Congenital syphilis declines.

Continuing a roughly decade-long decline, the rate of congenital syphilis fell 21%, from 14.2 to 11.2 cases per 100,000 live births, between 2000 and 2002. (1) An analysis of national surveillance data shows that the rate was stable (at 1.5 cases per 100,000 live births) among non-Hispanic white infants, but that all racial and ethnic minority groups (who have rates ranging from 4.4 to 43.7 per 100,000) registered marked declines: American Indians and Alaska Natives, 51%; Asians and Pacific Islanders, 22%; and non-Hispanic blacks, 20%. The rate was up 1% in the Northeast but fell 13-30% in the South, West and Midwest. Three-quarters of cases in 2002 involved mothers who had received no or inadequate treatment for syphilis before or during pregnancy, or for whom no information on treatment was reported. Nearly one-third involved women who had not received prenatal care, and most mothers who had gotten prenatal care had started it after the first trimester. Noting that "the majority of [congenital syphilis] cases reported in 2002 were preventable," the Centers for Disease Control and Prevention calls for broad-based efforts "to promote access to and use of comprehensive prenatal care for women who are uninsured or who are covered by public insurance programs."

(1.) Edozien AO et al., Congenital syphilis-United States, 2002, Morbidity and Mortality Weekly Report, 2004, 53(31):716-719.