According to the Colorado Department of Public Health, rates of syphilis in our state have increased more than three times over since 2018, representing a nearly 80% increase. Nationally, congenital syphilis is also on the rise, meaning that infected individuals are unknowingly passing the disease to their infants.
Dr. Ina Park, a medical consultant for the CDC’s Division of STD Prevention, says when the pandemic hit, a lot of clinics actually shut down completely.
"And then clinics that didn't shut down actually, and you made a policy that said anybody who doesn't have symptoms, you know, we're not going to see. We're only going to see people who are actively having symptoms and testing them for STIs. And so as you know, many sexually transmitted infections don't have any symptoms. So there was a lot less testing going on,” she said.
“And then there was actually a national shortage of test kits because a lot of the materials that are used to make the test kits for STI testing were actually diverted to making COVID test kits. And so we did see a dip in 2020 in the numbers of STI cases reported to the CDC. But the interesting thing is, by the end of 2020, gonorrhea and syphilis had caught up to the same levels that we had seen in 2019, and chlamydia still quite hasn't caught up because I still don't think that people have gotten back completely into their routine of doing their health care maintenance and screening. And we've seen that also for mammograms, colonoscopies, you know, other healthcare maintenance. A lot of people kind of fell off the wagon."
While Dr. Park says that the healthcare system has been able to recoverfairly well from the overload of the pandemic, many minority demographics are still at a disadvantage.
"If we look at syphilis among women, the communities the most sort of affected by the highest rates are American Indian and Alaska Native women, as well as non-Hispanic Black and African American women. But I want to point out that actually rates of syphilis are rising in women of all races,” she said.
“And then with babies, we've seen almost a 200 percent increase in congenital syphilis in the past five years. So again, you know, those reflect the communities that are also affected by syphilis in women, but we've seen a huge increase in deaths. Also, almost 300 of those 3,700 babies that were born with syphilis in 2022, were actually either stillborn or died in the first 30 days of life. You know, 9 out of 10 of these cases of congenital syphilis were completely preventable, and it was issues like mom didn't have any prenatal care or didn't access prenatal care in time or didn't actually gettreated in time, you know, the baby needs to be treated at least 30 days before the birth to avoid a case of congenital syphilis. So it was issues that are reflected in structural barriers and historical barriers that affect certain communities in terms of accessing care."
Syphilis testing for infants varies all over the country. Some states mandatetesting at 28 weeks and then again at delivery. In all states, testing for syphilis is mandatory at the first prenatal visit, but some mothers never make it in.
Syphilis is difficult to detect. Only in certain stages can providers identify it through visual symptoms like rashes and hair loss. Besides that, it is asymptomatic. However, if it's allowed to progress, it can cause lasting damage to the body.
"Even in the very, very beginning, the first weeks of the infection, it can go into your brain, it can go into your eyes, it can actually go into your liver. So what it does is it just goes in there and it just quietly starts to multiply. And for the most part, It will not actually cause any type of destruction or any huge awareness on your part that it's happening,” said Dr. Park.
“Later on, if it's left untreated, like if you let it go a few months, it can actually start to deposit in your scalp and cause hair loss. It can cause growths on the genitals and then it's going to start to deposit in the skin and that's when you're going to see a rash. Classically, it happens on the hands and the feet, but it can actually happen all over the body. If you let it go evenlonger, that's when it can start causing things like brain damage, eye damage, it can cause hearing loss, that kind of thing. We really want to catch it as early as possible."
Dr. Park says that the healthcare system at large would be improved byremoving barriers for patients and encouraging testing for everyone. However, there are ways for individuals to lower their risk of venereal disease.
"As an individual, the thing I think that we can do is make sure that when we start a new relationship, to get tested before we enter that relationship, before we actually have sex for the first time so that we know whether or not we might be spreading something to the next person. And so that's the thing I think we can take control of and accept some personal responsibility for."
More information on public health and the prevention of STIs can be found at cdc.gov/std.
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