Saturday, August 18, 2018

PRO/EDR> Syphilis - Barbados: congenital, rising incidence

SYPHILIS - BARBADOS: CONGENITAL, RISING INCIDENCE
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A ProMED-mail post
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International Society for Infectious Diseases
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Date: Fri 17 Aug 2018
Source: Outbreak News Today [edited]
<http://outbreaknewstoday.com/barbados-reports-syphilis-increase-pregnant-women-68618/>


Barbados health officials are reporting an increase in syphilis in
pregnant women in recent years. The health ministry is now seeing an
abnormally high rate of syphilis in pregnant women and, by extension,
an increase in the number of babies born at risk for congenital
syphilis.

Statistics show a rise from the average one or 2 cases a year of
syphilis in pregnant women to 17 in 2016. According to the Ministry
official, preliminary analyses from 2017 show a similarly high rate.

Dr. Anton Best, senior medical officer of health with responsibility
for the HIV/STI programme, said that effective prevention and
detection of congenital syphilis depends on the identification of the
sexually transmitted infection (STI) in pregnant women. He noted that
the Ministry of Health and Wellness' guidelines make it clear that all
pregnant women should be offered a screening test for syphilis at
booking and at 28 weeks gestation.

--
Communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>

[The number of syphilis cases in Barbados was reported to have started
to increase in 2012, from 24 in 2011 to 41 in 2012 and to 112 in 2013,
and then to have stabilized in 2014 (100 cases), 2015, and 2016
(<http://www.nationnews.com/nationnews/news/98007/stis-major-concern-ministry-health>).
72 percent of new syphilis cases reportedly occurred in men between
the ages of 15 and 49 years old, with the average age being 34; more
than 95 percent of pregnant women were screened for syphilis during
pregnancy, and no increase in syphilis cases in pregnant women
occurred during a 4-year study (2011-2014), with only one case of
syphilis being transmitted through birth in 2014
(<https://caribbeannewsservice.com/now/syphilis-outbreak-in-barbados/>).

However, the news report above says that, although only one or 2 cases
a year of syphilis occurred in pregnant women previously, 17 cases
occurred in 2016, and a similar number occurred in 2017, but we are
not given the number treated or outcome of these pregnancies.

Syphilis is a bacterial infection caused by the spirochete _Treponema
pallidum_. Transmission from mother to fetus occurs via the
bloodstream during maternal spirochetal infection. Transmission may
also occur during delivery if maternal genital lesions are present.
Late abortion, stillbirth, and neonatal death may result from
congenital infection in untreated pregnancies. Among survivors,
manifestations that develop in the 1st 2 years of life are called
"early" and are similar to adult secondary syphilis; manifestations
that develop after age 2 years are called "late" and include tooth
abnormalities (Hutchinson teeth), bone changes (saber shins),
"Clutton's joints" (bilateral painless swelling of the knee joints),
neurological involvement, blindness, and deafness.

Control of congenital syphilis is achieved by antenatal screening and
treatment of mothers who are infected. Routine serologic screening
should be done at the 1st prenatal visit in all pregnant women, and,
in communities and populations in which the risk for congenital
syphilis is high, serologic testing and a sexual history also should
be obtained at 28 weeks gestation and at delivery. Groups at high risk
include uninsured women, women living in poverty, sex workers, illicit
drug users, women diagnosed with sexually transmitted diseases, and
those living in communities with high syphilis morbidity
(<http://www.ahrq.gov/clinic/uspstf09/syphilis/syphpgsum.htm>). No
mother or neonate should leave the hospital without maternal serologic
status having been documented at least once during pregnancy and, if
the mother is considered high risk, also at delivery.

Barbados, with a population of 277 821 residents, is a sovereign
country and the easternmost island in the Caribbean region of North
America; its capital and largest city is Bridgetown
(<https://en.wikipedia.org/wiki/Barbados>). A map showing the location
of Barbados can be found at
<https://en.wikipedia.org/wiki/West_Indies#/media/File:Caribbean_general_map.png>.
- Mod.ML

HealthMap/ProMED-mail map:
Barbados: <http://healthmap.org/promed/p/32>

HealthMap/ProMED map available at:
Barbados: <http://healthmap.org/promed/p/32>]

[See Also:
Syphilis - USA (07): (CA) rising incidence, men, women, congenital
http://promedmail.org/post/20180723.5920692
Syphilis - New Zealand (02): congenital
http://promedmail.org/post/20180718.5912643
Syphilis - USA (06): (CA) congenital, rising incidence
http://promedmail.org/post/20180605.5839373
Syphilis - USA (05): (CA) congenital, rising incidence
http://promedmail.org/post/20180517.5799883
Syphilis - USA (02): (WI) cluster, mostly young men, HIV, congenital
http://promedmail.org/post/20180310.5678019
Syphilis - Australia: (QL) fatal, congenital, incr. cases, indigenous
http://promedmail.org/post/20180304.5665085
Syphilis - USA: congenital, rising incidence
http://promedmail.org/post/20180208.5615435
2016
----
Syphilis - USA (15): (AL) congenital, rising incidence
http://promedmail.org/post/20161215.4698181
Syphilis - Australia: (QL) fatal, congenital, indigenous
http://promedmail.org/post/20160527.4248380
Syphilis - USA (05): (CA) pregnant women, congenital, rising incidence
http://promedmail.org/post/20160403.4136361
Syphilis - USA (03): (CA) pregnant women, congenital, rising incidence
http://promedmail.org/post/20160315.4094546
2015
----
Syphilis - USA (16): pregnant women, congenital, rising incidence
http://promedmail.org/post/20151114.3791354
Syphilis - Australia (02): (NT,WA) increase, indigenous, congenital,
fatal http://promedmail.org/post/20151102.3760394
Syphilis - USA (09): (CA) pregnant women, congenital, rising incidence
http://promedmail.org/post/20150715.3512635
2014
----
Syphilis - USA (11): (OH) MSM, congenital, rising incidence, RFI
http://promedmail.org/post/20141006.2837388]
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