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The number of babies born with syphilis in Mississippi has increased more than tenfold since 2016, amid US-wide growth in cases of the potentially fatal but entirely preventable disease.

Rates of congenital syphilis, which occurs when a mother transmits the infection to the fetus, have more than doubled over the past five years, with the largest spikes in southern and western states, according to data from the federal Centers for Disease Control and Prevention.

In Mississippi, the number of newborns hospitalized with congenital syphilis surged between 2016 and 2022, from 10 to 110, according to a study by public health researchers from the John D Bower School of Population Health at the University of Mississippi medical center.

Premature birth and very low birth weight were significantly higher among infants with syphilis, and at least six babies died, half of them in 2022. Nine out of 10 of the infected infants were insured by Medicaid, not private health insurance. More than 70% of the babies hospitalized were Black.

A complex mix of poverty, institutional racism, inadequate public health services and untreated addictions are contributing to the troubling spike, the study authors said.

Congenital syphilis can lead to a number of immediate and long-term health complications including anemia, jaundice, failure to thrive, and respiratory and neurological disorders. Untreated syphilis in pregnancy also increases the risk of spontaneous abortion, preterm delivery, stillbirth and infant death.

Despite such serious but preventable consequences, Mississippi only mandated prenatal screening for syphilis in March this year.

“Our study provides evidence that the spike in congenital syphilis is already elevating the high number of infant deaths in the state … Half those deaths occurred in 2022, underlying the current nature of this rapidly escalating reemergent public health menace and urgent need for public health interventions,” the study authors wrote.

“Mississippi could reduce infant illness and death by promptly diagnosing and treating pregnant patients with syphilis.”

Almost one in four of newborns with syphilis in Mississippi since 2016 was born to a mother with a substance misuse disorder.

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Researchers said that “reveals the entanglement between the ongoing drug epidemic and the resurgence of maternal and congenital syphilis and suggests the need for holistic approaches that treat illicit drug use as one way to curtail congenital syphilis rates”.

Mississippi has some of the deepest social and health inequities in the US, including the highest pre-term birth and infant mortality rates.

Despite being a resource-constrained state with severe health disparities, Mississippi has neither expanded Medicaid nor adopted presumptive eligibility for pregnant people without insurance.

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