Prevention of Congenital Syphilis

H. Hunter Handsfield, MD; Sheila A. Lukehart, PhD
JAMA. 1984;252(13):1750-1751. doi:10.1001/jama.1984.03350130064038.
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Congenital infection with Treponema pallidum is the most serious form of syphilis. Following the introduction of widespread serological testing of pregnant women and other public health control measures, the United States' incidence of congenital syphilis in infants younger than 1 year of age underwent a dramatic and gratifying decline to a low of 115 reported cases in 1978.1 Subsequently, however, the number of reported cases rose to 159 in 1982 and 158 in 1983, a 38% increase that parallels a striking rise in primary and secondary syphilis in women, from 5,331 to 9,082 reported cases.1 These numbers undoubtedly underestimate the true magnitude of the problem, because of misdiagnosis and the occurrence of undocumented cases manifested by spontaneous abortion or stillbirth. Moreover, the importance of congenital syphilis is magnified beyond its numbers because of its high morbidity and mortality, because it selectively affects socioeconomically disadvantaged populations, because its victims are


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