As syphilis circumstances proceed to spike throughout the U.S. — with some cities and states just lately reporting outbreaks — there’s a rising concern concerning the availability of Bicillin, the injectable penicillin that’s used to deal with the sexually transmitted an infection in adults and youngsters.
The city of Houston formally declared a syphilis outbreak on July 13. It cited a 128% enhance in circumstances amongst girls and a nine-fold rise in congenital syphilis in Houston and Harris County, in keeping with an announcement from the Houston Health Department.
Last month, the Food and Drug Administration (FDA) introduced that it expects a “limited supply and impending stock out situation” for choose Bicillin drugs.
Spike in syphilis circumstances
Cases of syphilis, a bacterial an infection that’s unfold by way of sexual contact or from a mom to an unborn baby, have been on the rise within the U.S. for the previous a number of years.
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Since 2017, all levels of the illness have risen by 74%, with over 176,000 circumstances reported in 2021, in keeping with the Centers for Disease Control and Prevention (CDC).
Cases of syphilis, a bacterial an infection unfold by way of sexual contact or from a mom to an unborn baby, have been on the rise within the U.S. for the previous a number of years. (Getty Images)
Between 2020 and 2021 alone, syphilis circumstances elevated by 32%.
Cases of congenital syphilis, which happens when a mom passes the an infection on to her child throughout being pregnant, additionally rose by 32% — leading to 220 stillbirths and toddler deaths.
Certain areas of the nation have seen an much more dramatic spike. In Texas, congenital syphilis circumstances have risen by 650% since 2016, per the Texas Department of Health and Human Services.
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James Hodges, M.D., an internist in Waco, Texas, has been in follow for greater than 20 years.
He shared with Dr. Marc Siegel, professor of medication at NYU Langone Medical Center and a Fox News medical contributor, that two Texas prisons have seen a surge in constructive syphilis circumstances amongst their girls’s consumption items.
“They’ve seen somewhere in the neighborhood of twice the amount compared to just 18 months ago,” he advised Fox News Digital. “Those inmates are largely coming from Houston and San Antonio, and extra now from Dallas-Ft. Worth.
Since 2017, all stages of the disease have risen by 74%, with more than 176,000 cases reported in 2021, according to the Centers for Disease Control and Prevention (CDC). (FREDERIC J. BROWN/AFP via Getty Images)
“They are usually not involved about it, and are sometimes quoted as saying, ‘It’s no massive deal, there’s a treatment.’”
Hodges estimated that young White women and young Black women comprise the largest share of cases in women’s prisons.
Some county sheriffs he spoke with were unaware of the syphilis problems, as the county jails don’t typically test for the disease, Hodges added.
Syphilis screenings at the border
The CDC provides guidance for all physicians performing medical screening examinations for immigrants and refugees entering the U.S., according to Letitia Bligh, the agency’s health communications specialist in Atlanta.
Immigrants with certain communicable diseases are not eligible to obtain a visa or enter the country, according to Section 212(a)(1)(A) of the Immigration and Nationality Act (INA).
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Syphilis is one of the diseases on that list, in addition to tuberculosis, gonorrhea, COVID-19, polio, smallpox, pandemic flu and others.
The CDC “doesn’t observe illnesses by immigration standing.”
“CDC has complete surveillance techniques to trace communicable illnesses (illnesses that may be transmitted to others) for individuals within the U.S.,” Bligh said. “However, CDC doesn’t observe illnesses by immigration standing.”
Between 2014 and 2019, approximately 445 out of every 100,000 tested immigrants and refugees were positive for some form of syphilis, per the CDC.
Immigrants with certain communicable diseases are not eligible to obtain a visa or enter the country. (Getty Images)
The CDC website states that “syphilis checks should be carried out on the time of the immigration medical examination and on the laboratory said within the panel doctor settlement” — but some doctors are skeptical.
“They are usually not being examined for COVID as they arrive throughout [the border], a lot much less for syphilis,” Hodges, the Texas physician, told Siegel.
The Texas-Mexico border region “has the bottom charges of gonorrhea and first and secondary syphilis, however has the very best charge of congenital syphilis,” in keeping with the Texas Department of State Health Services.
“Out of the reported 25,469 syphilis circumstances in Texas throughout 2022, 143 of these circumstances had been reported to amass the an infection from Mexico,” said a spokesperson for the Texas Department of State Health Services. (Getty Images)
A spokesperson for the Texas Department of State Health Services told Fox News Digital on Thursday that they are unable to quantify the impact of immigration on reported syphilis cases in Texas.
“The knowledge supply used for geographical reporting of syphilis illnesses inside Texas is the consumer’s house handle reported by the supplier,” the spokesperson continued.
“We try to get hold of [information about] sexual companions from newly recognized people to facilitate their testing and remedy, however we’re unable to differentiate Mexico residents from Texas from the knowledge supplied.”
The spokesperson also said, “Of the reported 25,469 syphilis circumstances in Texas throughout 2022, 143 of these circumstances had been reported to amass the an infection from Mexico.”
