Cases of syphilis hit dangerous record high, CDC says. Why it’s not just another STD

Cases of syphilis have hit record high numbers following a five-year trend, the Centers for Disease Control and Prevention said.

A report published Jan. 30 examined the total cases of three sexually transmitted diseases in the United States and reported shocking results.

“The most alarming concerns center around the syphilis and congenital syphilis epidemics, signaling an urgent need for swift innovation and collaboration from all STI prevention partners,” the CDC said.

Syphilis is caused by the bacteria Treponema pallidum, according to the CDC, and is most commonly spread from one person to another through vaginal, anal and oral sex, but it can also be transmitted from a pregnant person to an unborn child.

The disease has four stages and starts with sores around the sex organs or mouth, which progresses to rashes, fever, sore throat and muscle aches, the CDC says.

Left untreated, sometimes for decades, the disease starts to attack internal organs before manifesting in severe neurological symptoms, blindness and deafness.

Cases of sexually transmitted diseases, or STDs, and sexually transmitted infections, or STIs, have been steadily rising since the turn of the century, data shows, but a recent spike in cases of syphilis has health experts sounding the alarm.

Here’s what you need to know.

Nearly 80% increase in five years

From 2018 to 2022, syphilis cases have risen nearly 80%, the highest number of cases since 1950, national data shows.

More than 115,000 cases were reported in 2018, already a 25-year high, but that number has nearly doubled in the five years since.

South Dakota led the country in syphilis cases per 100,000 people in 2022. California had the highest number of cases overall, followed by Texas and Florida. Southern states made up nine of the top 20 states, according to CDC data.

In total, 22 states reported cases higher than the national average in 2022.

The numbers are alarming and have some health experts warning STDs and STIs are the next epidemic demanding national attention.

‘Real lives at stake’

“The CDC’s latest STI data shows that our nation is facing a rapidly deteriorating public health crisis with real lives at stake,” disease experts with the National Coalition of STD Directors wrote in an open letter on Jan. 30. “STIs — especially syphilis — will continue to spiral out of control until the administration and Congress provide communities with the funding they need to provide the most basic screening, treatment and prevention services.”

The group noted the particularly dangerous increase in congenital syphilis cases represented in the data, which occurs when a pregnant person has syphilis and passes it to their child while still in utero.

National cases of congenital syphilis have nearly tripled in the past five years, and cases are the highest they’ve been since 1993, according to the CDC.

In 2022, 102 out of every 100,000 babies born in the United States were born with congenital syphilis, making the condition more common than perinatal HIV and hepatitis B, data shows.

It’s a 937% increase in the past decade, Laura Bachmann, acting director of the CDC’s Division of STD Prevention, wrote in a statement accompanying the data.

Congenital syphilis can be particularly hard to treat, according to the CDC, because if even one day’s dose is missed, the entire treatment regimen must be restarted.

“The 2022 surveillance data shows millions of people were impacted by entirely preventable infections. Increasingly, though, women and babies have been forced to bear the most devastating consequences of the nation’s STI epidemic as syphilis and congenital syphilis continue to rage with treatment shortages, workforce cuts and attacks on women’s healthcare only adding to the fire,” the National Coalition of STD Directors wrote.

The group said drug shortages continued past 2022 and there have been significant cuts to the health care workforce in the past two years, suggesting the next round of statistics could be even worse.

“Nearly every state reported having at least one congenital syphilis case. Some states are feeling the impact more than others – Texas, California, Arizona, Florida, and Louisiana represented 57 percent of all reported congenital syphilis cases. Tragically, these infections resulted in 282 stillbirths and infant deaths in 2022,” Bachmann wrote.

A dangerous trend

Oscar Wilde, Friedrich Nietzsche, Casanova, Ivan the Terrible, Vincent van Gogh, Ludwig van Beethoven and King Henry VIII of England all dealt with the damaging symptoms of syphilis during their life, along with countless other famous names, according to a study in the Journal of Medicine and Life.

These famous men were more well known for their promiscuity than their level heads, which may have been influenced by the disease.

“Al Capone, the famous gangster who led a crime syndicate in the times of Prohibition in the United States supposedly died of neurosyphilis, as a consequence of aggravation of its manifestation after his imprisonment in Alcatraz,” the study said.

Notorious gangster Al Capone battled neurosyphilis near the end of his life, exacerbated by his time in Alcatraz, health researchers said.
Notorious gangster Al Capone battled neurosyphilis near the end of his life, exacerbated by his time in Alcatraz, health researchers said.

Despite its wide distribution, a truly effective treatment wasn’t found until penicillin was first used against the bacteria in 1940, according to the study.

Penicillin quickly became an effective and cost-effective treatment, and after the highest number of cases in the U.S. were recorded in 1943, cases declined over the next 80 years, CDC data shows.

Now, rich, worldly men aren’t the ones fighting off the STD. Instead, Americans in regions with declining maternal health care and racial and ethnic minorities are making up the majority of cases.

“American Indian or Alaska Native people experienced the highest rate of congenital syphilis—for every 155 births in 2022, there was one congenital syphilis case. Black or African American people experienced about 30 percent of congenital syphilis cases in 2022,” Bachmann wrote.

Many of these cases are also preventable.

In a recent CDC report, Vital Signs, data showed that in 2022 almost 9 out of 10 congenital syphilis cases could have been prevented if the mother had been tested and treated for the disease during pregnancy.

“Increasing rates of syphilis among babies reflect a failure of the U.S. health system,” the CDC said. “Too many people are not being tested and treated early enough during pregnancy.”

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