Selected Podcast
Syphilis in Pregnancy
Dr. Agnes Oberko and Dr. Jodie Dionne-Odom lead an interactive discussion on Syphilis in Pregnancy.
Featuring:
Learn more about Jodie Dionne-Odom, MD
Agnes Oberkor, DrPH, CRNP, DTM is a Consultant, Congenital Syphilis Coordinator, Alabama Department of Public Health, STD Division.
Jodie Dionne-Odom, MD | Agnes Oberkor, DrPH, CRNP, DTM
Dr. Jodie Dionne-Odom is an Associate Professor of Medicine in the Division of Infectious Diseases, Chief of Women's Health at the 1917 HIV Clinic, and the Associate Director of Global Health in the UAB Center for Women's Reproductive Health. As a physician-scientist, she leads clinical trials to identify new ways to treat and prevent infections in women and pregnancy.Learn more about Jodie Dionne-Odom, MD
Agnes Oberkor, DrPH, CRNP, DTM is a Consultant, Congenital Syphilis Coordinator, Alabama Department of Public Health, STD Division.
Transcription:
Dr. Warner Huh: Hello, everyone. This is Dr. Warner Huh, the Chair of Obstetrics and Gynecology at the University of Alabama Birmingham. And I'd like to welcome you into this monthly episode of Women's Health with Dr. Huh. Today, we're going to discuss an important issue that's affecting pregnant women specifically. It's the topic of syphilis in pregnancy.
And with me today are Dr. Oberkor and Dr. Dionne. And I want to just introduce their background. Dr. Oberkor is the Congenital Syphilis Coordinator for the Alabama Department of Public Health. And then Dr. Jody Dionne who's the Associate Professor of Medicine in the Division of Infectious Diseases, but she also serves as the Chief of Women's Health at the 1917 HIV Clinic and is also the Associate Director for Global Health in the UAB Center for Women's Reproductive Health. Welcome, Dr. Oberkor and Dr. Dionne.
Dr. Agnes Oberkor: Thank you for having us.
Dr. Jodie Dionne-Odom: Thank you.
Dr. Warner Huh: So, you know, I think this is a really important topic and one I'm hearing about more and more, and that's the issue of syphilis that's being diagnosed during pregnancy. When I learned more about this topic, and I know that you all will talk about this further, it was alarming to me at least in terms of the marked rise in the number of cases that we're seeing particularly in pregnancy, but particularly in the state of Alabama. So I thought maybe, Dr. Dionne, you could talk a little bit about what syphilis is and why it's so important to discuss infection in pregnancy.
Dr. Jodie Dionne-Odom: Yeah. Thanks, I'm happy to. So this is an infection that we've known about for centuries. It's been around for a very long time. It's a bacterial infection caused by a pathogen called Treponema pallidum. And it is spread from person to person often with sexual contact, but also spread to the baby during pregnancy when a pregnant woman gets syphilis.
There's a few things that are really important to know about syphilis. One of them is it is incredibly infectious and it can spread to the baby during pregnancy at any stage. Between 60% and 100% of women who get syphilis during pregnancy will pass the infection to the baby. So it's one of the most infectious diseases that there are in pregnancy.
We also fortunately know that treatment for syphilis is incredibly effective. The penicillin that we use to treat pregnant women with syphilis works very well. But because this is often an asymptomatic infection, we have to screen, we have to look for it, otherwise it will be missed. So those are some sort of basics to know about the infection.
Dr. Warner Huh: So, what I'm hearing is at least for our listeners is that syphilis is an infectious disease that actually can be passed on to the fetus or the baby at remarkably high rate. But more importantly, that the treatments are highly effective, they're still effective to this day. Is that correct?
Dr. Jodie Dionne-Odom: Exactly. Unlike other pathogens that we manage in Infectious Disease, this is a pathogen that has not grown resistant. Our old treatment of penicillin still works incredibly well.
