January 18, 2023

Case of Congenital Syphilis in Maine

Syphilis rates in the United States (U.S.) have been increasing since 2012. From 2012 through 2021, the rate of syphilis cases increased by 224% in the U.S. and by 405% in Maine. In 2022, 112 cases of syphilis were reported in Maine, 20.5% of whom were women between the ages of 15 and 44 years (preliminary data).

Maine CDC recently received notification of a case of probable congenital syphilis (CS). This is the first case of CS reported in a Maine resident in nearly 30 years. In 2021, there were 2,677 cases of CS reported in the U.S., an increase of 702% from 2012. In 2021, the highest rates of CS were among birthing persons who were non-Hispanic American Indian or Alaska Native (364 cases per 100,000 live births), non-Hispanic Native Hawaiian or other Pacific Islander (221 cases per 100,000 live births), and non-Hispanic Black or African American (153 cases per 100,000 live births).

CS occurs when a pregnant person with syphilis passes the infection to the fetus during pregnancy. This can happen during any stage of syphilis and any trimester of pregnancy; the risk of transmission is highest if the pregnant person has been infected recently. Approximately 40% of babies born to persons with untreated syphilis can be stillborn or die from the infection as a newborn. CS can lead to preterm labor and newborn/childhood illness including hydrops fetalis; hepatosplenomegaly; rashes; fevers; failure to thrive; deformity of the face, teeth, and bones; blindness; and deafness. Adequate and timely treatment of syphilis in pregnant persons is 98% effective in preventing CS. During 2017 through 2021, the majority of missed prevention opportunities among persons delivering babies with CS in the U.S. were those with no timely prenatal care or syphilis testing (38% of cases) and those with timely syphilis testing but no adequate treatment of the pregnant person (34% of cases).

Advisory (PDF)