Remind Your Patients About Water Safety

Drowning is the leading cause of death in children between the ages of one and four. Last year, the Virginia Department of Health (VDH) reported 12 pool drownings among children ages 0 to 5, which sadly represented a six-year high in the number of pool drownings. 

Remind your patients about water safety, and use our water safety social media toolkits, which are available in English, Spanish, Arabic, Chinese, Hindi, Korean, and Vietnamese.

Syphilis Treatment During Pregnancy 

Benzathine penicillin G (Bicillin L-A®) is currently the only recommended treatment for syphilis during pregnancy. There is an ongoing shortage of this medicine in the United States. In the United States, the only Food and Drug Administration (FDA)‑approved product is made by King Pharmaceuticals (a Pfizer company). This medication is still in shortage. In April 2026, Pfizer announced that the next shipment of both 1.2 million‑unit and 2.4 million‑unit prefilled syringes is scheduled for October 2026. They expect the full supply to be restored by Quarter 4 of 2027. This new timeline is one year later than what was first expected. The FDA website will continue to share updates. 

The FDA is allowing the temporary importation of Lentocilin© due to the ongoing limited availability and extended recovery of Bicillin® L-A. The National Network of STD Prevention Training Centers has posted information for health care providers on the administration of Lentocilin©. Until recently, health departments in Virginia had enough supply of Bicillin L-A® to treat all patients referred to their clinics. However, the shortage has lasted long enough that restrictions are now needed. As of May 31, 2026, health department clinics are using Bicillin L‑A® only for the following patients: 

• Pregnant women of any age. 

• Women of reproductive age (15-44), regardless of pregnancy status, who are infected with or exposed to syphilis.   

• Partners of pregnant women infected with syphilis. 

• Patients for whom there is a contraindication to alternative treatment regimens such as doxycycline, or who are highly unlikely to comply with an oral treatment regimen, are prioritized on a case-by-case basis, and as supply allows. 

Please continue to follow the syphilis alternative treatment guidance described in the clinician letter dated June 24, 2025. Should you need to treat a pregnant patient, infant or person allergic to doxycycline, VDH has Bicillin® L-A doses available through the Bicillin® L-A delivery program. 

New World Screwworm Detected in Animals in US along Border with Mexico   

The United States Department of Agriculture (USDA) recently confirmed the detection of New World Screwworm (NWS) in animals in the United States.  As of June 28, 2026, 27 animal cases have been reported in Texas and New Mexico.  The current status of NWS in animals is available at screwworm.gov.  

NWS myiasis is typically a disease of livestock, but it can also affect other animals, including people. The hallmark of NWS myiasis is that fly larvae feed on live tissue. Note: there are endemic fly species associated with human myiasis but these do not feed on live tissue. 

You should suspect NWS myiasis if the patient: 

• Has a recent travel history to an affected area. 
  • Especially if they report interactions with livestock, spend a lot of time outdoors during day, or have uncovered wounds or breaks in skin.  

• Has visible larvae (infesting live tissue) or egg masses or sensation of movement in wounds or body orifices. 

• Has painful wounds with foul odor or bloody discharge. 

If you suspect your patient has NWS myiasis:  

• Report it immediately to your local health department. 

• Remove all of the larvae from the affected site.  Kill and preserve the larvae by placing them directly into concentrated (70%) ethyl or isopropyl alcohol.   

• Do not discard any live larvae into the trash or outdoors. 

• Healthcare providers should consult with local health department or state health department personnel regarding guidance for proper larvae preservation for identification and confirmatory diagnosis. 
  • Local and state health department personnel can help facilitate clinical and diagnostic support from CDC.      

 For more information visit CDC’s Clinical Overview of New World Screwworm.