Syphilis Cases in the U.S. Reach Highest Numbers in 75 Years, Experts Discuss Causes and Solutions
Syphilis, a sexually transmitted disease (STD), is experiencing a resurgence in the United States, with cases reaching the highest numbers in nearly 75 years. According to the Centers for Disease Control and Prevention (CDC), there was a 10% increase in syphilis cases in 2022, totaling 203,500 cases. This marks a significant rise of 68% since 2018. Experts are now examining the causes behind this surge and discussing potential solutions to combat the infection.
A Multifaceted Public Health Issue
Dr. Bryan Dechairo, CEO of Sherlock Biosciences, a diagnostic testing provider in Massachusetts, describes the recent surge in syphilis cases as a “multifaceted public health issue” that reflects broader systemic challenges. One of the primary reasons behind the increase is the lack of testing and insufficient access to testing, particularly among populations most at risk. Without newer, more accessible, and accurate tests, individuals may not be aware that they have an STI and are more likely to transmit it to others.
Decline in Protected Sex and Reduction in Sexual Health Services
Dechairo also attributes the surge in syphilis cases to a decline in protected sex, especially among younger people. The success of HIV prevention and treatment has led to a perception of reduced risk for sexually transmitted infections, resulting in less cautious sexual behavior. Moreover, there has been a reduction in sexual health services and professionals, which has created a perfect storm for the resurgence of syphilis, particularly among marginalized communities.
Rise in Illicit Drug Use and Dating Apps
Dr. Jarod Fox, an infectious disease specialist with Orlando Health, highlights the rise in illicit drug use in the U.S. as another contributing factor to the spike in syphilis cases. Risky sexual encounters are more prevalent among individuals engaging in drug use, increasing the likelihood of contracting STIs. Additionally, the rise of dating apps has made it easier for individuals to expand their sexual networks, leading to a wider spread of STIs.
High-Risk Groups and Symptoms
According to the CDC, most cases of syphilis affect men who have sex with men (MSM). Certain racial and ethnic groups, such as Black Americans and Native American/Alaska Natives, also show higher rates of infection due to systemic inequities in healthcare access. The early symptoms of syphilis include painless genital ulcers and enlarged inguinal lymph nodes, which can be easily missed and lead to delayed diagnosis. A rash on the palms and soles may develop after the initial ulcers have healed, and the infection can also have neurologic and vision-related effects.
Treatment and Complications
The primary treatment for syphilis is intramuscular penicillin injections, with the number of injections depending on the stage of the infection. However, there have been intermittent shortages of penicillin, leading to the use of alternative treatments such as doxycycline in some cases. If left untreated, syphilis can progress through various stages, causing severe health complications such as damage to major organs, neurological issues, blindness, and even death. In cases of congenital syphilis, the infection can be passed from mother to child, resulting in miscarriage, stillbirth, or severe birth defects.
A Comprehensive Approach to Combat Syphilis
To reverse the upward trend in syphilis cases, experts emphasize the need for a comprehensive approach. This includes increased access to new types of testing, including home testing, to slow the spread of not only syphilis but also all STDs. It is crucial because people with one type of infection are more likely to have another concurrent infection. Additionally, targeted public health interventions and education are necessary to reduce infections among high-risk groups. Establishing more clinics and training more healthcare professionals to treat syphilis patients is also essential. Furthermore, prenatal care plays a crucial role in preventing cases of congenital syphilis.
Conclusion
The surge in syphilis cases in the United States is a cause for concern, with numbers reaching the highest levels in 75 years. Experts attribute this increase to various factors, including a lack of testing and insufficient access to testing, a decline in protected sex, reduction in sexual health services, rise in illicit drug use, and the popularity of dating apps. Men who have sex with men and certain racial and ethnic groups are most at risk. Early diagnosis and treatment are crucial to prevent severe health complications. A comprehensive approach that includes increased testing, targeted interventions, and improved access to healthcare is needed to combat the spread of syphilis and improve public health outcomes for all communities.
