In the attached Dear Colleague letter, the California Department of Public Health (CDPH) is asking for your assistance in responding to concerning increases in congenital syphilis and perinatal HIV in California. In 2019, 446 congenital syphilis cases were reported in California, the highest number of cases since 1993. In 2020 there were also six perinatal HIV transmissions in California, compared to four in 2019 and three in 2018. Most of the birthing parents of children with perinatal HIV were co-infected with or had a recent history of syphilis, one of the indications for offering HIV prevention medication (i.e., Pre-Exposure Prophylaxis or PrEP). This highlights the need for an integrated approach to these devastating and preventable infections.
Orange County has not been immune to these increases in congenital syphilis. Between 2016 and 2020, Orange County saw congenital syphilis cases increase by 533%. Preliminary data from 2021 shows a 59% increase over 2020. Most disturbingly, so far this year we have seen three stillbirths and one baby die shortly after delivery. While Orange County has not had any perinatal HIV transmissions this year, our neighboring counties have.
Perinatal HIV transmission and congenital syphilis can be prevented with timely testing and treatment. A common risk factor, however, is receiving late or no prenatal care. HIV and syphilis testing and treatment must expand beyond prenatal care clinics to other settings serving women at elevated risk for HIV and syphilis. CDPH and the Orange County Health Care Agency request your assistance to implement the policies and best practices contained in this letter to Screen, Treat and Prevent, and Prepare for perinatal transmissions.
Link for “Dear Colleague letter” above:
