title: Congenital syphilis investigation processes and timing in Louisiana.
abstract: BACKGROUND
  Congenital syphilis (CS) is a potentially life-threatening yet preventable infection. State and local public health jurisdictions conduct investigations of possible CS cases to determine case status and to inform public health prevention efforts. These investigations occur when jurisdictions receive positive syphilis test results from pregnant women or from infants.
  
  
  METHODS
  We extracted data from Louisiana's electronic case management system for 328 infants investigated as possible CS cases in 2010 to 2011. Using date stamps from the case management system, we described CS investigations in terms of processes and timing.
  
  
  RESULTS
  Eighty-seven investigations were prompted by positive test results from women who were known to be pregnant by the health jurisdiction, and 241 investigations were prompted by positive syphilis test results from infants. Overall, investigations required a median of 101 days to complete, although 25% were complete within 36 days. Investigations prompted by positive test results from infants required a median of 135 days to complete, and those prompted by positive test results from pregnant women required a median of 41 days.
  
  
  CONCLUSIONS
  Three times as many CS investigations began with reported positive syphilis test results from infants as from pregnant women, and these investigations required more time to complete. When CS investigations begin after an infant's birth, the opportunity to ensure that women are treated during pregnancy is missed, and surveillance data cannot inform prevention efforts on a timely basis. Consistently ascertaining pregnancy status among women whose positive syphilis test results are reported to public health jurisdictions could help to assure timely CS prevention efforts.
authors.affiliation: From the *Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA; and †Louisiana Office of Public Health STD/HIV Program, New Orleans, LA.
authors.forename: Heather
authors.initials: H
authors.lastname: Bradley
authors.forename: DeAnn
authors.initials: D
authors.lastname: Gruber
authors.forename: Camille E
authors.initials: CE
authors.lastname: Introcaso
authors.forename: Joseph
authors.initials: J
authors.lastname: Foxhood
authors.forename: Debbie
authors.initials: D
authors.lastname: Wendell
authors.forename: Mohammad
authors.initials: M
authors.lastname: Rahman
authors.forename: Joy
authors.initials: J
authors.lastname: Ewell
authors.forename: Robert D
authors.initials: RD
authors.lastname: Kirkcaldy
authors.forename: Hillard S
authors.initials: HS
authors.lastname: Weinstock
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008145:Louisiana / Q000453:epidemiology; D008297:Male; D019095:Point-of-Care Systems; D011159:Population Surveillance; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D011296:Prenatal Diagnosis / Q000379:methods*; D017064:Process Assessment, Health Care; D011634:Public Health; D013590:Syphilis, Congenital / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D014481:United States / Q000453:epidemiology