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Department of Public Health Newsroom 2017

April 24, 2017: Local Public Health Agencies Urge Vigilance and Action to Combat Rise in Congenital Syphilis Cases
April 17, 2017: St. Louis ReCAST to Kick Off Regional Efforts on Saturday, April 22, 2017
April 6, 2017: City of St. Louis Department of Health and Saint Louis County Department of Public Health to Focus on Sexually-Transmitted Infections (STI) during STI Awareness Month


Local Public Health Agencies Urge Vigilance and Action to Combat Rise in Congenital Syphilis Cases

St. Louis County, MO – (April 24, 2017) – In 2016, the rate of congenital syphilis in Missouri rose to the highest it has been in decades. The Saint Louis County Department of Public Health, the St. Louis City Department of Health, and the St. Louis STI Regional Response Coalition (STIRR) are joining together to call for vigilance and action by everyone in the local health community to address the problem.

“Sexually-transmitted infections are entirely preventable,” said Dr. Faisal Khan, director of the Saint Louis County Department of Public Health. “Everyone in local health community needs to be aware of the problem in order to combat this unacceptable increase.”

Missouri is not the only state affected by rising rates of congenital syphilis. The U.S. saw a 39% increase from 2012-2014. Preventative techniques, medical recommendations, and timely treatments are all being encouraged to both prevent congenital syphilis as well as ensure the health and safety of mothers, their sexual partner(s), and children.

“It is also critical that the local health community understand that risk factors outside of unprotected sex exist in the contraction and spread of syphilis,” said Dr. Fredrick Echols, director of the Division of Communicable Disease Control Services at the Saint Louis County Department of Public Health. “These include drug use, the diagnosis of another sexually-transmitted infection, new or multiple partners during pregnancy, and sex with non-monogamous partners.”

The Centers for Disease Control and Prevention (the CDC) recommends that pregnant women be tested for syphilis during their first trimester. Missouri law requires that such testing occur either during the first trimester or during the initial prenatal screening. In addition, since women who remain sexually active during their pregnancy can still contract syphilis, it is recommended that women continue to be screened for syphilis periodically throughout their pregnancy. Monitoring for syphilis is vital since an infection can cause abnormal fetal development, miscarriage, birth defects, and because it can be passed from mother to child during delivery.

Because of the high prevalence of primary and secondary syphilis in the St. Louis region, STIRR is recommending an additional screening for syphilis between 28 and 32 weeks and repeat testing at delivery for all pregnant women. This testing may be considered as early as 24 weeks.

Added Dr. Hilary Reno, director of STIRR, “Combining precision prevention methods and compassionate treatment options are steps the health community must take to prevent further maternal, partner, and infant exposure and infection with syphilis.”

Medical and other healthcare professionals are being reminded to follow all recommended testing and treatment protocols regarding pregnant women and congenital syphilis. In addition, local public health agencies are recommending the following for medical professionals:

Treatment for pregnant women who test positive for syphilis is vital. It has been shown that early detection and swift treatment more than 30 days before delivery dramatically decreases the number of congenital syphilis cases. Pregnant women with syphilis should be treated with benzathine penicillin. However, it should also be recognized that pregnant women, especially those who show fetal abnormalities on an ultrasound, are at increased risk for treatment failure and a second dose of penicillin G can be given one (1) week later for primary, secondary, or early latent syphilis. Patients with penicillin allergies should be desensitized and treated with penicillin.

With infants, consideration should be given to both live birth and stillbirth circumstances. In the case of a live birth, infants should not be discharged from the hospital without syphilis testing of the mother at least once during pregnancy and preferably again at delivery. Decisions for the evaluation and treatment of newborns should be based on the timing and treatment regimen of the mother and the history of ultrasound finding of the neonate. In the case of patients with a stillbirth after 20 weeks of pregnancy, testing for syphilis should also occur.

To control a congenital syphilis outbreak, other testing, evaluation, actions, and care should be considered. Screening for syphilis with nontreponemal antibody testing is typical, but reverse screening protocols using treponemal antibody testing are also acceptable. Since syphilis is a reportable illness, all incidents should be reported to the Missouri State Department of Health and Senior Services. The testing and treatment of partners should also be considered, especially to prevent reinfection during pregnancy. Encouraging prenatal care not only works to ensure a healthier pregnancy, but also increases the chances for early syphilitic symptom detection. Finally, syphilis infections are closely related to the risk of an HIV infection, so strong consideration should be given to testing for that as well.


St. Louis ReCAST to Kick Off Regional Efforts on Saturday, April 22, 2017

(April 17, 2017) – St. Louis ReCAST – a grant-funded effort to promote community well-being – is holding its public kick-off meeting on Saturday, April 22, at 11:00 a.m. at the O’Fallon Rec Center at 4343 W. Florissant Drive (63115).

