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 2012 to 2021, female early syphilis cases increased over 1,113 percent and CS cases increased 1,500 percent, from 33 cases in 2012 to 528 cases in 2021. This is the highest number of reported CS cases since 1992 when 522 cases were reported. According to the U.S. CDC, California had the 11th highest congenital syphilis rate of all states in 2021. Thirty-seven (60.7 percent) of California’s 61 local health jurisdictions reported at least one case of congenital syphilis in 2021. 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

• CLIA-Waived Syphilis Point-of-Care Testing Options for Providers (PDF)​​​

• ​California Department of Public Health (CDPH) Updates Syphilis Screening Recommendations (10/14/24)​ ​
  

• ​​Emergency Department Screening and Treatment for Syphlis
  

• ​Considerations for the Implementation of Point of Care Tests for Syphilis (PDF) (hhs.gov)​

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

• Pregnancy and Substance Use: A Harm Reduction Toolkit​
  

• Health Alert: Increasing Cases of Congenital Syphilis and Syphilis Among Females in the Central Coast Region of California (May 2023) ​(PDF)
  

• 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)
  

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

• Screening for Syphilis in Emergency Departments Implementation Guide
  

• 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, 44MB)

• Penicillin Allergy Factsheet - CDC (PDF)
  

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

• CDPH STD Clinical Guidelines

• California STI Treatment Recommendations in Pregnancy
  

• California STI/HIV Screening Recommendations in Pregnancy
  

• 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
  

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

• National STD Curriculum website and postcard (PDF)
  

• CDC STD Program​
  

​​**Please note, the STI treatment guidelines referenced in this document are out of date. Please refer to the 2021 STI Treatment guidelines for the current treatment regimens.​

Resources for Local Health Jurisdictions

• A Prenatal Care Model for Congenital Syphilis Prevention: The Pregnancy Connections Clinic Guide (PDF)

• ​​Emergency Department Screening and Treatment for Syphlis

• Congenital Syphilis One-Pager​ (PDF)​
  

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

• Screening for HIV, Hepatitis C, and Syphilis in Emergency Departments Implementation Guide
  

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

• 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]

• Protect Yourself and Your Baby from Syphilis - One Pager (PDF) (English) 

• Protect Yourself and Your Baby from Syphilis - One Pager (PDF) (Spanish​)
  

• Protect Yourself and Your Baby from Syphilis - Two Pager (PDF) (English) 

• Protect Yourself and Your Baby from Syphilis - Two Pager (PDF) (Spanish)
  

Resources for the Public