Syphilis Spike in Maryland, Which Included Newborns, Overshadowed by COVID-19

During the same week the COVID-19 pandemic erupted in Maryland in March 2020, state health officials alerted each other of the outbreak of another dangerous illness, according to internal emails and public records obtained by the News4 I-Team.

The state faced a fast-rising number of congenital syphilis cases last spring — a spike that was potentially exacerbated and masked by the early days of the coronavirus pandemic.

Internal emails exchanged by officials in the Maryland Department of Health Office of Preparedness and Response on March 5, 2020, warned of an “ongoing syphilis and congenital syphilis” outbreak. But the emails also indicate a disagreement over how forcefully and directly to issue warnings to doctors about the cases, due to the massive campaign to get the attention of physicians about the looming COVID-19 crisis.

I’d never seen syphilis until the last year and now I’m seeing syphilis once or twice a month at least.

Sheri Denham, Brooke’s House medical director

Congenital syphilis is a potentially catastrophic condition passed to infants by mothers who give birth while suffering untreated syphilis. 

“When syphilis is not detected, it can be passed on to a baby through pregnancy,” said Amanda Cary, sexual health manager with Whitman-Walker Health. “Untreated syphilis can lead to miscarriages, stillbirth and early infant death.”

A News4 I-Team review of state public health records in Maryland, Virginia and Washington, D.C., show a 25 percent increase in congenital syphilis cases between 2018 and 2020, impacting at least 75 local newborns at its peak. The increasing cases paralleled a fast-rising spread of general syphilis among adults during the same time frame.   

In internal emails from the first week of March 2020, Maryland health officials alerted each other that the syphilis and congenital syphilis cases had become an “outbreak.”  

But due to the emerging COVID-19 pandemic at that same time, Maryland Department of Health administrators were conflicted over how to warn doctors about the congenital syphilis risk.

In one email, an administrator of the agency’s Office of Preparedness and Response urged colleagues to send a letter to physicians statewide about the syphilis spread. But a fellow official responded to the email with a note saying the agency would instead post a warning on its website. In her emailed response to the colleague, a health official wrote, “The Board voted to send letters to Clinicians on behalf of the Secretary regarding the Coronavirus only. We are happy to post this information to the Board's website.”

Later in 2020, the growing syphilis crisis became evident to clinicians and doctors.

Sheri Denham, a medical director at the Brooke’s House addiction-recovery home in Hagerstown, said she found cases soared last year.

“I’d never seen syphilis until the last year and now I’m seeing syphilis once or twice a month at least,” Denham said.

Peter DeMartino of the Maryland Department of Health Center for HIV Prevention and Health Services said the agency must always navigate a “balancing act” when issuing public health warnings to avoid overloading the public and medical professionals.

DeMartino said doctors should be regularly informing patients about the need for sexually transmitted disease screenings, even when outbreaks are not occurring.  

“We can’t forget that pregnant Marylanders are still sexual being,” he said. “One sexual transmitted disease screening in the first trimester is not enough. We need to do it again at 28 weeks and again just before birth.”

Syphilis cases did peak later in 2020 before beginning to decline by year’s end, according to a series of data reports and interviews conducted by the I-Team.

But medical experts are worried cases could spike again, because some people are forgoing regular screenings to avoid entering medical facilities as the pandemic continues.   

“There’s still some degree of people forgoing screenings because they’re still nervous to come out into the world with COVID or their access to healthcare system has changed,” Cary said.

Here are some of the local organizations and facilities offering STI screenings:

Washington, D.C.

The DC Health and Wellness Center
77 P Street NE
Washington, DC 20002
202-741-7692

Frederick County, Maryland

• Planned Parenthood, 170 Thomas Johnson Drive, Suite 100, Frederick
• Saving Lives Center, 3 Hillcrest Drive, Suite A101, Frederick
• Or check with other urgent care facilities or your primary care provider

Prince George’s County, Maryland

Sexually Transmitted Disease (STD) Control Program
3003 Hospital Drive
Suite 3048
Cheverly, MD 20785
301-583-3150

Montgomery County, Maryland

Montgomery County HIV/STI Services
Dennis Avenue Health Center
2000 Dennis Avenue
Silver Spring, MD 20902
240-777-1760

Free HIV testing, comprehensive STI testing on a sliding fee scale based on income. No one will be turned away for inability to pay.

Walk-ins are normally accepted, but due to COVID-19 precautions, please call to make an appointment.

Free HIV testing mailed discreetly to your home.

Fairfax County, Virginia

Due to COVID-19 operations, the Joseph Willard Health Center is the only county location offering STI screenings at this time, and right now those are available but by appointment only.

More information: Sexually Transmitted Infections (STIs) | Health (fairfaxcounty.gov)

Prince William County, Virginia

Immunization services are available by appointment in Manassas and Woodbridge clinic sites.

For an appointment call:

Manassas: 703-792-6300

Woodbridge: 703-792-7300

Services offered during STI clinics include:

• Services for the detection, screening and treatment of STIs;
• Confidential HIV testing, counseling and education;
• STI education, information and referral to other services as appropriate;
• Risk reduction counseling.

Reported by Scott MacFarlane, produced by Katie Leslie and Rick Yarborough, and shot and edited by Evan Carr and Steve Jones.