Fewer Deaths and Lower Costs: How Southern Nevada Used PHIG to Reduce Congenital Syphilis Cases
Success StoriesIn Nevada, stillborn deaths due to congenital syphilis cases rose 1,500% over 8 years – from three deaths in 2014 to 48 in 2022. For the Southern Nevada Health District, that number wasn’t just a statistic. It was a call to action because one child’s death due to congenital syphilis is one too many.
Todd Nicholson, Workforce Director with the Southern Nevada Health District, shares how Public Health Infrastructure Grant (PHIG) funding made it possible to hire a certified case management nurse, and how the congenital syphilis case management program has transformed the district’s ability to prevent or treat syphilis. In under three years, his team eliminated an overwhelming patient waitlist, identified opportunities for screening and treatment outside of traditional prenatal care settings, and connected patients to necessary healthcare and social supports. The results are measurable: congenital syphilis cases dropped from 55 in 2023 to 36 in 2024, with research forecasting a continued decline through 2034. The financial case is just as compelling. A hospital stay for a high-risk birth can cost nearly two million dollars. A healthy birth? Less than seven thousand. Prevention isn’t just the right thing to do — it’s the smart investment.
Video Transcript
The transcript has been lightly edited for clarity.
How is syphilis impacting the health of parents and babies in Nevada?
The incidence of congenital syphilis has gone unchecked within the communities of the 17 counties in Nevada. Untreated congenital syphilis can lead to lifelong health issues and potentially stillborn babies. To quote one of our nurses, “One child death due to congenital syphilis is too many.” Our investigation of health records of this reportable disease in Nevada shows a rise of 1,500% in stillborn rates, from three deaths due to congenital syphilis in 2014 to 48 stillborn deaths in 2022. The combination of syphilis and congenital syphilis creates a significant health risk to mothers, fathers, and children.
Our research team of public health experts here at the Southern Nevada Health District determined that the lack of prenatal care was a considerable barrier to timely testing and treatment in Clark County, Nevada. Encounters in non-traditional care settings, including but not limited to emergency departments, could provide opportunities for screening of pregnant females who do not normally have access to traditional care.
How are you using PHIG to address congenital syphilis?
One of the opportunities provided to the Southern Nevada Health District as a direct recipient of the Public Health Infrastructure Grant, or PHIG, was the opportunity to hire a dedicated public health nurse with the certified case management, or CCM, credentials. For almost three years, our case management team has decreased an overwhelming waitlist to zero and is following up with the current patient population through multiple avenues. Reducing the backlog requires educating, appointments, and follow-up reminders, which is a support system outside the patient’s home. Through social media outlets like TikTok, Facebook, and our public health news releases, the case manager is working to get the word out about congenital syphilis and the services of the Southern Nevada Health District.
The goal of the congenital syphilis case management program is to reduce the number of congenital syphilis cases, build trust and engagement within the healthcare system, and increase our community knowledge and provide education to our community providers.
What our case management services do, besides working on syphilis treatment for the completion of a pregnant person and partners — which includes their education and health coaching and referral links to care — we do prevention of STIs (sexually transmitted infections), we do third trimester and infant testing, we do assistance with follow-ups for the infant, we do home and joint provider visits, we link our patients to Medicaid, OB providers, transportation, housing, and sexual assault treatment programs.
What results have you seen so far?
We’ve seen a decrease in our congenital syphilis rates from 55 cases in 2023 to 36 cases in 2024. The research conducted in Southern Nevada referencing congenital syphilis is forecasting a decreasing trend from 2025 to 2034.
How are you reducing costs and improving health outcomes for Nevada communities?
Prevention through screening is a cost-saving method and ultimately cheaper than a long-term stay in the hospital, which could cost upwards of nearly two million dollars. A healthy birth can cost less than seven thousand dollars, based on research from 2022. Those numbers are growing due to inflation and other factors outside of our control.
As I started to say previously, one child death due to congenital syphilis is one too many. Through funding provided by the Public Health Infrastructure Grant through the CDC, we have been able to reach out to more people, decrease our backlog, and decrease our cases of congenital syphilis — and we will continue to do the work that needs to be done to ensure we have a healthy and safe community.