The St. Louis ReCAST project is being funded by a 5-year, $4.7 million grant from the Substance Abuse and Mental Health Services Administration (SAMHSA) that was awarded to the Saint Louis County Department of Public Health last year. St. Louis County’s Office of Community Empowerment helped secure the grant. Partners in the effort include the St. Louis City Department of Health, the Saint Louis Mental Health Board, and over 70 other local agencies, not-for-profits, and municipalities.

“The ReCAST grant is great example of regional cooperation that is helping us find solutions to longstanding problems in our communities,” County Executive Steve Stenger said.

The project will focus on the St. Louis Promise Zone – a federally-designated area in North St. Louis City and County that encompasses 11 wards in North St. Louis City and 28 municipalities in North St. Louis County. Priorities for ReCAST include:

  • violence prevention;
  • youth engagement;
  • peer support;
  • mental health; and,
  • trauma-informed care.

Each year, St. Louis ReCAST will allocate $650,000 to community microprojects in the Promise Zone that address ReCAST priorities. All the funds will be awarded through a community-based, participatory budgeting process that will include residents from the targeted communities. The meeting on April 22, 2017, is to begin the process of selecting the community delegates that will make the funding decisions for the first year of the effort.

Anyone who lives in the Promise Zone is eligible to be a community delegate, provided they are at least 11 years old (parental permission will be required for those under 18). Those selected to be community delegates will be eligible for childcare and transit passes as needed.


City of St. Louis Department of Health and Saint Louis County Department of Public Health to Focus on Sexually-Transmitted Infections (STI) during STI Awareness Month

(April 6, 2017) – April is STI Awareness Month and the City of St. Louis Department of Health and the Saint Louis County Department of Public Health are using the event to educate residents about the very serious health challenges posed by STIs for communities in the St. Louis region.

According to the Centers for Disease Control and Prevention (CDC), nearly 20 million new STIs occur in the United States every year and they cost the American healthcare system nearly $16 billion in direct medical costs alone. In addition, there has been an alarming rise nationally in the number of syphilis cases, which serves as a reminder to local health officials and medical providers to follow CDC screening recommendations.

The CDC estimates that half of all new STIs occur among young men and women aged 15 to 24. In 2016, a significant percentage of all new STI cases in the St. Louis region were in persons under 25 years of age. For that reason, prevention efforts must include age-appropriate education for teens and young adults and the development and use of online options to reach this population.

“If we are to respond effectively and improve and protect the health of St. Louis residents and visitors, we must work together,” said Dr. Faisal Khan, director of the Saint Louis County Department of Public Health. “There are a lot of factors at work here and a regional response is required to both address the immediate disease specifics and those factors that contribute to the problem, such as the lack of health insurance, a lack of knowledge about sexual health and available sexual health resources, the inability to cover medical costs, and a lack of transportation to needed services.”

Added Melba Moore, acting director and commissioner of health for the City of St. Louis Department of Health: “Through the continued coordination of regional prevention efforts, screenings, and treatments, we are working with all our regional and community partners to close the gap on STIs by enabling and empowering our communities to access the services they need.”

Added St. Louis County Executive Steve Stenger: “I applaud these efforts as they relate directly to my strategic initiative to engage in more preventative public health measures that support optimal health for all residents in the region.”

Added Dr. Fredrick Echols, director of the Division of Communicable Disease Control Services at the Saint Louis County Department of Public Health: “People from all walks of life can play an important role in the prevention and education efforts for HIV and other STIs. Regardless of sexual orientation, religious beliefs, age, income, or any other distinctions, lives are worth saving.”

There are effective ways to prevent, diagnose, and treat STIs. Screenings and early diagnoses are crucial in preventing the spread and long term health consequences of STIs. Health officials in both the city and county are reminding parents and guardians to talk to their children about the risks associated with sexual activity and the steps they can take to protect themselves and prevent the spread of STIs.

There are simple measures people can take to lower their chances of getting an STD:

  • abstain from having sex;
  • be in a monogamous relationship with a partner who has tested negative for STIs;
  • consistently and correctly use condoms every time you have sex; and
  • talk openly and honestly with your healthcare provider to find out what tests may be right for you.

If you test positive for an STI, get treated right away and make sure your partner is treated to reduce the risk of becoming infected again. Safe, effective vaccines are also available to prevent hepatitis B and some types of the human papillomavirus (HPV) that cause disease and cancer. And for all individuals who are sexually active – particularly young people – STI screening and prompt treatment (if infected) are critical to protect a person’s health and prevent transmission to others.

Area youth (and their parents or guardians) are encouraged to visit www.STLCondoms.com, www.STLProtectYours.org, and www.GetTestedSTL.org, for STI-related information and resources.