In few places is it worse than California’s Central Valley. If untreated, the infection has devastating consequences, causing severe neurological disorders, organ damage, and even infant death. Congenital syphilis occurs when the infection is passed from mother to baby during pregnancy. Rates of infection have ballooned to numbers not seen in two decades. Vang works for the county health department, where he’s on the frontlines of California’s fight against maternal and congenital syphilis. Photos by Larry Valenzuela, CalMatters/CatchLight Local Last: STD Investigator Hou Vang speaks with a pregnant patient to inform them of their diagnosis and provide information on July 14, 2022. Vang says many of his patients struggle to get to the nearest hospital that can provide treatment for syphilis. “I have a lot of questions for my kid’s dad.” First: STD Investigator Hou Vang drives to a rural town in Fresno County to make a home visit with a pregnant patient and provide them with information on July 14, 2022. We like to disclose in-person in case there are any questions,” Vang says. “It’s an STD (sexually transmitted disease).

The woman allowed CalMatters to report on her diagnosis on the condition of anonymity. “I mean, you hear things,” she says, distractedly eyeing a family member’s car pulling into the driveway. She lives with her parents in Reedley, California, a small town 30 minutes southeast of the city of Fresno, surrounded by neat rows of grapevines, orange groves and almond trees. “Are you familiar with syphilis?” Hou Vang, a county communicable disease specialist, asks a pregnant woman standing in the shade of a tree outside her home. Life expectancy in Fresno County drops by 20 years depending on where you live, and it’s those who live in historically poor, redlined or rural neighborhoods who are most impacted by a resurgence of maternal and congenital syphilis. In the Central Valley, where two-thirds of the nation’s fruit and nuts are grown, the pastoral landscape masks entrenched racial and economic disparities. Public health workers say the increase coincides with a decline in funding for public health and a drop in the rate of women accessing prenatal care. The number of congenital syphilis cases has ballooned to rates not seen in two decades.

Gonorrhea symptoms in women photos