Congenital Syphilis

Congenital syphilis (CS) is an infection transmitted from pregnant person to child during pregnancy and/or delivery caused by the bacterium Treponema pallidum. CS can cause severe illness in infants including premature birth, low birth weight, birth defects, blindness, and hearing loss. It can also lead to stillbirth and infant death. Tests and treatment for pregnant people are readily available.

Over the last several years, California has experienced a steep increase in syphilis among females and CS. From 2011 to 2020, female early syphilis cases increased over 1,181% and CS cases increased over 950%, from 46 cases in 2011 to 483 cases in 2020. This is the highest number of reported CS cases since 1992 when 522 cases were reported. In 2020, most CS cases were reported from Central and Southern California; however an increasing number of counties throughout California are reporting CS cases; 39 of California's 61 counties reported at least once case of CS in 2020. Most pregnant females who gave birth to infants with CS received prenatal care late in pregnancy or not at all.

Included below are CS specific resources for providers, local health jurisdictions, field investigation, and the public + CS data and surveillance information. General information on syphilis can be found on the California Department of Public Health STD Control Branch syphilis webpage.

Resources for Providers

• *NEW* Health Advisory: Bicillin® L-A (Benzathine Penicillin G) Shortage​
  

• CDPH Dear Colleague Letter - Opt-Out ED Screening for HIV, HCV, and Syphilis (3/28/22) (PDF)
  

• Dear Colleague Letter: Call to Expand HIV and Syphilis Testing for Pregnant Women (PDF)
  

• Health Alert: Increasing Cases of Congenital Syphilis and Syphilis Among Females in Northern California (Oct. 2021) (PDF)

• Expanded Syphilis Screening Recommendations for the Prevention of Congenital Syphilis Guidelines for California Medical Providers 2020 (PDF)

  • High Congenital Syphilis Morbidity in California: List of Local Health Jurisdictions​ (PDF)​

  • Key Finding Spotlight: Implementation of Expanded Syphilis Screening Protocols in California Family Planning Clinics​ (PDF)​

• CDPH Dear Colleague Letter - Expanded Syphilis Screening Recommendations for the Prevention of Congenital Syphilis (12/8/20) (PDF)

• Screening for Syphilis in Emergency Departments Resource Guide (PDF)

• Syphilis in Pregnancy Pocket Guide (PDF)

• Evaluating Infants for Congenital Syphilis (PDF)

• Congenital Syphilis Update for California Health Care Providers (PDF)

• Use of Treponemal Immunoassays for the Screening and Diagnosis of Syphilis: Guidance for Medical Providers and Laboratories in California (PDF)

• Syphilis Pocket Guide - CDC (PDF)

• Penicillin Allergy Factsheet - CDC (PDF)
  

• Medscape and CDC Video - A Devastating Surge in Congenital Syphilis: How Can We Stop It?
  

• CDPH STD Clinical Guidelines

• California STI Treatment Recommendations in Pregnancy (PDF)
  

• California STI/HIV Screening Recommendations in Pregnancy (PDF)
  

• STD Treatment Guidelines, 2021 (CDC)
  

• California Prevention Training Center (PTC)
  

• ​Evaluating Patients for Primary Syphilis (PDF)

• Evaluating Patients for Secondary Syphilis (PDF)

• CA PTC Webinars on Syphilis (PDF)

• STD Clinical Consultation Network (STDCCN) website and postcard (PDF, 1.12 MB)

• National STD Curriculum website and postcard (PDF)
  

• CDC STD Program
  

Resources for Local Health Jurisdictions

• Congenital Syphilis One-Pager​ (PDF)​
  

• Emerging Practices for Responding to the Congenital Syphilis Crisis in California: Findings from 2021 Strategy Ses​​sions​ (PDF)
  

• Clinical Interpretation of Syphilis Screening Algorithms (PDF) (californiaptc.com)

• Screening for Syphilis in Emergency Departments Resource Guide (PDF)

• Congenital Syphilis Prevention Guidance for CA Local Health Jurisdictions (PDF)

• Congenital Syphilis Press Release, 2015

• Congenital Syphilis Morbidity & Mortality Review Toolkit​ (PDF)​
  

• Provider Detailing for STD Prevention

• Health Care Provider Visit Data Summary Resource (PPTX)

• Pregnancy Planning and Syphilis Educational Material (PDF) [contact stdcb@cdph.ca.gov to customize with local contact information]
  

• Pregnancy Intention + Contraceptive Information: Interactions for Reducing Congenital Syphilis Training (Essential Access Health)

• Protect Yourself and Your Baby from Syphilis [contact stdcb@cdph.ca.gov to customize with local contact information]

• One Pager (PDF) [English] [Spanish​]
  

• Two Pager (PDF) [English] [Spanish]

• CDC Call to Action - Let's Work Together to Stem the Rising Tide of Syphilis in the United States (PDF, 2.8 MB)