What is Congenital Syphilis?
Congenital syphilis is a severe, disabling, and often life-threatening infection seen in newborns. It occurs when
syphilis bacteria, Treponema pallidum, are transmitted from an infected mother to her baby during pregnancy. This transmission can happen at any stage of syphilis, but the risk is highest when the mother has primary or secondary syphilis. Early diagnosis and treatment are crucial to prevent severe complications or fetal loss.
How is Congenital Syphilis Transmitted?
The transmission of syphilis from the mother to the fetus occurs via the placenta. If a pregnant woman has
untreated syphilis, the bacteria can cross the placental barrier and infect the fetus at any stage of pregnancy. The most critical period of transmission is during the second half of pregnancy when fetal development is more advanced.
What are the Symptoms of Congenital Syphilis?
Babies with congenital syphilis can present with a wide range of
symptoms or may even be asymptomatic at birth. However, if left untreated, they may develop manifestations within the first few weeks to months of life. Symptoms include:
Rashes on the skin, especially on the palms of the hands and soles of the feet
Nasal discharge, often bloody
Bone deformities
Enlarged liver and spleen
Jaundice
Anemia
Lymphadenopathy
Long-term complications can include hearing loss, dental deformities, and neurologic impairment.
How is Congenital Syphilis Diagnosed?
Diagnosis of congenital syphilis involves a combination of maternal and newborn testing. Pregnant women are routinely screened for syphilis using serologic tests. If a mother is diagnosed with syphilis during pregnancy, further evaluation and testing of the newborn are required. For the infant,
testing may include:
Physical examination
Serologic tests (VDRL, RPR, or treponemal tests)
CSF analysis to rule out neurosyphilis
Radiographic studies of bones
How is Congenital Syphilis Treated?
The cornerstone of treatment for congenital syphilis is
penicillin, which remains highly effective. Treatment regimens depend on the age of the infant and the severity of the disease. For infants less than 30 days old with proven or highly probable congenital syphilis, a 10-day course of intravenous penicillin G is typically administered. Early treatment can prevent most complications of the disease.
How Can Congenital Syphilis be Prevented?
Preventing congenital syphilis involves a multi-faceted approach focusing on early detection and treatment of syphilis in pregnant women. Key prevention strategies include: Routine prenatal screening for syphilis in all pregnant women
Early treatment for women diagnosed with syphilis during pregnancy
Partner notification and treatment to prevent re-infection
Public health campaigns to raise awareness about the importance of prenatal care
What are the Public Health Implications?
Congenital syphilis is a preventable condition, yet its incidence is rising in many parts of the world, including the United States. This increase reflects broader issues in public health, such as access to care, health disparities, and the need for improved
public health interventions. Efforts to reduce congenital syphilis require coordination between healthcare providers, public health officials, and community organizations to ensure comprehensive care for all pregnant women.
