Congenital syphilis: a reminder about the return of an old scourge.

Congenital syphilis had almost become a forgotten disease with the advent of maternal prenatal serology and penicillin therapy for infected mothers. From the 1950s into the mid-1980s, cases of congenital syphilis steadily declined to only 688 cases in the United States in 1988; however, the number of cases increased to 2,841 by 1990. The heralding event occurred between 1981 and 1989 with a 34% increase nationally in the incidence of primary and secondary syphilis. A peak in the number of cases of congenital syphilis was attained in 1992 in the country at large, but in 1993 in the State of Missouri, there were almost three times as many cases as were reported in 1992. Physicians, particularly those who practice in the metropolitan areas of the state, should be alert to the clinical profile of prospective mothers who may have primary or secondary syphilis.