No Time to Lues: A Call to Arms Amidst a Congenital Syphilis Epidemic

Saturday, April 29, 2023

2:00 PM – 3:30 PM ET

Location: Convention Center: 146 C

CE: Live CME: 1.50

Selected By: PIDS
Co-sponsored By: AAP SoNPM

Chair(s)

Ryan Rochat, MD, PhD, MS

Assistant Professor
Pediatrics, Infectious Diseases
Texas Children's Hospital, Baylor College of Medicine
Baylor College of Medicine
Houston, Texas, United States
Pablo Sanchez, MD

Professor of Pediatrics
Pediatrics
Nationwide Children's Hospital -OSU
Columbus, Ohio, United States

Disclosure(s):

Ryan H. Rochat, MD, PhD, MS: No financial relationships to disclose

Pablo J. Sanchez, MD: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Session

Description: Congenital syphilis (CS) is a chronic infection acquired by the fetus during pregnancy from a mother infected with Treponema palladium. It has a large spectrum of disease manifestations, from asymptomatic infection to blindness, abnormal bone and teeth formation, deafness, or even death. Despite having a safe and effective treatment for syphilis, cases in the US have reached levels not seen since the 1940s. Unfortunately, as cases have risen in the reproductive population, so have cases of CS which are up nearly 200% over 4 years from 2017 to 2021. Given this resurgence, there is a need to galvanize our approach to management of this congenital infection, a undertaking that hinges on multidisciplinary education (i.e. OBGYN, neonatology, infectious disease, and primary care providers). In this session we will cover the following topics: the epidemiology of syphilis past and present, laboratory testing to detect syphilis and the role of testing in conventional and reverse algorithms, prenatal care in the prevention of CS, management of CS in the newborn, and preventing CS through statewide health policy. In this Hot-Topic session we hope to cover some of the convoluted aspects of syphilis testing and how test performance and interpretation can lead to misdiagnosis in CS, while highlighting how social determinants of health play a significant role in acquiring this congenital infection. Our planned speakers represent the fields of OBGYN, Neonatology, Pediatrics, and Infectious Disease, and include insights from the CDC and Health Departments who have seen success in mitigating this congenital infection.

Learning Objectives:

Review the epidemiology, prevention, and pathogenesis of syphilis, with a focus on how social determinants of health contribute to this congenital infection
Discuss the management and complications of perinatal infections with Treponema pallidum
Recognize limitations with current testing strategies and their effect on the interpretation of algorithms for evaluation and treatment of congenital syphilis.

Presentations:

2:00 PM – 2:15 PM ET

Epidemiology of syphilis past and present: Insights into a resurgence
Speaker: Ryan H. Rochat, MD, PhD, MS – Texas Children's Hospital, Baylor College of Medicine
2:15 PM – 2:35 PM ET

Laboratory testing to detect treponema pallidum infection: A paradox of choice
Speaker: Kevin P. O'Callaghan, MB BCh FAAP (he/him/his) – Centers for Disease Control and Prevention
2:35 PM – 2:55 PM ET

Prenatal care and the prevention of congenital syphilis: See one, screen one, treat one
Speaker: Irene Stafford, MD – McGovern Medical School at the University of Texas Health Science Center at Houston
2:55 PM – 3:10 PM ET

Management of congenital syphilis: Follow the Yellow Brick Road?
Speaker: Pablo J. Sanchez, MD – Nationwide Children's Hospital -OSU
3:10 PM – 3:25 PM ET

Preventing congenital syphilis through statewide health policy: An ounce of prevention and a pound of cure
Speaker: Katherine K. Hsu, MD, MPH (she/her/hers) – Mass Dept of Pub Health / Boston Univ Med Ctr