Congenital Syphilis: From Near-Elimination to Crisis
Year: 2025
Type: article
Abstract: This analytic essay examines the transformation of congenital syphilis (CS) in the United States from near-elimination to crisis. Drawing from the January 2025 Congenital Syphilis Summit in Atlanta, Georgia—convening public health leaders, Tribal health departments, the National Coalition of STD Directors, and Centers for Disease Control and Prevention experts—we contrast prevention systems during near-elimination (1998–2005) with the current crisis (2018–2025). Evidence revealed how dismantling public health infrastructure produced dramatically different outcomes, with CS cases increasing 937% over the past decade and racial/ethnic disparities worsening. American Indian/Alaska Native communities face rates up to 100 times higher than White populations in some regions, illustrating the multiplicative effects of system failures on vulnerable communities. We identify 5 critical system failures: cyclical boom-and-bust funding, workforce deterioration, fragmented surveillance, disconnected health care systems, and health equity failures. We present policy proposals for rebuilding prevention infrastructure through a deliberate phased approach transitioning from crisis response to sustained maintenance, ensuring prevention systems receive continuous support rather than episodic investments that have characterized past approaches. ( Am J Public Health. 2026;116(1):103–112. https://doi.org/10.2105/AJPH.2025.308266 )
Authors: Chad J. Abresch, Irene A. Stafford, Regan M. Johnson, Kayode Olabanji, Ashleigh M. Sutphen, Helen E. Cejtin, Ashley Hoover
Language: English
Subfield: Physiology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4415252472