HJAR Jul/Aug 2022

HEALTHCARE JOURNAL OF ARKANSAS I  JUL / AUG 2022 43 Jennifer Dillaha, MD Director Arkansas Department of Health a person can be re-infected after treatment. Sexually active people should get tested regularly, especially if they are pregnant, have HIV infection, or have partners who have already tested positive for syphilis. Men who have sex with men should also get tested regularly. Testing is available through healthcare providers or the nearest ADH Local Health Units, which are located in all 75 counties. Partners of people who test positive for syphilis need to be notified immediately. Syphilis among pregnant women is a serious concern due to the potential of congenital syphilis, which happens when a mother with syphilis passes the infection to her baby during pregnancy. Arkansas re- quires pregnant women to be tested at their first prenatal visit and during their third trimester, between 28 to 32 weeks of their pregnancy. Testing at delivery is required if no tests were done during the pregnancy. A woman must be tested each time they be- come pregnant. Congenital syphilis is preventable if de- tected early and treated before delivery. Un- treated syphilis during pregnancy can lead to stillbirth, preterm delivery, and congeni- tal abnormalities. Arkansas saw a 254% in- crease (from 13 to 46) in congenital syphilis cases from 2017 to 2021. Nine babies died before birth in this timeframe, with 55% of these deaths (5) occurring in 2021. Up to 40% of babies born with untreated syphilis may be stillborn or die as newborns. In 2021, roughly one out of three pregnant syphilis patients in Arkansas delivered a baby with congenital syphilis. More knowledge is critical to accurate decision-making. It is essential that health- care providers have an open and honest talk with their patients about sexual history and encourage regular testing, especially if their patients are at risk for syphilis. If a patient’s test is positive for syphilis, advise them to notify their sexual partners to seek testing and treatment immediately. Physicians are required to report all positive cases to the ADH within 24 hours. The report can be made by fax at 501-661-2428 or by phone at 501-537-8969 (after hours to 1-800-554-5738). Faxed re- ports are preferred when possible. A report form can be downloaded at https://www. healthy.arkansas.gov/images/uploads/pdf/ CdReportingForm.pdf. More information about syphi- lis testing and treatment is available by contacting the ADH Infectious Dis- ease Branch at 501-661-2408 or visiting www.healthy.arkansas.gov . n InApril 2022,Jennifer Dillaha,MD,was appointed di- rector of theArkansas Department of Health and the state health officer forArkansas.Before her appoint- ment,she was theADH chief medical officer,medical director for immunizations, andmedical director for outbreak response. Before joining the ADH in 2001, Dillaha previously served as the state epidemiologist fromMarch 2020 toAugust 2021,special advisor for strategic initiatives in the office of the director from June 2010 toApril 2013,and director of the Center for HealthAdvancement fromAugust 2005 toJune 2010. SYPHILIS is a sexually transmitted infec- tion that can cause serious health problems if not treated. Infection occurs from direct contact with a syphilis sore during vaginal, anal, or oral sex. It can also be spread from a mother with syphilis to her unborn baby. People cannot get syphilis through casual contact with objects like toilet seats or shar- ing clothing. People can lower their chances of getting syphilis by using condoms every time they have sex. Being in a monogamous relationship with a partner who has been tested and does not have syphilis can also lower a person’s chances of getting syphilis. Syphilis is divided into four clinical stages: primary, secondary, latent, and tertiary. Dif- ferent signs and symptoms are associated with each stage, and they range from open sores, rash, and flu-like symptoms to long- term damage to the heart, brain, and other organs. Symptoms may start anywhere from 10 to 90 days after exposure. About 600 cases of syphilis are typically reported to the ADH each year. However, from 2017 to 2021, the state saw a 164% in- crease (from 562 to 1,482) in early syphi- lis cases and a 285% increase (from 155 to 597) among women of reproductive age (age 15-44 years). The COVID-19 pandemic has hindered efforts to lower cases because it limited resources and access to screening and testing. Syphilis is easy to cure in its early stages and can be treated using a medication pre- scribed by a healthcare provider. However, “IN 2021 , ROUGHLY ONE OUT OF THREE PREGNANT SYPHILIS PATIENTS IN ARKANSAS DELIVERED A BABY WITH CONGENITAL SYPHILIS.”