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Lauri E. Markowitz - One of the best experts on this subject based on the ideXlab platform.
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Challenges in Congenital Syphilis surveillance: how are Congenital Syphilis investigations classified?
Sexually transmitted diseases, 2013Co-Authors: Camille E. Introcaso, Deann Gruber, Heather Bradley, Thomas A. Peterman, Joy Ewell, Deborah Wendell, Joseph Foxhood, Hillard Weinstock, Lauri E. MarkowitzAbstract:Background Congenital Syphilis is a serious, preventable, and nationally notifiable disease. Despite the existence of a surveillance case definition, Congenital Syphilis is sometimes classified differently using an algorithm on the Centers for Disease Control and Prevention's case reporting form. Methods We reviewed Louisiana's Congenital Syphilis electronic reporting system for investigations of infants born from January 2010 to October 2011, abstracted data required for classification, and applied the surveillance definition and the algorithm. We calculated the sensitivities and specificities of the algorithm and Louisiana's classification using the surveillance definition as the surveillance gold standard. Results Among 349 Congenital Syphilis investigations, the surveillance definition identified 62 cases. The algorithm had a sensitivity of 91.9% and a specificity of 64.1%. Louisiana's classification had a sensitivity of 50% and a specificity of 91.3% compared with the surveillance definition. Conclusions The differences between the algorithm and the surveillance definition led to misclassification of Congenital Syphilis cases. The algorithm should match the surveillance definition. Other state and local health departments should assure that their reported cases meet the surveillance definition.
Hillard Weinstock - One of the best experts on this subject based on the ideXlab platform.
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Missed Opportunities for Prevention of Congenital Syphilis — United States, 2018
MMWR. Morbidity and mortality weekly report, 2020Co-Authors: Anne Kimball, Hillard Weinstock, Elizabeth Torrone, Kathryn Miele, Laura Bachmann, Phoebe Thorpe, Virginia B. BowenAbstract:Congenital Syphilis is an infection with Treponema pallidum in an infant or fetus, acquired during pregnancy from a mother with untreated or inadequately treated Syphilis. Congenital Syphilis can cause miscarriage, stillbirth, or early infant death, and infected infants can experience lifelong physical and neurologic problems. Although timely identification and treatment of maternal Syphilis during pregnancy can prevent Congenital Syphilis (1,2), the number of reported Congenital Syphilis cases in the United States increased 261% during 2013-2018, from 362 to 1,306. Among reported Congenital Syphilis cases during 2018, a total of 94 resulted in stillbirths or early infant deaths (3). Using 2018 national Congenital Syphilis surveillance data and a previously developed framework (4), CDC identified missed opportunities for Congenital Syphilis prevention. Nationally, the most commonly missed prevention opportunities were a lack of adequate maternal treatment despite the timely diagnosis of Syphilis (30.7%) and a lack of timely prenatal care (28.2%), with variation by geographic region. Congenital Syphilis prevention involves Syphilis prevention for women and their partners and timely identification and treatment of pregnant women with Syphilis. Preventing continued increases in Congenital Syphilis requires reducing barriers to family planning and prenatal care, ensuring Syphilis screening at the first prenatal visit with rescreening at 28 weeks' gestation and at delivery, as indicated, and adequately treating pregnant women with Syphilis (2). Congenital Syphilis prevention strategies that implement tailored public health and health care interventions to address missed opportunities can have substantial public health impact.
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Challenges in Congenital Syphilis surveillance: how are Congenital Syphilis investigations classified?
Sexually transmitted diseases, 2013Co-Authors: Camille E. Introcaso, Deann Gruber, Heather Bradley, Thomas A. Peterman, Joy Ewell, Deborah Wendell, Joseph Foxhood, Hillard Weinstock, Lauri E. MarkowitzAbstract:Background Congenital Syphilis is a serious, preventable, and nationally notifiable disease. Despite the existence of a surveillance case definition, Congenital Syphilis is sometimes classified differently using an algorithm on the Centers for Disease Control and Prevention's case reporting form. Methods We reviewed Louisiana's Congenital Syphilis electronic reporting system for investigations of infants born from January 2010 to October 2011, abstracted data required for classification, and applied the surveillance definition and the algorithm. We calculated the sensitivities and specificities of the algorithm and Louisiana's classification using the surveillance definition as the surveillance gold standard. Results Among 349 Congenital Syphilis investigations, the surveillance definition identified 62 cases. The algorithm had a sensitivity of 91.9% and a specificity of 64.1%. Louisiana's classification had a sensitivity of 50% and a specificity of 91.3% compared with the surveillance definition. Conclusions The differences between the algorithm and the surveillance definition led to misclassification of Congenital Syphilis cases. The algorithm should match the surveillance definition. Other state and local health departments should assure that their reported cases meet the surveillance definition.
