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Syphilis cases on the rise in California
Central Valley records a high rate
syphilis pic
Secondary stage syphilis sores (lesions) on the palms of the hands. Referred to as "palmar lesions." - photo by Photo courtesy of the Centers for Disease Control and Prevention

The rate of women diagnosed with syphilis in California is on the rise and has alarmed health officials, especially with an increase of cases involving pregnant woman and newborns.

“The increase in congenital syphilis is particularly concerning,” said Dr. Karen Smith, the director of the California Department of Public Health and the state health officer. “Congenital syphilis occurs when syphilis is transmitted from an infected mother to her child during pregnancy. It is a needless tragedy that can be prevented with good prenatal care and timely and effective treatment.”

Syphilis is a sexually transmitted disease that can cause long-term complications if not treated correctly. Symptoms in adults are divided into stages — primary, secondary, latent, and late syphilis. The primary stage is when a syphilis sore first appears. The sore can be confused for an ingrown hair, zipper cut, or other seemingly harmless bump. The sore lasts three to six weeks and heals regardless of whether or not a person receives treatment. Even though the sore goes away, a person must still receive treatment so the infection does not move to the secondary stage. The secondary stage is usually marked by the presence of a rash. The rash can look like rough, red, or reddish brown spots on the palms of the hands and/or the bottoms of the feet. Other symptoms can include fever, swollen lymph glands, sore throat, patchy hair loss, headaches, weight loss, muscle aches, and fatigue. The symptoms from this stage will go away whether or not a person receives treatment, but without the right treatment, the infection will move to the latent and possibly late stages of syphilis.

According to the CDPH, most people with untreated syphilis do not develop late stage syphilis. However, when it does happen it is very serious and would occur 10 to 30 years after an infection began. Symptoms of the late stage of syphilis include difficulty coordinating your muscle movements, paralysis, numbness, blindness, and dementia. In the late stages of syphilis, the disease damages the internal organs and can result in death.

From 2012 to 2014, the annual number of reported early syphilis cases among women more than doubled from 248 cases to 594. The annual number of reported congenital syphilis cases more than tripled during the same period, from 30 to 100. Syphilitic stillbirths also increased, from one case in 2012 to six cases in 2014. The increasing trend of syphilis among women appears to continue in 2015.  

Most of the congenital syphilis cases have been reported in the Central Valley and Los Angeles County. Stanislaus County had a rate of 12.3 cases per 100,000 residents in 2014. The age bracket with the largest number of cases for men and women in Stanislaus County was the 30 to 34 age range. The CDPH has not identified a cause for the increase in congenital syphilis, which is often associated with poverty and lack of access to health care. Most of the women who gave birth to babies with congenital syphilis did not receive adequate or timely prenatal care, according to the CDPH.

“When women do not receive proper prenatal care, they’re missing a crucial opportunity to be screened for syphilis and other sexually transmitted diseases,” Dr. Smith said. “It is vital that pregnant women get comprehensive prenatal care, including getting tested for STDs, to avoid transmitting infections to their babies.”

CDPH is addressing the rise of syphilis cases by working with local health departments to identify causes, reach out to infected pregnant women to make sure they and their partners are treated, and intensify efforts to follow-up on contacts of syphilis cases, particularly women of childbearing age.