Dr. Warner Huh: Okay. Thank you. Dr. Oberkor, so what's the current state of a congenital syphilis in the United States, but more specifically in the state of Alabama?
Dr. Agnes Oberkor: The current state of congenital syphilis is very alarming. From 2015 to 2019, congenital syphilis increased by 276% in the nation. However, in Alabama, the increase was 400%. And now between 2015 and present as we speak, congenital syphilis increased in Alabama by 967%. So this is very alarming and concerning for all of us.
Dr. Warner Huh: And are there specific explanations for why we're seeing this marked increase in the number of cases in the state of alabama?
Dr. Agnes Oberkor: Yes. The analysis we've done mirrored what CDC also said. We have seen cases in six main areas. Number one is unable to identify seroconversion during pregnancy. That means the mother received prenatal care, the initial testing was negative, but then show up at delivery or close to delivery with an infection. The next is inadequate treatment. The mother was tested, had a positive test, but treatment was inadequate. So the infection was an acute. Third one is no syphilis testing, although the mother received timely prenatal care.
Another area that is a little bit concerning is a missed opportunities that we don't know. That means the mother received adequate treatment, but when the baby came out, was born, has lab values and complications that we have to report as a congenital syphilis case to CDC.
Next one is no prenatal care for some women who did not receive prenatal care and the other women, just few weeks before delivery before they received prenatal care, so untimely. So these are the areas that we have identified.
Now, the reason why we are talking about this to the medical community is that about 67% of these missed opportunities can be prevented by the provider. That's another testing after the initial negative test should be routine. And then another between 28 and 32 weeks, we're recommending a second test and then the final test will be at delivery. And then also treating the women adequately with the penicillin series as syphilis comes in stages and the treatment should follow the stages of syphilis, primary, secondary or the late stage. So the treatment should be adequate to what the stage is that used for.
Then another thing is timely screening of this women, so we can identify and treat before delivery. And the CDC analysis shows that if we're able to treat this patient 30 days before delivery, we can get the chances of reducing the risk of syphilis in the babies.
Dr. Warner Huh: So, you know, you partially already answered this, I believe, the question I'm about to ask you, which is, you know, we have a lot of women's healthcare providers, OB-GYNs, that are listening to this podcast. And so they might say, "Well, my understanding is that the number of affected infants is a relatively small absolute number." I'm not sure if you agree or disagree with that, but even if you do or don't, what do you think women's health care providers need to focus on specifically?
Dr. Agnes Oberkor: They need to specifically focus on prevention. That's the whole thing. If we can prevent congenital syphilis, we have to identify promptly and early during pregnancy. So they should focus on screening. And now I think that maintenance screening the women at the initial visit, then there should be a second test at the 28 to 32 weeks pregnancy and then at delivery. And that way we can identify, we can catch any seroconversion that wasn't there initially, and we can give them the treatment.
Dr. Warner Huh: Okay. So Dr. Dionne, so what can OB-GYNs and other providers who take care of pregnant women do to prevent congenital syphilis? It's kind of a followup question to Dr. Oberkor's question.
Dr. Jodie Dionne-Odom: I think the most important thing is to maintain a really high clinical suspicion. If you wait for signs and symptoms, if you wait for a stillbirth, it's too late to prevent the outcome you don't want to have. Nobody wants these devastating outcomes. So that means you have to screen quite frequently, just the way Dr. Oberkor is explaining. Not enough to just screen at the first presentation to ANC care. It's more important to continue to screen at the followup visits. For example, many cases are missed if that 28-week test is not performed. And since some women don't come consistently for prenatal care, that test at the time of delivery is also important to recognize these cases and to get treatment as early as we possibly can.
Dr. Warner Huh: Yeah. I mean, it makes total sense to me. And so I'm curious, what does the Alabama Department of Public Health and, maybe on a broader scale, the CDC doing in terms of increased awareness prevention, treatment, et cetera, Dr. Oberkor?
