2023
Congenital Syphilis Update, Information and Recommendations for Providers
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 72% in New Jersey since 2019. For
infectious stages of syphilis (primary (e.g., chancre) and secondary (e.g.,
rash)), reported cases have increased 62% since 2019. Cases of congenital syphilis have increased
227% (15 cases in 2019 to 49 cases in
2022).
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 (28-32 weeks) 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 all 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/
This information has been broadcast to: First Responders/Emergency Medical Services; Health Care Facilities/Other; Health Care Providers; Hospitals/Acute Care; Hospitals/Other; Hospitals/Veterans; Labs/Non-Sentinel; LINCS Epidemiologist; LINCS Coordinator; LINCS Health Officer;