestation

Characterization of reports of Congenital Syphilis in Pernambuco from 2018 to 2019

Syphilis is a Sexually Transmitted Infection (STIs) caused by the bacterium Treponema Pallidum, which can be controlled through effective public health actions and measures, due to effective and low-cost treatment. The congenital form of syphilis is a serious outcome, since most newborns have physical, sensory or developmental sequelae, when they do not result in fetal and perinatal loss. This is a public health problem that remains an important challenge in Brazil. To characterize the prevalence of congenital syphilis in the state of Pernambuco between 2018 and 2019. This is a descriptive, observational, quantitative study, using secondary data from the Database of the Unified Health System - DATASUS/Ministry of Health. Tabbed by TABNET. Through the database of the Notifiable Diseases Information System (SINAN), notifications for congenital syphilis in the state of Pernambuco were evaluated from 2018 to 2019. The results showed that there were 2,731 reported cases of Congenital Syphilis in the state of Pernambuco from 2018 to 2019. Where the age group with the highest number of infected children are those with less than 07 days, corresponding to 96.48%, already in relation to the age group of the mother, the most affected is between 20 and 29 years. Even with a considerable number of 79.75% of pregnant women who underwent prenatal care, most partners did not have treatment, with a percentage of 38.92%. With the high number of confirmed cases of congenital syphilis, it is necessary to create strategies to reduce these numbers, it is necessary to reflect on the deficiencies in the quality of prenatal care services. It is known that vertical transmission of the disease is prevent Table, provided that the pregnant woman is diagnosed and treated appropriately.

Epidemiological profile of the reported cases of maternal and congenital syphilis in a reference maternity hospital from Belo Horizonte

Epidemiological profile of the reported cases of maternal and congenital syphilis in a reference maternity hospital from Belo Horizonte

Epidemiological profile of congenital and gestational syphilis cases in the State of Piauí, Brazil

This study aimed to identify the epidemiological profile of congenital syphilis in pregnant women residing in the State of Piauí from 2007 to 2017. An ecological epidemiological study was carried out between January and February 2019 in the Notifiable Diseases Information System and the Live Births Information System. The incidence of congenital syphilis increased during the period studied (2007 to 2017), with an emphasis in the “Entre Rios” Health Region. Regarding neonates, they were predominantly diagnosed with up to 6 days of life (94.5%), males (49.9%), mixed race/color (66.4%), recent syphilis (82.8%), and evolved to live (91.9%). Pregnant women are aged between 20 and 39 years (69.9%), brown color (70.5%), low schooling (28.9%), underwent prenatal care (85.4%), received diagnosis during prenatal care (46.6%), did not undergo a treponemal test (46.2%), the non-treponemal test was reactive (86.8%), had a primary form of the disease (30.5%), and partners without treatment (60.8%). It is necessary to improve surveillance and prenatal care actions that result in the planning and adoption of interventions in order to change this epidemiological picture.

Ocorrência de Sífilis Congênita em uma capital da Amazônia Ocidental Brasileira de 2010 a 2019

Syphilis is an infectious disease caused by the bacterium Treponema pallidum, and its main forms of contagion are the sexual and vertical pathways. When women in the gestational period acquire the disease and are not treated or receive inadequate treatment, they end up transmitting the microorganism to the congenital, leading to the development of congenital syphilis (CS). A cross-sectional descriptive study was carried out, covering epidemiological data available from the State Health Department of Acre (SESACRE), together with information from the Notifiable Diseases Information System (SINAN). During the study period, 245 cases of CS were registered, the records of the SINAN records showed a delay of 5.76% in the number of cases, when compared to the information from SESACRE in the same period. The most affected children were aged less than 7 days old, the maternal age group between 20 and 29 years old was the most affected, prenatal care was provided by 73.47%, however 57.14% received the diagnosis of disease only in childbirth. The occurrence of the disease in the city of Rio Branco-AC from 2010 to 2019 was 245 cases. Undeniably needing improvements in the Public Health System and the proper epidemiological surveillance systems.

