Questionnaire Survey of Reported Early Congenital Syphilis

Kaufman, Richard E.; Jones, Oscar G.; Blount, Joseph H.; Wiesner, Paul J.

doi:10.1097/00007435-197710000-00003

Cited by 57 publications

(12 citation statements)

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“…From 1984 to 1991 cases were defined using the Kaufman criteria. 9 By 1992 most states were using a revised CDC case definition (confirmed, presumptive, stillbirth) to identify CS in infants. 10 To minimize the effects of the change in case definition, the current analysis focuses on the years 1992-1998.…”

Section: Methodsmentioning

confidence: 99%

Mortality Associated With Congenital Syphilis in the United States, 1992–1998

et al. 2002

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ABSTRACT. Objective. To summarize national trends in the incidence of congenital syphilis (CS) and associated mortality.Methods. We analyzed CS surveillance data reported to the Centers for Disease Control and Prevention by 50 states and the District of Columbia from 1992-1998.Results. From 1992-1998, 942 deaths, including 760 stillbirths, were reported among 14 627 cases of CS, yielding a case fatality ratio (stillborns and deaths/all cases) of 6.4%. Untreated, inadequately treated, or undocumented treatment of syphilis during pregnancy accounted for 87.4% of reported cases. Among CS cases, there was an inverse relationship between the number of prenatal care visits (0, 1-4, 5-9, >10) and risk of fatal outcome. Among deaths, 52% of deliveries occurred by 30 weeks' gestation. Among live born infants with CS, death occurred more often in infants for whom no radiograph or cerebrospinal fluid evaluation was reported. Although both cases and deaths from CS declined from 1992-1998, there was no significant change in the case fatality ratio.Conclusion. Mortality associated with CS continues to be an important public health problem that will resurge if adult syphilis rates increase. Because a large proportion of deaths occur at low gestational age, earlier diagnosis and treatment of maternal syphilis may substantially reduce the case fatality ratio. Pediatrics 2002; 109(5). URL: http://www.pediatrics.org/cgi/content/full/ 109/5/e79; congenital syphilis, mortality, case fatality ratio, prenatal care, early treatment.

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Section: Methodsmentioning

confidence: 99%

Mortality Associated With Congenital Syphilis in the United States, 1992–1998

et al. 2002

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“…The FTA-ABS 19S IgM test is not available in kit form, and matching the reagents to be used in the test is extremely difficult. The predecessors of the FTA-ABS 19S IgM test, the FTA-IgM and the FTA-ABS IgM, were reported to be both nonspecific and lacking in sensitivity (1,92,99,116,125,139). The specificity of the FTA-ABS IgM test for neonatal congenital syphilis, as well as other indirect immunofluorescent IgM tests for prenatal infections, has been questioned by the observation that newborns may produce IgM antibodies in response to passively transferred maternal IgG antibody rather than in response to the infectious agent itself (116,139,166,172).…”

Section: Treponemal Testsmentioning

confidence: 99%

Laboratory diagnosis and interpretation of tests for syphilis

1995

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The lack of a method for demonstrating the presence of Treponema pallidum by growth necessitates the use of alternative methods. Traditionally, these methods are divided into direct detection methods (animal inoculation, dark-field microscopy, etc.) and serologic tests for the presence of patient antibody against T. pallidum. Serologic methods are further divided into two classes. One class, the nontreponemal tests, detects antibodies to lipoidal antigens present in either the host or T. pallidum; examples are the Venereal Disease Research Laboratory and rapid plasma reagin and tests. Reactivity in these tests generally indicates host tissue damage that may not be specific for syphilis. Because these tests are easy and inexpensive to perform, they are commonly used for screening, and with proper clinical signs they are suggestive of syphilis. The other class of test, the treponemal tests, uses specific treponemal antigens. Confirmation of infection requires a reactive treponemal test. Examples of the treponemal tests are the microhemagglutination assay for antibodies to T. pallidum and the fluorescent treponemal antibody absorption test. These tests are more expensive and complicated to perform than the nontreponemal tests. On the horizon are a number of direct antigen, enzyme-linked immunosorbent assay, and PCR techniques. Several of these techniques have shown promise in clinical trials for the diagnosis of congenital syphilis and neurosyphilis that are presently difficult to diagnose.

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“…Alternatively, an infant may be infected at the time of delivery through contact with infectious maternal blood, secretions, or a genital lesion. Although neonatal manifestations of congenital infection are well described (Ingall et al, 1995;Kaufman et al, 1977;Centers for Disease Control, 1988;Sanchez, 1992), the precise mechanism of spirochetal transplacental passage is poorly understood.…”

Section: Discussionmentioning

confidence: 99%

“…Monthly quantitative VDRL titres were followed until delivery. All infants were evaluated by quantitative VDRL titre, long bone radiological survey, and physical examination for signs of congenital syphilis (Kaufman et al, 1977;Centers for Disease Control, 1993), and the newborns were followed until seroreversion to negative.…”

Section: Methodsmentioning

confidence: 99%