South Dakota in Midst of Syphilis Outbreak

Friday, March 4, 2022
the bacterium Treponema pallidum that causes Syphilis
the bacterium Treponema pallidum that causes Syphilis

RAPID CITY – The Great Plains Tribal Leaders’ Health Board and the Great Plains Tribal Epidemiology Center are warning people in South Dakota and surrounding tribal-nations of a dangerous outbreak of syphilis.

In 2021, South Dakota saw 668 cases of syphilis, a 3081% increase over the 5-year median of 21 cases. In 2021the number of congenital syphilis cases increased in South Dakota, including an increased number of fetal and infant deaths. Many cases have been diagnosed in western South Dakota.

Congenital syphilis is a chronic infectious disease caused by a spirochete (treponema pallidum) acquired by the fetus in the uterus before birth. Symptoms of this disease may not become apparent until several weeks or months after birth and, in some cases, may take years to appear.

Syphilis can be cured with one to three shots of benzathine penicillin G, 2.4 million units IM depending on the stage of syphilis (see CDC treatment guidelines). In pregnancy, Penicillin G is the only known effective antimicrobial for preventing maternal transmission to the fetus and treating fetal infection. 

Congenital syphilis can cause serious symptoms in infected infants and even death. But it is preventable. 

Per CDC and USPSTF guidelines, because of the high rates of syphilis: 

  1. All adolescents and adults – even if asymptomatic – should be screened for syphilis.
  2. Pregnant women should be screened at least 3 times in pregnancy (at first prenatal visit, at start of third trimester and at delivery).
  3. No infant should leave the hospital without the mother’s serological status documented at delivery

Local medical care facilities should consider implementing universal screening using reminder prompts in its Electronic Health Records system.

The following people should be screened for syphilis: 

  1. All asymptomatic adolescents and adults. People who are at highest risk include:
    1. Those who live in Western South Dakota
    2. American Indians/Alaska Natives
  2. All Pregnant People
    1. At the first prenatal visit
    2. At the start of the third trimester (28 weeks)
    3. At delivery
  3. Anyone who has a stillbirth after 20 weeks

Test anyone who has been exposed to syphilis and/or has symptoms and consider presumptive treatment.

You can report cases to the South Dakota Department of Health here (https://doh.sd.gov/diseases/infectious/reporting.aspx#Instructions) or call 800-592-1861 to report anytime. 

For more detailed information on syphilis screening, testing and treatment guidelines, see https://www.cdc.gov/std/syphilis/syphilis-pocket-guide-final-508.pdf or https://www.cdc.gov/std/treatment-guidelines/syphilis.htm 

*The Great Plains Tribal Epidemiology Center (GPTEC) was founded in 2003 as a core component of the Great Plains Tribal Leaders’ Health Board (GPTLHB). GPTEC’s mission is to provide leadership, technical assistance, support, and advocacy for the 18 tribal nations and communities serviced by the Great Plains Area IHS in order to achieve our vision of eliminating the disparities in health that currently exist for tribal peoples within the four-state region of South Dakota, North Dakota, Nebraska and Iowa.

*Established in 1986, the GPTLHB represents tribal communities in South Dakota, North Dakota, Nebraska, and Iowa. The organization is overseen by the elected tribal leaders of 17- tribal entities in the area. Through public health practices and the formation of tribal partnerships, it works to improve the health of the American Indian peoples through health support, health care advocacy, and direct-patient care at the Oyate Health Center.

Written by Derek Olson
Last modified on: Monday, March 21st, 2022 @ 2:36 pm

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