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Syphilis is one of the sexually transmitted infections (STIs) caused by bacteria. If left untreated, it can cause serious health problems; however, treatment is available with antibiotics. Yet cases of syphilis are on the rise in USA.

From 2018 to 2022, reported cases rose 80% in the U.S. In 2022, cases of congenital syphilis among newborns were 10 times higher than in 2012, at 3,700 cases. The increase in case numbers is alarming.  What, then, needs to be done to reverse the rising rates of syphilis?

What is Syphilis?

Syphilis is a sexually transmitted infection caused by the bacterium Treponema pallidum.  It is spread by unprotected vaginal, anal, and oral sex.  It is highly contagious when sores or the rash are present and can cause permanent damage without treatment.  It can also present asymptomatically and, therefore, be spread unknowingly, even through the sharing of sex toys.  This is why testing for syphilis and any STI is so imperative for prevention and treatment. 

Testing for Syphilis

Testing for syphilis is either a simple blood test or swab of a sore or chancre.  It is both easy to test and then to treat with antibiotics.  It is very important that you tell your sexual partners if you test positive so that they may get tested as well. In 2018 there were over 113,000 cases of syphilis in the US. And as of 2022 this number has almost doubled to over 200,000 cases.   This increase has also resulted in the resurgence of congenital syphilis, where the bacteria responsible for causing syphilis are passed through the placenta to a developing fetus.  The CDC states that 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.

Prevention

As with all STIs, the only absolute way to prevent transmission is to abstain from any sexual activity.  But there are things that can be done to help reduce the risk of transmission when engaging in sexual activity.

• Get tested regularly, after new sexual partners or if a condom or barrier breaks during use
• Use a Dam (Oral Barrier) every time you have oral/vaginal or oral/sex
• Use a condom every time you have vaginal or anal sex
• Don’t share sex toys or clean them before sharing
• Condoms should be used to cover the penis during oral sex
• Talk with your sexual partners about both of your sexual health

Some of the biggest roadblocks in prevention are the following:

• Removing the stigma surrounding STIs
• Increasing awareness of testing and treatment options
• Navigating socio-economic barriers for ease of access to healthcare options
• Having health practitioners integrate screening for sexually transmitted and blood-borne infections into routine medical care

Next Steps

The good news is that syphilis is both preventable and treatable.  So, what are next steps to make sure the messages surrounding prevention and treatment are shared across the nation?  A recent John Hopkins article states the following:

“We have good diagnostics, we know how it’s transmitted, there’s no animal reservoir, and we know how to treat it. 

But there are wider public health challenges. Screening is inadequate: While some women get routinely tested for STIs at their annual exam, men are far less likely to get routine screenings. And because many people with syphilis have no symptoms, they won’t seek out screening. Plus, many at-risk patients don’t have access to health care, and a lot of sexual health clinics have closed over the last decade.

Also, the stigma of STIs doesn’t just happen from the patient side, it also comes from clinicians —many physicians think, “my patient doesn’t have syphilis.”

Finding patients’ partners has also become more difficult in the online dating era—partners are often identified with an online handle, not a physical location.”

We need to take a multi-faceted and cooperative approach to address the current public health crisis that the US is experiencing with the growing numbers of syphilis.