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minutesNEW YORK — The rate of infectious syphilis cases in the US has risen by 9% in 2022, according to a new federal government report on sexually transmitted diseases in adults. In contrast, the rate of new gonorrhea cases fell for the first time in a decade. Health officials at the U.S. Centers for Disease Control and Prevention expressed uncertainty about the reasons behind the increase in syphilis and the decrease in gonorrhea and suggested that it is too early to determine if this marks a new trend. The focus remains primarily on syphilis due to its potential severity, even though it is less common than gonorrhea or chlamydia. Despite historically affecting gay and bisexual men, syphilis is increasingly impacting heterosexual men and women, and is also posing a growing threat to newborns, according to CDC officials. The total number of syphilis cases in 2022 surpassed 207,000, marking a 17% increase and the highest count in the United States since 1950. This figure includes not only the most infectious stages of the disease but also latent cases and instances where pregnant women transmitted syphilis to their babies. Syphilis is a bacterial disease that can manifest as painless genital sores and if left untreated, it can lead to paralysis, hearing loss, dementia, and even death. 59,000 of the 2022 cases involved the most infectious forms of syphilis, with about a quarter affecting women and nearly a quarter affecting heterosexual men. Dr. Philip Chan, who teaches at Brown University and serves as the chief medical officer of Open Door Health, a health center for gay, lesbian, and transgender patients in Providence, Rhode Island, highlighted the lack of testing and awareness of syphilis in the cisgender heterosexual population as a possible reason for its unintentional spread. The report also revealed that rates of the most infectious types of syphilis increased not only across the country but also across different racial and ethnic groups, with American Indian and Alaska Native people having the highest rate. South Dakota had the highest rate of infectious syphilis at 84 cases per 100,000 people — more than twice as high as the state with the second-highest rate, New Mexico. Dr. Meghan O’Connell, chief public health officer at the Great Plains Tribal Leaders’ Health Board in Rapid City, South Dakota, attributed South Dakota’s increase to an outbreak in the Native American community. The U.S. Department of Health and Human Services recently formed a syphilis task force with a focus on stopping the spread of the STD in places with the highest rates. The task force is primarily concentrating on South Dakota, 12 other states, and the District of Columbia. The report also examined the more common STDs of chlamydia and gonorrhea. Chlamydia cases showed little change from 2021 to 2022, remaining at a rate of about 495 per 100,000, with declines noted in men and particularly women in their early 20s. Gonorrhea rates notably declined, especially among women in their early 20s. Experts are uncertain about the reasons behind the decrease in gonorrhea rates, which were observed in about 40 states, indicating that it occurred across most of the country. The disruption in STD testing during the COVID-19 pandemic is believed to be the reason behind the decline in the chlamydia rate in 2020, and it is possible that testing and diagnoses were still being adjusted in 2022. Dr. Jonathan Mermin, director of the CDC’s National Center for HIV, Viral Hepatitis, STD, and TB Prevention, expressed encouragement regarding the significant decline in gonorrhea rates, albeit acknowledging that the rate is still higher than pre-pandemic levels. Further research is needed to determine the cause of the decrease and its potential continuation.