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Dr. Jason E. Zucker, assistant professor of medicine at Columbia University Irving Medical Center in New York, told Siegel that while he’s unsure of the exact percentage, he does treat some immigrants with syphilis.
“That stated, syphilis charges within the home inhabitants have been growing for years — so anecdotally, whereas we’re seeing some current immigrants, the bulk of our sufferers with syphilis are usually not current immigrants,” he said.
Pfizer says Bicillin is ‘limited’ but no official shortage
Pfizer is the only pharmaceutical company that makes Bicillin, producing the drug in its Rochester, Michigan, facility.
A Pfizer spokesperson told Fox News Digital said the drug is “undoubtedly taxed” and in “constrained provide,” however denied that there’s an official scarcity.
Cases of congenital syphilis, which occurs when a mother passes the infection on to her baby during pregnancy, rose by 32% between 2020 and 2021. (iStock)
In 2022, during the convergence of RSV, flu and COVID, there was a shortage of the popular antibiotic amoxicillin. This led doctors to begin prescribing Bicillin as a backup to treat strep throat and other bacterial infections in children, which hadn’t happened before, the Pfizer rep said.
Those factors, coupled with the spike in syphilis cases, led to the dwindling supply.
“We’re pushing arduous to supply extra Bicillin and provide the market,” the spokesperson added.
After amoxicillin became widely available again, Pfizer switched its focus to making more of the adult form of Bicillin, pausing production of the children’s version.
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“We decided to deprioritize the pediatric model of the drug — which is never ever utilized by pediatricians for antibiotic functions with youngsters — and to prioritize the grownup model for the affected person neighborhood that wants it most,” the spokesperson said.
“It’s important for pregnant girls with syphilis to get the drug, as a result of if they do not, their infants might die or be born with delivery defects. So it was a comparatively simple name.”
The pediatric version is expected to run out eventually, the rep confirmed, but he also said, “There is not going to be a stock-out of the grownup drug.”
Currently, the drug is “not as available as we wish, however there may be provide,” he said.
Mark C. Poznansky, M.D., PhD, an infectious disease physician at Massachusetts General Hospital and an associate professor at Harvard University, told Siegel that the potential shortage of Bicillin didn’t affect them much until the past few weeks.
“The hospital does nonetheless have some Bicillin, and we’re capable of procure some from the state instantly, however at the moment the drug is being prioritized for pregnant individuals with syphilis and their contacts, or individuals who, for no matter purpose, can not obtain doxycycline,” he explained.
“The state provide can be used for individuals with major/secondary/early latent syphilis.”
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At Columbia University, physicians are seeing an increase in syphilis cases across gay, bisexual and other men who have sex with men (MSM) as well as people born female, Zucker told Siegel.
“That is coupled with the nationwide scarcity of Bicillin, pushed by elevated demand, which has led us to develop protocols to attempt to scale back Bicillin utilization every time attainable,” he said.
In Nashville, Tennessee, Dr. Zachary Hoy, a board-certified pediatric infectious disease specialist and medical director at Pediatrix Medical Group, mainly sees cases of congenital syphilis, which happens when an infant is born to a mother with the infection.
Pfizer is the only pharmaceutical company that makes Bicillin, the penicillin drug that treats syphilis. (iStock)
“Currently we’ve got not skilled a scarcity of Bicillin at my facility, however there are some hospitals in Nashville which can be involved a few scarcity,” he told Fox News Digital.
Pfizer expects to reach “full restoration mode” — which is when there is an “ample backup provide” of six to eight weeks’ worth of excess supply on the shelves — by mid- to late-2024, the company spokesperson told Fox News Digital.
What to know about syphilis: Diagnosis, treatment, prevention
The first sign of syphilis is usually a painless sore on the mouth, genitals or rectum, according to the Mayo Clinic. Later symptoms can include a body rash, hair loss, muscle aches, sore throat, fever and swollen lymph nodes.
In its early stages, syphilis can be treated with an injection of penicillin (Bicillin).
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If left untreated, up to 30% of people may develop tertiary syphilis, which can eventually damage the brain, nerves, eyes, heart, blood vessels, liver, bones and joints, per the Mayo Clinic.
With congenital syphilis, an infected mother can pass the disease on to her unborn baby, which can cause fetal death, premature birth or birth defects.
With congenital syphilis, an infected mother can pass the disease on to her unborn baby, which can cause fetal death, premature birth or birth defects. (iStock)
Those most at risk include people who engage in unprotected sex, have sex with multiple partners, are men who have sex with men, or are infected with HIV, the Mayo Clinic states.
There is currently no vaccine for syphilis.
“Many sexually transmitted infections are treatable, however should be recognized and adopted with a remedy plan,” Hoy told Fox News Digital.
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“STI screening is free or at a considerably diminished value at public well being departments,” he added. “Some screening may even be completed by way of urine or swab testing and should not require a blood draw.”
Those who suspect they may be infected should seek screening right away, the doctor advised.
