Fresno County ranks highest in California for newborns with syphilis for a second year in a row.
And the county is holding a meeting for baby doctors and other health providers who care for pregnant women on Wednesday to talk about what can be done to manage an unprecedented number of babies born with the STD.
The Fresno County congenital syphilis forum comes one day after the federal government reported that syphilis among newborns in the United States had reached a 20-year-high. California had the third-highest rate of infants with syphilis in 2017 at 57.5 cases per 100,000 live births. Louisiana had the highest rate at 93.4 and Nevada had the second-highest rate at 57.9.
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Cases of congenital syphilis – when syphilis is passed from mother to baby during pregnancy – more than doubled in the U.S. since 2013, outpacing overall increases in STDs nationwide, the Centers for Disease Control and Prevention said. Congenital syphilis can result in miscarriage, newborn death and severe lifelong health problems.
Fresno County has worked with the California Department of Public Health and the CDC to target congenital syphilis, adding resources beginning in 2016. This year the county added a social worker to provide case management to pregnant women who have syphilis, said Joe Prado, community health division manager at the Fresno County Department of Public Health. A public health nurse also has been assigned to provide help to the women.
In 2015, the county ordered doctors to screen for syphilis three times during pregnancy, and health providers are required to screen all pregnant women at the first prenatal visit, again early in the third trimester of pregnancy and again at delivery. But many of the congenital syphilis cases involve women who lack prenatal care because of homelessness, substance abuse or incarceration, Prado said. “Those are some of the maternal risk factors we’ve been observing in these cases,” he said.
The forum will allow the county and the California Department of Public Health to share data with the community and inform doctors about resources that are available to them to better support managing congenital syphilis, he said.
Syphilis can be easily cured with antibiotics, but Prado said Fresno County health providers were not treating women in their offices because of insufficient reimbursement from Medi-Cal, the state-federal insurance program for people of low income. The county began providing the antibiotic, Bicilin, to doctors for free two years ago, Prado said.
“Training our community to look for and treat syphilis has been a significant challenge during this epidemic,” he said.