{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T09:59:18Z","timestamp":1790935158443,"version":"4.1.0"},"reference-count":33,"publisher":"American Public Health Association","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Public Health"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>This analytic essay examines the transformation of congenital syphilis (CS) in the United States from near-elimination to crisis. Drawing from the January 2025 Congenital Syphilis Summit in Atlanta, Georgia\u2014convening public health leaders, Tribal health departments, the National Coalition of STD Directors, and Centers for Disease Control and Prevention experts\u2014we contrast prevention systems during near-elimination (1998\u20132005) with the current crisis (2018\u20132025).<\/jats:p>\n                  <jats:p>Evidence revealed how dismantling public health infrastructure produced dramatically different outcomes, with CS cases increasing 937% over the past decade and racial\/ethnic disparities worsening. American Indian\/Alaska Native communities face rates up to 100 times higher than White populations in some regions, illustrating the multiplicative effects of system failures on vulnerable communities.<\/jats:p>\n                  <jats:p>We identify 5 critical system failures: cyclical boom-and-bust funding, workforce deterioration, fragmented surveillance, disconnected health care systems, and health equity failures. We present policy proposals for rebuilding prevention infrastructure through a deliberate phased approach transitioning from crisis response to sustained maintenance, ensuring prevention systems receive continuous support rather than episodic investments that have characterized past approaches. ( Am J Public Health. 2026;116(1):103\u2013112. https:\/\/doi.org\/10.2105\/AJPH.2025.308266 )<\/jats:p>","DOI":"10.2105\/ajph.2025.308266","type":"journal-article","created":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T20:00:08Z","timestamp":1760644808000},"page":"103-112","source":"Crossref","is-referenced-by-count":2,"title":["Congenital Syphilis: From Near-Elimination to Crisis"],"prefix":"10.2105","volume":"116","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7210-0279","authenticated-orcid":false,"given":"Chad J.","family":"Abresch","sequence":"first","affiliation":[{"name":"Chad J. Abresch, Regan M. Johnson, Kayode Olabanji, and Ashleigh M. Sutphen are with the Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, Omaha. Irene A. Stafford is with the Department of Obstetrics, Gynecology, and Reproductive Sciences, Division of Maternal\u2012Fetal Medicine, McGovern Medical School at UTHealth, Houston. Helen E. Cejtin is with the Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL. Ashley Hoover is with The Raven Collective, Multnomah County, Grayslake, IL."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene A.","family":"Stafford","sequence":"additional","affiliation":[{"name":"Chad J. Abresch, Regan M. Johnson, Kayode Olabanji, and Ashleigh M. Sutphen are with the Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, Omaha. Irene A. Stafford is with the Department of Obstetrics, Gynecology, and Reproductive Sciences, Division of Maternal\u2012Fetal Medicine, McGovern Medical School at UTHealth, Houston. Helen E. Cejtin is with the Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL. Ashley Hoover is with The Raven Collective, Multnomah County, Grayslake, IL."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Regan M.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Chad J. Abresch, Regan M. Johnson, Kayode Olabanji, and Ashleigh M. Sutphen are with the Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, Omaha. Irene A. Stafford is with the Department of Obstetrics, Gynecology, and Reproductive Sciences, Division of Maternal\u2012Fetal Medicine, McGovern Medical School at UTHealth, Houston. Helen E. Cejtin is with the Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL. Ashley Hoover is with The Raven Collective, Multnomah County, Grayslake, IL."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9430-1773","authenticated-orcid":false,"given":"Kayode","family":"Olabanji","sequence":"additional","affiliation":[{"name":"Chad J. Abresch, Regan M. Johnson, Kayode Olabanji, and Ashleigh M. Sutphen are with the Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, Omaha. Irene A. Stafford is with the Department of Obstetrics, Gynecology, and Reproductive Sciences, Division of Maternal\u2012Fetal Medicine, McGovern Medical School at UTHealth, Houston. Helen E. Cejtin is with the Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL. Ashley Hoover is with The Raven Collective, Multnomah County, Grayslake, IL."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7957-1422","authenticated-orcid":false,"given":"Ashleigh M.","family":"Sutphen","sequence":"additional","affiliation":[{"name":"Chad J. Abresch, Regan M. Johnson, Kayode Olabanji, and Ashleigh M. Sutphen are with the Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, Omaha. Irene A. Stafford is with the Department of Obstetrics, Gynecology, and Reproductive Sciences, Division of Maternal\u2012Fetal Medicine, McGovern Medical School at UTHealth, Houston. Helen E. Cejtin is with the Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL. Ashley Hoover is with The Raven Collective, Multnomah County, Grayslake, IL."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen E.","family":"Cejtin","sequence":"additional","affiliation":[{"name":"Chad J. Abresch, Regan M. Johnson, Kayode Olabanji, and Ashleigh M. Sutphen are with the Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, Omaha. Irene A. Stafford is with the Department of Obstetrics, Gynecology, and Reproductive Sciences, Division of Maternal\u2012Fetal Medicine, McGovern Medical School at UTHealth, Houston. Helen E. Cejtin is with the Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL. Ashley Hoover is with The Raven Collective, Multnomah County, Grayslake, IL."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-5449-509X","authenticated-orcid":false,"given":"Ashley","family":"Hoover","sequence":"additional","affiliation":[{"name":"Chad J. Abresch, Regan M. Johnson, Kayode Olabanji, and Ashleigh M. Sutphen are with the Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, Omaha. Irene A. Stafford is with the Department of Obstetrics, Gynecology, and Reproductive Sciences, Division of Maternal\u2012Fetal Medicine, McGovern Medical School at UTHealth, Houston. Helen E. Cejtin is with the Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL. Ashley Hoover is with The Raven Collective, Multnomah County, Grayslake, IL."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"844","reference":[{"key":"bib1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.7073"},{"issue":"14","key":"bib2","first-page":"413","volume":"59","author":"Centers for Disease Control and Prevention","year":"2010","journal-title":"MMWR Morb Mortal Wkly Rep."},{"key":"bib3","unstructured":"Centers for Disease Control and Prevention.\n                      Sexually Transmitted Infections Surveillance 2022\n                      . March 12, 2025. Available at: https:\/\/www.cdc.gov\/sti-statistics\/media\/pdfs\/2024\/11\/2022-STI-Surveillance-Report-PDF.pdf. Accessed March 11, 2025."},{"key":"bib4","unstructured":"Centers for Disease Control and Prevention.  National overview of STIs in 2023. March 12, 2025. Available at: https:\/\/www.cdc.gov\/sti-statistics\/annual\/summary.html. 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