South Dakota has a syphilis problem

Syphilis is close to eradication While cases were on the rise in the United States in the 1990s, cases in South Dakota were on the rise in the years before the COVID-19 pandemic. The number of syphilis infections nationwide has increased rapidly in recent years, and is expected to reach its highest level in 70 years in 2022, according to the latest data from the Centers for Disease Control and Prevention. The rise is penicillin shortageIt is the most effective treatment as syphilis cases are increasing nationwide.The shortage is expected to continue until the end of this year.

Megan Currie O’Connell, a member of the Cherokee Nation and public health director for the Great Plains Tribal Leadership Health Council, said hospitals were overwhelmed treating the coronavirus in 2020 and 2021, with patients suffering from sexually transmitted infections. He said he was hesitant to undergo testing and treatment for the disease. Located in Rapid City.

“The entire system needed to ensure people are tested and treated for sexually transmitted infections has been completely overwhelmed by COVID-19, along with everything else,” said a trained family physician. said Curry O’Connell. “In South Dakota in particular, additional challenges such as difficult access to care in very rural areas arose, further exacerbating the effects of the pandemic.”

Native American communities hardest hit

In South Dakota and nationally, Native American communities have been hardest hit by this outbreak. Approximately 90% of South Dakota’s congenital syphilis cases are among Native American infants; According to the state health department.

Syphilis causes a variety of symptoms, including rashes, sores, and hair loss. However, if the disease is not treated, symptoms may disappear even though the infection remains, and sexually active people should be educated about the disease, practice safe sex, and regularly Unless people are tested regularly, the disease will become very widespread, said Currie O’Connell.

If untreated, the disease can last for decades and can be fatal. If a pregnant person becomes infected, it poses a dangerous risk to the baby. Congenital syphilis causes bone deformities, severe anemia, jaundice, meningitis, and can be fatal. In 2022, CDC recorded Of the 3,761 cases of congenital syphilis reported that year, there were 231 stillbirths and 51 infant deaths due to syphilis.

Great Plains Tribal Leadership Health Committee and Tribal Leaders in North Dakota, South Dakota, Nebraska, and Iowa asked The federal Department of Health and Human Services declares a public health emergency in each state.declaration will expand Staffing, funding, and access to contact tracing data across the region.

“It’s important to get treatment. We want to prevent these outcomes and it’s very easy for people to do that,” said Currie O’Connell. “For new infections, most people only need one dose of penicillin.”

Congenital syphilis infection rate among Native Americans ( 644.7 items The rate per 100,000 people in 2022 is the same as the rate of the total U.S. population in 1941 (per 100,000 people).651.1) before doctors started using penicillin to treat syphilis. According to KFF Health News.

This risk is particularly high for people with limited access to health care.

“These people are more likely to go untreated if they put off treatment or don’t have regular contact with their doctor,” says Currie-O’Connell. “Regardless of the reason or barrier, the inability to take time off from work, the distance to travel, or the lack of readily available transportation can cause symptoms to disappear.”

How SD organizations are responding to infectious disease outbreaks

Mr. Bloghammer’s position is funded by a grant from the Indian Health Service. Bloghammer said his “boots on the ground” method is the most effective way to treat patients, but it’s also “polishing.”

Many patients have a hard time getting to Oyate Health on Rapid City’s west side, Bloghammer said, for reasons including homelessness, financial and privacy concerns. He meets patients wherever they are, including his home, hotel, and parking lot.

“Some days we get five or six calls, which is great. Other days we pick up the phone and we’re looking for people, and we might not find anyone.” Bloghammer said. “It’s not as simple as just calling and meeting. We have a significant number of homeless relatives who have no phone, no address, and are difficult to find. There is literally nothing to do. There is also.”

Some other health systems test for syphilis, but they don’t go to the patient’s location.

“At the root of all of this is that it’s extremely resource-intensive, especially in rural areas,” said Currie O’Connell. “But we still don’t know anything that can replace this. Getting out there, going out and talking to people, testing, doing what you need to do is basic public health. It’s just a job, and there’s nothing more effective than that.”

Some tribes and Indian Health Service locations are also sending nurses across reservations in South Dakota to find and treat people. The state Department of Health plans to launch its Wellness on Wheels program in May, with five vans traveling around the state providing services such as sexually transmitted disease testing, treatment, education, counseling and referrals to community resources. It will provide basic medical care to rural areas.

The van will also offer pregnancy care services, safe sleep coaching and child development testing, WIC services, maternal depression screening, immunizations and oral hygiene.

“We hope to utilize these vans several times a week to reach customers who do not have access to our physical locations,” Tia Kafke, the agency’s media spokeswoman, said in an emailed statement. Stated. “Weather permitting, the vans will operate in the winter months as much as possible.”

Currie O’Connell said states, tribes and tribal health boards meet monthly about syphilis. IHS recommends that all patients age 16 and older be tested for syphilis at least once a year. Pregnant patients should undergo her examination three times during pregnancy.

Bloghammer often receives calls from the state Department of Health asking for leads on people who have tested positive for syphilis.

“I know they work hard because it saves them time and energy,” Bloghammer said.

In December, the state department began piloting a rapid testing partnership with a health care provider in Mission on the Rosebud Reservation. In the first three months, 50 patients were tested and eight tested positive and are receiving treatment.

Experts agree that the move to rapid testing is an important advance. Patients can receive treatment immediately, rather than waiting days or weeks for results from a laboratory. The department has seven regular testing centers in the state.

Syphilis cases in South Dakota have declined since their peak in 2022, but remain at epidemic levels. Congenital syphilis can only be prevented by treating pregnant women. The number of congenital syphilis cases in South Dakota increased from 2022 to 2023.

Prenatal care and intervention are key to combating congenital syphilis

Bloghammer said he recognizes the effectiveness of collaboration, but said there is potential for more organizations to work together across the state to implement more activities.

Currie O’Connell said more efforts were needed to test pregnant women who are not receiving antenatal care. Nearly one-third of congenital syphilis cases in the first half of 2023 did not receive prenatal care. According to the state.

Most women will encounter the health care system at some point during their pregnancy, even if they do not receive prenatal care. Currie O’Connell said at that point she would need to be screened with a rapid test.

“Many women will receive some type of care during pregnancy, so if someone has an emergency treatment or is admitted to the hospital for something unrelated to pregnancy, that’s where you’ll start,” Curry says.・Mr. O’Connell said. “The key is to try to maximize the screening potential of these visits.”

Bloghamer said education is an important tool.

“I think the most important thing is to get tested,” Bloghammer said. “If you are sexually active, stay safe, get tested and get tested. Be mindful of safe sex practices with your partner.”

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