An alarming surge in congenital syphilis cases threatens the health of American newborns, exposing systemic failures in healthcare and drug supply chains.
Story Overview
- Congenital syphilis cases have more than tripled in recent years, hitting the highest numbers since 1992.
- Health officials cite gaps in prenatal care and a shortage of benzathine penicillin as key factors.
- The crisis disproportionately affects racial and ethnic minorities.
- Urgent calls for mandatory screening and improved drug supply are being made.
Surge in Congenital Syphilis Cases
In 2023, the United States reported 3,882 cases of congenital syphilis (CS), marking the highest incidence since 1992. This represents a significant increase from previous years, with cases more than tripling. Health officials attribute this alarming trend to systemic gaps in prenatal care, a lack of timely testing and treatment, and a critical shortage of benzathine penicillin, the only effective antibiotic for treating CS.
The crisis is particularly acute in certain states and among racial and ethnic minorities, highlighting disparities in healthcare access and outcomes. The Centers for Disease Control and Prevention (CDC) reports that nearly 90% of CS cases could be prevented with timely testing and treatment. However, ongoing shortages of benzathine penicillin have forced hospitals to ration supplies, further exacerbating the situation.
Congenital syphilis cases are rising among women of childbearing age across the country, and there’s a shortage of the only safe treatment during pregnancy.
All pregnant women should get tested. Healthcare providers should prioritize their treatment: https://t.co/1mVvyGK96F pic.twitter.com/vTQz35BqUV
— Mecklenburg County (@MeckCounty) August 20, 2025
Historical Context and Contributing Factors
Historically, syphilis was a leading cause of infant mortality, but cases declined significantly with the introduction of penicillin and widespread prenatal screening in the mid-20th century. Recent years have seen a reversal of this trend, with syphilis rates among women increasing since 2017. Contributing factors include declining public health funding, social determinants such as poverty and limited healthcare access, and disruptions caused by the COVID-19 pandemic.
The US healthcare system’s fragmentation, particularly for uninsured and marginalized populations, has been a significant barrier to effective disease management. Additionally, benzathine penicillin faces global shortages due to its low profitability and manufacturing challenges. These issues underscore the need for comprehensive policy and healthcare interventions to address the crisis.
Watch: Congenital Syphilis: A Preventable Problem
Impact and Urgency for Action
The surge in CS cases has severe implications for public health, with increased infant mortality and long-term health complications for affected newborns. Short-term impacts include a strain on neonatal and pediatric healthcare services, while long-term effects could see sustained high rates of CS if systemic issues remain unaddressed. The crisis disproportionately impacts marginalized communities, widening existing health disparities.
There is growing political pressure for public health funding and pharmaceutical regulation to address the crisis. Experts emphasize the need for mandatory screening, improved drug supply, and comprehensive community outreach to prevent further tragedies. The situation highlights broader social and economic inequities, calling for urgent action at multiple levels, including policy, healthcare delivery, and pharmaceutical manufacturing.
Sources:
JAMA, 2025-05-13
CDC, 2024-11-12
FDA, 2025-01-31
Johns Hopkins, 2024-03-13
CDC, 2025-01-31