Use of Interrupted Time Series Analysis in Understanding the Course of the Congenital Syphilis Epidemic in Brazil

To fight against the rising incidence of syphilis, the Brazilian Ministry of Health (MoH) launched the "Syphilis No!" Project (SNP), with specific resources funded by a parliamentary amendment. Then, in 2018, a national rapid response started to be implemented on the Brazilian Unified Health System (SUS, Sistema Único de Saúde) in two strategic lines (1) to reinforce SUS's universal actions and (2) to implement specific ones to 100 municipalities chosen by the MoH as priorities for syphilis congenital response. In 2015, such localities represented 6895% of congenital syphilis cases in Brazil. In this context, SNP has implemented actions to strengthen epidemiological surveillance of acquired syphilis and congenital syphilis by instituting an integrated and collaborative response through health services networks and reinforcing interstate relations. A quasi-experimental study using time series analysis was conducted to assess immediate impacts and changes to the trend in national congenital syphilis before and after the project, from September 2016 to December 2019. Data were assessed considering rates of congenital syphilis per 1,000 live births in all priority municipalities (n=100) covered by the project and in non-priority municipalities (n=5,470) from all five macro-regions of Brazil. Priority municipalities showed a greater reduction (change in trend) in comparison to non-priority. The linear regression model revealed trend changes after the intervention, with both groups of municipalities showing a drop in the average monthly number of cases per 1,000 live births, with a reduction of -0·21 (CI 95% -0·33 to -0·09; p=0·0011) in priority municipalities and of -0·10 (CI 95% -0.19 to -0.02; p=0·0216) in non-priority municipalities. The study using ITS provides important evidence on the direction, timing, and magnitude of the effects of interventions introduced as part of the SNP on congenital syphilis in Brazil. Our results suggest that the Syphilis No! Project influenced the trends of congenital syphilis in Brazil from 2018, with higher reductions achieved in the priority municipalities. The research is funded by a grant to the Syphilis No! Project from Brazilian Ministry of Health (Project Number: 54/2017). The funders had no role in study design, analysis, decision to publish, or preparation of the manuscript.

Risk Factors Associated with Gaps in Post-Treatment Surveillance for Perinatal Syphilis

During 2019, 1,870 cases of congenital syphilis were reported by the Centers for Disease Control and Prevention (CDC). Diagnosis and treatment of syphilis in mothers and newborns is dependent on post-treatment surveillance via serology for up to 15 months to ensure absence of infection. The objective of this study was to determine demographic, socioeconomic, obstetric and neonatal risk factors associated with gaps in adherence to recommended post-treatment surveillance.

166. Congenital Syphilis in Minnesota, 2016-2020

BackgroundNationally, cases of congenital syphilis (CS) have increased over the past 5 years. We reviewed CS cases in Minnesota from 2016-2020.MethodsAll cases of syphilis, including CS, are reported to the Minnesota Department of Health (MDH), including accompanying data on maternal age, baby’s sex, race, test results, maternal stage and treatment of mother and child. Medical records and case interviews were reviewed; the 2018 national case definition was used to classify cases.ResultsDuring 2016-2020, there were 47 CS cases from 45 mothers, peaking in 2020 at a rate of 3.2/10,000 live births. 43 (91.5%) cases of CS had no clinical signs, 1 (2.1%) CS case was inadequately treated, and there were 2 deaths.The median maternal age was 28 (IQR 9, range 18-38). 13 (28.9%) identified as Black, non-Hispanic, 13 (28.9%) as American Indian/Alaska Native (AI/AN), 9 (20.0%) as White, non-Hispanic, 3 (6.7%) as Hispanic, 2 (4.4%) as Asian/Pacific Islander, and 5 (11.1%) Other/Unknown. Twenty-four (51.1%) cases occurred in the Minneapolis/St. Paul metropolitan area. 2 (4.4%) cases were primary, 1 (2.2%) was secondary, while 18 (40.0%) maternal cases were staged as early non-primary, non-secondary (ENPNS) and 24 (53.3%) were late unknown duration. 14 (31.1%) of mothers had their initial prenatal visit in the first trimester, 6 (13.3%) in the 2nd trimester, 11 (24.4%) in the 3rd, and 14 (31.1%) unknown. None of the maternal cases were HIV+, 2 were identified as positive for hepatitis C. 18 (40.0%) mothers had no or limited prenatal care, 21 (46.7%) had inadequate treatment for syphilis, and 18 (40.0%) had inadequate maternal testing. No cases reported substance use, but one case had a positive substance screen at delivery, and case interviews also documented a role of substance use and home instability in several other cases. ConclusionCase rates of CS are the highest ever seen in MN. There is disproportionate impact in persons of color and indigenous Minnesotans. Lack of access to prenatal care, missed opportunities for testing, and incomplete or insufficient treatment were found in maternal cases. More work needs to be done with communities at risk and with prenatal care providers to ensure adequate testing, identification and treatment for syphilis in women of child-bearing age.Disclosures All Authors: No reported disclosures

