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Congenital Syphilis among Newborns -- Texas, 1981

Thirty-seven cases of congenital syphilis were reported among newborns in Texas during 1981. An increase of 164% over the 14 cases reported in 1980, this represents the highest number since 1971 when 52 cases were reported. Reported cases of early syphilis among women in Texas increased 47.3% from 2,024 in 1980 to 2,982 in 1981.

Data submitted with each congenital syphilis case were reviewed, and cases were classified according to the diagnostic criteria of Kaufman et al. (1). No case was classified as definite; 25 (67.6%) were classified as probable, based on serologic evidence and clinical findings; eight (21.6%) as possible, based on serologic evidence alone; and four (10.8%) as unlikely. The unlikely cases for which the diagnosis appeared to be based solely on evidence of maternal infection at delivery time have been excluded from the analysis that follows.

Of 33 infants evaluated, five (15.2%) were white, not of Hispanic origin; 16 (48.5%) were black, not of Hispanic origin; and 12 (36.4%) were Hispanic. Fourteen were male and 19, female. Thirty-one were live births, and two were stillborn. Two infants died within 6 days of delivery; prematurity was listed as contributing to both deaths.

The mean age of the 33 mothers was 21.7 years. Ten (30.3%) were 15-19 years; none of those was married. Among all 33 mothers, seven were married; three were separated; and 23 were single. The stage of the mother's infection at delivery time was primary or secondary in eight instances (24.2%) and early latent 1 year in 23 (69.7%); two patients (6.1%) had late syphilis.

Twenty-five of the 33 mothers received no prenatal care. Of the eight who received prenatal care, five began seeing a physician late in the third trimester, and three who had negative results of serologic tests for syphilis (STS) during the first trimester did not have a repeat STS in the third trimester. Reported by R Pelosi, Infectious Disease Control Div, CD Alexander, MD, Bureau of Communicable Disease Svcs, CR Webb, Jr, MD, State Epidemiologist, Texas Dept of Health; Veneral Disease Control Div, Center for Prevention Svcs, CDC.

Editorial Note

Editorial Note: Congenital syphilis is completely preventable. Its development can be related to two factors: when the pregnant woman becomes infected and how long she remains infected. Detection of untreated syphilis before delivery and prompt administration of appropriate therapy can often prevent congenital infection and can usually prevent complications among fetuses infected in utero.

Congenital syphilis can be eliminated or greatly reduced by: 1) preventing the spread of syphilis in the heterosexual community through rapid and thorough epidemiologic investigations; 2) educating females at risk of infection about the need to seek early and continuous prenatal care; and 3) encouraging medical care providers to perform serologic tests for syphilis on patients in the third, as well as the first, trimester.

References

  1. Kaufman RE, Jones OG, Blount JH, Wiesner PJ. Questionnaire survey of reported early congenital syphilis: problems in diagnosis, prevention, and treatment. Sex Transm Dis 1977;4:135-9.



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