Overview

• New York State Department of Health has recorded 21 congenital syphilis cases outside New York City so far in 2025, including three infant deaths that prompted a formal warning.
• The state requires syphilis testing at a pregnant person’s first prenatal visit, during the third trimester and at delivery to eliminate infections in newborns.
• Public health experts estimate half of congenital syphilis cases occur despite prenatal care because of missed or delayed penicillin treatment, while the rest affect people not engaged in care.
• Benzathine penicillin shortages have complicated treatment nationwide and spurred federal recommendations such as the U.S. Preventive Services Task Force’s A-grade guidance for universal pregnancy screening.
• Racial and ethnic disparities remain acute, with the highest congenital syphilis rates among Native American, Alaska Native, Hispanic and Black communities, highlighting the need for outreach and point-of-care testing.