Federal data released this week show that Arizona has one of the highest rates of congenital syphilis - mother to infant transmission - in the country.
And the problem is particularly bad in Southern Arizona, said Dr. Michelle McDonald, chief medical officer for the Pima County Health Department.
"I would argue that Pima County has one of the worst rates in the state and in the country," McDonald said Tuesday. "The numbers went down slightly from 2008 but we are still at what we would call elevated values. … I am disappointed, but it has been challenging to get the message out."
Babies born with syphilis are at risk for hearing, nerve, bone and brain damage. Pregnant women are at extremely high risk of stillbirth if infected. Antibiotic treatments even a month before birth could prevent damage.
The new 2009 data on sexually transmitted diseases were released by the U.S. Centers for Disease Control and Prevention this week. The report says gonorrhea in the U.S. last year reached its lowest point since 1941. While chlamydia cases have increased, the report says that growth likely reflects expanded screening efforts, and not necessarily a true increase in the disease. Arizona's chlamydia rate is 400 per 100,000 people, which is lower than the national average.
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For the first time in five years, reported syphilis cases did not increase among U.S. women overall. Likewise, cases of congenital syphilis did not increase for the first time in four years.
But in Arizona, the news was not as good. While cases went down, the state had the third-highest rate of congenital syphilis in the country, the CDC report says. Only Maryland and Texas had higher rates.
There were 28 cases of congenital syphilis statewide in 2009, including 12 in Maricopa County and nine in Pima County. Maricopa County's population is nearly four times larger than that of Pima County, putting Pima County at a higher rate.
And the rate of primary and secondary cases of syphilis in Pima County is also higher than the national average.
New recent cases of syphilis reverse a trend from the 1990s and early 2000s when syphilis appeared nearly eradicated.
McDonald says all pregnant women in Pima County should be tested three times during their pregnancy - within the first trimester, at seven months and at birth.
Also, all residents with more than one sexual partner should be tested at least once per year, she said.
Testing requires a blood test, and those who test positive can be treated with injectable penicillin.
The majority of reported syphilis cases nationwide continues to be among men who have sex with men.
But that's not true in Pima County.
"In Pima County, the outbreak - and I'd call it an outbreak -Â is not driven by men who have sex with men. Here it's more like 30 percent gay and bisexual men. The problem here is in reproductive age heterosexuals and therefore pregnant women," McDonald said.
A lack of access to prenatal care and to health care in general is often the problem, she said.
McDonald hopes mothers-to-be know that the county's Theresa Lee Clinic does syphilis testing, and does not turn anyone away if they are unable to pay.
Like other sexually transmitted diseases, syphilis disproportionately affects minorities, locally and nationally. In Southern Arizona, Hispanic and American Indian women are most likely to give birth to babies with syphilis.
"I would still have a long-term goal of syphilis eradication, I would have a more short-term goal of just getting it to lower levels than we have previously enjoyed in the community," McDonald said.
Contact reporter Stephanie Innes at sinnes@azstarnet.com or 573-4134.
