Syphilis cases in Chicago babies more than doubled in two years, study shows

More babies are being born with syphilis in Chicago, mirroring an alarming national trend that public health experts say is almost entirely preventable.

Cases of congenital syphilis in newborns more than doubled in the city in just two years, according to data released by the Chicago Department of Public Health in December. A report published last month by the Centers for Disease Control and Prevention showed cases nearly tripled across Illinois over the same period.

Nationally, congenital cases have jumped elevenfold over a decade — from 334 cases in 2012 to 3,761 in 2022, the CDC reported.

Syphilis in adults is curable, often mild and can go undetected before treatment. But congenital syphilis is rare and severe enough that doctors say it should be a “never event,” a life-threatening infection that’s almost always preventable if caught and treated in time.

“There really is no excuse in this day and age for there to be any cases of syphilis, especially not in infants,” said Dr. Kimberly Stanford, the director of HIV/STI testing for the Chicago Center for HIV Elimination.

“It’s a sign of the many ways in which our health system is failing people, especially the people who need our help the most.”

Untreated syphilis can cause miscarriages, premature births and stillbirths. Babies also have a high chance of contracting syphilis in the womb. Congenital syphilis can cause infant death, organ damage, fetal anemia, heart failure, seizures, damaged vision and hearing, and long-term health and developmental complications for surviving babies.

All syphilis cases in the U.S. jumped 80% from 2018 to 2022, according to the CDC, though cases increased in Illinois by 28% during that same period.

The surge in congenital syphilis cases was more stark. Cases in Illinois spiked from 29 to 85 between 2020 and 2022, according to the CDC. Chicago cases jumped from 17 to 46 over those two years, according to the city’s public health department. There were eight cases in the city in 2019. Doctors agree the number should be zero.

In a statement, the health department said the city had taken steps to address rising cases, including forming a syphilis task force in 2019, improving procedures for catching more cases and studying what factors, like access to adequate health care, have contributed to the spike.

“However, much more research and more prevention efforts are needed to adequately curb the resurgence of this epidemic — especially in Black communities, and among young, sexual- and gender-minorities,” the statement reads.

Other common sexually transmitted infections haven’t spiked like syphilis has. Gonorrhea cases declined and chlamydia cases stayed level, according to the CDC.

“Within the STI epidemic, syphilis is one infection that stands alone. It has emerged as a unique public health challenge,” Dr. Laura Bachmann, director of the CDC’s division of STD prevention, said in a statement.

‘As you take money away, it resurges’

Dr. Lynn Yee, a maternal fetal medicine physician at Northwestern Medicine, tells the Sun-Times she’s seeing more cases of congenital syphilis now than at any point in her 15-year career.

There are a few reasons for the spike, she said.

COVID-19 is partially to blame, since the pandemic shifted attention away from syphilis prevention and treatment.

In 2020, 96% of U.S. health departments reassigned staff from STI prevention work to COVID-19-related duties, according to a report in the journal Sexually Transmitted Diseases. Departments reported major disruptions to tracking, testing, lab work and intervention efforts related to STIs. Those disruptions further exacerbated rising infection rates, especially for syphilis.

“There’s an old adage that the more a program is working and the disease disappears, the less money goes to it,” Yee said. “And as you take money away, it resurges.”

Patients were also reluctant to visit their doctors in person during the pandemic, opting instead for telehealth appointments or not going to the doctor at all, which hampered STI prevention. According to Stanford, since testing for syphilis requires a blood draw and treatment requires penicillin shots, many cases went untreated.

Tyler Pasciak LaRiviere/Sun-Times

But the pandemic only accelerated an existing problem, Yee said. Syphilis was already rising before lockdown due to a lack of testing or strong public health messaging and poor access to health care and insurance. The problem is compounded by a global shortage of penicillin, the only antibiotic used to treat a pregnant person with syphilis.

Some communities are being hit harder than others. In Chicago, babies born to Black people suffer the vast majority of congenital syphilis cases, making up nearly 90% of cases in 2022.

Neighborhoods on the South and West sides were also hit the hardest — areas that experience the most exposure to STIs but are the most under-resourced. Average rates were highest in Fuller Park, West Garfield Park and Greater Grand Crossing between 2018 and 2022.

Public health groups, including the AIDS Healthcare Foundation. are trying to raise more awareness about congenital syphilis.

The international organization, which operates two clinics on the North and South sides, recently put up seven billboards around Chicago warning pregnant people about the risks syphilis can pose to their babies and encouraging them to get tested for the infection, said Imara Canady, a spokesperson with the foundation.

“We use marketing like this to capture people’s attention and make them want to learn more about the issue,” Canady said.

Tyler Pasciak LaRiviere/Sun-Times

Stanford, who also works as an emergency medicine physician at the University of Chicago, says that in order to better serve people who are at the most risk, health care providers need to go directly into communities and provide testing and treatment there.

Another way to reach people is in the emergency room, she said. Her emergency department screens everyone who comes into the ER for STIs.

“The emergency department is really the place where people seek care when other options are not available or not accessible,” Stanford said. “That has been a really important opportunity to reach people who have limited access to care. If they can’t go to primary care, they don’t go to primary care.”

Testing is a critical part of prevention, Yee said. Syphilis often goes undetected in adults, sometimes indefinitely. If a person isn’t tested, they might never know they had the infection. If a person isn’t treated, the infection can remain in their body but with no visible signs.

“Everybody should understand the importance of that testing so that they can access early treatment,” Yee said.

Getting tested early in pregnancy is one of the best ways to prevent congenital syphilis, Yee said. Mothers should be tested at their first prenatal visit, and again in the third trimester.

The Illinois Department of Public Health launched the Perinatal Syphilis Warmline in November. Health care providers can call (800) 439-4079 to receive clinical help on treating pregnant patients and newborns with syphilis.

Yee is one of the doctors who answers those calls.

“Resources are there,” Yee said. “We don’t want any clinician or patients to feel alone in having to figure this out.”