Topline
The state of Mississippi saw cases of congenital syphilis rise elevenfold between 2016 and 2022, a new study by University of Mississippi Medical Center researchers shows, contributing to an already high rate of infant illness and death in the state amid a dire rise in cases of the deadly disease that has echoed across the nation in recent years.
The University of Mississippi Medical Center.
Key Facts
The study out Wednesday says 367 infants in Mississippi—the poorest state in America—were hospitalized with undiagnosed congenital syphilis in the seven-year period studied, 92.6% of which were covered by Medicaid, 58% of which were from rural counties and 25% of which were born to mothers with a substance use disorder.
Researchers said the dramatic increase in the condition highlights the link between health, poverty and institutional racism in “fueling transmission of severe but preventable infections.”
More than 70% of the babies hospitalized with congenital syphilis were African American, though the number of white babies born with the disease increased 2,600% in the time studied, compared to a 1,029% increase among Black children.
Babies born with syphilis—which is passed on from the mother but completely preventable if she receives treatment early—were also more likely to be born prematurely or have very low birth weight, the study showed, and six of the babies diagnosed in the last four years of the study died from the condition.
Pockets of Ohio, Missouri and Minnesota have also seen a rise in congenital syphilis—Missouri last year reported the highest number of cases since 1994, cases in Minnesota increased 42% in 2022 and cases in Ohio rose 158% from 2019 to 2021.
Cases in Arizona, New Mexico, Louisiana and Texas have also risen, CNN reported, with cases in the South growing 432% between 2016 and 2021.
Big Number
324. That’s how many congenital syphilis cases were reported to the Centers for Disease Control and Prevention in 2012. By 2021, that number had risen to 2,677.
Key Background
Every case of congenital syphilis represents “multiple failures of the health system,” Dr. Ali Khan, dean of the College of Public Health at the University of Nebraska Medical Center, told CNN in March, and researchers have blamed a lack of funding for the prevention of sexually transmitted diseases, a shortage of qualified personnel in public health programs and sporadic health coverage for the rise in rates. Syphilis is a disease that can cause sores, rashes and damage to the brain, nerves, eyes or heart if left untreated. It’s usually transmitted through sexual contact and is almost always curable with penicillin. Syphilis can spread from a mother with the condition to her unborn baby, but treatment in the last 30 days before birth can usually stop transmission. Medicaid requires that all pregnant women be tested for syphilis in their first trimester, but testing later in pregnancy or at birth is largely left up to states, with varying policies. States that don’t allow childless adults who are not disabled to be covered by Medicaid—the male partner of a pregnant woman, for instance—have seen the biggest increases in congenital syphilis, per CNN. Wednesday’s study showed that a diagnosis of congenital syphilis increases the mean hospital stay of a newborn to 14.5 days from a standard 3.8-day stay, and hospital charges rise from a mean of $14,945 to $56,802. Between 2016 and 2022, medical costs in Mississippi for congenital syphilis were $20.8 million—$19.4 million of which was paid for by Medicaid.
Tangent
African Americans have long been disproportionately affected by syphilis, the CDC says, and as of 2018, 35% of reported syphilis cases were among Black people and the rate of congenital syphilis cases that same year was 6.4 times higher for Black people than white. The connection between race and the disease was exploited by the U.S. government for 40 years when the CDC and United States Public Health Service conducted the Tuskegee Syphilis Study on nearly 400 Black men. Researchers told participants they would be treated for their illness but they instead observed the effects of the disease when left untreated and provided the men with placebos and other ineffective methods. The study ended in 1972 and then President Bill Clinton in 1997 issued a formal apology on behalf of the nation. Victims of the Tuskegee study were given the equivalent of $68 million today following a 1974 lawsuit by the NAACP.
Further Reading
Syphilis Is Rising—And May Not Be Recognized (Forbes)
Penicillin Shortage Explained: Increased Syphilis Rates And Amoxicillin Shortage Fueled Crisis (Forbes)
Syphilis Cases In Women And Congenital Syphilis Skyrocket In Houston: Symptoms And How To Stay Safe (Forbes)