המידע באדיבות מדיקונטקסט:By Emma Patten-Hitt, PhD

ATLANTA (Reuters Health) – Since 1997, the syphilis rate among infants has declined by 51% in the US, underscoring the success of a national campaign to eliminate the disease, according to the US Centers for Disease Control and Prevention (CDC).

In the July 13th issue of the CDC's Morbidity and Mortality Weekly Report, the CDC attributes the decline in congenital syphilis (CS) to programs initiated in conjunction with state and local authorities in 1998 to reduce rates of syphilis in both adults and infants.

According to the CDC, the 2000 goal of the National Syphilis Elimination Plan was to reduce the cases of primary and secondary syphilis in adults to <0.4 cases per 100,000 people and the number of CS cases to <40 cases per 100,000 live births.

To evaluate the progress towards reducing the number of CS cases, the CDC compared surveillance data from 2000 to that from 1997. In 2000, 529 cases of CS (13.4 cases per 100,000 live births) were reported, compared with 1077 cases (27.8 cases per 100,000 live births) in 1997.

CDC also released data today indicating that primary and secondary syphilis rates among women of reproductive age (15 to 44 years) dropped from 6 cases per 100,000 women in 1997 to 3.7 cases per 100,000 women in 2000.

The new data, however, indicate that African-American adults continue to be disproportionately affected by syphilis. "In 2000, reported rates of CS were more than 32 times higher for African Americans than for whites," CDC researchers note.

The number of CS cases was disparate among racial/ethnic groups as well. In 2000, CS cases per 100,000 live births were 49.3 for African Americans, 22.6 for Hispanics, 13.2 for American Indians/Alaska Natives, 5.9 for Asian/Pacific Islanders and 1.5 for whites.

The highest rates of syphilis were reported among mothers 19 years of age or less and in southern states. "All states reported rates of <40 per 100,000 live born infants, except Arkansas and South Carolina," the researchers note.

The CDC recommends that healthcare providers test all women for syphilis during early pregnancy. In addition, because syphilis can cause a stillborn delivery, the CDC recommends testing of all women who deliver a stillborn infant after 20 weeks of gestation.

"These data are extremely encouraging, particularly coming just 3 years after the launch of the CDC's National Syphilis Elimination Plan," said Dr. Judith Wasserheit, director of National Center for HIV, STD, and TB Prevention's (NCHSTP's) Division of STD Prevention during a press conference.

"The elimination of congenital syphilis is a feasible goal because of the limited number of cases and its highly concentrated geographic distribution," said Dr. George Counts the NCHSTP's syphilis elimination coordinator, noting that the cornerstone of prevention is early detection of maternal syphilis and treatment with antibiotics.

MMWR 2001;50:573-577.