You don’t hear much about syphilis these days. It seems as if other infectious diseases have taken over the limelight recently—Zika, for example. Yet as important as it is to be informed about new public health threats, many of the “old” ones are unfortunately alive and well and syphilis is certainly no exception.
Syphilis, in fact, is an infection that is on the rise. This is despite the fact that a good treatment has been available for decades. And the treatment hasn’t lost effectiveness due to resistant germs, as is true for so many other types of infection.
So…if we’ve known about syphilis for a while, and there are good treatments, why is there such a problem? And what does it have to do with babies? To answer that, it’s worth having a brief review of the disease.
Syphilis is caused by a type of bacteria known as a spirochete. While this germ is not easy to pick up, it can be spread by intimate sexual contact. Unfortunately, an infected person may not show too many symptoms after being exposed. There may be sore at the place where the germ entered in a few weeks. A few months later, an untreated person may have a rash, fever, headache, sore throat, or swollen glands. However, only 25 percent of people have symptoms at this stage, and that initial sore may easily be missed.
Untreated syphilis threatens the health of infected adults. However, a pregnant women faces special risks. Her unborn baby is a target for syphilis infection. If an infected mother is not treated early, her baby may be born with what is known as congenital syphilis.
Although some newborns with congenital syphilis have no symptoms at all, the germ can affect many different body systems: the heart, lungs, liver, kidneys, eyes, ears, bones and brain are just a partial list. While some of the complications are treatable, others are less easily reversed. And a syphilis infection can lead to premature birth or even stillbirth.
Even babies who appear to have no symptoms, but are infected with the bacteria, are at risk for complications. The most serious of these involve the eyes, ears, brain and bones.
So…How Can We Prevent This?
Syphilis is treatable with penicillin. Depending on circumstances such as the length of time of illness, both mother and infant can be treated either with a single shot, or with several days’ worth of medicine through the vein. But in order to treat the infection, we have to find it first! This is one reason for every pregnant woman to get early prenatal care.
Usually at an early prenatal visit, the obstetrician will perform a blood test for syphilis. The most common types of screens for the disease are known as RPR and VDRL. While these are not specific, they are quickly and easily done and not very expensive. If one of these test is positive, a more specific test for the syphilis antibody is done. In any case, all pregnant women need to have the test done.
Women who have not had prenatal care are tested at delivery. Your newborn’s provider in the hospital needs to know the result before sending the baby home. For this reason, women whose result is not available (for instance, if they received prenatal care from a provider not affiliated with the hospital) are often retested.
If a mother has had a positive test or treatment for syphilis, the newborn will have tests performed. This involves drawing blood, and may involve looking at other body systems by doing an x-ray of the chest or bones and/or performing a spinal tap. The provider will then check the newborn’s results, compare them with the mother’s and decide what treatment, if any, is necessary.
But Can I Avoid Getting Infected?
Yes! The methods of avoiding syphilis are similar to those used to avoid all sexually transmitted diseases. You can reduce your risk by:
- Being in a monogamous (one-partner) relationship with someone known to not be infected
- Practicing safe sex. For most types of activity that generally means knowing how to use a condom.
- Undergoing regular screens for syphilis, particularly if you have multiple partners or if your regular partner changes
We’ve known how to treat syphilis and prevent complications for a long time. No infant should have to suffer the complications of congenital syphilis. It’s important to have conversations with both your health care provider and your partner regarding ways of reducing your risk and keeping both you and your baby healthy.