Health officials gather in Fresno for syphilis-prevention meeting

The majority of women giving birth to babies with syphilis are very poor, homeless and using drugs, a state health official said Wednesday at a meeting in Fresno of county health officials from throughout California.

Cases of congenital syphilis are not “drawn along race or ethnic lines but along economic lines,” said Dr. Heidi Bauer, chief of the Sexually Transmitted Disease Control Branch at the California Department of Public Health.

But beyond that demographic, cases of syphilis and what’s driving an increase in babies infected with the disease can vary by county, Bauer said.

An overall increase in syphilis cases in California has alarmed health officials. From 2012 to 2014, the annual number of early syphilis cases in women more than doubled from 248 to 594. And more disturbing: Reported cases of the disease being transmitted from an infected mother to a child during pregnancy (congenital syphilis) more than tripled from 30 to 100. The central San Joaquin Valley has some of the highest rates of congenital syphilis, which made Fresno a logical place for a statewide prevention meeting.

Between 2012 and 2014, congenital syphilis cases increased from five to 24 in the Valley, according to state statistics in infants. Of the 24 cases in 2014, 18 were in Fresno County, four were in Tulare County and two were in Kings County. Fresno County had the second-highest rate of congenital syphilis at 110.9 per 100,000 live births, behind only Kern County’s rate of 121.1.

Substance abuse among women may be a factor in higher numbers of infections. And homelessness is an increasing problem in some counties that is making it harder for public health workers to provide treatment to women who are identified with syphilis, Bauer said. “They move around and it’s hard to track them.”

Denise Smith, director of disease control for Kern County, said one factor that could be contributing to her county’s high rate of congenital syphilis is more people having anonymous sex through social media hook-ups. The casual sex makes it harder for public health workers to track partners of infected individuals for screening and treatment, she said.

Syphilis cases are becoming harder to investigate, agreed Dr. Kenneth Bird, health officer for Fresno County.

Nationally, an increase in congenital syphilis cases between 2012 and 2014 mirrors what has been seen in California, said Sarah Kidd, a medical epidemiologist at the federal Centers for Disease Control and Prevention who attended the meeting. There’s no clear common denominator for the nationwide increase, Kidd said. “And even in California, there might be different things going on.”

Public health officials can benefit from sharing prevention, screening and treatment strategies, and the 70 public health officials gathered Wednesday told Bauer they want state help to communicate with each other. She said the state can disseminate information: “I’ve heard today that having information about what’s happening in surrounding jurisdictions is important.”

Congenital syphilis cases can be prevented if the mother is diagnosed and treated and the baby is evaluated and treated. Under health guidelines, doctors should screen pregnant women three times during pregnancy – at the initial prenatal visit, early during the third trimester of pregnancy and at delivery.

“Any baby born with syphilis is a very bad thing,” said Dr. Michael Maclean, health officer for Kings County. “The expected number is zero.”

This story was originally published September 2, 2015 at 7:29 PM with the headline "Health officials gather in Fresno for syphilis-prevention meeting."