Syphilis Cases Surge by 9% in the US, While Gonorrhea Declines: New Report
The United States is grappling with a surging syphilis epidemic, as the rate of infectious cases rose by 9% in 2022, according to a recent federal government report on sexually transmitted diseases (STDs) in adults. However, there is some unexpected good news: the rate of new gonorrhea cases fell for the first time in a decade. While officials at the U.S. Centers for Disease Control and Prevention (CDC) are puzzled by the simultaneous rise in syphilis and decline in gonorrhea cases, they are cautiously optimistic about a potential downward trend for the latter.
Syphilis, although less common than gonorrhea or chlamydia, is considered more dangerous. CDC officials are particularly concerned about the impact of syphilis on gay and bisexual men, but they note that it is also expanding in heterosexual men and women and increasingly affecting newborns. In 2022, total syphilis cases surpassed 207,000, marking a 17% increase and the highest count in the United States since 1950. This count includes not only the most infectious stages of the disease but also latent cases and cases where pregnant women transmitted syphilis to their babies.
Syphilis is a bacterial disease that initially presents as painless genital sores but can lead to severe complications such as paralysis, hearing loss, dementia, and even death if left untreated. The introduction of antibiotics in the 1940s led to a significant decline in new syphilis infections in the U.S., reaching its lowest point in 1998.
Out of the 2022 cases, approximately 59,000 involved the most infectious forms of syphilis. Surprisingly, about a quarter of these cases were women, and nearly a quarter were heterosexual men. Dr. Philip Chan, a professor at Brown University and the chief medical officer of Open Door Health, a health center for LGBTQ+ patients in Providence, Rhode Island, believes that syphilis is unknowingly spreading in the cisgender heterosexual population due to a lack of testing and awareness.
The report also reveals that rates of the most infectious types of syphilis have risen across different racial and ethnic groups in the country, with American Indian and Alaska Native people experiencing the highest rate. South Dakota has the highest rate of infectious syphilis, with 84 cases per 100,000 people—more than double the rate of the state with the second-highest rate, New Mexico. Dr. Meghan O’Connell, the chief public health officer at the Great Plains Tribal Leaders’ Health Board, attributes South Dakota’s increase to an outbreak in the Native American community. She explains that STD testing and treatment were already limited in isolated tribal communities and worsened during the pandemic.
To address the escalating syphilis crisis, the U.S. Department of Health and Human Services established a syphilis task force last year. This task force is focused on halting the spread of the STD, with a particular emphasis on states with the highest syphilis rates, including South Dakota, 12 other states, and the District of Columbia.
The report also examines the more common STDs of chlamydia and gonorrhea. Chlamydia cases remained relatively stable from 2021 to 2022, with a rate of about 495 per 100,000. However, declines were noted in men and especially women in their early 20s. As for gonorrhea, the most significant decline was observed in women in their early 20s as well.
Experts are uncertain about the reasons behind the decline in gonorrhea rates. The decrease occurred in approximately 40 states, suggesting that it was a widespread phenomenon. Disruptions in STD testing during the COVID-19 pandemic may have contributed to the decline in chlamydia rates in 2020. Dr. Jonathan Mermin, the director of the CDC’s National Center for HIV, Viral Hepatitis, STD, and TB Prevention, acknowledges that further investigation is needed to understand the decline in gonorrhea cases and determine if it will continue.
While the rise in syphilis cases is concerning, the decline in gonorrhea rates offers a glimmer of hope. However, it is crucial to remain vigilant and address the underlying factors contributing to the spread of these STDs. Increased testing, awareness campaigns, and accessible healthcare services are essential in curbing the transmission and impact of these infections on individuals and communities across the United States.
In conclusion, the recent report on STD rates in the U.S. highlights the alarming surge in syphilis cases and the unexpected decline in gonorrhea cases. The findings underscore the urgent need for comprehensive strategies to combat these sexually transmitted infections and protect public health.
