Syphilis is rising in the US
Syphilis, once nearly eradicated in the United States, continues to emerge reached the highest number of new infections since 1950the Centers for Disease Control and Prevention said Tuesday.
More than 207,000 cases were diagnosed in 2022, the last year for which data is available. That represents an increase of 80 percent since 2018, and 17 percent from the previous year, according to a new CDC report.
The numbers rose dramatically in every age group, including newborns. In November, the CDC said more than 3,700 cases of congenital syphilis would be reported in 2022, about 11 times the number a decade ago. The disease caused 231 stillbirths and 51 infant deaths in 2022.
Experts pointed to a host of reasons for the continued rise in syphilis and other STDs
Substance use, which is linked to risky sexual behavior, has increased. With better prevention and treatment of HIV, condom use has fallen out of fashion and declined about 8 percentage points between 2011 and 2021, for example, among high school students.
And, crucially, there are far fewer sexual health clinics, along with the disease intervention specialists and nurses who staff them.
Syphilis has increased even in countries with national health systems because “sexual health care remains inadequate compared to needs almost everywhere,” says Dr. Jay Varma, chief medical officer at Siga Technologies and a former deputy health commissioner in New York. City.
“But it's especially a problem here in the United States,” said Dr. Varma.
“If you miss one case, you get two more cases, and if you miss two cases, you get four,” he added. “That's how epidemics grow.”
At more than 84 cases per 100,000 residents, South Dakota had the highest rate of syphilis infections, more than double that of New Mexico, the state with the next highest incidence. (Arkansas, Oklahoma and Mississippi rounded out the top five.)
Black Americans made up about 30 percent of primary and secondary syphilis cases. But at 67 cases per 100,000 people, Native American/Alaska Native people had the highest rates.
“The syphilis epidemic affects nearly every community, but some racial and ethnic groups are hardest hit due to longstanding social inequities,” said Dr. Jonathan Mermin, director of the National Center for HIV, Viral Hepatitis, STD and TB Prevention at the CDC .
If left untreated, syphilis can damage the heart and brain and cause blindness, deafness and paralysis. Infection during pregnancy can lead to miscarriage and stillbirth, and babies who survive may become blind or deaf or have serious developmental delays.
Chlamydia is by far the most common sexually transmitted disease, with almost 1.7 million cases. The number of reported diagnoses dropped sharply in 2020 and started to pick up again in 2021; the rate in 2022 remained flat.
There was gonorrhea increasing steadily after hitting an all-time low in 2009, but appeared to have declined in 2022, from over 700,000 the year before to around 648,000 cases. The rates fell by race, gender and age, but the decline was most pronounced among women aged 20 to 24.
But without confirmation that these trends are real, “we shouldn't celebrate this,” says Dr. Ina Park, an STD expert at the University of California, San Francisco.
“These two diseases are often asymptomatic,” said Dr. Park. “If we see declines in young women, it may be because they are simply not being screened.”
The Biden administration has taken several steps in an effort to curb STDs. Last summer, the Department of Health and Human Services created a national task force on syphilis, focusing on the 14 jurisdictions with the highest rates, according to Admiral Rachel Levine. , Assistant Secretary of the Department.
The CDC suggested prescribing doxycycline, a commonly used antibiotic, to gay and bisexual men and transgender women who have had unprotected sexual encounters. The Food and Drug Administration has temporarily allowed import of an alternative to the syphilis treatment Bicillin LA, which is in short supply in the United States.
The FDA has also cleared the first home sample collection kit for chlamydia and gonorrhea. And the CDC is helping develop a simple syphilis test that could be used in clinics within the next two years, said Dr. Mermin.
About 86 percent of syphilis cases were diagnosed outside sexual health clinics in 2022, said Dr. Mermin. That suggests that controlling the epidemic will require primary care physicians, emergency departments, community health centers, and correctional and drug treatment programs to screen for the infection.
“Wishing hard will not prevent sexually transmitted infections,” said Dr. Mermin. “We need sustained public health efforts.”