High Congenital Syphilis Case Counts among U.S. Infants Born in 2020

This correspondence reports a concerning rise in congenital syphilis cases among U.S. infants born in 2020, with 2,022 cases reported as of July 2021 the highest count since 1994. The cases, spanning 47 states and D.C., included 139 syphilis related deaths (6.9%). The increase reflects untreated syphilis in women and geographic spread beyond traditional urban and Southern hotspots. Despite CDC recommendations for universal prenatal screening (with repeat testing for high risk women), pandemic related healthcare disruptions exacerbated the crisis. The authors advocate for resource allocation akin to successful perinatal HIV prevention strategies to curb congenital syphilis, emphasizing its preventability through timely maternal diagnosis and treatment.

This correspondence reports a concerning rise in congenital syphilis cases among U.S. infants born in 2020, with 2,022 cases reported as of July 2021 the highest count since 1994. The cases, spanning 47 states and D.C., included 139 syphilis related deaths (6.9%). The increase reflects untreated syphilis in women and geographic spread beyond traditional urban and Southern hotspots. Despite CDC recommendations for universal prenatal screening (with repeat testing for high risk women), pandemic related healthcare disruptions exacerbated the crisis. The authors advocate for resource allocation akin to successful perinatal HIV prevention strategies to curb congenital syphilis, emphasizing its preventability through timely maternal diagnosis and treatment.