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Increasing Numbers of Syphilis, Congenital Syphilis and Diagnoses of Other Sexually Transmitted Infections Across Louisiana. 

Sexually Transmitted Disease (STD) Surveillance, 2021

 annual report and identified over 2.5 million cases of chlamydia, gonorrhea and syphilis reported across the nation. New diagnoses of syphilis are on the rise nationally and across Louisiana. The number of syphilis cases in Louisiana increased by 36% from 2020 to 2021. In 2021, Louisiana ranked 11th in the nation for Primary & Secondary (P&S) syphilis case rates. In 2021, Louisiana reported 995 new diagnoses of P&S syphilis, 21.5 per 100,000 people. Of particular concern are the disproportionate rates of early syphilis among women, people of color, and gay and bisexual men in Louisiana. In 2021, 68% of early syphilis occurred among people of color and 38% of diagnoses were among gay and bisexual men; 48% of all early syphilis diagnoses were among Black men.

In 2021, Louisiana had the 3rd highest case rate in the nation with 110 congenital syphilis (CS) cases— an increase of 75% compared to 2020; 65% of cases occurred among Black women and 64% of mothers were under the age of 30 at delivery. In 2021, the rate of CS in Louisiana was 191.5 per 100,000 live births. During this same time, all nine of Louisiana’s public health regions reported congenital syphilis cases involving pregnant women and their babies. 

The most commonly missed care opportunity among mothers linked to 2021 congenital syphilis cases was the lack of timely syphilis retesting within the third trimester (44%). 

Across the nation, CS has increased 464% since 2001.

In addition to high rates of syphilis and congenital syphilis, Louisiana also has high rates of gonorrhea and chlamydia. In 2021, Louisiana had the 3rd highest rate of gonorrhea and the 3rd highest rate of chlamydia in the nation. In 2021, Louisiana reported 16,390 cases of gonorrhea for a rate of 354.5 per 100,000 people, and reported 33,759 cases of chlamydia for a rate of 730.1 per 100,000 people. Increases in gonorrhea and chlamydia are being reported across the nation with the highest reported cases to date.

The Louisiana Department of Health, Office of Public Health is requesting all healthcare providers in the state to increase syphilis screening and ensure timely treatment and reporting of syphilis 

according to CDC recommendations and Louisiana reporting requirements that are referenced and summarized below:

Early Syphilis (Primary, Secondary, Early Non-Primary Non-Secondary)

Benzathine penicillin G 2.4 million units IM once

Treatment with Doxycycline 100 mg PO BID x 14 days

Late Latent Syphilis or Syphilis of Unknown Duration

Benzathine penicillin G 2.4 million units IM x 3 doses

Give as 2.4 million units IM each week for 3 consecutive weeks.

A minimum of 6 days and maximum of 14 days between doses or series must be restarted.

Benzathine Penicillin G 2.4 million units IM x 3 doses· Give as 2.4 million units IM each week for 3 consecutive weeks.· 

Due to pregnancy, a strict dosage schedule for every 7 days for 3 doses (7.2 million units total) should be followed 

; however, a range of 6-9 days between each dose is allowable.· If any doses are given outside of the 6-9 day range, then restart the entire 3 dose series again.

Louisiana State Sanitary Code LAC 51:II.105 requires healthcare providers and laboratories to report notifiable diseases including syphilis, syphilis in pregnancy and perinatal exposure of syphilis. Disease intervention specialists (DIS) confidentially notify exposed partners to prevent additional transmission. Timely reporting of new syphilis cases and treatment are essential to mitigating the spread of syphilis and decreasing the number of congenital syphilis cases in Louisiana. Providers can report syphilis diagnoses and treatment by submitting the STD 43 form:

https://ldh.la.gov/assets/oph/HIVSTD/STDForm43NewCRx_Design-FormsCommitteeerapprovedNov202.pdf

Please report all information related to clinical and laboratory reports on suspected/probable congenital syphilis cases to Perinatal Surveillance Supervisor Elizabeth Lindsay at 504-568-7047.