Prather Pediatric and Allergy Center - Ask Doctor Brent

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Title: Louisiana Leads Nation in Syphlis

Category: Child Care


Louisiana is leading our country in many health statistics which put us very near last place. One of these is syphilis in which we lead the nation in cases among young women. We are also seeing a major rise in congenital syphilis which is infection of the newborn with active syphilis infection. It increased from 10 cases per 100,000 live births in 1980 to over 100 cases per 100,000 live births in 1989.

The major cause of this increase, in both adult and congenital syphilis, is the use of drugs and the lack of prenatal care. With the increasing use of crack and cocaine, more women are exchanging sex for drugs. Most of these women do not have easy access to health care. Three out of four receive no prenatal care. About 1/2 admit to drug use during pregnancy. All in all, too many of these high risk women are showing up to deliver their babies without a record of being tested or treated for syphilis.

Among the babies born with congenital syphilis, over 3/4 have no noticeable symptoms at the time of birth. Only one in ten babies will have the classic symptoms which make the diagnosis easy.

These symptoms include swelling of the liver and spleen, rashes over the body, heavy runny nose right at birth, other bone and skin changes, and jaundice (from syphilis involvement of the liver).

During my eight years around Charity Hospital in New Orleans and twelve years in practice, I have never seen a case of congenital syphilis with obvious symptoms. I talked to a senior medical student at LSU recently, who during his brief rotation on pediatrics, had seen two cases in the nursery at one time. Unfortunately, this is only one more sad statistic which we are faced with, and work hard to reverse.

The best way of diagnosing, preventing and treating syphilis and congenital syphilis is to insure prenatal care for all pregnant women in our state. They should be checked for syphilis in the first and third trimester and at delivery. A simple blood test will diagnose the condition early and it can be treated to prevent complications to both the mother and child. Other benefits from early and adequate prenatal care would be less prematurity and treatment other infectious diseases which lead to deaths and suffering in so many of our newborn infants. Hopefully as we face this challenge of providing better overall access to care to the needy in our society, we will see a reversal of these dismal statistics in the following decade.