Neonatal syphilis increasing More babies are being born with infection

Infant dies in Balto. Co.

Health officials warn area doctors to be vigilant

June 15, 1996|By Diana Sugg | Diana Sugg,SUN STAFF

Sixteen babies have been born with syphilis, and one has died from the infectious disease, after an outbreak among adults that started several months ago in the Baltimore area.

The increase in congenital syphilis is blamed on three factors:

* A failure of the men and women infected and their health care providers to recognize the disease.

* Delayed reporting of confirmed syphilis cases to local public health officials.

* A rise in high-risk behavior such as unprotected sex and illicit drug use, particularly the crack-for-sex trade.

Health officials from Baltimore, Baltimore County and the state yesterday warned the public, health care providers and hospitals to be alert for syphilis, which can easily mimic other conditions. Workers are visiting all high-volume prenatal care and labor and delivery facilities to deliver the message, and labs are being reminded to report positive blood tests on syphilis to local health departments within 48 hours.

"We want to remind people that syphilis is back," said Dr. Peter Beilenson, city health commissioner. "This is one of those cases where public health can make a difference. This is not just in the city."

In Baltimore County, four cases, including the death, have been identified, said Dr. Michelle A. Leverett, Baltimore County health officer. Of the remaining three, one baby has hydrocephalus, or excess fluid in the brain, which can cause neurological and developmental problems. A second baby has signs of bone damage. A third baby has no symptoms yet, Leverett said.

If the rate of infection among newborns continues, cases of congenital syphilis in the Baltimore metropolitan area for 1996 will be triple last year's 12 cases.

The disease is spread through sexual contact, or from mother to fetus through the placenta. Symptoms in adults include painless rashes on the hands, face and genital areas. Women in particular may have undetected syphilis infections. If caught early, syphilis can be treated with penicillin and cured, but people can catch it repeatedly. If untreated, it can damage vital organs, including the heart and brain.

In pregnancy, the disease can cause miscarriages or stillbirths. Newborns can suffer jaundice from liver infection, or severe pain from bone infection. Some may have rashes, but others may not have any visible symptoms, said Dr. Diane Matuszak, deputy director of community health surveillance at the state Department of Health and Mental Hygiene.

A 10-day dose of intravenous penicillin will cure the baby, she said.

State law requires that pregnant women be screened for syphilis at their first prenatal visit, and again at the beginning of the third trimester. But some physicians apparently have been assuming that the results of the screening tests are false positives, and haven't done the definitive lab work, health officials said.

"They are testing the mothers, but they might get a positive syphilis test and not believe it," Leverett said. "Some providers may feel she doesn't fit the profile."

Those at highest risk to contract the disease are people who have unprotected sex, multiple sex partners, or use injection drugs or have partners who use injection drugs. Health officials said that any woman who arrives at a hospital in labor with little or no prenatal care needs a syphilis test.

In two of the four Baltimore County cases, the mother did have prenatal care, and had symptoms, but the physicians did not diagnose the syphilis, Leverett said.

From 1994 to 1995, the number of syphilis cases in Baltimore City soared by 83 percent, to 351. Besides the way the increase in syphilis cases is translating into infections among newborns, Beilenson said he fears that the spread in syphilis will foreshadow a rise in AIDS cases. That is because people with syphilitic lesions are more likely to get the virus that causes AIDS or infect their sex partners.

Pub Date: 6/15/96

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