The Kenai Public Health Center is seen on a cloudy Monday, Feb. 6, 2023, in Kenai, Alaska. (Jake Dye/Peninsula Clarion)

The Kenai Public Health Center is seen on a cloudy Monday, Feb. 6, 2023, in Kenai, Alaska. (Jake Dye/Peninsula Clarion)

State issues new guidance to combat ongoing syphilis epidemic

The alert urges increased screening for pregnant people

A Health Alert was issued Tuesday by the State Department of Health warning of annually increasing rates of syphilis and congenital syphilis since 2018. The alert urges increased screening for pregnant people, as well as prioritization of a key treatment experiencing a national shortage.

The increasing rates of the infection have previously been reported by the department in two Epidemiology Bulletins published in November and in June warning first of a “continuing statewide epidemic” of syphilis, then a connected trend wherein cases of congenital syphilis “increased dramatically.”

The health alert says that most cases of syphilis are being found in people who identify as heterosexual and who live in “urban environments.” The alert says that around half of the cases identified in 2021 were in women, 90% of whom were “of reproductive age.”

The alert also notes that racial disparities are being observed in confirmed cases, and that co-factors include coinfection with other sexually transmitted infections and the use of heroin or methamphetamine.

The alert brings updated guidance for medical providers about screening for congenital syphilis in pregnant people. Congenital syphilis is described in the latter bulletin as a “preventable health event” which occurs when the bacteria that causes syphilis is transmitted from a pregnant person to a developing fetus. The condition can cause physical or mental disability and death.

The new guidance, per the alert, is to screen all pregnant people “regardless of risk factors,” during the first prenatal visit, during their third trimester and at delivery. Screening should also be performed when a pregnant person is seen for an unrelated medical service if they haven’t already had a screening or if they are at increased risk. The alert says that those at risk or who test positive for syphilis should also be tested for other infections, and that newborn children should be evaluated if their parent has certain indicators during testing.

Because of a shortage listed by the U.S. Food and Drug Administration, the alert says to prioritize doses of the only Centers for Disease Control and Prevention approved treatment for pregnant people and babies with congenital syphilis. After that group, doses should be prioritized for those with unstable housing, the alert says.

Syphilis is a bacterial infection spread primarily through sexual contact. The disease typically starts as a painless sore that may not be noticed at first, and spreads from person to person via skin or mucous membrane contact with these sores. The disease is easily curable and early treatment after exposure can prevent infection. When left untreated, however, syphilis can affect the heart, brain and other organs in the body.

For more information about syphilis in Alaska, visit health.alaska.gov/dph/epi.

Reach reporter Jake Dye at jacob.dye@peninsulaclarion.com.

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