(836) The Illinois Perinatal Syphilis Warmline: A public health initiative to address the syphilis epidemic

In response to the sharp rise in congenital syphilis (CS) cases in the United States and the complexities of perinatal syphilis management, the Illinois Department of Public Health (IDPH) implemented the first statewide perinatal syphilis clinical support warmline to aid CS prevention. We aimed to evaluate the first 9 months of warmline activity and characterize the public health need for perinatal syphilis consultation.


Study Design:

The IDPH Perinatal Syphilis Warmline offers remote medical consultation with MFM, adult infectious disease, and pediatric infectious disease experts regarding syphilis diagnosis and treatment during pregnancy and the newborn period, coordinates record searches of prior testing and treatment, and assists in mandatory reporting and linkage to local health department resources. In this prospective cohort study, we performed descriptive analysis of calls to the Warmline from its inception in November 2023 through July 15, 2024.


Results:

The Warmline served providers from Chicago (55%), other Illinois areas (40%), and outside Illinois (5%). Of 62 consultations, 53% were from outpatient clinics, 21% from labor and delivery units, and 19% from newborn care units. Consultations were primarily requested by obstetric nurses or nurse practitioners (21%), obstetricians (16%), or pediatricians (16%). Most consultations focused on antepartum (40%) or immediately postpartum (31%) management, mainly due to a reactive syphilis test (Fig. 1). Among 46 consultations for syphilis staging in pregnant or recently postpartum individuals, we identified 2 cases of primary syphilis, 6 early latent, 32 late latent, 4 unknown stage, and 2 false positives (Fig. 2). Among 24 neonatal consultations, by CDC CS surveillance case definitions, 9 were possible CS cases, 8 less likely, 3 unlikely, and 4 unknown (Fig. 2).


Conclusion:

This statewide public health initiative has provided critical, timely expertise on diagnosing and managing perinatal syphilis. We offer a blueprint for other public health jurisdictions to adopt this successful model of enhanced public health surveillance and consultation.