(NPR and ProPublica chose not to use Angelica's last name to protect her privacy.)Īngelica shook her head. "You're not in trouble," Yang said, before revealing the results of her blood test. Angelica seemed reticent, surprised by the sudden appearance of the two health officers. Yang led her away from the tent, so they could speak privately. The two women were about the same age: Yang 26 and Angelica 27. Yang couldn't tell if she was visibly pregnant yet, as her body was obscured by an oversized shirt. "Hi, I'm from the health department, I'm looking for Angelica."Īngelica emerged, squinting in the sunlight. Yang stopped outside one of the structures, calling a greeting.
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They made their way to the barren patch of land behind Huron Valley Foods, the local grocery store, where people took shelter in makeshift lean-tos composed of cardboard boxes, scrap wood and scavenged furniture, draped with sheets that served as ceilings and curtains. Right: In Huron, Yang looked for Angelica near a former homeless encampment where she used to live. Left: Communicable disease specialists Yang (left) and Hou Vang walk to the Fresno County Department of Public Health in Fresno. The result: The hardest to reach and most vulnerable populations are the ones left suffering, after everyone else looks away. The last fraction of cases can be the hardest to solve, whether that's eradicating a bug or getting vaccines into arms, yet too often, that's exactly when political attention gets diverted to the next alarm. Then, as fear ebbs, so does the attention and motivation to finish the task. Tom Frieden calls "a deadly cycle of panic and neglect" in which emergencies propel officials to scramble and throw money at a problem - whether that's Ebola, Zika or COVID-19. The United States goes through what former CDC director Dr.
But the effort lost steam and cases soon crept up again. There was a time, not too long ago, when CDC officials thought they could eliminate the centuries-old scourge from the United States, for adults and babies. Patients in rural areas like Huron often have less access to care.
Yang drives to Huron, a rural town an hour outside of Fresno, Calif., in search of Angelica. Black, Hispanic and Native American babies are disproportionately at risk. Case counts from 2020 are still being finalized, but the CDC has said that reported cases of congenital syphilis have already exceeded the prior year. In the same time period, cases of congenital syphilis quadrupled: 1,870 babies were born with the disease 128 died. In the United States, more than 129,800 syphilis cases were recorded in 2019, double the case count of five years prior. Each is considered a "sentinel event," a warning that the public health system is failing. Every case of congenital syphilis, when a baby is born with the disease, is avoidable. Yang knew, though, that if she helped Angelica get treated with three weekly shots of penicillin at least 30 days before she gave birth, it was likely that the infection would be wiped out and her baby would be born without any symptoms at all. If she was not treated, her baby could end up like the one in the picture or worse - there was a 40% chance the baby would die. Angelica had tested positive for syphilis. She was looking for a pregnant woman named Angelica, whose visit to a community clinic had triggered a report to the health department's sexually transmitted disease program.
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