Healthcare Hurdles: Nevada’s Efforts to Curtail Rising Syphilis Rates Among Newborns
Although Nevada has increased its efforts in recent years to make syphilis testing more accessible, especially for expectant women, health officials report that barriers to medical care continue to exist, resulting in an increase in the incidence of syphilis in newborns.
“That is if they are fortunate enough to be born,” said Southern Nevada Health District senior disease investigation and intervention specialist Tabby Edelman. “Unfortunately, six syphilitic stillbirths occurred in 2023.”
Health officials addressed challenges in mitigating the high syphilis rates in Clark County and the continuous endeavors to address overdose fatalities during the Southern Nevada Health District’s 2024 State of Public Health on Tuesday.
According to health officials, congenital syphilis, which occurs when a pregnant woman with the infection transmits it to her child, has increased by 1,567 percent between 2014 and 2023.
Southern Nevada saw 53 cases in 2015, compared to three cases in 2014.
The issue transcends the borders of Nevada. The tenfold increase in the number of children born with syphilis in the United States from 2012 to 2022 “reflects a failure of the U.S. health system,” as stated by the Centers for Disease Control and Prevention.
Edelman stated, “This is entirely preventable,” adding that syphilis, being a bacterial infection, is treatable with antibiotics such as penicillin. Still, it has a significant impact on our community.
According to the Centers for Disease Control and Prevention, Nevada had the fourth-greatest number of infants born with syphilis in the United States in 2020.
“According to the most recent national data from 2022, Nevada ranked eighth,” stated health district senior epidemiologist Angel Stachnik. “Our performance in terms of rankings and rates is improving. The quantity of our cases continues to rise. Our comparatively lower ranking is solely attributable to the concurrent increases observed in other states.
In light of the state’s initial positive trajectory, legislators enacted legislation to strengthen regulations and accessibility of sexually transmitted infection testing. Passed in 2021, Assembly Bill 192 mandates that emergency rooms of hospitals and other medical facilities admitting expectant women conduct syphilis screenings.
Legislators passed Senate Bill 211 during the same session, which authorizes primary care physicians and hospitals to inquire whether patients 15 years or older would like an STI test.
Both measures have facilitated access to infection screening for a greater number of individuals, including pregnant women. Health officials caution that there are still barriers to connecting individuals with medical treatment.
63% of the mothers who presented with congenital syphilis cases in Southern Nevada in 2022 lacked prenatal care, according to Carissa Orozco, a district community health nurse.
Orozco stated, “Among the challenges we face is providing for our homeless population.” Tracking and involving them in caregiving can present challenges.
Additional obstacles consist of traversing the public transportation system or experiencing embarrassment when visiting clinics. She stated, “Our clients are hesitant to participate in our health care system.” “Some individuals feel uneasy being observed at our clinics.”
She further stated that the health district is striving to “meet our clients where they are at” by increasing the number of community events catering to individuals who are hesitant to visit clinics out of concern that their lack of insurance will hinder their access to treatment.
Despite this, a considerable number of present patients continue to be uninsured and encounter difficulties navigating the medical system.
“There are numerous missed opportunities for STI testing, and primary care providers continue to be misinformed about syphilis treatment,” Orozco stated.
Policymakers could further enhance the provision of age-appropriate and medically accurate sex education by expanding its accessibility.
“Patients continue to report contracting syphilis from the toilet,” she continued. “This suggests to me that we should implement age-appropriate sex education in schools and improve health literacy and educational materials.”
Unintentional Overdoses are Decreased
Health officials noted during the State of the Public Health that there was a marginal decline in the incidence of unintentional overdoses over the past year. The rate increased from 20.71 per 100,000 in 2018 to 24.08 per 100,000 in 2021, according to district epidemiologist Marco Mendez.
“It is critical to note that although there has been a decline, overdose rates remain above those observed before the pandemic,” he stated.
Health officials have not only issued warnings regarding the potential for overdose from stimulants containing fentanyl but have also provided access to fentanyl test strips and nasal naloxone, both of which can counteract the effects of an opioid overdose.