Hawaii health officials, including physician Gov. Josh Green, said Wednesday that expanded screening and treatment are necessary to address the increasing rate of syphilis cases in women and newborns. 

The Department of Health said in a release that the continuing rise in women and the congenital system is “alarming and requires immediate attention.”

The number of babies born with congenital syphilis ranged from zero to four cases from 2000 to 2019 and 20 cases in 2021. 

Preliminary data indicates at least 22 cases last year – a dramatic rise in cases associated with increasing infections in adults. 

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“All sexually active people with risk factors for sexually transmitted infections (STIs) should be regularly tested for syphilis and other STIs,” Dr. Diana Felton, chief of the Department of Health Communicable Disease and Public Health Nursing Division, said in a statement.

 “For pregnant persons, we now recommend syphilis screening three times: as early as possible during the first trimester, at 28 to 32 weeks of gestation and at the time of delivery. It is important that sexual partners are also treated to prevent reinfection,” she added. 

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Due to the fact that most cases of congenital syphilis in Hawaii have been reported in people who received late or no prenatal care, the department is urging enhanced screening in health care interactions other than prenatal care. 

“Syphilis can have severe health impacts, especially for developing babies, including increased risk of stillbirth or death shortly after birth,” Felton said. “The devastating effects of untreated syphilis are preventable if infections are detected early and treatment is initiated promptly.” 

Visits to emergency rooms, urgent care and primary care clinics present opportunities both to identify and treat syphilis and prevent recurrence of congenital syphilis. 

The department continues to strongly recommend that women begin receiving prenatal care as soon as they learn they are pregnant, ideally in the first trimester.

The health department is also alerting health care providers to be vigilant in screening for cases of syphilis in people who may become pregnant and during pregnancy.

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