Pennsylvania: Rise in Syphilis, Cuts in Funding a Worry in Philadelphia

Public health workers seeking to thwart the spread of STDs in Philadelphia are facing twin challenges: a sharp rise in syphilis, concurrent with a 34 percent reduction in state funding for city HIV prevention efforts. The lost money would have supported HIV testing for 8,000 people, together with risk-reduction services for 4,000.

Infectious syphilis rose by 45 percent in Philadelphia last year. Cases among women ages 15 to 29 spiked from five to 23 -- an especially disturbing statistic given that these are prime childbearing years, and the STD has devastating effects when transmitted in the womb.

Last year the city saw four babies born with congenital syphilis, two of which were delivered by Dr. Dimitrios S. Mastrogiannis, director of maternal/fetal medicine at Temple University Hospital. One mother who had received no prenatal care presented for delivery with preeclampsia, a dangerous combination of high blood pressure and other conditions indicating immediate delivery or abortion. Her baby was born with a rash and bone abnormality typical of syphilis and required a 10-day stay in the neonatal intensive care unit.

Such care, Mastrogiannis said, costs $10,000 to $100,000, versus the $10 cost of a syphilis test during pregnancy. Now, whenever a pregnant woman not receiving prenatal care comes to the Temple emergency department for any reason -- "even if she has a toothache," Mastrogiannis said -- she is screened for the STD.

The city health department runs a Web site, www.stdphilly.org, at which people diagnosed with an STD can inform their partners anonymously, and it offers free antibiotics to medical providers who need them. The department recommends that doctors conduct annual syphilis testing on all females ages 15 to 40 who had more than one sex partner in the previous year.

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