Health Department Warns of Increased Congenital Syphilis Risk
Shortage in treatment drug coincides with continued rise in cases
The county health department issued an urgent public health advisory on Wednesday warning pregnant people about the increased risk of congenital syphilis due to a nationwide shortage of the medication used to treat the disease during pregnancy coinciding in a rise in syphilis cases locally and nationwide.
A Mecklenburg County Public Health (MCPH) release on Tuesday afternoon warns of a nationwide shortage of Bicillin L-A, aka penicillin G benzathine, the only recommended and effective treatment for syphilis during pregnancy.
Congenital syphilis refers to untreated syphilis that passes from a mother to her baby during pregnancy, which can lead to blindness, miscarriage, premature birth and other serious health complications for the infant, including stillbirth.
“Every case of congenital syphilis is preventable, but timely testing and receiving adequate treatment are critical,” said (MCPH) Director Dr. Raynard Washington. “The national shortage of Bicillin L-A is a serious threat to ensuring all pregnant patients receive timely syphilis treatment.
“We are urging all pregnant women to make sure they get tested for syphilis and take steps to reduce their risk of exposure,” Washington continued. “It is equally imperative that all health care providers reserve available Bicillin L-A for pregnant patients only.”
According to the release, Mecklenburg County, like much of North Carolina and the nation, has seen a rise in syphilis infections, particularly among women of childbearing age. The most recent case reporting does show an improvement toward reducing infections, but the treatment shortage could impact that progress, the release stated.
MCPH releases communicable disease statistics monthly, though case numbers for syphilis and congenital syphilis are reportedly quarterly.
While the most recent reporting only runs through May, the data shows that there were 201 cases of syphilis recorded in Mecklenburg County from January-March this year and nine cases of congenital syphilis.
It’s unclear how many cases of each were reported in the second quarter of 2025, though Queen City Nerve has reached out to MCPH for those numbers.
Last year’s data shows that 853 total cases of syphilis were reported, a 15% increase from the previous year (742). The number of congenital syphilis cases more than doubled from 2023 to 2024, going from 10 to 21, respectively. That number is on pace to rise again with nine cases reported in the first quarter.
In early 2024, Atrium Health officials warned that syphilis rates had been steadily climbing for 12 years in North Carolina, leading to a 631% increase in cases between 2012-24.
Read more: Atrium Doctors Warn of Rapid Rise in Syphilis Cases Locally and Statewide (2024)
In Tuesday’s release MCPH urged all pregnant people to be tested for syphilis at their first prenatal visit, during the third trimester, and again at delivery as required by law. The agency asks that health care providers prioritize Bicillin L-A for pregnant patients and notify the MCPH immediately if unable to access treatment.
MCPH also recommends that any pregnant person or person planning to become pregnant in the future practice safe sex, seek routine STI testing and, if diagnosed, seek treatment immediately.
MCPH advises pregnant people or health care providers to call the agency if they need assistance with low-cost or free syphilis testing for pregnant patients and their partners or help locating Bicillin treatment in the Charlotte area. Call 704-336-6500 or visit the website for more information or to schedule an appointment.
