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Re-emergence of Congenital Syphilis in Ohio

Cooper, Joshua M., MD*; Porter, Makeda, MSW; Bazan, José A., DO†,‡; Nicholson, Lisa M., PhD§; Sánchez, Pablo J., MD*,¶

The Pediatric Infectious Disease Journal: December 2018 - Volume 37 - Issue 12 - p 1286–1289
doi: 10.1097/INF.0000000000001995
Maternal-Neonatal Reports

Background: The recent occurrence of congenital syphilis in Columbus, OH, raised concern for an increase in syphilis among women and infants. The objectives were to examine the rates of syphilis among men, women and infants in Ohio from 2003 to 2016 and compare these rates to the rest of the United States.

Methods: This retrospective study evaluated cases of syphilis among men, women and infants from 2003 to 2016 using data from the Ohio Department of Health and the Centers for Disease Control and Prevention.

Results: In Ohio from 2003 to 2016, the number of all syphilis cases among women significantly increased from 153 (2.6/100,000) to 294 (5.2/100,000), respectively (b = 0.26; P = 0.001; 95% confidence interval [CI]: 0.137–0.382). From 2003 to 2016, congenital syphilis in Ohio also increased significantly from 3 (2/100,000) to 13 cases (9.3/100,000), respectively (b = 1.05; P ≤ 0.001; 95% CI: 0.687–1.408). The increase in congenital syphilis mirrored the increase in all cases of syphilis in women but not with the rates of primary and secondary syphilis. Among men, cases of primary and secondary syphilis increased significantly in Ohio and the rest of the United States, from 156 (2.8/100,000) and 5956 (4.2/100,000) in 2003 to 622 (10.5/100,000) and 24,724 (15.6/100,000) in 2016, respectively (Ohio: b = 0.55; P < 0.001; 95% CI: 0.426–0.679; United States: b = 0.77; P < 0.001; 95% CI: 0.629–0.916).

Conclusions: The association of congenital syphilis with all syphilis cases in women highlights the importance of reporting all cases and not just primary and secondary syphilis. The increase in congenital syphilis reinforces the recommendation for repeat maternal screening during pregnancy.

From the *Department of Pediatrics, Nationwide Children’s Hospital, The Ohio State University College of Medicine, Columbus, Ohio

Columbus Public Health, Columbus, Ohio

Division of Infectious Diseases, The Ohio State University College of Medicine, Columbus, Ohio

§Statistical Consulting, Nationwide Children’s Hospital, Columbus, Ohio

Divisions of Neonatology and Pediatric Infectious Diseases, Department of Pediatrics, Center for Perinatal Research, Nationwide Children’s Hospital, The Ohio State University College of Medicine, Columbus, Ohio.

Accepted for publication December 23, 2017.

Joshua M. Cooper, MD is currently at the Department of Neonatology, Wake Forest Baptist Health, Winston Salem, NC.

The authors have no funding or conflicts of interest to disclose.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s website (www.pidj.com).

Address for correspondence: Joshua M. Cooper, MD, Department of Neonatology, Wake Forest Baptist Health, Medical Center Boulevard, Winston Salem, NC 27157. E-mail: Jocooper@wakehealth.edu.

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