Dr. Agnes Oberkor: I would start with what CDC is doing. CDC is very supportive and have come out with a recent treatment guidelines to recognize the need for the early third trimester screening, that's the 28 to 32 weeks screening. They've also recognized the need to look into the treatment pattern. So even during the early syphilis, we can treat with two series of the penicillin injection instead of one, just to make sure we don't miss anything. And when it comes to the state level, CDC recognized our efforts, what we are doing and supports with technical support when we need it. Research, they help us with research so we can identify what's going on.
When it comes to Alabama Department of Public Health, we have made so many efforts to support OB-GYNs to help the women, their clients. We have updated our screening administrative law, so they can screen routinely at the initial visit, 28 to 32 weeks gestation and at delivery.
Another thing we are doing is sharing data. It's important for them to know. So we share data, we put it together and send it out. We do hunt and we do quality reports. We are making our clinics available, testing, treatment for free for providers who need assistance so they can send their patients to us. We can test them and provide free treatment for them.
Another thing we've added to our screening efforts is at-home testing. So the patient can order a kit if they can only make our website information available to their client, that's something that is available to their nature. They can just order the kit test at home and we'll receive the results and we will treat them. So we've made all this available for providers to know that we are in support. We want to help.
Another thing we can do for providers is provide technical support. Whatever they need, we are ready to help with that knowledge. And if we have to even have a disease intervention specialist to help them bring in a woman in for testing and treatment, we have that available for free as well.
Dr. Warner Huh: So basically, you've basically pulled all the stops and made it extremely convenient and hassle-free for our providers to basically start testing and treating women to prevent congenital syphilis is what it sounds like to me.
Dr. Agnes Oberkor: Absolutely.
Dr. Warner Huh: Okay. And, you know, again, can you just comment to the listeners what resources are available? Like, so obviously they can go to ADPH and CDC, but are there other resources that you would recommend I guess to providers or to patients about learning more about how to prevent and/or treat congenital syphilis?
Dr. Agnes Oberkor: I want to address for patients first that the disease is here and it's dangerous. It can affect the baby. The complications are serious and even lead to death of the baby. Maybe before the baby comes out, it's already dead or dead on arrival. And the complications that syphilis will create for the infant will be permanent. It's not reversible. So there's the need to also be proactive in their care. I want them to ask the provider that they need a testing initially. They need a second testing when they are 28 to 32 weeks pregnant. And when they deliver, they need a test. So, this is what I want patients to know.
Another thing that I want them to know is when they have the baby and in case they were diagnosed with syphilis or before or during delivery, they should ask the pediatrician to screen their babies, because that is something that we have to identify. Women were treated during pregnancy, but then when they deliver the baby has complications. And if the baby is not tested, that means the baby goes home with syphilis. So we want mothers to be very proactive.
Another thing is that this will sound like, in the south, you don't talk about it, but if you're having sex, you have a risk. And so it explains why mothers would test negative initially and then become positive at delivery. I mean, they got infected at some point in time in between. So they should understand that if they're having sex during pregnancy, they have the risk of getting any kind of STD, including syphilis and so they need to get tested. They need to ask your partners to get tested and treated because if they don't, they get infected. And if they're treated and their partners are not treated, they will get the infection again. So there's the need when they receive the treatment, to make sure that the partners are treated.
And to the providers, I wanted to say that it's our moral duty to prevent this preventable disease. It's serious. The complications are very severe. And so as providers and medical providers, it's our moral duty to prevent.
Another thing is that I've heard some providers and leaders that say it's not worth the bang for the buck because there's not many in the community. I think that's a serious ethical issue and also health equity issue as we talk about inclusive and to include everybody in whatever you're doing and businesses are hiring based on inclusion. I think we need to step back and think about it as medical providers and not think that it's not worth the bang for the buck when we test pregnant women for syphilis.
Dr. Warner Huh: Couldn't agree with you more. I mean, it was an extremely compelling answer. But any other closing thoughts or comments, Dr. Dionne?
