Syphilis infections in the United States skyrocket to a level not seen since 1950

The syphilis epidemic in the United States is increasing and the infection rate shot up 9% in 2022, according to a federal government report on sexually transmitted diseases in adults.

But there is some good news. The rate of new gonorrhea cases has fallen for the first time in a decade.

It’s unclear why syphilis rose 9% while gonorrhea fell by a similar percentage, CDC officials said, adding that it’s too early to know if there will be any in the future. a decrease.

Photo of a tissue with the bacteria responsible for syphilis: Treponema pallidum.Associated Press

Officials are focusing primarily on syphilis, less common than gonorrhea or chlamydia but considered more dangerous. Total cases of the disease surpassed 207,000 in 2022, the highest number in the United States since 1950, according to data released Tuesday.

Although the disease continues to have a disproportionate impact on gay and bisexual men, it is expanding in heterosexual peopleand increasingly affects newborns as well, CDC officials said.

Syphilis is a bacterial disease that can manifest as painless genital ulcers, but can lead to paralysis, hearing loss, dementia and even death if left untreated.

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New syphilis infections plummeted in the United States beginning in the 1940s, when antibiotics became widely available, and reached their lowest level in 1998.

Some 59,000 cases in 2022 corresponded to the most infectious forms of syphilis. Of these, approximately a quarter occurred in women and almost a quarter in heterosexual men.

“I think it’s spreading unknowingly among the cisgender heterosexual population, because we don’t really test for it. We’re not really looking for it” in that population, said Dr. Philip Chan, who teaches at Brown University and is director doctor at Open Door Health, a health center for gay, lesbian and transgender patients in Providence, Rhode Island.

The report also found that rates of the most infectious types of syphilis increased not only nationwide, but also across racial and ethnic groups, with American Indians and Alaska Natives having the highest rates. South Dakota has the highest rate of infectious syphiliswith 84 cases per 100,000 inhabitants, more than double that of the state in second place: New Mexico.

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South Dakota’s surge was due to an outbreak in the Native American community, according to Dr. Meghan O’Connell, chief public health officer for the Great Plains Tribal Leaders Health Board, based in Rapid City. in South Dakota. Almost all cases occurred in heterosexual people. O’Connell said testing and treatment for sexually transmitted diseases was already limited in isolated tribal communities and worsened during the pandemic.

The U.S. Department of Health and Human Services last year created a syphilis task force focused on stopping the spread of syphilis, focusing on places with the highest rates of syphilis: South Dakota, 12 others states and the District of Columbia.

The report also looked at more common sexually transmitted diseases such as chlamydia and gonorrhea.

Chlamydia cases remained relatively stable between 2021 and 2022, with a rate of around 495 per 100,000 inhabitants, although decreases were observed in men and, especially, in women between 20 and 30 years old. In the case of gonorrhea, the most pronounced decrease was also observed in women between 20 and 25 years old.

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Experts have said they don’t understand why gonorrhea rates have dropped. The phenomenon occurred in about 40 states, so whatever explains the decline appears to have occurred in most of the country. Testing for sexually transmitted diseases was halted during the COVID-19 pandemic, which officials believe is why the chlamydia rate dropped in 2020.

Testing and diagnostics may still be in the midst of a recovery process in 2022, said Dr. Jonathan Mermin, director of the CDC’s National Center for HIV, Viral Hepatitis, Sexually Transmitted Diseases and Tuberculosis Prevention.

“We are encouraged by the magnitude of the decline,” Mermin said, although the gonorrhea rate remains higher now than before the pandemic. “We have to examine what has happened and whether it will continue to happen.”