OHA sounds alarm on congenital syphilis crisis, rising rates in rural Oregon
NIAID
OREGON — The Oregon Health Authority says congenital syphilis cases are rising across the state, according to preliminary data.
In a memorandum to Oregon healthcare providers on Wednesday, the OHA reported 45 congenital syphilis cases in 2024, compared to two cases in 2014 — a 2,150 percent increase over ten years. Congenital syphilis occurs when a fetus is infected with syphilis during pregnancy.
“Historically, congenital syphilis has occurred predominantly in the Portland-metro area,” says Dr. Peter Singson, Medical Director for the HIV, STI and Tuberculosis section of the Oregon Health Authority. “In the last few years, we’re seeing more and more rural and frontier counties also experiencing cases, as well, which is concerning to us.”
The latest published data from the Oregon Public Health Division shows a congenital syphilis incident rate of 669.3 for Curry County, 99.9 for Jackson County and 151.7 for Klamath County. The incident rate indicates new congenital syphilis diagnoses per 100,000 births. Cases are highest in Oregon among people ages 25 to 29 experiencing pregnancy.
The OHA also said the Tuskegee Syphilis Study — where Black men with syphilis were left untreated over a 40-year period so researchers could study the progression of the disease — has contributed to mistrust in the medical communities among Black Americans and other communities of color. The OHA said disparities within the syphilis epidemic are caused “by the compounded effects of systemic racism, poverty, houselessness, incarceration, substance use, and stigma.”
The OHA listed the following strategies to address the outbreak within Oregon:
- Universal screening and immediate treatment for syphilis in pregnancy
- Expanding syphilis screening
- Empiric treatment without delay (treatment before an exact cause is determined)
- Strengthening public health partnerships
- Reinforcing prevention strategies (i.e. condom use, doxycycline post-exposure prophylaxis [doxyPEP])
“We’re recommending that all providers that offer prenatal care screen their pregnant patients for syphilis at least 3 times during pregnancy,” Dr. Singson advises. “That’s at the very first prenatal visit, again at 28 weeks or sometime early in the third trimester and then once more when the patient presents for delivery.”
Another problem for healthcare providers and patients is that congenital syphilis can be hard to identify.
“A small round or oval lesion might be noted at the site of infection. Typically this lesion is painless, so it can be easily be written off as an ingrown hair or some kind of other lesion that’s not necessarily syphilis,” Dr. Singson tells NewsWatch 12. “If it goes untreated during the pregnancy, it can result in miscarriage, pre-term birth, growth abnormalities, and even still birth during the pregnancy. In newborns, it can affect nearly every organ system including the liver, the brain, the nervous system and it can cause abnormal bone development. Rarely, in a newborn it can actually be fatal.”