Dr. Jodie Dionne-Odom: I think just to remind people this can be sort of confusing. Sometimes these lab tests come in and they're giving discordant results. Sometimes you have a patient who has a penicillin allergy or not sure what to do. It's not that you have to have answers of all of these. We're trying to give you resources today, so you know who to call and you know what to do, but not that you need to have it all figure it out yourself. So reach out if you're not sure how to manage the person in front of you, your local health department is a great resource. Infectious Diseases is always happy to help. So let's work together to bring these numbers down.
Dr. Warner Huh: Dr. Oberkor, any final comments or thoughts?
Dr. Agnes Oberkor: I will say this is the United States and seeing one case of congenital syphilis is too many. And with all the resources we have, testing, the medicine to treat, is curable and preventable, easily preventable, we have to make sure we do our best to turn these numbers around.
Dr. Warner Huh: So this is fantastic. Thank you to both of you. I think that, you know, in this podcast series, some of the best podcasts that we've done so far are those that very much mirror a public service type announcement or a PSA, which I think this very much qualifies for.
And I'm with you. I agree with you, Dr. Oberkor, that we live in an era where there shouldn't be a single case of congenital syphilis. You're talking about a disease that has, you know, what's known as a high vertical transmission rate, transmission from mother to fetus, that it sounds like there's six potential reasons for why women get syphilis and then thus develop congenital syphilis. And that more importantly, that you guys have really created all of these resources to make it hassle-free. And it's our job now is really to educate providers and understanding how important this is.
I think from my perspective, as someone that is also equally interested in public health and prevention and screening, is to recognize that the consequences of congenital syphilis can be catastrophic. And you're talking about the consequences for an infant for the rest of his or her life. And I think people need to look at it from this perspective. You can diagnose it, you can adequately treat it. So from my perspective, there's no reason for us not to be doing this actively.
Dr. Jodie Dionne-Odom: We totally agree with you.
Dr. Agnes Oberkor: Yes. Okay.
Dr. Warner Huh: Well, again, I want to thank both doctors Oberkor and Dionne for their time and sharing their experience in the area of syphilis in pregnancy. Again, this is an incredibly important and timely topic to make the listeners aware of the marked rising cases in the state of Alabama.
So as always, please rate this podcast and we welcome any comments, particularly on topics that you all are interested in. And for more information on syphilis in pregnancy and the other clinical services that UAB provides, please check out uabmedicine.org. And until next time, thank you and have a wonderful day and happy holidays.
Dr. Warner Huh: Hello, everyone. This is Dr. Warner Huh, the Chair of Obstetrics and Gynecology at the University of Alabama Birmingham. And I'd like to welcome you into this monthly episode of Women's Health with Dr. Huh. Today, we're going to discuss an important issue that's affecting pregnant women specifically. It's the topic of syphilis in pregnancy.
And with me today are Dr. Oberkor and Dr. Dionne. And I want to just introduce their background. Dr. Oberkor is the Congenital Syphilis Coordinator for the Alabama Department of Public Health. And then Dr. Jody Dionne who's the Associate Professor of Medicine in the Division of Infectious Diseases, but she also serves as the Chief of Women's Health at the 1917 HIV Clinic and is also the Associate Director for Global Health in the UAB Center for Women's Reproductive Health. Welcome, Dr. Oberkor and Dr. Dionne.
Dr. Agnes Oberkor: Thank you for having us.
Dr. Jodie Dionne-Odom: Thank you.
Dr. Warner Huh: So, you know, I think this is a really important topic and one I'm hearing about more and more, and that's the issue of syphilis that's being diagnosed during pregnancy. When I learned more about this topic, and I know that you all will talk about this further, it was alarming to me at least in terms of the marked rise in the number of cases that we're seeing particularly in pregnancy, but particularly in the state of Alabama. So I thought maybe, Dr. Dionne, you could talk a little bit about what syphilis is and why it's so important to discuss infection in pregnancy.
