(P14) CONGENITAL SYPHILIS: LESSONS LEARNED IN PEDIATRIC FOLLOW-UP

Background:
Since 2012, Louisiana has ranked among the top ten states for congenital syphilis, and in 2022 identified an all-time high of 115 cases. Throughout surveillance activities conducted by the Louisiana STD/HIV/Hepatitis program, the need for pediatric follow-up after a maternal syphilis exposure became exceedingly clear. Infants exposed to syphilis may not be symptomatic at delivery but are at risk of death and significant developmental problems later in life. In addition, pediatric follow-up for congenital syphilis within the primary care setting is not considered a norm, as pediatric providers may be unaware of current guidelines. The goal of this abstract is to outline the need for a pediatric protocol through case examples, describe implementation, and provide lessons to help combat the effects of the congenital syphilis crisis in the United States.

Methods:
Syphilis and congenital syphilis investigations are collected through Louisiana’s centralized surveillance system (PRISM). A standardized protocol for pediatric follow-up was constructed in early 2024 to help guide field staff and perinatal case managers on infant follow-up.

Results:
Cases were assessed for follow-up through multiple factors, including maternal and infant clinical findings. These assessments were completed through collaboration between field staff, perinatal case managers, and state surveillance staff. Any cases with no documentation adequate treatment are selected for a high-priority review to confirm needed infant follow-up. Once a plan of care has been established, disease intervention specialists and perinatal case managers coordinate with clients and providers to carry out the treatment plan.

Conclusion:
The congenital syphilis epidemic has shown no signs of abatement. This pediatric follow-up protocol is a step in the right direction. However, the ever-present limitations on state public health work are huge barriers to the continuation of this work, and additional federal guidelines are needed to ensure that no infant exposed to syphilis goes without proper care.