JACKSON, Miss. — The number of babies in Mississippi receiving treatment for Congenital syphilis it has risen more than 900% in five years, wiping out the progress the nation’s poorest state had made in nearly quelling what experts say is an avoidable public health crisis. The rise in cases has put newborns at greater risk of life-threatening harm in a state already home to the worst infant mortality rate in the country.
In 2021, 102 newborns in Mississippi received treatment for the sexually transmitted disease, up from 10 in 2016, according to an analysis of hospital billing data shared by Dr. Thomas Dobbs, medical director of the Department of Health’s Crossroads Clinic. Mississippi State Health in Jackson. , which focuses on sexually transmitted infections.
Dobbs, a former state health official, said he has spoken with health care providers who are “absolutely appalled” that babies are born with the disease and, rarely, die from it.
“This seems like something that should have happened a hundred years ago, not last year,” said Dobbs, who is also dean of the University of Mississippi Medical Center. “There really is kind of a shock.”
The Mississippi State Department of Health does not formally track deaths from congenital syphilis, but said at least one baby died in 2021.
Congenital syphilis occurs when the infection is passed from a mother to her child while she is pregnant. If left untreated, a pregnant woman with syphilis has a 80% chance to pass it on to your baby.
Babies infected with syphilis may not initially show symptoms, but for those who do not receive treatment within three months of birth, complications can be serious. Syphilis can damage a baby’s organs. The disease can hit a child’s nervous system and impair her vision and hearing. In the most serious cases, newborns die.
The 2021 numbers Dobbs shared are the latest indicator of a growing congenital syphilis problem in Mississippi and across the country. Preliminary data from the Centers for Disease Control and Prevention shows that cases in the US have more than doubled from 941 in 2017 to at least 2,677 in 2021.
In Mississippi, the Department of Health has not released its final 2021 numbers, which are based on doctors reporting cases directly to the state, but the preliminary numbers reflect the increase Dobbs found based on insurance billing codes, the department said. Dr. Paul Byers, State Director. epidemiologist
The resurgence also shows how the state’s racial disparities can be present from the first day of life. In 2020, black newborns accounted for 70% of congenital syphilis cases in the state, despite 42% of live births in the state that year. Byers said in a statement that he expects similar disparities in the state’s final data for 2021.
Cases of congenital syphilis can be prevented if the mother receives a series of penicillin injections at least one month before giving birth. When a mother has not received proper treatment, babies usually have to stay in the hospital for two weeks after birth, as the penicillin is administered intravenously.
For a growing number of Mississippi mothers and their children, treatment is not taking place on time.
Some counties in the state missing an obstetrician, which means pregnant residents must travel for care. Depending on your job, time away from work means lost income, while unreliable transportation can cause a patient to miss appointments. And many pregnant Mississippians have to wait weeks before their first prenatal visit; last year, it took about a month on average for applicants to be approved for a public health insurance program through Medicaid that covers most pregnancies in the state.
Dr. Anita Henderson, a Hattiesburg pediatrician, said she has treated more babies with congenital syphilis in the past three to four years than in nearly all of her 25-year career. “I don’t think many people are aware that there is a possibility that babies will die of congenital syphilis,” she said.
Henderson is concerned that the state’s public health infrastructure has weakened. In 2016, the Department of Health Announced was closing nine county health departments. Last year, the Mississippi Delta, which has some of the highest poverty rates in the country and has long faced lean access to vital maternal and child health care services: saw the last remaining neonatal intensive care unit nearwhile another provider, Greenwood Leflore Hospital, closed its labor and delivery ward.
“In a rural state like Mississippi, we’re going to have to see where the hot spots are and how we can reach those mothers,” Henderson said, “but I also think our state really has to think about investing in pregnant women, investing in your health”.
In the mid-2000s, there were years in which only one or no cases of congenital syphilis were reported. reported in Mississippi. But last year, Dr. Nina Ragunanthan, an OB/GYN practicing in Mound Bayou, which was founded in 1887 by a group of formerly enslaved people in the Mississippi Delta, had two patients test positive. One of the women had received poor prenatal care, missing opportunities for optimal treatment. Another tested negative during her pregnancy but tested positive at delivery.
“I think it’s entirely possible to lower these rates,” Ragunanthan said. “It is not something esoteric. It’s a bit straightforward, but sometimes it’s just the logistical challenge.”
But tackling the problem — getting patients admitted early, so there’s no late diagnosis, and making sure their partners get medicine, so reinfection doesn’t happen — “requires money,” he said.
At Delta Health Center, where patients are seen regardless of insurance status or ability to pay, Ragunanthan tests pregnant patients for syphilis during their initial prenatal visit, in their third trimester, and again when they report to labor. childbirth at the local hospital where she also works
Mississippi does not require such tests, but forgoing them carries acute risk. The symptoms of syphilis may not be noticeable. Without testing, someone may not suspect that they have been infected.
Byers said the state Department of Health is exploring the possibility of a testing mandate through its regulatory authority. In 2016, Mississippi was one of six states without a law requiring prenatal syphilis screening, according to a 2018 study. study.
Dr. Braveen Ragunanthan, husband of Nina Ragunanthan and a practicing pediatrician at Delta Health and Bolivar Medical Center, has seen at least two babies in the past year with highly probable cases of congenital syphilis.
When this happens, follow the CDC recommendations. guidelines for treatment. The baby’s X-rays are examined to see if the disease has deformed its bones. A lumbar puncture tests your spinal fluid. The newborn is started on IV treatment with penicillin. Ragunanthan monitors how they respond. She then waits, hoping that follow-up tests will show progress.
“It’s really a very devastating condition,” he said.