Health Advisory: Syphilis Increase and Prevention of Congenital Syphilis

Requested Actions

  • Test all pregnant women for syphilis at the first prenatal encounter.
  • Repeat syphilis testing during the third trimester among women at risk for STD (e.g., recent history of bacterial STD, multiple partners, homelessness; methamphetamine, opioid, or cocaine use; exchanging sex for money, drugs, etc.; having a sex partner who is a man who has sex with men).
  • If a mother delivers with no syphilis serology on record, ensure completion of syphilis serologic testing prior to discharge of the mother and baby.
  • Within three days, report any clinical or laboratory evidence of syphilis in pregnant women, delivering mothers, or their infants to the Health Department.
  • Within three days, report all suspected and confirmed cases of syphilis to the Health Department.


  • Syphilis increases are occurring statewide, particularly in larger urban areas (e.g., King, Spokane, Pierce, Snohomish and Yakima Counties).
  • These increases raise concern because syphilis is known to facilitate the transmission of HIV.
  • Heterosexual cases are occurring as well as among men who have sex with men.
  • Neurologic and ocular involvement has been reported more frequently than in prior years.

Additional Resources

  1. CDC: Syphilis in STD Treatment Guidelines 2015.
  2. CDC: Clinical Advisory: Ocular Syphilis in the United States.