How Syphilis Sneaked Up on Americans

In 2018, rates of sexually transmitted diseases in the United States increased for the fifth year in a row, and combined cases of syphilis, gonorrhea, and chlamydia reached a record high, a Centers for Disease Control and Prevention report released today showed. The number of primary and secondary syphilis cases—the disease’s most infectious stages—increased 14 percent from 2017 to 2018, to more than 35,000 cases, the highest number reported since 1991. Gonorrhea and chlamydia cases are also on the rise, with a 5 and 3 percent increase, respectively, since 2017.

The past year has also seen a 40 percent rise in congenital syphilis, the type passed from mothers to their babies. Congenital syphilis can cause neurological problems, deformity, and death, and in 2018, 94 babies died from the disease. Five states—Texas, California, Florida, Arizona, and Louisiana—accounted for 70 percent of congenital-syphilis cases.

In its report, the CDC points to several reasons behind the ongoing STD surge. The opioid epidemic, along with other types of drug use, can lead to risky behavior, including unprotected sex and avoiding medical care. Young people and gay and bisexual men are using condoms less, in part because pre-exposure prophylaxis medications that can prevent HIV transmission are more broadly available. And in recent years, more than half of local STD treatment and prevention programs have faced budget cuts. Together, all of these factors point to roughly the same sentiment: Americans have stopped taking STDs seriously.

Local health departments play a crucial role in preventing the spread of STDs. Preventing congenital syphilis requires testing pregnant women for syphilis the first time they see their doctor. Then, health-department employees have to follow up with them to be sure they get treated—with as many as three doses of an antibiotic.

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