Syphilis testing adherence among women with livebirth deliveries: Indianapolis 2014-2016

BackgroundThe number of congenital syphilis (CS) cases in the United States are increasing. Effective prevention of CS requires routine serologic testing and treatment of infected pregnant women. The Centers for Disease Control and Prevention (CDC) recommends testing all pregnant women at their first prenatal visit and subsequent testing at 28 weeks gestation and delivery for women at increased risk.MethodsWe conducted a cross-sectional cohort study of syphilis testing among pregnant women with a livebirth delivery from January 2014 to December 2016 in Marion County, Indiana. We extracted and linked maternal and infant data from the vital records in a local health department to electronic health records available in a regional health information exchange. We examined syphilis testing rates and factors associated with non-testing among women with livebirth delivery. We further examined these rates and factors among women who reside in syphilis prevalent areas.ResultsAmong 21260 pregnancies that resulted in livebirths, syphilis testing in any trimester, including delivery, increased from 71.7% in 2014 to 86.6% in 2016. The number of maternal syphilis tests administered only at delivery decreased from 16.6% in 2014 to 4.04% in 2016. Among women living in areas with high syphilis rates, syphilis screening rates increased from 79.6% in 2014 to 94.2% in 2016.ConclusionImprovement in prenatal syphilis screening is apparent and encouraging, yet roughly 1-in-10 women do not receive syphilis screening during pregnancy. Adherence to recommendations set out by CDC improved over time. Given increasing congenital syphilis cases, the need for timely diagnoses and prevention of transmission from mother to fetus remains a priority for public health.

"Luotest" (syphilitic rabbit testicle extract) with luetin reaction

Planner (Wien. Klin. Woch., 1929, no. 36) tried Luotest (extract of syphilitic rabbit testicle) with luetin reaction in 106 cases of tertiary and late congenital syphilis, receiving 80% positive results. Since the luetin reaction in experiments a. coincided with RW only in 70%, giving often positive results with negative RW, then a. highly recommends introducing it into syphilis serology along with RW.

Severe Congenital Syphilis in the Neonatal Intensive Care Unit: A Retrospective Case Series.

There has been a 291% relative increase in congenital syphilis (CS) cases in the United States from 2015 to 2019. Although the majority of affected fetuses/infants are stillborn or are asymptomatic, a subset is born with severe clinical illness. We describe a series of severe CS cases in the neonatal intensive care unit. Retrospective review of infants with CS, admitted to the Duke Intensive Care Nursery from June 2016 to February 2020. We recorded birthweight, gestational age, medications, procedures, diagnoses, laboratory data and outcomes. Severe symptoms included: birth depression, hypoxic ischemic encephalopathy (HIE), disseminated intravascular coagulopathy and/or persistent pulmonary hypertension (PPHN). Seven infants with CS were identified and 5 with severe presentations were included. Median gestational age was 35.1 weeks (range: 29-37 weeks, median: 35 weeks). All infants required intubation at birth, 2 required chest compressions and epinephrine in the delivery room. One had hydrops fetalis and died in the delivery room. All 4 surviving infants had HIE, severe PPHN, hepatitis and seizures. All infants had a positive rapid plasma reagin, and were treated with penicillin G. Maternal rapid plasma reagin was pending for 3 of 5 infants at delivery, and later returned positive; 2 were positive during pregnancy but not treated. Other infectious work-up was negative. Three infants survived to discharge. CS can be associated with HIE, PPHN and disseminated intravascular coagulopathy in affected infants. Clinicians should have a high index of suspicion and include CS in their differential diagnoses. This study also highlights the importance of adequate treatment of identified cases and screening during the third trimester and at delivery.

