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The number of babies infected with syphilis was already skyrocketing.Then a pandemic occurred

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The woman said that when hospital workers reported the news, she suffered from pain and distrust in the hospital bed and her belly was smoothed with ultrasonic gel: a baby in her I was there.

It was a boy. Half a year.

And his heart wasn’t beating.

For months, a 30-year-old woman was shaking off her swollen belly and ankles. She had a hard time getting pregnant in the past, so it seemed impossible to get pregnant.

Besides, she said, “When you are high, you put all the bad thoughts on the back burner.”

She said it was only a few days later that the nurse called her to tell her what had happened when she saddened her unexpected baby at her home in Los Angeles County. She calls it an “S”. She is still an embarrassing illness to name.

More and more babies in LA County are infected with syphilis in the womb, which can cause stillbirth, neurological problems, blindness, bone abnormalities, and other complications. Nine years ago, only six cases were reported across LA County, according to a Public Health Service report. Last year, that number reached 113.

Before the arrival of COVID-19, the number had already skyrocketed, Public health authorities Fearing that the pandemic would exacerbate the problem, he closed the clinic to screen people for syphilis and other sexually transmitted diseases and made new efforts to fight the disease on ice.

A stillborn woman, who spoke on condition of anonymity to protect her privacy, said she gave birth in a hotel room in January. She avoided seeing a doctor despite her painful pain.

At the time, she said she was afraid that she would be imprisoned for using stimulants when she went to the clinic. “You think,’I’m expensive, so I’ll be in trouble,'” she said.

Rapid increase Congenital syphilis It is especially frustrating for professionals, as pregnant people can be prevented from illness if they are tested and treated in time. In recent years, some countries, such as Thailand and Belarus, have allegedly stopped mother-to-child transmission of syphilis.

Federal officials once thought the United States was on the verge of joining them. Instead, the number of cases of congenital syphilis has skyrocketed nationwide, rising from 334 in 2012 to over 2,000 in 2020.

“There wasn’t a long-lasting investment needed to really eradicate syphilis over the years,” said Mario Perez, director of the HIV and STD Program Division at the LA County Public Health Service.

Experts have linked a broader rise in syphilis to entanglement of factors such as methamphetamine use and condomless sex. Men who have sex with men are particularly vulnerable, but the increasing number between women and babies is health Officials as it can have catastrophic consequences.

Syphilis can be cured in infants if detected and treated in time, but if the mother is also HIV positive, syphilis infection can increase the risk of transmitting HIV to the baby by breaking the natural barriers of the placenta. There is sex. Mikaela Cielo, LA County-Pediatric Infectious Diseases Doctor at USC Medical Center.

The disease has acted as a kind of severe prism, refracting social problems such as addiction and the homeless. In Los Angeles County, a public health agency survey of cases from 2016 to 2018 found that up to two-thirds of mothers who gave syphilis to their babies used the drug during pregnancy.

It was not contained between 10% and 20%. 40 percent have never received prenatal care. And almost 30% had a history of arrest or imprisonment. Eight cases of syphilis were identified in 170 pregnant patients seen in a Los Angeles County prison as of late August, said Dr. Noah Nattel, who oversees the health of women in the county’s orthodontic service agency. Said.

Syphilis is rarely confined to prisons, but “every system in place to imprison someone is also a system that guides people to avoid or eliminate people from the medical system,” he said. rice field.

The disease also reflects racial inequality. According to county statistics, the majority of cases of syphilis reported in women of reproductive age in LA County affect Latina and black women.

The woman who lost her baby said she began using stimulants at an overwhelming time in her life in the face of stressful work, school, and the demands of tense relationships after struggling to get pregnant.

At that time, the drug felt like a “ticket to freedom.” She quit her worthwhile job. Her boyfriend has moved. Stimulants encouraged “finally to take a deep breath.”

She started seeing a man who told her she didn’t need to use condoms with her. She now considers the decision naive. After they broke up, she became a friend of her baby’s father.

