Congenital Syphilis Cases in U.S. Babies Reach Highest Level Since 1950s

U.S. health data showed nearly 4,000 new cases of congenital syphilis in 2024, the highest annual total since the mid-1950s.

The increase follows reductions in local public health funding that began after the Great Recession. CDC evaluations found most cases occurred when pregnant women were not tested or did not receive treatment after a positive test. Only about 80 percent of women who received prenatal care were tested for syphilis.

Barriers included lack of insurance, limited clinic access, and competing medical conditions.

Public health measures include expanding Medicaid coverage for prenatal care, placing testing sites in existing service locations, and requiring immediate treatment upon a positive screening result. Electronic health record prompts and standing protocols can increase compliance with screening mandates already in place in nearly all states.

Rapid point-of-care tests approved by the FDA can be used in emergency departments and other non-traditional settings. Reliable supplies of injectable benzathine penicillin G remain necessary for prompt treatment. Expanded roles for nurses and pharmacists, plus state-level stockpile systems, can improve availability.

CDC technical assistance and adequate staffing of disease intervention specialists are listed as requirements for sustained case investigation and partner services. Performance targets for testing rates, time to treatment, and pre-delivery treatment completion would allow ongoing monitoring by health systems.

Integration of prenatal care with substance-use treatment programs is presented as a needed step in areas where drug use contributes to missed care.