Congenital Syphilis Case Review Board

Congenial syphilis (CS) occurs when syphilis is passed to babies during pregnancy. Congenital syphilis can cause:

• Miscarriage (losing the baby during pregnancy)
• Stillbirth (a baby born dead)
• Prematurity (a baby born early)
• Low birth weight
• Death shortly after birth

Babies born with CS can have the following:

• Deformed bones
• Severe anemia (low hemoglobin blood count, which results in reduced oxygen to organs)
• Enlarged liver and spleen
• Jaundice (yellowing of the skin or eyes)
• Brain and nerve problems, like blindness or deafness
• Meningitis (inflammation of the fluid and membranes around the brain and spinal cord)
• Skin rashes

Many babies born with CS do not show any signs of illness, however if not treated for syphilis, serious health problems such as seizures or death may occur within the first few weeks of birth and other issues, including developmental problems, may not show up until years later. ¹

Congenital Syphilis Fact Sheet: https://nvose.org/wp-content/uploads/2025/01/Congenital-Syphilis-Fact-Sheet.pdf

Congenital syphilis is preventable. Nevada CS cases increased from four (4) cases in 2009 to 80 cases in 2023.² Take action and prevent congenital syphilis.

• Regularly test for syphilis during pregnancy, starting at the first prenatal care visit, 3^rd trimester, and again at delivery. This is best practice and is in alignment with recommendations from the American College of Obstetrician and Gynecologists.³
• Treat syphilis among pregnant persons with Bicillin or Lentocilin
  • CDC Treatment Guidelines: https://www.cdc.gov/std/treatment-guidelines/syphilis.htm
  • OSE Technical Bulletin on Bicillin Shortage: https://nvose.org/continued-bicillin-l-a-shortage-lentocilin-and-syphilis-treatment/

¹ The Centers for Disease Control and Prevention. About Congenital Syphilis. https://www.cdc.gov/syphilis/about/about-congenital-syphilis.html

² Nevada Health Authority. Surveillance of Sexually Transmitted Infections (STIs) in Nevada Dashboard. https://app.powerbigov.us/view?r=eyJrIjoiMzI3NDBkZDItNWM0NC00YWUxLWEzYjAtYjE1Mzk3MzE0ZDU0IiwidCI6ImU0YTM0MGU2LWI4OWUtNGU2OC04ZWFhLTE1NDRkMjcwMzk4MCJ9

³ American College of Obstetricians and Gynecologists. Screening for Syphilis in Pregnancy. Accessed https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2024/04/screening-for-syphilis-in-pregnancy

The Steering Committee consists of state and local health district staff, including epidemiologists, disease intervention specialists, program leadership, and Maternal Child Health program personnel. This team meets monthly to discuss goals and objectives and determines which cases should be prioritized and presented during the Case Review Board meetings. The Steering Committee summarizes missed opportunities and barriers, highlights what works well for preventing congenital syphilis, and provides the information to the Community Action Team (CAT) to provide support for processes and policy changes to prevent congenital syphilis.

The Case Review Team (CRT) is a multidisciplinary team that meets quarterly to conduct in-depth case reviews to identify missed opportunities for prevention and propose follow-up actions for interventions and systems-level change.

Participants of the CRT include infectious disease, obstetric, and pediatric providers, representatives of health care systems, members of the public health sector, health educators, community health workers, substance use providers, and personnel who work in social services. Congenital syphilis case summaries are presented to the CRT to provide insight into maternal and infant medical care and into the maternal experience prior, during, and after pregnancy, including the partner outcomes related to testing and treatment. During CRT meetings, cases are reviewed to identify missed opportunities for prevention and barriers that contributed to the congenital syphilis diagnosis.

Case Review meetings are held online and can only be attended by those who agree to abide by the participation conduct rules via registration prior to the meeting.

The Community Action Team (CAT) is composed of medical directors, STD program directors, directors of family services, and Health District leadership. CAT meets semi-annually to receive updates from the Steering Committee to identify solutions, support policy change efforts, and receive knowledge and tools for advocating within their communities to implement interventions to prevent congenital syphilis.

If you have questions, would like to register for the Case Review meetings, or participate in the CAT, please contact Heather Kerwin at h.kerwin@health.nv.gov.