Colorado has declared a syphilis epidemic – and babies are at the highest risk

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Jill Hunsaker Ryan Jared Polis Coronavirus Emergency
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Jill Hunsaker Ryan, the executive director of the Colorado Dept. of Public Health and Environment, listens as Gov. Jared Polis declares a state of emergency to deal with the spread of coronavirus Tuesday, March 10, 2020.

On Thursday the Colorado Department of Public Health and Environment, backed by Gov. Jared Polis, issued a public health order to address what has been deemed an epidemic.

State data shows that between 2018 and 2023, congenital syphilissyphilis that is present in infants at birth – increased from seven to 50 reported cases in Colorado.

Syphilis is contracted through contact with an infected sore on the body of someone carrying the infection. According to the Centers for Disease Control, syphilis can be spread during sexual intimacy, pregnancy and through a vaginal birth.

So far this year, the state has seen 25 reported cases of congenital syphilis, including five stillbirths and two neonatal deaths, according to state data. This puts the state on track “to have maybe 100 cases” by the end of the year, said Jill Hunsaker Ryan, executive director of the state’s health department.

“We are very concerned about this growing epidemic, both in the state and nationally,” said Ryan.

Forty percent of babies with untreated congenital syphilis may be stillborn or die from the infection, according to the Centers for Disease Control.

“An aggressive and coordinated all-state response is appropriate at this stage of the epidemic,” said Scott Bookman, senior director for Public Health Readiness and Response with the state health department.

Although the statewide congenital syphilis epidemic is on the rise, “The good news is that highly effective treatments exist,” said State Epidemiologist Rachel Herlihy. “We just need to get people in soon enough to save infants’ lives and prevent long-term complications.”

What does the new state order mandate?

The order declares that the state will expand access to syphilis testing during pregnancy, including testing for pregnant inmates. To prevent congenital cases, all medical providers caring for expecting and new mothers must offer syphilis tests in the first and third trimester, at the time of birth, and under other specific conditions, such as cases of miscarriage after 20 weeks or stillbirth. Patients aren’t required to undergo testing, but their providers must give them the option.

The order also mandates staffing and support for an after-hours line for urgent needs, as well as resources for community outreach and syphilis education.

Most state insurance companies should cover testing as part of the state's plan.

How can I get tested and find care?

According to a statement from the state, testing will be covered without co-pays for the vast majority of Coloradans with commercial insurance, as well as Coloradans with Medicaid coverage through Health First Colorado.

Coloradans without health insurance or a healthcare provider, the health department suggests applying for the state’s Medicaid Program. In the meantime, free and low-cost testing is available and Coloradans can also order free at-home test kits.