Over the past five years, more than a dozen babies have been born in Spokane with a potentially fatal illness that could have been detected by a simple blood test.
The number of congenital syphilis cases continues to rise in Spokane County and across the country, and has prompted new guidance from the Spokane Regional Health District on who should get tested, and when, for the sexually transmitted illness.
“Syphilis is our No. 1 focus in our program,” said Kirsten Duncan, lead disease investigation specialist at the health district.
The bacterial infection, which is spread through sexual contact and appears initially as a sore at the infected spot, was identified in 287 people in Spokane County in 2019, the most recent year for which data is available. That’s an increase of 386% from 2015, when just 59 cases were identified.
Spokane County also has a disproportionate share of the cases of congenital syphilis compared with Washington state. From 2015 through 2019, the county accounted for 43% of Washington babies born with the infection, according to health district figures. Five of the six Washington babies born with the illness in 2017 were from Spokane County.
Seven babies were born in Spokane County with syphilis in 2019. Two of those were stillbirths, Duncan said. According to a recent study published by the National Academies of Sciences, Engineering, and Medicine, 40% of babies born with syphilis do not survive.
Washington law requires pregnant women to receive the blood test for syphilis at their first prenatal checkup. But some women do not receive prenatal care, and there is no national recommendation that expectant mothers receive the test.
“It’s something that not a lot of people know,” said Jessica Lucht, director of collaborative learning at Planned Parenthood of Greater Washington and North Idaho. “People think that when they go to their provider, they’re being tested for everything.”
Syphilis requires a blood test to diagnose, while other illnesses can be detected with a urine sample, Duncan said. Expectant mothers should ask for a blood test on their first checkup if it isn’t offered, and should specifically ask their doctor if they’re being screened for syphilis, Lucht said.
The new guidance also calls for testing in the third trimester of pregnancy, Duncan said.
“Often what we see is women have a negative test, then they go on to acquire syphilis during pregnancy,” she said.
Partners should talk about getting tested sooner, Lucht said. They’re offered at Planned Parenthood and other health care clinics.
“We really want to destigmatize testing,” she said. “It’s nothing to be ashamed of. The tests are quick, most of them are noninvasive and painless. It’s nothing to be afraid of.”
Treatment of a syphilis infection is typically an injection of a special type of long-lasting penicillin, Duncan said. Expectant mothers may receive two doses in order to protect them and their child.
The health district is required to be notified if there’s a confirmed case of the infection. The district also has doses of the antibiotic, called benzathine penicillin, that is provided for free to health care providers to administer to their patients.
The availability of testing and effective treatment make the serious cases of the illness, especially in children, even more difficult to combat, Duncan said.
“It’s an entirely preventable disease,” she said. “When we have even one case, it’s tragic.”
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