According to a new federal government report on sexually transmitted diseases (STDs) in adults, the U.S. is facing an ongoing syphilis epidemic, with cases rising by 9% in 2022. The report, released by the U.S. Centers for Disease Control and Prevention (CDC), highlights the concerning increase in syphilis infections, reaching a total of over 207,000 cases last year – the highest count in the United States since 1950.

While the reasons behind the rise in syphilis cases remain unclear, officials at the CDC noted that a simultaneous decline of 9% in gonorrhea cases is also puzzling. It is too soon to determine if this drop indicates a new downward trend for gonorrhea, which is more common than syphilis and chlamydia but considered less dangerous.

Despite syphilis historically impacting gay and bisexual men to a greater extent, CDC officials warn that the infection is now expanding in heterosexual men and women, and is increasingly affecting newborns as well. The report reveals that the most infectious forms of syphilis accounted for approximately 59,000 cases in 2022, with a quarter of those cases involving women and a quarter involving heterosexual men.

Dr. Philip Chan, an expert from Brown University and chief medical officer of Open Door Health, emphasizes the need for increased testing and awareness of syphilis in the cisgender heterosexual population. Dr. Chan suggests that the disease is unknowingly spreading due to inadequate testing efforts, particularly in this specific demographic.

Alarming trends were noted across various racial and ethnic groups, with American Indian and Alaska Native individuals experiencing the highest rate of syphilis infections. The state of South Dakota reported the highest rate of infectious syphilis at 84 cases per 100,000 people, more than double the rate of the state with the second-highest number of cases, New Mexico.

Dr. Meghan O'Connell, chief public health officer at the Great Plains Tribal Leaders' Health Board, attributes the increase in South Dakota to an outbreak in the Native American community. O'Connell explains that limited access to STD testing and treatment, exacerbated by pandemic-related challenges, has contributed to the spread of syphilis in isolated tribal communities.

To combat the syphilis epidemic, the U.S. Department of Health and Human Services established a syphilis task force in the prior year, focusing on areas with the highest rates, including South Dakota, 12 other states, and the District of Columbia.

The report also examined the more common STDs of chlamydia and gonorrhea. Chlamydia cases remained relatively steady from 2021 to 2022, with a rate of approximately 495 per 100,000 individuals. Notable declines in chlamydia cases were observed in men and women in their early 20s. Similarly, gonorrhea rates declined, particularly among women in their early 20s. However, experts are unsure about the reasons behind this decline, as it occurred across approximately 40 states.

The disruptions caused by the COVID-19 pandemic, including reduced access to STD testing, likely contributed to the decrease in chlamydia cases in 2020. Dr. Jonathan Mermin, director of the CDC's National Center for HIV, Viral Hepatitis, STD, and TB Prevention, acknowledges the significance of the decline in gonorrhea rates but cautions that further examination is necessary to understand if the trend will continue.

As the U.S. continues to grapple with the ongoing syphilis epidemic, health officials emphasize the importance of widespread testing, increased awareness, and accessible treatment to curb the spread of this dangerous STD.