Congenital syphilis. Why is it still occurring?

A total of 159 cases of early congenital syphilis were reported in the United States during 1982, with Texas reporting 50 cases. We reviewed these Texas cases to identify the most important characteristics on which to focus control efforts. Thirty-eight mothers were 25 years of age or younger; 33 were unmarried. All were from minority groups. No congenital syphilis occurred in whites. Blacks were twice as likely as Hispanics to have an infected infant. Foreign-born Hispanic women were three times more likely to be delivered of an infected child than Hispanics born in the United States. Attendance at prenatal care facilities significantly affected the risk of being delivered of an infected child in both black and Hispanic women; 31 women received no prenatal care. Based on these findings, congenital syphilis in Texas can be reduced primarily through improving prenatal care for high-risk populations and by refining casefinding efforts to control infectious syphilis in the community.