With cases of syphilis skyrocketing, including dangerous infections that are passed from pregnant women to their infants, new recommendations have been issued for much more widespread testing for the disease, the Alaska Department of Health announced on Tuesday.
All sexually active adults under 45 should get a test at least once this year, the department said. That corresponds to new recommendations issued by the U.S. Centers for Disease Control and Prevention, the department said.
Testing is especially important to prevent congenital syphilis – the infection that is spread from pregnant women to their fetuses. Results of congenital syphilis can be grave. They include stillbirth or death shortly after birth, brain or nerve damage that causes blindness or deafness, bone deformities and other serious health problems, according to the CDC.
“Alaska currently has one of the highest rates of syphilis in the country,” Dr. Anne Zink, Alaska’s chief medical officer, said in a statement released by the department. “Everyone of reproductive age who is sexually active should be tested for syphilis if they are unsure of their syphilis status.” Everyone should be retested each time they have a new sexual partner and be tested every three to six months if they have multiple partners, Zink added.
For adults, untreated syphilis can cause multiple debilitating health conditions and even death.
While only 20 cases were recorded in Alaska in 2016, there were 424 known cases in 2022, according to the department.
Also in 2022, there were 12 congenital syphilis cases identified in Alaska, a record for the state. All were in Anchorage and the Matanuska-Susitna Borough, according to department statistics. From 2020 to 2022, the total was 25, including one that ended in a stillbirth. In comparison, there was only one congenital syphilis case identified in Alaska in 2018 and none in 2019.
Alaska in 2021 ranked eighth in the nation for syphilis and 20th for congenital syphilis, said Dr. Elizabeth Ohlsen, the acting program manager for the state’s HIV/STD program. Data was not yet available for 2022 and 2023 rankings, she said.
Alaska health officials are concerned that the state’s rates will continue to climb because Alaska has high rates for other sexually transmitted infections, Ohlsen said. The state has the nation’s highest rate for chlamydia and ranks 10th for gonorrhea, “so opportunities for transmission are there,” she said by email.
Prenatal care is key to preventing congenital syphilis, she said. “Pregnant women should be tested at least three times during pregnancy based on a national recommendation: once during the first trimester, once during the third trimester, and again at delivery. Those with additional risk factors should be tested more often,” she said.
Alaska law, like laws in other states, requires syphilis screening at pregnant patients’ first prenatal visits. However, not all pregnant women get even that first visit. Most of the Alaska congenital syphilis cases seen so far “have been associated with mothers who had inadequate or no prenatal care,” Ohlsen said.
That is similar to the national pattern.
Nationally, the number of congenital syphilis cases increased by more than 10-fold from 2012 to 2022, the CDC reported.
Most of the cases stemmed from lack of prenatal testing entirely or inadequate testing, according to a CDC analysis.
Syphilis is caused by a bacterial infection. When detected early, it can be cured with antibiotics.