Colorado county leaders work to improve testing for congenital syphilis in the community

Adams County Medical Officer Bernadette Albanese says she has seen the impact time and time again; a baby infected by infected by congenital syphilis.

Health leaders and elected officials in Adams County and throughout Colorado are working to improve testing amid a spike in the potentially deadly disease over the last six years.

"It's very disruptive to start one's life already with this burden on board," said Albanese. "I've had to do the diagnosis [and] work them up, do the spinal tap, find out if it's infected their spinal fluid or their brain, examined their eyes, treat their pneumonia, treat their liver disease. When you have babies that are severely infected, those are the kinds of things that we can have real problems with."

Between 2017 and 2023, congenital syphilis increased by more than 900% in Colorado. Meanwhile, Adams County has the third highest syphilis rates along Interstate 25 corridor counties.

"I think the biggest thing is that it's a very treatable disease," said Julia Marvin, state rep. for Colorado's 31st House District.

Up until now, however, women who were pregnant were only required to be tested for the disease once, which typically happened during the first trimester.

"So, you test, if it was negative, they were done. It's just simply not working," said Albanese.

Albanese says the disease could still unknowingly creep up later on in the pregnancy and infect the fetus, possibly putting the child at risk of complications or even death upon birth.

"I've had several patients over the last few years come in with positive testing that they weren't expecting and that was a surprise to them," said Anna Euser, associate professor of maternal-fetal medicine at the University of Colorado.

However, with a new public health order that took effect last week, a minimum of three tests are now required throughout the course of a pregnancy to help detect syphilis sooner and be able to treat it.

"First trimester or entry into prenatal care. During the third trimester and again at delivery," said Albanese. "Sort of a last check to make sure the pediatrician will have that data to decide whether anything else needs to be done with the newborn."

It is not just women with prenatal care who are benefitting from changes out of this public health order.

"It's now becoming mandated that if a patient is seen at an urgent care or at an emergency department or by any health care provider and they are known to be pregnant, they should be checked at those same time frames too," said Euser.

Representative Marvin hopes the legislature will take this new measure a step further, with a bill dedicated to making this public health order a board of health rule that can be modified in the future depending on the need for more testing to combat syphilis.

"It will give authority for rulemaking to the board of health and that will allow them to come up with the testing parameters and be able to be a little bit more agile with making those decisions," said Marvin. "Because it takes [testing] requirements out of statute, and so it gives that to the public health department to determine."

Above all, doctors hope that addressing congenital syphilis can be a step forward in reducing the disease footprint in the community, while also reducing the stigma behind the disease.

"It's something that is out there and unfortunately many people never know that they have it, and so nobody should be embarrassed by it," said Euser.