Pablo J Sánchez - One of the best experts on this subject based on the ideXlab platform.
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re emergence of Congenital Syphilis in ohio
Pediatric Infectious Disease Journal, 2018Co-Authors: Joshua M Cooper, Makeda Porter, Jose A Bazan, Lisa Nicholson, Pablo J SánchezAbstract:BACKGROUND The recent occurrence of Congenital Syphilis in Columbus, OH, raised concern for an increase in Syphilis among women and infants. The objectives were to examine the rates of Syphilis among men, women and infants in Ohio from 2003 to 2016 and compare these rates to the rest of the United States. METHODS This retrospective study evaluated cases of Syphilis among men, women and infants from 2003 to 2016 using data from the Ohio Department of Health and the Centers for Disease Control and Prevention. RESULTS In Ohio from 2003 to 2016, the number of all Syphilis cases among women significantly increased from 153 (2.6/100,000) to 294 (5.2/100,000), respectively (b = 0.26; P = 0.001; 95% confidence interval [CI]: 0.137-0.382). From 2003 to 2016, Congenital Syphilis in Ohio also increased significantly from 3 (2/100,000) to 13 cases (9.3/100,000), respectively (b = 1.05; P ≤ 0.001; 95% CI: 0.687-1.408). The increase in Congenital Syphilis mirrored the increase in all cases of Syphilis in women but not with the rates of primary and secondary Syphilis. Among men, cases of primary and secondary Syphilis increased significantly in Ohio and the rest of the United States, from 156 (2.8/100,000) and 5956 (4.2/100,000) in 2003 to 622 (10.5/100,000) and 24,724 (15.6/100,000) in 2016, respectively (Ohio: b = 0.55; P < 0.001; 95% CI: 0.426-0.679; United States: b = 0.77; P < 0.001; 95% CI: 0.629-0.916). CONCLUSIONS The association of Congenital Syphilis with all Syphilis cases in women highlights the importance of reporting all cases and not just primary and secondary Syphilis. The increase in Congenital Syphilis reinforces the recommendation for repeat maternal screening during pregnancy.
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Congenital Syphilis.
Seminars in perinatology, 2018Co-Authors: Joshua M Cooper, Pablo J SánchezAbstract:Congenital Syphilis remains a major public health problem worldwide, and its incidence is increasing in the United States. This review highlights the ongoing problem of this preventable infection, and discusses vertical transmission and clinical manifestations while providing a practical algorithm for the evaluation and management of infants born to mothers with reactive serologic tests for Syphilis. Every case of Congenital Syphilis must be seen as a failure of our public health system to provide optimal prenatal care to pregnant women, as Congenital Syphilis can be prevented by early and repeated prenatal serologic screening of mothers and penicillin treatment of infected women, their sexual partners, and their newborn infants.
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Placental histopathology of Congenital Syphilis
Obstetrics and gynecology, 2002Co-Authors: Jeanne S. Sheffield, George D. Wendel, Pablo J Sánchez, David W.i Fong, Linda R. Margraf, Fiker Zeray, Donald D. Mcintire, Beverly Barton RogersAbstract:Abstract OBJECTIVE: To evaluate the contribution of placental histopathology to the diagnosis of Congenital Syphilis. METHODS: From January 1, 1986, through December 31, 1998, all pregnant women presenting to a large, urban Dallas County labor and delivery unit with untreated Syphilis at delivery and who had placental evaluation performed were identified. Women were clinically staged, and the infants were evaluated for Congenital Syphilis using a standard protocol. Each placenta was evaluated by two independent pathologists. Histologic characteristics of the placenta related to Congenital Syphilis in live-born and stillborn infants were then analyzed. RESULTS: Sixty-seven women met the study criteria: 33 (49%) stillborn and 18 (27%) live-born infants with Congenital Syphilis, 15 (22%) uninfected live-born infants, and one uninfected stillborn fetus diagnosed by current criteria. There were no differences between the groups with regard to demographic characteristics, prenatal care, or stage of Syphilis. Stillborn infants were more likely to deliver preterm (P CONCLUSION: Our results show that histopathologic examination of the placenta is a valuable adjunct to the contemporary diagnostic criteria used to diagnose Congenital Syphilis.
