Risks of Congenital Syphilis to Babies – S2 E10

[00:00:00] Jessica Stewart Gonzalez: Welcome to The Parenting Brief. I’m your host, Jessica Stewart-Gonzalez, an Arizona working mom and Chief of the Office of Children’s Health at the Arizona Department of Health Services. On this podcast, we talk about how to take care of your little ones and yourself. If you’ve been feeling overwhelmed or just looking for parenting tips,

[00:00:25] you’ve come to the right place.

[00:00:34] Thank you for tuning in to this episode of The Parenting Brief. One of the best ways we can keep our kiddos safe is by keeping ourselves safe and healthy. That means regular doctors’ visits, checking in with yourself and noticing if anything feels off. Recently, there’s been an uptick of syphilis cases in Arizona, rising at an even higher rate for women. Syphilis not only impacts your health, but for people who can get pregnant, [00:01:00] it impacts the fetus as well. Knowing how to detect syphilis, understanding how it spreads and what you can do to protect yourself is important for you and your baby. Luckily, there is a treatment plan if you are someone you know is experiencing symptoms.

[00:01:15] We have everything you need to know up next

[00:01:23] With us today is Bree Anderson. Bree is an epidemiologist with the Center for Disease Control. Thank you for joining us, Bree.

[00:01:31] Bree Anderson: So happy to be here.

[00:01:33] Jessica Stewart Gonzalez: I think we should start with the basics. What is syphilis and how does it spread?

[00:01:39] Bree Anderson: Yeah, so syphilis is spread when you come into contact with another person’s syphilis sore or lesions. The first symptom is gonna be a painless lesion that appears at the site of exposure, and from there, the symptoms may temporarily go away or they might overlap with the next stage. [00:02:00] The next stage can include multiple sores, a body rash, a rash on the palms of the hands or soles of the feet, and hair loss and flu-like symptoms. Since the infectious symptoms typically appear on intimate parts of the body, it’s usually passed through sex, including anal and oral sex.

[00:02:20] In the case of oral sex, the painless lesion may appear on the mouth, so coming into physical contact, for example, kissing with that mouth lesion could be enough to pass the infection.

[00:02:34] Jessica Stewart Gonzalez: What is the most effective way to prevent syphilis from spreading?

[00:02:38] Bree Anderson: So since the symptoms of syphilis are super subtle, testing and treatment are two important strategies for preventing spread within a community. Ideally, if we can identify the infection and provide treatment for all partners, then we can disrupt transmission. You’re at higher risk for infection if you’re having sex with multiple partners, or [00:03:00] you might only have one sex partner, but your partner has sex with other people. That can also put you at risk for becoming infected.

[00:03:08] You’ll also be at higher risk of getting syphilis if you don’t feel safe talking about how to reduce risk, things like using condoms with your partner. A good strategy for protecting yourself from STIs is to get tested for them in between partners before having sex with a new partner.

[00:03:27] Jessica Stewart Gonzalez: So can pregnant people pass syphilis to their fetus? And how does that impact the fetus?

[00:03:33] Bree Anderson: Yes, pregnant people can pass the syphilis infection to the developing fetus. And syphilis can be deadly for babies. A syphilis infection can put the mother and baby at risk for having a miscarriage, stillbirth, or even infant death. Babies may look healthy at delivery, but go on to develop lots of health problems, including hearing problems, vision problems, and problems with their brain and development if they have an [00:04:00] infection that’s left untreated. Most of these complications will occur within the first two years of life.

[00:04:06] Jessica Stewart Gonzalez: What is the treatment for syphilis? Can you receive treatment while pregnant?

[00:04:11] Bree Anderson: The treatment for adult syphilis is the same for pregnant persons as it is for nonpregnant persons, and yes, you can receive treatment while you’re pregnant.

[00:04:20] The caveat for treatment is that there is no alternative therapy available for pregnant persons. The only approved treatment for pregnant persons is an injection that can be painful, but it is a life saving medication that will protect the pregnant person and their unborn baby. For pregnant persons you can often prevent poor outcomes for syphilis if you initiate treatment more than 30 days prior to delivery. Even if that window is missed, treatment is still really important and can prevent further health complications.