Dr. Jodie Dionne-Odom: Yeah. Thanks, I'm happy to. So this is an infection that we've known about for centuries. It's been around for a very long time. It's a bacterial infection caused by a pathogen called Treponema pallidum. And it is spread from person to person often with sexual contact, but also spread to the baby during pregnancy when a pregnant woman gets syphilis.
There's a few things that are really important to know about syphilis. One of them is it is incredibly infectious and it can spread to the baby during pregnancy at any stage. Between 60% and 100% of women who get syphilis during pregnancy will pass the infection to the baby. So it's one of the most infectious diseases that there are in pregnancy.
We also fortunately know that treatment for syphilis is incredibly effective. The penicillin that we use to treat pregnant women with syphilis works very well. But because this is often an asymptomatic infection, we have to screen, we have to look for it, otherwise it will be missed. So those are some sort of basics to know about the infection.
Dr. Warner Huh: So, what I'm hearing is at least for our listeners is that syphilis is an infectious disease that actually can be passed on to the fetus or the baby at remarkably high rate. But more importantly, that the treatments are highly effective, they're still effective to this day. Is that correct?
Dr. Jodie Dionne-Odom: Exactly. Unlike other pathogens that we manage in Infectious Disease, this is a pathogen that has not grown resistant. Our old treatment of penicillin still works incredibly well.
Dr. Warner Huh: Okay. Thank you. Dr. Oberkor, so what's the current state of a congenital syphilis in the United States, but more specifically in the state of Alabama?
Dr. Agnes Oberkor: The current state of congenital syphilis is very alarming. From 2015 to 2019, congenital syphilis increased by 276% in the nation. However, in Alabama, the increase was 400%. And now between 2015 and present as we speak, congenital syphilis increased in Alabama by 967%. So this is very alarming and concerning for all of us.
Dr. Warner Huh: And are there specific explanations for why we're seeing this marked increase in the number of cases in the state of alabama?
Dr. Agnes Oberkor: Yes. The analysis we've done mirrored what CDC also said. We have seen cases in six main areas. Number one is unable to identify seroconversion during pregnancy. That means the mother received prenatal care, the initial testing was negative, but then show up at delivery or close to delivery with an infection. The next is inadequate treatment. The mother was tested, had a positive test, but treatment was inadequate. So the infection was an acute. Third one is no syphilis testing, although the mother received timely prenatal care.
Another area that is a little bit concerning is a missed opportunities that we don't know. That means the mother received adequate treatment, but when the baby came out, was born, has lab values and complications that we have to report as a congenital syphilis case to CDC.
Next one is no prenatal care for some women who did not receive prenatal care and the other women, just few weeks before delivery before they received prenatal care, so untimely. So these are the areas that we have identified.
Now, the reason why we are talking about this to the medical community is that about 67% of these missed opportunities can be prevented by the provider. That's another testing after the initial negative test should be routine. And then another between 28 and 32 weeks, we're recommending a second test and then the final test will be at delivery. And then also treating the women adequately with the penicillin series as syphilis comes in stages and the treatment should follow the stages of syphilis, primary, secondary or the late stage. So the treatment should be adequate to what the stage is that used for.
Then another thing is timely screening of this women, so we can identify and treat before delivery. And the CDC analysis shows that if we're able to treat this patient 30 days before delivery, we can get the chances of reducing the risk of syphilis in the babies.
Dr. Warner Huh: So, you know, you partially already answered this, I believe, the question I'm about to ask you, which is, you know, we have a lot of women's healthcare providers, OB-GYNs, that are listening to this podcast. And so they might say, "Well, my understanding is that the number of affected infants is a relatively small absolute number." I'm not sure if you agree or disagree with that, but even if you do or don't, what do you think women's health care providers need to focus on specifically?
