Surge in Syphilis Cases Reverses Progress in the United States
In a shocking turn of events, the United States has witnessed a reversal in its progress towards eliminating syphilis. According to a report by the U.S. Centers for Disease Control and Prevention (CDC), the number of syphilis cases has skyrocketed from under 32,000 in 2000 to over 207,000 in 2022. This alarming surge amounts to 62 cases per 100,000 people.
The impact of this crisis is particularly devastating for pregnant individuals and their babies. The maternal rate for syphilis during pregnancy has risen from 87 per 100,000 births in 2016 to a staggering 280 per 100,000 births in 2022. Without proper treatment, syphilis can be transmitted from the pregnant person to the fetus, resulting in congenital syphilis. This can lead to miscarriage, stillbirth, premature birth, severe health problems after birth, or even the death of the infant. Shockingly, more than 3,700 babies were born with syphilis in 2022, which is approximately ten times the number recorded in 2012.
One of the key challenges in addressing this issue lies in testing. Syphilis is often referred to as “the great pretender” because it can mimic symptoms of other conditions or even remain asymptomatic. Allison Agwu, a pediatric and adult infectious disease clinician and researcher at Johns Hopkins School of Medicine, emphasizes the importance of testing for syphilis to identify cases. She believes that testing should be destigmatized and integrated into regular medical checkups. Agwu asserts, “If you have been sexually active ever, you should have a syphilis test.”
In an interview with Science News, Agwu sheds light on the factors contributing to the rise in syphilis cases. She highlights the asymptomatic nature of the disease, which often leads to missed signs and delayed diagnosis. Additionally, the collapse of the public health infrastructure, coupled with decreased access and funding, has exacerbated the problem. The impact is particularly severe in communities with limited access to healthcare services. Agwu also mentions the presence of stigma surrounding syphilis and the occurrence of medicine shortages.
To address the missed opportunities in testing for syphilis, Agwu emphasizes the need for healthcare providers to be proactive in testing individuals. She shares instances where elderly individuals have presented with complications related to untreated syphilis, underscoring the importance of considering syphilis as a potential diagnosis. Agwu also stresses the significance of testing during early pregnancy and ensuring that pregnant individuals receive appropriate counseling and care to prevent transmission to their babies.
The rise in maternal syphilis rates is a cause for concern across all demographics. The CDC report reveals that American Indian and Alaska Native women experienced a staggering 783 percent increase in maternal syphilis rates from 2016 to 2022.
To combat this alarming trend, Agwu emphasizes the need for education, destigmatization, and normalization of discussions around sexuality and sexual exploration. She believes that by creating a positive environment for sexual health care, testing, prevention, and treatment, it will be possible to tackle syphilis effectively.
Syphilis is categorized into stages and can have severe consequences if left untreated. It is caused by the bacteria Treponema pallidum and progresses through various stages, featuring different symptoms. Testing for syphilis typically involves a blood test and is recommended for sexually active individuals at increased risk, including those with HIV infections or other sexually transmitted infections, as well as men who have sex with men. Pregnant individuals are advised to undergo syphilis testing during their first prenatal visit.
Treatment for syphilis involves a shot of a special formulation of penicillin. However, there has been a shortage of this drug, posing challenges for pregnant individuals. Nonpregnant individuals may be prescribed the oral antibiotic doxycycline for treatment.
The surge in syphilis cases in the United States is a wake-up call for the nation’s public health infrastructure. It is imperative to prioritize education, destigmatization, and access to testing and treatment to reverse this alarming trend. By normalizing discussions around sexual health and ensuring comprehensive care, it is possible to eliminate syphilis once again and protect the well-being of pregnant individuals and their babies.