Suggested actions to reduce syphilis and congenital syphilis for improved maternal and infant health

To:   State, territorial, tribal, and local administrators of agencies and programs focused on child, youth, and family health and well-being 

Dear Colleague,

Maternal and infant health is an urgent priority, and a coordinated effort across health and human services is crucial to foster positive maternal health outcomes. The Administration for Children and Families (ACF) and other divisions of the U.S. Department of Health and Human Services (HHS) are responsible for many programs that support maternal and infant health, including home visiting, Head Start, child care, Medicaid, TANF, child support and others. One under-recognized risk to pregnant women and babies is the increasing rates of syphilis and congenital syphilis, now at their highest levels since 1950. While syphilis can be cured with proper testing and treatment, if left untreated it can lead to severe health complications and can be transmitted as congenital syphilis when an infected mother passes the disease to her baby during pregnancy or childbirth. This can result in outcomes that include miscarriages, stillbirths, low birth weight, and long-term health complications. Congenital syphilis is preventable with early detection and treatment.

New CDC data  paint a concerning picture, revealing that more than 3,700 babies were born with congenital syphilis in 2022—a dramatic increase compared to just 350 cases in 2012. This tenfold rise over the past decade follows rising syphilis cases among women of reproductive age combined with social and economic factors  that create barriers to high-quality prenatal care, declines in the prevention infrastructure, and a lack of access to resources. Of particular concern is the increase in  cases  among American Indian and Alaskan Native populations.

HHS established the National Syphilis and Congenital Syphilis Syndemic Federal Task Force , led by the Office of the Assistant Secretary for Health (OASH), in September 2023 to work to reduce syphilis and congenital syphilis through a variety of efforts. The Task Force members, from a variety of health and human services agencies across the federal government, have been working closely with many external partners to improve testing, treatment, and public awareness.

While some of those most at risk may not be seeking or receiving health care or medical attention, they are likely receiving services and benefits from ACF-funded programs, as well as Medicaid, SNAP, and WIC, which are administered by human services agencies across states, counties, tribes, and territories. Human services providers can play an important role in addressing the syphilis epidemic by raising awareness and helping to facilitate access to early testing and treatment. There are simple tests and effective antibiotic treatments, but many people are not aware of their risks nor where to obtain tests. Staff at human services agencies have a unique opportunity to intervene and help protect the health of pregnant women and babies by educating clients on the risks and encouraging early and regular prenatal care, including testing, and treatment when necessary.

Here are some ways you and your staff can get involved:

• Display consumer-focused rack cards  or posters  in locations where human services are administered
• Share the link to a new HHS short video 7 things about syphilis
• Provide accessible, detailed resources  (PDF) and a syphilis brochure  (PDF) from the CDC to clients
• Act as trusted messengers in engaging clients with conversations about health and behaviors
• Provide information on testing locations
• Offer linkages to early and regular prenatal care

Thank you for your support and partnership. Together we can make a meaningful difference in curbing this epidemic and saving lives.