Dr. Agnes Oberkor: They need to specifically focus on prevention. That's the whole thing. If we can prevent congenital syphilis, we have to identify promptly and early during pregnancy. So they should focus on screening. And now I think that maintenance screening the women at the initial visit, then there should be a second test at the 28 to 32 weeks pregnancy and then at delivery. And that way we can identify, we can catch any seroconversion that wasn't there initially, and we can give them the treatment.
Dr. Warner Huh: Okay. So Dr. Dionne, so what can OB-GYNs and other providers who take care of pregnant women do to prevent congenital syphilis? It's kind of a followup question to Dr. Oberkor's question.
Dr. Jodie Dionne-Odom: I think the most important thing is to maintain a really high clinical suspicion. If you wait for signs and symptoms, if you wait for a stillbirth, it's too late to prevent the outcome you don't want to have. Nobody wants these devastating outcomes. So that means you have to screen quite frequently, just the way Dr. Oberkor is explaining. Not enough to just screen at the first presentation to ANC care. It's more important to continue to screen at the followup visits. For example, many cases are missed if that 28-week test is not performed. And since some women don't come consistently for prenatal care, that test at the time of delivery is also important to recognize these cases and to get treatment as early as we possibly can.
Dr. Warner Huh: Yeah. I mean, it makes total sense to me. And so I'm curious, what does the Alabama Department of Public Health and, maybe on a broader scale, the CDC doing in terms of increased awareness prevention, treatment, et cetera, Dr. Oberkor?
Dr. Agnes Oberkor: I would start with what CDC is doing. CDC is very supportive and have come out with a recent treatment guidelines to recognize the need for the early third trimester screening, that's the 28 to 32 weeks screening. They've also recognized the need to look into the treatment pattern. So even during the early syphilis, we can treat with two series of the penicillin injection instead of one, just to make sure we don't miss anything. And when it comes to the state level, CDC recognized our efforts, what we are doing and supports with technical support when we need it. Research, they help us with research so we can identify what's going on.
When it comes to Alabama Department of Public Health, we have made so many efforts to support OB-GYNs to help the women, their clients. We have updated our screening administrative law, so they can screen routinely at the initial visit, 28 to 32 weeks gestation and at delivery.
Another thing we are doing is sharing data. It's important for them to know. So we share data, we put it together and send it out. We do hunt and we do quality reports. We are making our clinics available, testing, treatment for free for providers who need assistance so they can send their patients to us. We can test them and provide free treatment for them.
Another thing we've added to our screening efforts is at-home testing. So the patient can order a kit if they can only make our website information available to their client, that's something that is available to their nature. They can just order the kit test at home and we'll receive the results and we will treat them. So we've made all this available for providers to know that we are in support. We want to help.
Another thing we can do for providers is provide technical support. Whatever they need, we are ready to help with that knowledge. And if we have to even have a disease intervention specialist to help them bring in a woman in for testing and treatment, we have that available for free as well.
Dr. Warner Huh: So basically, you've basically pulled all the stops and made it extremely convenient and hassle-free for our providers to basically start testing and treating women to prevent congenital syphilis is what it sounds like to me.
Dr. Agnes Oberkor: Absolutely.
Dr. Warner Huh: Okay. And, you know, again, can you just comment to the listeners what resources are available? Like, so obviously they can go to ADPH and CDC, but are there other resources that you would recommend I guess to providers or to patients about learning more about how to prevent and/or treat congenital syphilis?
Dr. Agnes Oberkor: I want to address for patients first that the disease is here and it's dangerous. It can affect the baby. The complications are serious and even lead to death of the baby. Maybe before the baby comes out, it's already dead or dead on arrival. And the complications that syphilis will create for the infant will be permanent. It's not reversible. So there's the need to also be proactive in their care. I want them to ask the provider that they need a testing initially. They need a second testing when they are 28 to 32 weeks pregnant. And when they deliver, they need a test. So, this is what I want patients to know.
