Readout of ADM Rachel Levine’s visit to Georgia to learn about the impacts of congenital syphilis and syphilis

On Monday and Tuesday, U.S. Department of Health and Human Services (HHS) Assistant Secretary for Health ADM Rachel Levine traveled to Atlanta to hear from community partners and public health leaders how to best address the surge of syphilis and its impact on pregnant people and babies.

ADM Levine met with Centers for Disease Control and Prevention (CDC) leadership, visited Neighborhood Union Health Center to meet with health care providers, and met with Mayor Andre Dickens and LGBTQI+ stakeholders for a roundtable discussion to highlight efforts to spearhead a national congenital syphilis and syphilis public health response.

ADM Levine is chair of the newly established National Syphilis and Congenital Syphilis Syndemic (NSCSS) Federal Task Force.  The group’s mission is to leverage broad federal resources to reduce rates, promote health equity, and share resources with impacted communities.  The HHS Task Force utilizes a syndemic approach because of the complex nature of this public health challenge, in which social and economic environments can exacerbate negative health outcomes.

Actions the NSCSS will focus on during the next 90 days, include:

Working directly with the jurisdictions to maximize syphilis testing, particularly with pregnant people, and promoting sexual health discussions;  

Expanding equitable access to syphilis testing and treatment in communities with limited health care resources;

Promoting alternative testing locations for pregnant persons beyond traditional prenatal care settings, such as substance use facilities, harm reduction programs, and emergency departments;

Educating health care providers who see pregnant persons about emphasizing syphilis testing, promoting evidence-based sexual health discussions, and ensuring prompt testing and treatment in high-risk counties; and

Working with health departments to identify counties with high syphilis rates, as well as new ways to notify physicians about the need for increased testing, collaborate on reducing barriers to patient care, monitor pregnancy status for timely treatment to prevent newborn syphilis, and facilitate partner notification after diagnosis.

The goal of the HHS Task Force is to avert five percent of congenital syphilis cases by September 2024.

ADM Levine and CDC Director Dr. Mandy Cohen discussed recently released CDC data and the tragic consequences of testing people too late and not receiving appropriate treatment for syphilis, especially during pregnancy. Timely testing and treatment during pregnancy can help keep people healthy and could have prevented 9 out of 10 of the newborn syphilis cases in 2022.

Neighborhood Union Health Center offers free sexual health and drug user health services with a sex positive harm reduction framework, and includes immunizations, child health checks and other services. ADM Levine heard from a variety of health care providers about opportunities for more immediate treatments to help stop the spread of syphilis and save lives, especially those of newborn infants. Participants stressed the need to ensure no one is left behind in addressing the spread of syphilis and getting needed interventions to everyone.

The roundtable focused on the recent alarming increase in congenital syphilis, the increasing prevalence of syphilis, and its frequent overlap with other LGBTQI+ health concerns. One health center serving the Atlanta-area saw 500 deliveries last year, at least 10 positive cases of syphilis, two of which died. Most doctors would not expect to see a single case of congenital syphilis in a baby during their career.

ADM Levine’s trip focused on congenital syphilis because Georgia is one of the 14 priority jurisdictions recently identified by the HHS Task Force as having the highest burden of disease. The Task Force will focus its efforts on Arizona, Arkansas, California, the District of Columbia, Florida, Georgia, Louisiana, Mississippi, New Mexico, New York, Ohio, Oklahoma, South Dakota, and Texas. Together, these jurisdictions make up nearly 75 percent of congenital cases and 50 percent of our nation’s syphilis cases.