When a wave of pain began to hit her in a hotel room where she was spending time with her boyfriend, another man and his girlfriend, the girlfriend soon realized she was working. She said she urged her to call 911. But she remembered that the man was dissatisfied with the idea because there was a drug there and he didn’t want the police’s attention.

Jennifer Wagman, an associate professor of community health science at the UCLA Fielding School of Public Health, said the rising number of congenital syphilis across the country is a sign that she missed the opportunity to stop the disease. rice field. Researchers have found that not all pregnant people are screened for syphilis nationwide, despite requests from health authorities.

According to an analysis by the US Centers for Disease Control and Prevention, nearly one-third of pregnant women with syphilis did not receive the necessary care, even when diagnosed. Wagman said many reasons are related to other problems in their lives: some are uninsured. Some people have been tested but have not received results or treatment due to lack of a regular address or phone number.

Others are concerned that if they see a doctor and find out that they are using a drug, they may be forced to give up their child. Between 2016 and 2018, LA County reported that at least 30% of infants with congenital syphilis were placed under the custody of the Department of Child and Family Services.

County officials said doctors could report child safety concerns to DCFS, but infants are removed “only in the most extreme cases” after postnatal assessments rather than prenatal care. “.

A woman in LA County was also afraid that she could be criminally liable for having methamphetamine in her pregnant body after her baby was stillborn. This led to the accusations of other women in California. At one point, the morgue told her that the cremation had to be put on hold because of “state involvement,” but she said the prosecution did not continue.

Some experts consider recurrent illnesses to be a short-term sign of sexual health. Jeffrey Klausner, a clinical professor of population and public health science at the USC Keck School of Medicine, said federal funding fell about 15 years ago and the subsequent recession continued to reduce public health institutions.

He argued that a county as large as Los Angeles needed an aggressive strategy to combat sexually transmitted diseases that would reach affected communities. Instead, “everything was very fragmented, responsive, and disjointed.”

The pandemic didn’t help. According to a state survey, in most of the health jurisdictions that responded, more than half of the workforce was reassigned to COVID-19 jobs as of September last year.

Reported cases of syphilis have fallen throughout California, but authorities warn that it may be due to fewer tests. Many of the clinics where the LA County Public Health Service provides screening, diagnosis, and treatment for STDs were temporarily closed during the pandemic.

Plans to launch a new team focused on “quick response” to cases of syphilis, including providing tests to people in homeless camps, have failed. The nurse, who normally manages cases of women diagnosed with syphilis, was drawn into a coronavirus mission. This meant that others had to manage 30-40 cases each in addition to other responsibilities and take on that task. County division of HIV and STD programs.

In August, the Los Angeles County HIV Commission warned that “almost all staff have been reassigned to COVID-19 jobs, which has already worsened STD response due to lack of staff and resources.” Most of the county and community programs have “significantly reduced capacity or have been put on hold altogether.”

A rare exception is Skid Row’s mobile clinic, which was set up during a pandemic by the Christian Health Center in Los Angeles, People Concern, and the county’s public health department to test people for sexually transmitted diseases.

Its rapid test detects exposure to syphilis, including previous infections, so more blood needs to be taken to check for current infections. It may take several days to get these results. This means tracking the patient on the street. Skid Row’s efforts also distribute hot meals, hygiene kits, and naloxone sprays to restore overdose and other necessities.

To reach out to marginalized people, “you need to find them and get out here to reassure them,” said Ciara De Vozza, director of the C3 homeless outreach team at Skid Row in People Concern. increase. “It’s not the way medical systems are designed.”

When her baby was cremated, a LA County woman asked her to put his ashes in an angel-decorated jar that wrapped her toddler with its wings.

“I always wanted a baby,” she said. “I always asked God for this, and now I have received this gift-and I have to decide how to rest this gift.”


2,022 U.S. Infants Born in 2020 Reported With Congenital Syphilis


© 2021 Los Angeles Times.
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The number of babies infected with syphilis was already skyrocketing.Then a pandemic occurred

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