— New Compendium Provides Comprehensive Look at Congenital Syphilis Program Across the U.S. —
Washington, DC, February 28, 2022 — The National Association of County and City Health Officials (NACCHO), representing the country’s nearly 3,000 local health departments, has partnered with the Centers for Disease Control and Prevention’s Division of Sexually Transmitted Disease Prevention to support local health departments engaged in lowering rates of congenital syphilis which have been on the rise and disproportionately affect people of color and their babies. These efforts have resulted in $300,000 in grant funding to address the issue in local communities and additional resources to highlight best practices against congenital syphilis.
Congenital syphilis is a disease that occurs when a pregnant person with syphilis passes the infection on to the fetus during pregnancy and it is entirely preventable with testing and treatment. CDC’s preliminary 2020 congenital syphilis data indicated that over 2,020 infants born in 2020 were reported as cases of congenital syphilis, up from 1,870 cases in 2019. 139 (7%) of those cases resulted in death of the infant or stillbirth. The data also highlighted the disproportionate impact of congenital syphilis on different populations: rates of congenital syphilis are highest among mothers who were non-Hispanic American Indian or Alaska Native (180.2 per 100,000 live births), followed by mothers who were non-Hispanic Native Hawaiian or other Pacific Islander (167.7 per 100,000 live births) and mothers who were non-Hispanic Black or African American (125.3 per 100,000 live births).
Innovations in Congenital Syphilis Prevention-Cohort 1
In partnership with the CDC’s Division of STD Prevention, NACCHO has awarded six local health departments and communities to implement and evaluate a program strategy to improve congenital syphilis prevention and control efforts in their areas. The objective was to help galvanize local efforts to address rising rates of congenital syphilis and syphilis among pregnant individuals and individuals of child-bearing capacity by improving support for pregnant individuals, including those who have syphilis and individuals with syphilis who could become pregnant but are not currently pregnant.
The six funded jurisdictions (each for $25,000) were selected through a competitive process to collaborate on this project were:
- Gwinnett, Newtown, and Rockdale Counties, GA: The goal of this project was to routinize STI testing with pregnancy testing to increase syphilis screening, case identification, and referrals.
- Maricopa County, AZ (Maricopa County Department of Public Health): The goal of this project was to expand health services to underserved populations to include syphilis testing and treatment and to increase syphilis screening, case identification, and treatment via a mobile health unit.
- Miami-Dade County, FL: The goal of this project was to automate syphilis screening of hospital emergency department patients to increase syphilis screening, case identification, and provide appropriate follow-up to individuals with syphilis (treatment, partner services, referrals).
- New York City, NY (NYC Bureau of Sexually Transmitted Infections): The goal of this project was to pilot a Congenital Syphilis Prevention Investigator model to streamline and focus eight specific disease investigation specialists on working with individuals of reproductive age with syphilis.
- San Antonio, TX (San Antonio Metropolitan Health District): The goal of this program was to enhance various efforts initiated through the development of the Fetal-Infant Mortality Review & Healthy Beats Program.
- Tulare County, CA: The goal of this program was to implement telehealth by disease investigation specialists to provide case management, referrals, and linkage to care support for pregnant and non-pregnant syphilis cases.
Innovations in Congenital Syphilis Prevention-Cohort 2
Building on the efforts funded in Cohort 1, NACCHO also funded two projects with $25,000 each to implement and evaluate a program strategy that would improve congenital syphilis in their area. The objective was to galvanize local efforts to address congenital syphilis focusing on linkage to prenatal care, syphilis and/or pregnancy screening in non-STD care/clinic settings, and/or implementing telehealth/medicine for individuals with syphilis who are pregnant.
The jurisdictions funded were:
- Tarrant County, TX: The goal of this program was to designate specialized disease investigation specialists to work on cases of pregnant people with syphilis and syphilis in individuals with child-bearing capacity.
- Duval County, FL: The goal of this program was to expand syphilis testing and treatment to underserved populations, specifically those who are engaged with substance use treatment.
Routine, Opt-out Syphilis Screening of Women, and other Individuals of Child-bearing Capacity in Jails
NACCHO also awarded three local health departments with funding for demonstration projects to conduct routine, opt-out syphilis screening of women and other individuals of child-bearing capacity housed in local jails, a critical population. The primary purpose was to assess the effectiveness of routine, opt-out syphilis screening of women and other individuals of child-bearing capacity in local jails as an intervention venue to identify and treat new cases of syphilis. The sites were awarded up to $75,000 each.
The three funded jurisdictions selected through a competitive process to collaborate on this project were:
- Washoe County Health District – Washoe, NV:
- Mobile County Health Department – Mobile, AL:
- Florida Department of Health – Tallahassee, FL:
Nationwide Program Compendium and Additional Resources
At the same time as funding the above demonstration projects, NACCHO recognized the benefits of sharing information and exchanging ideas among peers. That is why NACCHO developed a national scan of congenital syphilis prevention and control efforts, providing a comprehensive look at interventions and activities being utilized in the United States across the entire spectrum of prevention of syphilis among persons with child-bearing capacity and congenital syphilis. The compendium of the collected responses has been developed to highlight innovations in this field, increase peer-to-peer collaboration, and improve congenital syphilis prevention efforts.
In addition, NACCHO launched the Congenital Syphilis Community of Practice (CoP) to engage health department staff in collaborative learning and knowledge-sharing activities that enhance their capacity to implement or scale-up interventions to address congenital syphilis and syphilis among individuals of child-bearing capacity. The CoP included local health departments working to address congenital syphilis in their communities. The goals of the congenital syphilis CoP were to strengthen the capacity of health department staff to address congenital syphilis, contribute best practices and lessons learned regarding the creation and implementation of congenital syphilis interventions, and improve communication and strengthen strategic partnership among public health departments to support congenital syphilis prevention.
The National Association of County and City Health Officials (NACCHO) represents the nation’s nearly 3,000 local health departments. These city, county, metropolitan, district, and tribal departments work every day to protect and promote health and well-being for all people in their communities. For more information about NACCHO, please visit www.naccho.org.