Cases of syphilis among newborns have spiked in recent years — both nationally and in Michigan.
State officials say 14 newborns in the state were diagnosed with syphilis in 2017. That number more than doubled to 37 cases in 2022.
Syphilis can cause miscarriage, and severe birth defects including blindness or death in newborns, but it's highly treatable if the mother is tested and treated.
Dr. Natasha Bagdasarian is Michigan's chief medical officer.
She says part of the problem is that the public health system in the state has been focused on high syphilis transmission rates in the population of men who have sex with men.
But the pattern of transmission has shifted, Bagdasarian said, and there is now an increasing number of syphilis cases among heterosexual men and women.
"I think that there was still a belief out there that syphilis was not something that we needed to worry about in women of childbearing age," she said.
In response to the growing numbers, a state law was passed in 2018 to mandate testing for syphilis at a pregnant woman's first prenatal visit, and again in her third trimester.
But many lower-income women have sporadic, or no, access to regular prenatal care, said Bagdasarian.
"This is not medical providers not doing the right thing or not wanting to do the right thing," she said. "This is a result in large part due to interrupted care and missed opportunities."
Bagdasarian said the state is shifting its focus to emergency departments and urgent care clinics, where people without health insurance or primary care doctors often go for medical care.
She said doctors at emergency departments and urgent care clinics are now being asked to test pregnant women for syphilis, even though they came in for something else.
Bagdasarian said if the test is positive, the state will be notified and can make sure the mother gets treatment and followup care, including help with transportation to doctor visits.
One other problem that Michigan won't face, but only because it acted proactively, she said, is a national shortage of bicillin — the antibiotic used to treat syphilis. Michigan was able to procure enough of the drug to meet the state's needs, said Bagdasarian, but other states are scrambling to get enough.