Homelessness and other stressors linked to Alaska’s continued surge in syphilis at birth

babies
Newborns rest in the nursery of a recovery center. Preliminary data shows that 10 babies were born with syphilis in 2023. Such cases of congential syphilis, which are infections passed on by pregnant mothers, have increased dramatically in Alaska and nationally in recent years. (Photo by Seth Wenig/The Associated Press)

Ten Alaska babies were born with syphilis last year, continuing a surge that puts infants at grave health risks, state Division of Public Health officials reported on Tuesday.

The 2023 cases of congenital syphilis – the version of the sexually transmitted disease that is spread by pregnant women to their fetuses – were all reported to infants “born to women who experienced complex and substantial barriers to prenatal care,” said a bulletin issued by the division’s epidemiology section.

Congenital syphilis can cause stillbirth or death shortly after birth, according to the U.S. Centers for Disease Control and Prevention. It can also seriously harm babies’ bodies, potentially causing problems like bone deformities and brain and nerve damage and resulting effects such as blindness and deafness, according to the CDC. But treatment of pregnant women through antibiotic use can prevent infection spread to fetuses, and newborns with the disease can be treated with antibiotics if their infections are identified quickly, according to the CDC.

In Alaska, all 10 of the women giving birth to infected babies in 2023 had inadequate prenatal care, and seven had no care at all until the time of childbirth, the bulletin said. Seven were experiencing homelessness, and nine had tested positive or reported using methamphetamine or amphetamine.

Since 2020, there have been 35 cases of congenital syphilis in Alaska, including the record 12 cases in 2022 and the 10 likely cases last year. In comparison, there were no cases reported in 2019 and only one in 2018, according to health officials.

The cases reported in Alaska in 2023 are currently classified as probable or suspected; numbers could be revised in the future, the bulletin said. The total gives the state a rate of 105 congenital syphilis cases for every 100,000 births, the bulletin said. In comparison, the national rate in 2021 was 77.9 cases for every 100,000 births, according to the CDC.

Nationally, cases of congenital syphilis have skyrocketed in recent years, the CDC and other health organizations have reported. Numbers in the United States increased by more than tenfold from 2012 to 2022, from 335 to 3,751 reported cases, according to the CDC.

In response, federal and state health officials have issued recommendations for stepped-up testing, especially targeting at-risk populations.

Alaska law already requires a syphilis test for pregnant women early on in their prenatal care, but frequency of that testing should be at least tripled, according to state recommendations. Testing should be performed at the pregnant patients’ first prenatal visits and again during their third trimesters and at delivery of the newborns, according to the new recommendations.

Additionally, pregnant women who are coping with stressors like homelessness or substance abuse should be tested at the entry point for all health care treatments, including emergency services and substance-abuse treatment visits, according to the recommendations. Those efforts are intended to reach pregnant women who might otherwise have late or no prenatal care, the bulletin said.

There are other steps that state health officials recommend to reduce the spread of syphilis. Among them is a call for all sexually active adults of childbearing age to be tested at least once in the coming year, plus testing whenever there is a new sexual partner.

Alaska Beacon is part of States Newsroom, a network of news bureaus supported by grants and a coalition of donors as a 501c(3) public charity. Alaska Beacon maintains editorial independence. Contact Editor Andrew Kitchenman for questions: info@alaskabeacon.com. Follow Alaska Beacon on Facebook and X.

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