Virginia B. Bowen - One of the best experts on this subject based on the ideXlab platform.
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Missed Opportunities for Prevention of Congenital Syphilis — United States, 2018
MMWR. Morbidity and mortality weekly report, 2020Co-Authors: Anne Kimball, Hillard Weinstock, Elizabeth Torrone, Kathryn Miele, Laura Bachmann, Phoebe Thorpe, Virginia B. BowenAbstract:Congenital Syphilis is an infection with Treponema pallidum in an infant or fetus, acquired during pregnancy from a mother with untreated or inadequately treated Syphilis. Congenital Syphilis can cause miscarriage, stillbirth, or early infant death, and infected infants can experience lifelong physical and neurologic problems. Although timely identification and treatment of maternal Syphilis during pregnancy can prevent Congenital Syphilis (1,2), the number of reported Congenital Syphilis cases in the United States increased 261% during 2013-2018, from 362 to 1,306. Among reported Congenital Syphilis cases during 2018, a total of 94 resulted in stillbirths or early infant deaths (3). Using 2018 national Congenital Syphilis surveillance data and a previously developed framework (4), CDC identified missed opportunities for Congenital Syphilis prevention. Nationally, the most commonly missed prevention opportunities were a lack of adequate maternal treatment despite the timely diagnosis of Syphilis (30.7%) and a lack of timely prenatal care (28.2%), with variation by geographic region. Congenital Syphilis prevention involves Syphilis prevention for women and their partners and timely identification and treatment of pregnant women with Syphilis. Preventing continued increases in Congenital Syphilis requires reducing barriers to family planning and prenatal care, ensuring Syphilis screening at the first prenatal visit with rescreening at 28 weeks' gestation and at delivery, as indicated, and adequately treating pregnant women with Syphilis (2). Congenital Syphilis prevention strategies that implement tailored public health and health care interventions to address missed opportunities can have substantial public health impact.
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Use of National Syphilis Surveillance Data to Develop a Congenital Syphilis Prevention Cascade and Estimate the Number of Potential Congenital Syphilis Cases Averted.
Sexually transmitted diseases, 2018Co-Authors: Sarah Kidd, Elizabeth Torrone, Virginia B. Bowen, Gail BolanAbstract:BackgroundRecent increases in reported Congenital Syphilis have led to an urgent need to identify interventions that will have the greatest impact on Congenital Syphilis prevention. We sought to create a Congenital Syphilis prevention cascade using national Syphilis surveillance data to (1) estimate
Camille E. Introcaso - One of the best experts on this subject based on the ideXlab platform.
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Challenges in Congenital Syphilis surveillance: how are Congenital Syphilis investigations classified?
Sexually transmitted diseases, 2013Co-Authors: Camille E. Introcaso, Deann Gruber, Heather Bradley, Thomas A. Peterman, Joy Ewell, Deborah Wendell, Joseph Foxhood, Hillard Weinstock, Lauri E. MarkowitzAbstract:Background Congenital Syphilis is a serious, preventable, and nationally notifiable disease. Despite the existence of a surveillance case definition, Congenital Syphilis is sometimes classified differently using an algorithm on the Centers for Disease Control and Prevention's case reporting form. Methods We reviewed Louisiana's Congenital Syphilis electronic reporting system for investigations of infants born from January 2010 to October 2011, abstracted data required for classification, and applied the surveillance definition and the algorithm. We calculated the sensitivities and specificities of the algorithm and Louisiana's classification using the surveillance definition as the surveillance gold standard. Results Among 349 Congenital Syphilis investigations, the surveillance definition identified 62 cases. The algorithm had a sensitivity of 91.9% and a specificity of 64.1%. Louisiana's classification had a sensitivity of 50% and a specificity of 91.3% compared with the surveillance definition. Conclusions The differences between the algorithm and the surveillance definition led to misclassification of Congenital Syphilis cases. The algorithm should match the surveillance definition. Other state and local health departments should assure that their reported cases meet the surveillance definition.