Syphilis Treatment for Pregnant Patients

Official Message No.:111820-7-13-2023-PHUP
Contact Info: Amelia |
Attachments: Yes Attachment 1

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

Syphilis Pocket Guide for Providers

CDC Congenital Syphilis Page

NJDOH Congenital Syphilis Site

NJ STD Reporting Requirements

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;