As syphilis cases surge in the US, here’s what infectious disease experts want you to know

Syphilis is surging in the U.S., reaching the highest numbers in nearly 75 years.

Cases of the sexually transmitted disease (STD) rose 10% in 2022, reaching 203,500. The numbers have increased 68% since 2018, according to the Centers for Disease Control and Prevention (CDC).

Dr. Jarod Fox, an infectious disease specialist with Orlando Health, said there’s an “alarming trend” in STDs in general, and specifically syphilis, over the past decade. 

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Fox News Digital talked to experts about potential reasons behind the spread, who’s at risk — and how to combat the infection.

What’s behind the surge?

Dr. Bryan Dechairo, CEO of Sherlock Biosciences, a diagnostic testing provider in Massachusetts, calls the recent surge in syphilis cases a “multifaceted public health issue” that reflects “broader systemic challenges.”

“Most importantly, there are currently not enough people getting tested and there is insufficient access to testing, particularly among populations most at risk,” he told Fox News Digital. 

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“Without newer, more accessible, accurate tests, people do not know they have an STI and are, therefore, more likely to transmit it to other individuals.” 

Dechairo also named a decline in protected sex, particularly among younger people, as a factor in the increase. 

“This trend is partly attributed to the success in HIV prevention and treatment, leading to a perception of reduced risk for sexually transmitted infections,” he said.

Also contributing to the spike is the reduction in sexual health services and professionals, according to Dechairo.

“This, combined with broader social and economic inequalities, has created a perfect storm for the resurgence of syphilis, particularly affecting marginalized communities,” he said.

“There are currently not enough people getting tested and there is insufficient access to testing.”

Fox of Orlando Health added that the rise in illicit drug use in the U.S. has also led to more risky sexual encounters and thus a higher risk of STIs. 

“There has also been a rise in dating apps, and this makes it easier to expand an individual’s sexual network, making it easier for STIs to have a wider spread,” he told Fox News Digital.

Who is most at risk?

Most cases of syphilis affect men who have sex with men (MSM), according to the CDC.

Certain racial and ethnic groups are also at a higher risk, Dechairo said.

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“Black Americans and Native American/Alaska Natives, for instance, show higher rates of infection, likely due to systemic inequities in health care access,” he said. 

To reduce infections among men who have sex with men, Dechairo emphasized the need for targeted public health interventions and education.

Symptoms and treatment

Syphilis can cause painless genital ulcers and enlarged inguinal lymph nodes in the early stages, on average three weeks after exposure, Fox noted. 

These spontaneously heal in three to six weeks. 

“These early symptoms can be missed and lead to delayed diagnosis,” he warned. 

A rash on the palms and soles may develop after the initial ulcers have healed, said Fox. The infection can also have neurologic and vision-related effects.

The primary treatment for syphilis is intramuscular penicillin injections, with the number of injections based on whether it is an acute infection or late infection, Fox noted.

“There have been intermittent shortages of the penicillin, and so other treatments such as doxycycline may be used in some cases,” he said.

“Early symptoms can be missed and lead to delayed diagnosis.”

If left untreated, syphilis can progress through various stages with escalating severity, Dechairo warned.

“Initially, it may present as a painless sore, but without treatment, it can lead to severe health complications,” he said. 

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“In its later stages, syphilis can cause damage to major organs, neurological issues, blindness and even death.” 

In cases of congenital syphilis, the infection can also be passed from mother to child — which can result in miscarriage, stillbirth or severe birth defects, said Dechairo.

What needs to be done?

To reverse the upward trend in syphilis cases, Dechairo calls for a “comprehensive approach.”

Increased access to new types of testing — including home testing — is critical to slowing the spread of not only syphilis, but also all STDs, he said. 

This is particularly important because people with one type of infection are more likely to have another concurrent infection. 

“This is part of a broader sexual health education effort to promote safe sex practices and regular screenings, improve access to health care — especially in underserved areas — and increase public awareness to destigmatize STIs,” he told Fox News Digital. 

The expert also called for establishing more clinics and training more health care professionals. 

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“Additionally, targeted interventions focusing on high-risk groups and communities with high infection rates are essential,” Dechairo added. 

This would include prenatal care to help prevent cases of congenital syphilis, he said. 

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Said Fox, “More public health funding is needed to better take care of the minority communities that have been disproportionately affected by syphilis as well as other diseases.”

And Dechario noted, “Through these multifaceted efforts, the rising tide of syphilis infections can be curbed, improving public health outcomes for all communities.”

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