ANÁLISE DA SÍFILIS CONGÊNITA E SUA CORRELAÇÃO COM A ATENÇÃO À SAÚDE DA MULHER NO MUNICÍPIO DE BOM JESUS DO ITABAPOANA – RJ.

The congenital syphilis results from hematogenous dissemination of Treponema pallidum, from the infected mother to fetus, across placenta, that can affect multiplus systems. Because it is a disease that can be prevented, mainly through the proper monitoring of the pregnant woman to perform prenatal care, there is still a need for better articulation of public policies and programs. The present task is a scientific investigation based on an approach about congenital syphilis and its correlation with women's health care. The epidemiological data collected, for statistical elaboration, were extracted from government platforms, in which notifications of cases of congenital syphilis from 2016 to 2018 were analyzed, in the municipality of Bom Jesus do Itabapoana / RJ. The present study is of fundamental importance regarding the responsibilities of primary health care in the municipality of Bom Jesus de Itabapoana and the state of Rio de Janeiro in the social perspective, bearing in mind that gestational syphilis and congenital syphilis have been growing significantly due to the lack of care and support for women's health.

Congenital Syphilis Diagnosed Later in Infancy

Reported cases of congenital syphilis (CS) in the U.S. have increased dramatically in recent years. In this study, researchers reviewed data on all

Identification of United States Counties at Elevated Risk for Congenital Syphilis Using Predictive Modeling and a Risk Scoring System, 2018.

The persistence of congenital syphilis (CS) remains an important concern in the United States. We use the 2018 data to refine a previous predictive model that identifies US counties at elevated risk for CS in 2018. Using county-level socioeconomic and health-related data from various sources, we developed a logistic regression predictive model to identify county-level factors associated with a county having had 1 or more CS case reported to the National Notifiable Diseases Surveillance System in 2018. We developed a risk scoring algorithm, identified the optimal risk score cutpoint to identify counties at elevated risk, and calculated the live birth to CS case ratio for counties by predicted risk level to compare counties at elevated risk with counties not at elevated risk. We identified several county-level factors associated with a county having 1 or more CS case in 2018 (area under the curve, 88.6%; Bayesian information criterion, 1551.1). Using a risk score cutoff of 8 or higher (sensitivity, 83.2%; specificity, 79.4%), this model captured 94.7% (n = 1,253) of CS cases born in 2018 and identified 850 (27%) counties as being at elevated risk for CS. The live birth to CS case ratio was lower in counties identified as at elevated risk (2,482) compared with counties categorized as not at elevated risk (10,621). Identifying which counties are at highest risk for CS can help target prevention efforts and interventions. The relatively low live birth to CS case ratio in elevated risk counties suggests that implementing routine 28-week screening among pregnant women in these counties may be an efficient way to target CS prevention efforts.

Re-emergence of syphilis in women of reproductive age and its association with the increase in congenital syphilis in Mexico during 2010\u20132019: an ecological study

BackgroundSyphilis is a sexually transmitted infection that is re-emerging in different parts of the world. This infection can be transmitted during pregnancy, causing neonatal syphilis. The objective of this study was to examine trend in syphilis, congenital syphilis, and neonatal deaths among the Mexican population during 2010–2019.MethodsAn ecological study was carried out to collect information about the incidence of syphilis, the incidence of congenital syphilis, and the incidence of neonatal death from congenital syphilis. The variables were described considering age, sex, Mexican state, and year. Trends across time (calendar year) were analyzed using linear regression, increases were estimated with 95% confidence intervals, and p < 0.05 was considered statistically significant.ResultsThe incidence of syphilis increased by an average of 0.336 cases/100,000 per year and was higher among women aged 15–19 years (0.693 cases). Cases of congenital syphilis increased from 62 cases in 2010 to 372 cases in 2019; furthermore, the increase in syphilis cases among women aged 20 to 24 years was associated with an increase in cases of congenital syphilis. In 2010, 50% of Mexican states did not report cases of congenital syphilis, but in 2018, only 10% did not report cases of congenital syphilis. Between 2010 and 2018, 83 neonatal deaths were reported, with the highest incidence in 2018 (0.88 deaths/100,000 newborns).ConclusionThe incidence of congenital syphilis is increasing in Mexico. As a consequence of the reemergence of syphilis among the population of reproductive age, it is necessary to address and treat syphilis in various population groups.