Texas law now mandates three syphilis tests for all pregnant women: at the first prenatal exam, during the third trimester (no earlier than 28 weeks gestation), and at delivery. This new testing is required because congenital syphilis cases reported to the Texas Department of State Health Services (DSHS) more than doubled last year. There were 367 cases of congenital syphilis in Texas in 2018, up from 164 in 2017. The increase in reported cases is likely due to a combination of a higher incidence of disease among women and increased public health surveillance. A lack of or delayed prenatal care remains a significant factor in the growing number of congenital syphilis cases, and health officials encourage women to seek prenatal care as early in their pregnancy as possible.
The Department of State Health Services recently issued a Congenital Syphilis Health Advisory, which you can access here. The Advisory includes information on syphilis diagnosis and treatment. DSHS also reminds providers to notify your local or regional health department promptly of syphilis (any stage) at the time of diagnosis. It is important to include pregnancy status in the report.
It is important for prenatal providers to make syphilis testing results available to neonatal/pediatric providers and for neonatal/pediatric providers to evaluate thoroughly all newborns potentially exposed to syphilis in utero.