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Rising Cases of Congenital Syphilis in Tamil Nadu

by Mukta Sneha,

Tamil Nadu, India—

In a troubling development, Tamil Nadu has seen a significant surge in congenital syphilis cases, with reports indicating 600 affected babies in 2023-24, a sharp increase from just five cases in the previous year. According to the National AIDS Control Organisation (NACO), this spike has raised alarms across the country. However, the Tamil Nadu State AIDS Control Society has called this data an error, claiming that the actual number is far lower.

Congenital syphilis, a severe infection passed from mother to child during pregnancy, has long been a serious concern for public health. If a pregnant woman contracts syphilis and does not receive early and adequate treatment, the infection can be transmitted to her unborn child, resulting in birth defects, stillbirths, or even neonatal death. The World Health Organization (WHO) estimates that globally, 150,000 babies are affected by congenital syphilis every year. This makes it a critical issue that requires immediate attention and intervention.

In the 2023-24 report by NACO, Tamil Nadu’s numbers stand out, with 600 babies diagnosed with congenital syphilis. This stark contrast from previous years—where the state recorded only 14 cases in 2020-21 and 20 in 2021-22—has raised significant questions. The state’s AIDS control officials, however, have refuted the figures, attributing the rise to a “data error.” According to an official from the Tamil Nadu State AIDS Control Society, only eight cases were recorded in the state for the same period, pointing out the discrepancy between NACO’s figures and their own data collection.

This controversy highlights a larger issue with syphilis transmission during pregnancy in India. The NACO report indicates that across the country, 3,579 cases of congenital syphilis were diagnosed in 2023-24. States like Karnataka and Maharashtra were also reporting high numbers, with 933 and 836 cases respectively. Despite the alarming numbers, only a small fraction of the infected infants—111 in Tamil Nadu—received the necessary treatment.

NACO guidelines recommend immediate intervention for infants diagnosed with congenital syphilis, including the administration of benzathine penicillin G, a treatment that is critical for preventing further complications, including neurosyphilis. Yet, health officials in Tamil Nadu have pointed to shortages of essential treatment like penicillin and testing kits as key barriers to addressing the growing problem.

“Early detection of syphilis in pregnant women could prevent mother-to-child transmission,” said a senior health official. “All antenatal women are tested for HIV and syphilis at primary care facilities, and the increase in diagnoses could also indicate better detection.” This notion is echoed by experts, who believe that enhanced screening and early intervention could drastically reduce the incidence of congenital syphilis.

Symptoms of congenital syphilis in newborns include continuous crying, irritability, joint tenderness, and difficulty moving limbs. If untreated, babies can develop neurosyphilis, which may lead to long-term neurological damage, including seizures. Radiological and serological tests are essential for diagnosing the condition early, which can make a significant difference in preventing the disease’s devastating effects.

Despite the availability of effective treatments, syphilis continues to pose a significant risk, especially to pregnant women who may be unaware of their infection. The incidence of congenital syphilis is directly linked to the stage at which the infection is acquired during pregnancy, with untreated primary syphilis posing the highest risk for fetal transmission. Treatment with penicillin, administered in the early stages of pregnancy, can prevent the transmission of syphilis to the unborn child in nearly all cases, but delays or inadequate treatment still result in preventable cases.

As Tamil Nadu grapples with this surge in cases—whether due to data errors or a real increase in infections—the focus must shift towards strengthening healthcare infrastructure, ensuring that pregnant women have access to timely and effective treatment, and addressing the gaps in the supply of critical medications and testing kits.

Ultimately, the fight against congenital syphilis will require a multifaceted approach: better data collection, more accessible healthcare services, and continued education and awareness efforts to reduce the risk of mother-to-child transmission of syphilis. Public health experts agree that addressing the root causes of syphilis transmission can significantly reduce the number of affected newborns in the years to come, making early detection and treatment an essential part of this effort.

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Contact: author@sexandsexology.com

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