Opinion: As a physician, I have never been more concerned about rates of congenital syphilis
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- CDC reported nearly 4,000 new congenital syphilis cases in 2024, the highest number since the mid-1950s, with 5%-10% of cases ending in stillbirth or early death and many survivors left with lifelong disability or developmental delay.
- Dr. Jeffrey D. Klausner, a former federal and county public health official, traces the rise to defunding of local public health programs that began during the 2008 Great Recession.
- CDC evaluations found most congenital syphilis cases stem from missed testing and missed treatment, with only about 80% of pregnant women already in prenatal care actually being screened for syphilis.
- Three FDA-approved rapid point-of-care syphilis tests deliver results in under 15 minutes, and one emergency department deployment pushed screening among pregnant women from 2% to 56%.
- Benzathine penicillin G, the safe and highly effective treatment, has faced shortages, stock-outs, and recalls over the past decade, complicating same-day administration at clinics and testing sites.
- Klausner calls for accountability measures including public reporting of provider screening failures, hard-stop electronic health record prompts, and "sentinel event" reviews for every case—framing congenital syphilis as evidence of public health system failure.
- The author discloses he has served as a paid adviser to manufacturers of rapid syphilis tests, the very tools he is urging health systems to deploy.
Why it matters: A physician who once ran public health programs is calling this the worst moment of his career, and the source notes the underlying playbook—screening, penicillin, follow-up—is well known. The human toll is concrete: 4,000 cases, 5%-10% stillbirth or neonatal death, plus lifelong disability survivors, all driven by a defunded infrastructure the op-ed says can be rebuilt with Medicaid expansion, provider accountability, and stable penicillin supply.