Another thing that I want them to know is when they have the baby and in case they were diagnosed with syphilis or before or during delivery, they should ask the pediatrician to screen their babies, because that is something that we have to identify. Women were treated during pregnancy, but then when they deliver the baby has complications. And if the baby is not tested, that means the baby goes home with syphilis. So we want mothers to be very proactive.
Another thing is that this will sound like, in the south, you don't talk about it, but if you're having sex, you have a risk. And so it explains why mothers would test negative initially and then become positive at delivery. I mean, they got infected at some point in time in between. So they should understand that if they're having sex during pregnancy, they have the risk of getting any kind of STD, including syphilis and so they need to get tested. They need to ask your partners to get tested and treated because if they don't, they get infected. And if they're treated and their partners are not treated, they will get the infection again. So there's the need when they receive the treatment, to make sure that the partners are treated.
And to the providers, I wanted to say that it's our moral duty to prevent this preventable disease. It's serious. The complications are very severe. And so as providers and medical providers, it's our moral duty to prevent.
Another thing is that I've heard some providers and leaders that say it's not worth the bang for the buck because there's not many in the community. I think that's a serious ethical issue and also health equity issue as we talk about inclusive and to include everybody in whatever you're doing and businesses are hiring based on inclusion. I think we need to step back and think about it as medical providers and not think that it's not worth the bang for the buck when we test pregnant women for syphilis.
Dr. Warner Huh: Couldn't agree with you more. I mean, it was an extremely compelling answer. But any other closing thoughts or comments, Dr. Dionne?
Dr. Jodie Dionne-Odom: I think just to remind people this can be sort of confusing. Sometimes these lab tests come in and they're giving discordant results. Sometimes you have a patient who has a penicillin allergy or not sure what to do. It's not that you have to have answers of all of these. We're trying to give you resources today, so you know who to call and you know what to do, but not that you need to have it all figure it out yourself. So reach out if you're not sure how to manage the person in front of you, your local health department is a great resource. Infectious Diseases is always happy to help. So let's work together to bring these numbers down.
Dr. Warner Huh: Dr. Oberkor, any final comments or thoughts?
Dr. Agnes Oberkor: I will say this is the United States and seeing one case of congenital syphilis is too many. And with all the resources we have, testing, the medicine to treat, is curable and preventable, easily preventable, we have to make sure we do our best to turn these numbers around.
Dr. Warner Huh: So this is fantastic. Thank you to both of you. I think that, you know, in this podcast series, some of the best podcasts that we've done so far are those that very much mirror a public service type announcement or a PSA, which I think this very much qualifies for.
And I'm with you. I agree with you, Dr. Oberkor, that we live in an era where there shouldn't be a single case of congenital syphilis. You're talking about a disease that has, you know, what's known as a high vertical transmission rate, transmission from mother to fetus, that it sounds like there's six potential reasons for why women get syphilis and then thus develop congenital syphilis. And that more importantly, that you guys have really created all of these resources to make it hassle-free. And it's our job now is really to educate providers and understanding how important this is.
I think from my perspective, as someone that is also equally interested in public health and prevention and screening, is to recognize that the consequences of congenital syphilis can be catastrophic. And you're talking about the consequences for an infant for the rest of his or her life. And I think people need to look at it from this perspective. You can diagnose it, you can adequately treat it. So from my perspective, there's no reason for us not to be doing this actively.
Dr. Jodie Dionne-Odom: We totally agree with you.
Dr. Agnes Oberkor: Yes. Okay.
Dr. Warner Huh: Well, again, I want to thank both doctors Oberkor and Dionne for their time and sharing their experience in the area of syphilis in pregnancy. Again, this is an incredibly important and timely topic to make the listeners aware of the marked rising cases in the state of Alabama.
So as always, please rate this podcast and we welcome any comments, particularly on topics that you all are interested in. And for more information on syphilis in pregnancy and the other clinical services that UAB provides, please check out uabmedicine.org. And until next time, thank you and have a wonderful day and happy holidays.