Alerts:  Nov. 12, 2024: Pertussis (whooping cough) outbreak confirmed in Spokane County. SRHD urges parents and pregnant people to vaccinate. Read the press release.

Syphilis Alert for Healthcare Providers

Increase in Syphilis & Congenital Syphilis

Posted Jan. 31, 2024. Past health advisories and alerts are archived for historical purposes and are not maintained or updated.

Situation

Two cases of congenital syphilis have been reported in the first three weeks of 2024. In both cases, the mothers were not tested for syphilis until they were admitted for delivery, although there were opportunities for testing earlier in pregnancy in both cases.

Congenital syphilis is a devastating disease that can result in stillbirth, neonatal death, or severe long-term health outcomes for the infants. Congenital syphilis is also preventable through early detection and treatment of maternal syphilis infections. It is essential that all healthcare providers follow state and local screening recommendations for pregnant patients to combat congenital syphilis in our community.

Rates of acquired syphilis continue to rise in Spokane County. Preliminary data for 2023 indicate a 50% increase in primary and secondary syphilis from 2022, when 125 cases were reported.


Requested Actions

  • All pregnant patients should be tested for syphilis in the following circumstances:
    • At presentation to any healthcare facility (urgent care, ED, jail, substance use treatment facilities) during pregnancy when prenatal care status is unknown.
    • At initial prenatal visit (required by RCW 70.24.090).
    • At the time of 3rd trimester laboratory testing (24-28 weeks gestation).
    • Fetal demise occurs at or after 20 weeks gestation.
  • Additional screening should occur at delivery if patients have any of the following risk factors:
    • Diagnosis of any STI, including new onset of HSV, during pregnancy.
    • Substance use.
    • Unhoused or unstably housed.
    • Engaging in transactional sex.
    • History of incarceration in the last 2 years.
  • Hospital facilities are encouraged to screen ALL patients at the time of delivery if risk cannot be easily determined or if 3rd trimester screening was not completed during prenatal care.
  • All sexually active individuals are at risk for acquiring syphilis and should be tested annually. Additional screening, up to every 3 months, should be offered to those with any of the risk factors listed above.
  • Add syphilis testing to your typical STI screening panel.
  • Patients being tested for gonorrhea and chlamydia should also be tested for
    syphilis and HIV.
  • Be familiar with the common symptoms of primary and secondary syphilis and have a low threshold of suspicion for syphilis if patients have rashes, oral or genital lesions, or wart-like growths in the rectal/genital area.
  • Report all syphilis cases using our Confidential STD Case Report. The latest version can be found on our website: STD Case Report Form; please discard any previous versions of this form.

Resources