[00:04:53] Jessica Stewart Gonzalez: Is the treatment the same or different for infants who are born with congenital syphilis?[00:05:00]

[00:05:00] Bree Anderson: So infant treatment is super effective at halting the progression of the infection. So babies that are exposed to syphilis receive preventative treatment for the exposure, and infants with congenital syphilis will require 10 days of in-hospital treatment.

[00:05:17] Jessica Stewart Gonzalez: When someone completes the treatment, are they free and clear? Or is it something that has to be continuously monitored?

[00:05:25] Bree Anderson: If an adult is diagnosed with syphilis and receives proper treatment, they will be cured of the disease, but they will likely always test positive for syphilis. At diagnosis, the provider should run two different types of tests. One of the tests is going to include a number that the provider can monitor the treatment response, or to determine if the patient has been reinfected with syphilis.

[00:05:51] After treatment, the provider will likely monitor your test results to ensure that your infection has been cleared. Someone who has [00:06:00] syphilis once is likely to be reinfected with syphilis that they already exposed. So annual screening is always a good idea.

[00:06:07] Jessica Stewart Gonzalez: So for an infant that is born with congenital syphilis and treated, can any of the negative health impacts be reversed or go away?

[00:06:17] Bree Anderson: For a baby that’s born with syphilis and receives treatment, the negative impacts can be stopped with treatment, but they cannot necessarily be reversed. This is why it’s so important to get screened early in pregnancy and initiate treatment quickly, if you do test positive.

[00:06:35] Jessica Stewart Gonzalez: How does access to prenatal care play a part in managing the rise in cases and do pregnant people who regularly visit their doctor have better outcomes?

[00:06:46] Bree Anderson: Prenatal care plays a huge role in preventing syphilis, and those who are in prenatal care have better outcomes due to routine access to testing and being able to receive treatment. If they do test positive. [00:07:00] Prenatal care is a really great touch point with a provider who can and should order syphilis testing because the symptoms of syphilis can easily go unnoticed.

[00:07:08] You have to look for these infections through routine screening. Syphilis screening should be done by the provider during pregnancy. Testing for syphilis requires a blood test, so if the provider didn’t take a blood sample, then syphilis testing was not completed. Treatment can also be super tricky to navigate depending on the stage of diagnosis.

[00:07:30] Some patients may need to receive three injections at one week intervals if they have to travel a long distance for care. This can make completing treatment very difficult. If you have a missed or delayed dose, then you have to restart the treatment from the beginning. Many prenatal providers have this treatment on hand, and if they don’t, they can order it or they can also refer the patient to the county clinic for treatment.

[00:07:54] Jessica Stewart Gonzalez: So are there resources for people who want or need to be tested and or treated? And how can [00:08:00] people learn more?

[00:08:01] Bree Anderson: So, a really great place to start is your primary care provider, they will be able to screen you for syphilis. You can ask them to test you at your next appointment, and don’t forget to ask about the results of your test In Arizona, prenatal providers are required by law to test at first prenatal visit early in the third trimester, and again at delivery. If you are pregnant and aren’t sure if you’ve been tested, you can ask your prenatal care provider. If you’re looking for a testing location near you, GetTested.CDC.gov is a great resource for finding a location for free or low cost testing in your area.

[00:08:41] You can also contact your local health department for testing options that might be closer to you. And then lastly, we always like to end with this. You’re always welcome to reach out. If you have additional questions, you can send us an email [email protected], or you can our [00:09:00] website azdhs.gov/sti.

[00:09:05] Jessica Stewart Gonzalez: Well, thank you for sharing your insights with us today.

[00:09:08] Bree Anderson: For sure. It’s been great to be here.

[00:09:18] Jessica Stewart Gonzalez: We have parent health resources and more information on congenital syphilis in the show notes. Don’t forget to follow us wherever you listen to podcast. To stay up to date on the latest family health information and parenting tips. While you’re on that page, please send this episode to family and friends. Until next time, this is Jessica. You’ve got this.