As Congenital Syphilis Continues to Increase, Diagnostics and Education Play Key Roles to Reduce Incidence Rates

Ran in ContagionLive April 16, 2026

By Lily Li, MD, PhD, MBA, Medical Safety Officer and Senior Director, Medical & Scientific Affairs, QuidelOrtho

According to the Centers for Disease Control and Prevention (CDC), more than 3,700 babies were born with congenital syphilis in 2022, which was more than 10 times the number in 2012.1

CDC points out some other factors, including:

• Almost 9 in 10 cases of newborn syphilis in 2022 might have been prevented with timely testing and treatment during pregnancy.
• More than half were among people who tested positive for syphilis during pregnancy but did not receive adequate or timely treatment.
• Nearly 40 percent were among mothers who were not in prenatal care.1

“The congenital syphilis crisis in the United States has skyrocketed at a heartbreaking rate,” CDC Chief Medical Officer Debra Houry, MD, MPH, said in a statement. “New actions are needed to prevent more family tragedies. We’re calling on healthcare providers, public health systems, and communities to take additional steps to connect mothers and babies with the care they need.”1

A major driver of the increase is a widespread misconception that the disease is no longer a threat, according to Lily Li, MD, PhD, MBA, medical safety officer and senior director, Medical, Scientific & Clinical Affairs at QuidelOrtho.

“Syphilis was almost eliminated in the 1990s…So in many people's mind, this may be a disease of the past,” Li said, noting that this lack of awareness extends beyond the general public to some healthcare providers. As a result, routine screening and early detection are often overlooked.

The biology of syphilis itself further complicates control efforts. “Many people with syphilis have no symptoms…so people unknowingly spread the disease to others,” Li said. Even when early symptoms do appear, they are frequently painless or mistaken for other conditions, and may disappear without treatment giving patients a false sense that the infection has resolved.

This silent progression is particularly dangerous during pregnancy. Without diagnosis and treatment, syphilis can be transmitted to unborn children, leading to congenital infections that are largely preventable. Despite this, thousands of cases are still reported each year, highlighting gaps in prenatal screening and care.

Testing remains the most effective tool to break the chain of transmission, yet barriers persist. Limited access to affordable and timely diagnostics, along with stigma surrounding sexually transmitted infections, continues to delay care.

“Stigma and the lack of access to cure are the 2 major factors that cause the delay for testing, or even the total miss of testing,”Li said.

Encouragingly, advances in diagnostic technology are helping to address these challenges. Automated laboratory assays are improving efficiency and turnaround times in high-volume settings, while at-home testing options are expanding access and reducing stigma. Still, experts emphasize that these tools must be paired with confirmatory testing and proper clinical follow-up.

Public health strategies are also evolving. Li points out updated screening guidelines are a helpful strategy to capture cases.

“I'm very happy to see that in response to the increase cases in congenital syphilis, the ACOG [American College of Obstetricians and Gynecologists] has updated its guidelines in 2024 to implement or to recommend, a universal testing for all pregnant women in the United States,” Li said.

Alongside policy changes, experts stress that education remains foundational, ensuring people understand that syphilis is both detectable and curable when caught early.

Ultimately, controlling the resurgence will require a coordinated effort across healthcare systems, public health agencies, and communities.