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High incidence of congenital syphilis in the Chicago area.

This is a message from the Chicago Department of Public Health – Health Alert Network (HAN) – http://www.chicagohan.org

Chicago Provider,

The incidence of congenital syphilis (CS) in the United States has declined substantially in recent years and the majority of reported cases remain preventable. However, in Chicago, this is not the case. In 2012, a total of 21 cases of CS were reported to the Chicago Department of Public Health; a 50% increase compared to 2011. The majority (82%) of mothers giving birth to babies with congenital syphilis in 2012 were young and African-American (median age 22 years old). Opportunities for earlier maternal screening or diagnosis were missed in 60% of cases.

Perinatal transmission of syphilis can occur at any time during pregnancy and at any stage of the disease. Effective prevention and detection of congenital syphilis depends on the identification of syphilis in pregnant women. Therefore, CDC recommends routine serologic screening of pregnant women for syphilis during the first prenatal visit. However, in communities and populations in which the risk for congenital syphilis is high, repeated serologic testing and a sexual history also should be obtained at 28 weeks’ gestation and at delivery. Parenteral penicillin G is the recommended treatment for syphilis in pregnancy and prevention of CS cases.

The State of Illinois requires by law that all pregnant women be tested for syphilis at the time of the first examination, and a second test should be taken during the third trimester of pregnancy.

Please refer to the Illinois Prenatal Syphilis Act [410 ILCS 320] http://www.ilga.gov/legislation/ilcs/ilcs3.asp?ActiD=1553&ChapteriD=35.

Compliance with recommendations of the CDC and the Illinois state law requires that you conduct at minimum of two serological syphilis tests with all pregnant clients in your care. All positive blood tests, diagnoses, or treatment for syphilis should be reported to the Chicago Department of Public Health (CDPH) no later than seven days after laboratory notification of positive test result.

To enhance surveillance of congenital syphilis, the Centers for Disease Control and Prevention (CDC) has released a new Congenital Syphilis Case Investigation and Report Form. As a result, the CDPH STI Surveillance unit has also created a revised local Congenital Syphilis Worksheet (available on the Chicago HAN home page at https://www.chicagohan.org). The CS Worksheet should be completed for all pregnant females delivering newborns at your facility and reported to the CDPH STI Surveillance Unit no later than 2 days after delivery.

To report a CS case, please fax CS worksheet to 312-355-1915. If you have any questions, please feel free to contact the Syphilis Epidemiologist, Irina Tabidze, MD, MPH at 312-413-8032.

Thank you,
Chicago Health Alert Network

For assistance or to have questions answered, please contact the HAN Helpdesk at (312) 747-8789 or hanhelpdesk@cityofchicago.org