(P184) IMPLEMENTATION OF A STATEWIDE PERINATAL SYPHILIS CLINICAL SUPPORT WARMLINE IN ILLINOIS

Background:
Over the last decade, the U.S. has experienced a precipitous rise in congenital syphilis (CS). In Illinois, between 2013 and 2022, CS rates increased by 315%. Perinatal syphilis management is complex, yet many prenatal and birthing facilities lack specialty provider assistance for diagnosis and treatment. In response, the Illinois Department of Public Health implemented a statewide perinatal syphilis clinical support warmline collaboratively with the Chicago Department of Public Health. We present findings from the first four months of warmline activity.

Methods:
Data were obtained from a prospective, statewide initiative with real-time data collection and validation. The warmline offers clinicians medical consultation for syphilis diagnosis and treatment during pregnancy and the newborn period, coordination of syphilis record searches to obtain prior testing and treatment history, and assistance with mandatory reporting. Calls are answered within one business day by physicians with advanced expertise in reproductive and pediatric infectious diseases. Call documentation includes clinical and demographic characteristics and reasons for consultation. Cases were described using CDC surveillance case definitions (adults) and CDC evaluation scenarios (newborns).

Results:
The warmline launched with information disseminated through press releases and statewide public health alerts. Between 11/1/23 and 2/29/24, there were 32 calls (15 from Chicago, 17 from outside Chicago). Overall, 41% (13) of calls involved antepartum care, 50% (16) postnatal/infant care, and 9% (3) other concerns. Syphilis diagnosis was established for 24 cases: 2 primary, 1 early latent, 18 late latent, and 3 stage unknown. Among 15 calls regarding newborn evaluations for CS, there were 7 possible, 5 less likely, 2 unlikely, and 1 unknown.

Conclusion:
Implementation of a statewide perinatal syphilis clinical support service resulted in rapid utilization by Illinois clinicians, highlighting the clinical complexity of this condition. Our model may be replicated in other public health jurisdictions and could help reduce the incidence of CS locally and nationally.