The St. Louis region has long grappled with high rates of sexually transmitted infections, but an uptick in syphilis among women of child-bearing age is drawing the concern of public health officials.
In Missouri, 10 cases of congenital syphilis — when the infection is transmitted in the womb — were reported last year. That’s up from just two cases in 2015. Syphilis is treatable with penicillin, but can cause miscarriages, stillbirth and serious health problems if pregnant women do not receive medical care quickly. Men, however, make up the vast majority of cases.
“Congenital syphilis is one of those things that should not be happening in 2017,” Dr. Faisal Khan, St. Louis County health director, said in a meeting Wednesday with state health officials.
Dr. Randall Williams, director of the state's Department of Health and Senior Services, said the statistics made him realize that STI prevention should be part of a women’s health care initiative he is planning to pursue. Before a controversial year-and-a-half as a public health director in North Carolina, Williams worked as an OB-GYN physician in Raleigh.
“We have 67 counties [in Missouri] without obstetricians and gynecologists,” Williams said. “We just think that needs to be an imperative for us, to get more availability and access so those kinds of interventions can take place.”
Nine of Missouri’s 10 congenital syphilis cases occurred outside the St. Louis region last year. But cases of sexually transmitted syphilis in the city of St. Louis and St. Louis County were higher than usual in the first three months of 2017.
Members of the STI Regional Response Coalition are recommending that doctors test for syphilis three times during a pregnancy.
“The rates in St. Louis are of high enough concern to warrant universal third trimester testing for syphilis in pregnancy, as well as testing at delivery,” said Dr. Hilary Reno, medical director of the St. Louis County STD Clinic. “The sooner they have treatment, the better.”
Because congenital syphilis is rare, it's hard to judge if Missouri's uptick is an anomaly. In 2015, the Centers for Disease Control and Prevention released a study to show that while congenital syphilis rates declined between 2008 and 2012, the rate rebounded to nearly 12 cases per 100,000 live births in 2014.
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