Post by account_disabled on Feb 25, 2024 16:35:22 GMT 10
Catherine Sweeney, WPLN | (TNS) KFF Health News When Stephen Miller left his primary care practice to work in public health a little less than two years ago, he said, he was surprised by the number of syphilis cases the clinic was treating. For decades, rates of sexually transmitted infections were low. But the Hamilton County Health Department in Chattanooga, a medium-sized city surrounded by national forests and nestled in the Appalachian foothills of Tennessee, was seeing several syphilis patients a day, Miller said. A nurse who had worked at the clinic for decades told Miller that the surge of patients was a radical departure from the norm. What Miller observed in Chattanooga reflects a trend that is ringing alarm bells in health departments across the country. Nationally, syphilis rates are at their highest level in 70 years. The Centers for Disease Control and Prevention said Jan. 30 that 207,255 cases have been reported in 2022, continuing a sharp five-year increase. Between 2018 and 2022, syphilis rates increased by around 80%. The epidemic of sexually transmitted infections (especially syphilis) is “out of control,” the National Coalition of STD Directors said.
The increase has been even more pronounced in Tennessee, where infection rates for the first two stages of syphilis grew by 86% between 2017 and 2021. But this already difficult situation was complicated last spring by the shortage of a specific penicillin injection that is the gold standard treatment for syphilis. The current shortage is so severe that public health agencies have recommended that providers ration the drug, giving priority to pregnant Algeria Mobile Number List patients, since it is the only syphilis treatment considered safe for them. Congenital syphilis, which occurs when the mother transmits the disease to her fetus, can cause birth defects, miscarriages, and stillbirths. Nationwide, 3,755 cases of congenital syphilis were reported to the CDC in 2022, or 10 times the number a decade earlier, recent data show. Of those cases, 231 resulted in stillbirth and 51 in infant death. The number of cases in babies increased by 183% between 2018 and 2022. "Lack of timely testing and appropriate treatment during pregnancy contributed to 88% of congenital syphilis cases," said a CDC report published in November.
Testing and treatment gaps were present in the majority of cases across all races, ethnicities, and US Census Bureau regions." Hamilton County syphilis rates have mirrored the national trend, with cases increasing in all groups, including infants. In November, the maternal and child health advocacy organization March of Dimes released its annual report on state health outcomes. It found that, nationally, about 15.5% of pregnant people received care starting in the fifth month of pregnancy or later, or attended less than half of the recommended prenatal visits. In Tennessee, the rate was even worse, 17.4%. But Miller said even those who keep all recommended appointments may have problems because providers are required to test for syphilis only early in pregnancy. The idea is that if the test is done a few weeks before birth, there will be time to treat the infection. However, that recommendation depends on whether the provider suspects the patient was exposed to the bacteria that causes syphilis, which may not be obvious to people who say their relationships are monogamous. "What we found is that a lot of times their partner wasn't as monogamous and they brought that into the relationship," Miller said.
The increase has been even more pronounced in Tennessee, where infection rates for the first two stages of syphilis grew by 86% between 2017 and 2021. But this already difficult situation was complicated last spring by the shortage of a specific penicillin injection that is the gold standard treatment for syphilis. The current shortage is so severe that public health agencies have recommended that providers ration the drug, giving priority to pregnant Algeria Mobile Number List patients, since it is the only syphilis treatment considered safe for them. Congenital syphilis, which occurs when the mother transmits the disease to her fetus, can cause birth defects, miscarriages, and stillbirths. Nationwide, 3,755 cases of congenital syphilis were reported to the CDC in 2022, or 10 times the number a decade earlier, recent data show. Of those cases, 231 resulted in stillbirth and 51 in infant death. The number of cases in babies increased by 183% between 2018 and 2022. "Lack of timely testing and appropriate treatment during pregnancy contributed to 88% of congenital syphilis cases," said a CDC report published in November.
Testing and treatment gaps were present in the majority of cases across all races, ethnicities, and US Census Bureau regions." Hamilton County syphilis rates have mirrored the national trend, with cases increasing in all groups, including infants. In November, the maternal and child health advocacy organization March of Dimes released its annual report on state health outcomes. It found that, nationally, about 15.5% of pregnant people received care starting in the fifth month of pregnancy or later, or attended less than half of the recommended prenatal visits. In Tennessee, the rate was even worse, 17.4%. But Miller said even those who keep all recommended appointments may have problems because providers are required to test for syphilis only early in pregnancy. The idea is that if the test is done a few weeks before birth, there will be time to treat the infection. However, that recommendation depends on whether the provider suspects the patient was exposed to the bacteria that causes syphilis, which may not be obvious to people who say their relationships are monogamous. "What we found is that a lot of times their partner wasn't as monogamous and they brought that into the relationship," Miller said.