OHA public health physician says coordinated action, increased awareness and commitment to equitable care can help protect those most at risk
PORTLAND, Ore. —Health care providers in Oregon are deeply concerned that congenital syphilis rates continue to rise at an alarming pace, according to preliminary 2024 Oregon Health Authority data. This is despite overall rates of sexually transmitted infections (STIs) in Oregon stabilizing in recent years.
In 2014, Oregon recorded two cases of congenital syphilis. By 2024, that number had surged to 45—a staggering 2,150% increase—according to data analyzed by the HIV, STD and TB Section at OHA’s Public Health Division.
“Although rates of syphilis infections in Oregon have decreased in line with national trends, the rate of syphilis diagnosed during pregnancy is increasing, resulting in more infants affected by this preventable disease,” said Pete Singson, M.D., OHA’s HIV, STD and TB medical director.
“Congenital syphilis cases remain concentrated in urban areas, but we’re seeing a growing number of syphilis cases during pregnancy in rural and frontier counties,” Singson explained. “Half of the 2024 congenital syphilis cases were outside the Portland metro area.”
Pregnant people in the Black/African American, American Indian/Alaska Native, Native Hawaiian and Pacific Islander, and Hispanic/Latino populations in Oregon are disproportionately represented in this epidemic.
Singson said it’s critical to understand that these disparities are not due to race or ethnicity, but rather by the compounded effects of systemic racism, poverty, houselessness and stigma.
The risks of untreated syphilis during pregnancy include miscarriage, growth abnormalities, premature birth and fetal death. In a newborn, nearly every organ system can be affected, and severe cases can result in neonatal death. Providers have limited experience diagnosing syphilis due to its historically low prevalence, Singson said, which makes diagnosis even more challenging.
OHA is encouraging providers to work closely with local public health authorities to ensure patients complete their treatment, and to facilitate the testing and treatment of people with whom the patients have had sexual contact. Singson said OHA is aligned with American College of Obstetricians and Gynecologists guidance in recommending that all pregnant people be universally screened at three timepoints during their pregnancy: their first prenatal visit, at 28 weeks, and at the time of delivery.
Addressing this crisis requires not only a concerted effort to educate providers and communities but also expanding screening, treatment and access to care.
“With coordinated action, increased awareness and commitment to equitable care, we can end this crisis and protect future generations of Oregonians,” said Singson.
Increasing awareness and education about primary prevention, public health risks and preventive health services are among actions OHA is taking as part of its 2024-2027 Strategic Plan. The plan further supports expanding access to vaccines and other health resources for children, parents and families in all communities in Oregon.
To hear Dr. Singson talk about the dangers of congenital syphilis, click here.
