b'| INFECTIOUS DISEASE GUIDEIncreased Cases of STDs Create Numerous ConcernsNewborns, other populations atparticular riskBy Rob SeniorA t the end of 2019, the Center forCuts to STD programs at the state andWomen who are vulnerable to acquisition of Disease Control (CDC) releasedlocal levelin recent years, more thanSTDs or who live in high-prevalence areas information showing that combinedhalf of local programs have experiencedshould be tested again early in the third tri-cases of syphilis, gonorrhea, and chlamydiabudget cuts, resulting in clinic closures,mester and at delivery.reached an all-time United States high duringreduced screening, staff loss, and reducedThere are tools available to prevent every the previous year (2018), leading to numerouspatient follow-up and linkage to carecase of congenital syphilis, said Gail Bolan, unforeseen health consequences. services. M.D., director of CDCs Division of STD Perhaps the most tragic consequence?Prevention. Testing is simple and can help Newborn deaths as a result of congenitalTRAGIC CONSEQUENCES FORwomen to protect their babies from syphilis syphilis, up almost 25 percent during 2018NEWBORNSa preventable disease that can have irrevers-(from 77 deaths to 94 deaths.) A 40 percent increase in congenital syphilisible consequences.A breakdown of the three most commonlycases is the latest continuation of a dangerousThe national rise in congenital syphilis par-reported STDs, and their increase during thetrend seen in recent years. While many statesallels increases in syphilis among women of year 2018: reported at least one case of congenital syph- reproductive age. From 2017 to 2018, syphi-There were more than 115,000 syphi- ilis, five statesTexas, California, Florida,lis cases increased 36 percent among women lis cases. Arizona, and Louisianaaccounted for 70of childbearing age. Addressing rising syphilis The number of primary and second- percent of cases in the U.S. incidence is critical to prevent congenital syph-ary syphilis casesthe most infec- STDs can come at a high cost for babies andilis. Women can protect themselves by prac-tious stages of syphilisincreased 14other vulnerable populations, said Jonathanticing safer sex, being tested for syphilis by a percent to more than 35,000 cases, theMermin, M.D., M.P.H., director of CDCshealth care provider, and if infected, seeking highest number reported since 1991. National Center for HIV/AIDS, Viral Hepatitis,treatment immediately and asking her partner Among newborns, syphilis casesSTD, and TB Prevention. Curbing STDs willto get tested and treated to avoid reinfection.increased 40 percent to more thanimprove the overall health of the nation andCDC continues to work on numer-1,300 cases. prevent infertility, HIV, and infant deaths. ous fronts to address the nations STD epi-Gonorrhea increased 5 percent to moreWhile antibiotics are available to sure alldemic, providing resources to state and local than 580,000 casesalso the highestthree of the most common STDschlamydia,health departments for STD prevention and number reported since 1991. syphilis, and gonorrheawhen left untreated,surveillance. CDCs current funding pro-Chlamydia increased 3 percent to moreSTDs can and will be transmitted to others,gram for health departments, Strengthening than 1.7 million casesthe most everproducing adverse health outcomes includingSTD Prevention and Control for Health reported to CDC. infertility, ectopic pregnancy, and increasedDepartments, supports several high-priority Factors driving the uptick risk of HIV transmission. Congenital syphilisstrategies and activities, including eliminat-Not surprisingly, experts havent identified syphilis passed from a mother to her babying congenital syphilis. As part of this pro-a single factor responsible for the increase induring pregnancycan lead to miscarriage,gram, CDC supports health departments in STDs. Some areas of concerns for the CDC,stillbirth, newborn death, and severe lifelongconducting disease investigations, responding however, include:physical and neurological problems. to public health outbreaks, providing training Drug use, poverty, stigma, and unsta- Early prenatal care and STD testing arefor health care providers, community engage-ble housing, which can reduce access toessential with each pregnancy to safeguardment and partnerships, and other efforts.nSTD prevention and care. mothers and their babies from the dangers of Decreased condom use among vulnera- syphilis. CDC recommends syphilis testingFor a thorough listing of statistics pertaining to ble groups, including young people andfor all pregnant women the first time they seethe growing STD crisis in the United States, visit ISTOCKgay and bisexual men. a healthcare provider about their pregnancy.https://www.cdc.gov/std/stats18/default.htmwww.elitecme.com |2020| INFECTIOUS DISEASE GUIDE 23'