CDC Reports Highest Number of Syphilis Cases Since 1950s

According to a recent report from the Centers for Disease Control and Prevention (CDC), syphilis cases in the U.S. have reached their highest level since the 1950s.

Far from being a gradual increase, syphilis cases have surged by almost 80% between 2018 and 2022.

Although no specific U.S. region or age category recorded more cases than others, the CDC recognized that racial and ethnic minorities have been most affected by the recent outbreak of syphilis.

Incidents of congenital syphilis, i.e., syphilis transmitted from mother to baby during birth, have escalated by a rate of 937% over the past ten years. In the year 2022 alone, 3,755 cases of congenital syphilis were documented.

The CDC has identified the rise in syphilis cases as cause for alarm and signifies an urgent need for action.

Below is an examination of why cases of syphilis are on the rise, and how to seek screening and treatment for syphilis.

Besides syphilis, there have been recent upticks in cases of other STIs such as chlamydia and gonorrhea.

However, the increase in syphilis cases has been more pronounced and persistent compared to that of chlamydia or gonorrhea, with its growth rate steadily maintaining since 2018.

The report does not provide reasons for this surge, it simply establishes the occurrence.

As per Joseph Cherabie MD, a sexual healthcare expert and assistant professor of medicine at the Washington University School of Medicine in St. Louis, a continuous pattern of syphilis and congenital syphilis growth in the U.S. is demonstrative of the state of its public health situation.

The nation's public health state, Cherabie shared, has been “underfunded and exhausted for some time” due to the repercussions of the COVID-19 pandemic and mpox.

“The overspread of health departments affected prescription capacity for STIs,” he added.

On top of health departments being overworked, people’s access to STI screening facilities has lessened.

Within the past few years, funding for sexual health clinics has been cut, and many general practice clinics have quit availing specific STI screenings, as per Kevin Ard, MD, an infectious disease doctor at the Massachusetts General Hospital.

Regarding the rise in congenital syphilis, Cherabie suggested that an increase in these cases usually accompanies a surge in syphilis.

Another potential cause for the rising syphilis cases could be its tendency to be initially undetected.

Because the symptoms of syphilis aren’t like those of other prevalent STIs, it possibly remains unnoticed and does not urge people to immediately get tested for it.

“Syphilis typically manifests as a painless sore or ulcer, which may then fade,” mentioned Justin Dubin, MD, a men’s health specialist and urologist at the Memorial Healthcare System.

Dubin referred to syphilis as “the grand imposter” as it can simulate other conditions, potentially going unnoticed and spreading as its testing is different from that of common STIs like chlamydia and gonorrhea.

Once syphilis progresses, it can produce symptoms such as fever, sore throat, headaches, and fatigue, but these can subside. Nevertheless, the disease can persistently be transmitted and can even lead to severe complications like damage to the heart and brain, deafness, and paralysis.

Treating syphilis has encountered some roadblocks recently, predominantly due to a Bicillin shortage, an antibiotic used to treat syphilis, as explained by Cherabie.

A major concern in the escalation of syphilis cases is insufficient regular screenings usually involving two steps: a preliminary test identifying antibodies associated with a syphilis infection and another test confirming the disease. These are typically blood tests.

Cherabie noted that the specificity of these tests to syphilis makes it likely that healthcare practitioners have an initial suspicion of your possible infection or include syphilis in their standard screening procedure.

However, syphilis screening is also crucial during pregnancy.

“Congenital syphilis is arguably the harshest expression of syphilis and preventable with appropriate screening and treatment,” states Ard.

You can decrease your syphilis risk by using condoms and dental dams when having sex with someone who isn’t your regular partner.

While these safeguards are not foolproof, they notably reduce infection risks,” remarks Dubin.

In the case that you think that you have been exposed to syphilis, you may be eligible for something known as doxycycline post-exposure prophylaxis. According to Ard, using this three days after having sex with an infected person can “significantly curtail the risk of syphilis”.

If you develop a lump or lesion on your genitals, it is important to obtain a medical examination, urges Dubin.

Cherabie recommends sexually active people get tested for syphilis at least once a year, if not more often.

“I typically say, ‘If you have any new sexual partners, come in every three to six months and we’ll see if there’s anything asymptomatic going on,’” he said.