The state of Hawaii has seen an increase in the rate of syphilis cases discovered in newborns and women over the last four years. According to the state’s health department, the rate had held steady at zero to two cases per year between 2000 and 2016, but has jumped up to 11 probable cases so far in 2020.

Over the last four years, the number had increased to three to four cases per year. While the number may seem low, officials said it signals a need for urgent attention and intervention.

Congenital syphilis, a preventable illness that is increasing overall in the U.S., can cause major health issues for the child and even death. It occurs when a mother with syphilis passes the infection onto her baby during pregnancy and depending on how long the infection festers, can cause miscarriage, stillbirth, prematurity, low birth weight or death shortly after birth, according to the Centers for Disease Control and Prevention (CDC). Up to 40% of babies born to women with untreated syphilis may be stillborn or die from the infection.

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It can also cause deformed bones, low blood count, enlarged liver or spleen, jaundice, brain and nerve issues, meningitis and skin rashes, according to the health agency. It’s also possible that babies born with the illness don’t show any symptoms, but without treatment, the baby may go on to develop serious issues, even years after birth.

“While we know everyone’s current attention is focused on preventing the spread of COVID-19, we must also pay close attention to syphilis because of the potential health effects, especially for developing babies,” Dr. Glenn Wasserman, chief of the Department of Health’s Communicable Disease and Public Health Nursing Division, said in a news release. “Syphilis is preventable and easily treatable when diagnosed early.”

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The CDC advises that all pregnant women be tested for syphilis at the first prenatal appointment and that some should be tested more than once during pregnancy, especially as some may have syphilis and not be aware of it.

Wasserman said Hawaii is now recommended that pregnant women with risk factors for sexually transmitted infections be tested during the first trimester, again at 28 to 32 weeks gestation, and a third time at delivery.

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“It’s also important that sexual partners are also adequately treated to prevent women from becoming re-infected,” Wasserman said in the news release.

Syphilis infection can be successfully treated and cured with antibiotics. Wasserman said the state alerted all health care providers to be vigilant for cases of the infection in women and pregnant patients.