Newborn Syphilis Infection Cases Spike Across United States

The Centers for Disease Control and Prevention (CDC) headquarters in Atlanta on April 23, 2020. (Tami Chappell/AFP via Getty Images)

Syphilis cases among American adults have risen by 78 percent over a five-year period, with infections among newborns rising almost 10 times over a decade, the U.S. Centers for Disease Control and Prevention (CDC) has reported.

In 2022, there were 2.5 million cases of three sexually transmitted infections (STI)—syphilis, chlamydia, and gonorrhea, according to a CDC report released Jan. 30.

Chlamydia alone accounted for 1,649,716 of the cases.

“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 report said.

While cases of chlamydia declined between 2018 and 2022 and incidents of gonorrhea increased by only a tenth, syphilis cases jumped 78.9 percent during this period to 203,500 cases.

“In 2022, half (49.8%) of reported cases of chlamydia, gonorrhea, and syphilis (all stages) were among adolescents and young adults aged 15–24 years,” the CDC said.

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“Additionally, MSM [men who have sex with men] are disproportionally impacted by STIs, including gonorrhea and P&S [primary and secondary] syphilis, and co-infection with HIV is common; in 2022, 36.4% of MSM with P&S syphilis were persons with diagnosed HIV. ”

Congenital syphilis, which occurs when a mother with syphilis passes the infection to her baby during pregnancy, increased by over 183 percent during the five-year period.

“More than 3,700 congenital syphilis cases were reported in 2022, reflecting an alarming 937 percent increase in the past decade,” the report said.

Laura Bachmann, acting director at the CDC’s division of STD prevention, said that “swift action” is urgently needed to slow the curve of the “syphilis epidemic.”

Syphilis has four stages—primary, secondary, latent, and tertiary.

According to the CDC, the primary and secondary stages, which are the most infectious stages of the disease, increased by 10 percent in 2022 alone. Since 2018, these cases have risen by 68 percent.

Steady growth in primary and secondary stage syphilis among women “fuels the congenital syphilis epidemic, threatening the health of babies,” Ms. Bachman said while pointing out that congenital syphilis cases jumped 31 percent in 2022 from 2021.

“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,” she said.

Black people accounted for roughly 30 percent of congenital syphilis cases in 2022. American Indian or Alaska Native people had the highest rate of congenital syphilis at one case per 155 births.

Ms. Bachman said that the STI incidences in the United States have hit a “tipping point.” While these infections were common, “we have not faced such severe effects of syphilis in decades.”

Pandemic Effect

The CDC report on rising syphilis cases comes as health departments across the United States are still recovering from the impact of the COVID-19 pandemic.

“There’s no question that during the pandemic, public health was busy doing a lot of other things and we diverted a lot of people and resources … and that probably caused us to lose some ground on the progress that we’ve been making,” Scott Harris, the state health officer of Alabama, said in an interview with The Hill.

Ms. Bachman also blamed “recent public health emergencies” for diverting resources and threatening the health of individuals who are affected by STIs. “We must move now to pick up the pieces.”

Health agencies are also facing prospects of reduced funding as Congress is set to cut down public health workforce funds by $400 million—part of a debt ceiling deal made between Republicans and Democrats last year.

If Congress does not prevent the funding cuts, roughly 800 disease intervention specialists would need to be laid off, according to the National Coalition of STD Directors (NCSD).

Mr. Harris estimates that the funding cuts would result in the layoff of 24 front-line staff members who work with people who have STIs.

In a June 2023 statement, NCSD called the funding cuts “a devastating blow to the fight against rising STI rates … This decision has shaken the STI field to its core and seriously calls into question the forward progress we were making in the fight against rapidly rising STIs rates.”

The Infection

People who are sexually active and do not use a condom are at risk of syphilis. In the primary stage, individuals infected with syphilis can have sores on their body, usually around the penis, rectum, vagina, anus, lips, or mouth.

As sores tend to be painless, people may not usually notice anything unusual about them. The sores typically last for around three to six weeks after which they heal themselves irrespective of whether the person received treatment or not.

However, even if the sores went away on their own, the CDC recommends infected people to receive treatment as this will “stop your infection from moving to the secondary stage.”

In the secondary stage, skin rashes can appear. Additional symptoms during the stage include fever, headaches, weight loss, sore throat, muscle aches, patchy hair loss, fatigue, and swollen lymph glands. In the latent stage, no visible signs or symptoms exist. The infection can continue for years.

The final tertiary stage usually happens 10-30 years after the infection. Most people do not reach this stage.

However, when the disease progresses to this level, it will start affecting various organ systems like the brain, nervous system, heart, and blood vessels. The condition can lead to death.

“Syphilis is curable with the right antibiotics from your healthcare provider. However, treatment might not undo any damage the infection can cause.”

If an infant is affected by congenital syphilis (CS) during pregnancy, it can lead to miscarriage, stillbirth, premature birth, low birth weight, or death shortly after birth.

In case the infant survives, they can suffer from deformed bones, enlarged liver and spleen, skin rashes, severe anemia, jaundice, meningitis, and brain and nerve issues.

“Babies who have CS need to be treated right away—or they can develop serious health problems.”

The CDC advises all pregnant women to get tested for syphilis during their first prenatal visit.