Resurgence of congenital syphilis.

As a result of the alarming increase in primary and secondary syphilis in the United States, congenital syphilis has resurged in many areas, including Detroit. Several maternal risk factors have been identified as contributing to the increase in congenital syphilis, the most important of which are poor prenatal care and the trading of sex for illicit drugs, specially "crack" cocaine. Contact tracing programs are currently ineffective. To prevent the continuing increase in congenital syphilis, a comprehensive prenatal care program starting in early pregnancy is essential. STS should be determined during pregnancy and may be required more than once in high-risk mothers. Results of STS must be verified before infants are discharged from nurseries. Obstetricians, neonatologists, pediatricians, and general practitioners should be more aware of the problem of congenital syphilis and the need for early intervention and treatment.