2022
Congenital Syphilis Update, Information and Recommendations for Providers
Date: July 12, 2022
Public Health Message Type: Advisory, Update
Counties Effected:
All
Intended Audience: Healthcare providers, All public
health partners, local health departments
Contact: Amelia Hamarman, STD Program amelia.hamarman@doh.nj.gov
Message: New Jersey
continues to see alarming increases in cases of early syphilis, syphilis in
women and congenital syphilis. In
response, NJ DOH is recommending additional testing precautions for pregnant
patients throughout New Jersey.
Total
reported syphilis cases have increased by 63% in New Jersey since 2019. For
infectious stages of syphilis (primary (e.g., chancre) and secondary (e.g.,
rash)), reported cases have increased 46%.
Cases of congenital syphilis have increased from 15 cases in 2019 to 49
cases in 2021.
N.J.A.C.26:4-49.4 requires a physician who treats a
patient for pregnancy to conduct syphilis testing at the first prenatal visit
and at the time of delivery. The NJ DOH supports
the joint recommendation from the Centers for Disease Control and Prevention
(CDC) , the American
College of Obstetricians and Gynecologists (ACOG) and the American Academy of
Pediatrics (AAP) for additional syphilis screening early in the third trimester for patients at increased risk for
syphilis, which includes those living in higher-prevalence geographic areas. Given the historical increases in syphilis
cases throughout New Jersey, the NJDOH is recommending additional third
trimester screening for all pregnant patients. Specifically, NJ DOH is recommending that physicians
offer syphilis testing to pregnant patients:
·
At
their first prenatal visit
·
Early
in the third trimester of pregnancy (about 28 weeks gestation)
·
At
time of delivery of an infant
·
At
time of fetal death after 20 weeks gestation
A complete
syphilis test includes BOTH an RPR and a specific treponemal (e.g. FTA. TPPA)
test. Please work with your IT team to ensure
that EHR lab orders are coded properly to include “reflex to confirmatory”. Delaying
confirmatory testing can create delays to treatment as well as increased spread
of disease. For assistance interpreting
results, reporting treatment, or other concerns, please call the NJ DOH STD
Program at 609-826-4869.
Resources and
Information:
Syphilis testing and treatment https://www.cdc.gov/std/treatment/default.htm
Syphilis Pocket Guide for Providers
https://www.cdc.gov/std/syphilis/Syphilis-Pocket-Guide-FINAL-508.pdf
CDC Congenital Syphilis Page https://www.cdc.gov/std/syphilis/stdfact-congenital-syphilis.htm
NJDOH Congenital Syphilis Site http://www.nj.gov/health/hivstdtb/stds/congenital_syphilis.shtml
NJ
STD Reporting Requirements http://www.nj.gov/health/hivstdtb/stds/
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