Kiła – Epidemiologia

Kiła
Epidemiologia

Kiła (syphilis) to wieloukładowa infekcja przenoszona drogą płciową wywołana przez Treponema pallidum, charakteryzująca się rosnącą globalną zachorowalnością, szczególnie wśród mężczyzn mających kontakty seksualne z mężczyznami (MSM), osób żyjących z HIV oraz kobiet w wieku rozrodczym. W 2022 roku WHO oszacowało około 8 milionów nowych zakażeń u dorosłych w wieku 15-49 lat oraz 700 000 przypadków kiły wrodzonej, która powoduje poważne powikłania okołoporodowe, w tym 150 000 wczesnych zgonów płodów i martwych urodzeń. W USA liczba nowych przypadków kiły wzrosła do 207 255 w 2022 roku, a kiły wrodzonej do 3755 przypadków, co stanowi najwyższe wartości od dekad. Epidemiologia kiły wykazuje znaczne zróżnicowanie regionalne i demograficzne, z najwyższą zapadalnością w Afryce Subsaharyjskiej, Azji Południowo-Wschodniej, Ameryce Łacińskiej i na Karaibach oraz wśród populacji o ograniczonym dostępie do opieki zdrowotnej. Czynniki ryzyka obejmują promiskuityzm, stosowanie narkotyków (szczególnie metamfetaminy), brak badań przesiewowych oraz ograniczony dostęp do opieki prenatalnej, co sprzyja transmisji wertykalnej i wzrostowi kiły wrodzonej.

Epidemiologia kiły

Kiła (łac. syphilis) to infekcja przenoszona drogą płciową wywołana przez bakterię Treponema pallidum. Jest to poważna choroba ogólnoustrojowa, która może prowadzić do znacznej chorobowości i śmiertelności na całym świecie, mimo że jest łatwa do zdiagnozowania i wyleczalna przy odpowiednim leczeniu¹². W ostatnich latach obserwuje się globalny wzrost zachorowań na kiłę, co stanowi istotny problem dla zdrowia publicznego wymagający zwiększonej czujności i inwestycji³.

Globalne rozpowszechnienie kiły

Według szacunków Światowej Organizacji Zdrowia (WHO), w 2022 roku około 8 milionów dorosłych w wieku 15-49 lat zakaziło się kiłą na całym świecie¹. Badanie Global Burden of Disease z 2019 roku wskazało na światową chorobowość na poziomie około 50 milionów przypadków kiły, co oznacza alarmujący 60% wzrost ogólny w latach 1990-2019¹. WHO szacuje również, że w 2022 roku na całym świecie wystąpiło 700 000 przypadków kiły wrodzonej².

Rozpowszechnienie kiły różni się znacznie między regionami świata i grupami populacyjnymi. Najwyższą zapadalność obserwuje się w Afryce Subsaharyjskiej, Azji Południowo-Wschodniej, Ameryce Łacińskiej i na Karaibach². Ponad 60% wszystkich nowych diagnoz pochodzi z krajów o niskich i średnich dochodach¹, gdzie kiła jest endemiczna, szczególnie wśród osób ubogich i mających ograniczony dostęp do opieki zdrowotnej².

Trendy epidemiologiczne w krajach rozwiniętych

W krajach rozwiniętych zachorowalność na kiłę spadała do początku XXI wieku z powodu powszechnego stosowania antybiotyków¹. Jednak od około 2000 roku wskaźniki kiły zaczęły ponownie wzrastać w Stanach Zjednoczonych, Wielkiej Brytanii, Australii i Europie². Ten trend jest szczególnie widoczny wśród mężczyzn mających kontakty seksualne z mężczyznami (MSM)¹.

W Stanach Zjednoczonych liczba przypadków kiły wzrosła o 38% w latach 2008-2012 i o 80% między 2018 a 2022 rokiem, osiągając 207 255 nowych przypadków w 2022 roku³. Według CDC w 2022 roku odnotowano ponad 200 000 przypadków kiły, co stanowi najwyższą liczbę przypadków od 1950 roku¹¹. Podobny trend zaobserwowano w Unii Europejskiej, gdzie w 2023 roku zgłoszono 41 051 potwierdzonych przypadków kiły (9,9 przypadków na 100 000 mieszkańców), co stanowi 13% wzrost w porównaniu z 2022 rokiem i 100% wzrost w porównaniu z 2014 rokiem¹.

Kiła wśród grup wysokiego ryzyka

Niektóre grupy populacyjne są nieproporcjonalnie dotknięte kiłą. Na całym świecie szacuje się, że 7,5% homoseksualnych mężczyzn i innych mężczyzn mających kontakty seksualne z mężczyznami ma kiłę, w porównaniu z 0,5% mężczyzn w populacji ogólnej³³. W Stanach Zjednoczonych mężczyźni stanowią większość przypadków (83% przypadków kiły pierwotnej i wtórnej w 2019 roku)¹, a częstość występowania kiły wśród MSM (229 przypadków na 100 000) jest 214 razy wyższa niż u mężczyzn heteroseksualnych². CDC donosi, że ponad 80% przypadków kiły pierwotnej i wtórnej w USA występuje w populacji MSM, z czego 47% ma również HIV¹.

W ostatnich latach zaobserwowano również znaczny wzrost przypadków kiły wśród kobiet. W USA wskaźniki kiły pierwotnej i wtórnej wśród kobiet niemal potroiły się w latach 2015-2019². W Kanadzie wskaźniki wśród kobiet wzrosły o 773% w latach 2016-2020, w porównaniu z 73% wśród mężczyzn². Ten wzrost jest szczególnie niepokojący, ponieważ przyczynia się do zwiększenia liczby przypadków kiły wrodzonej¹.

Kiła wrodzona – rosnące zagrożenie

Kiła wrodzona, która występuje, gdy matka przekazuje infekcję dziecku podczas ciąży, stanowi poważny problem globalny. Szacuje się, że na całym świecie rocznie rodzi się 1,5 miliona dzieci z kiłą wrodzoną, głównie w krajach o niskich dochodach, choć wskaźniki w krajach zachodnich również rosną w alarmującym tempie¹. Według WHO, przypadki kiły wrodzonej z 2022 roku doprowadziły do szacowanych 150 000 wczesnych zgonów płodów i martwych urodzeń, 70 000 zgonów noworodków, 55 000 przedwczesnych urodzeń lub urodzeń o niskiej masie urodzeniowej oraz 115 000 niemowląt z klinicznym rozpoznaniem kiły wrodzonej⁴.

W Stanach Zjednoczonych CDC poinformowało, że krajowa zapadalność na kiłę wrodzoną wzrosła niemal czterokrotnie między 2015 a 2019 rokiem i dziesięciokrotnie w ciągu ostatnich 10 lat². W 2022 roku zgłoszono 3755 przypadków kiły wrodzonej, co stanowi wzrost o 30% w porównaniu z 2021 rokiem i ponad dwukrotnie więcej niż w 2018 roku²¹. Wskaźnik w 2021 roku wynosił około 78 przypadków na 100 000 żywych urodzeń, co jest ponad 30% więcej niż w 2020 roku, a ten trend utrzymywał się do 2023 roku z dodatkowym 32% wzrostem w ciągu zaledwie jednego roku³.

Nadzór epidemiologiczny nad kiłą

Skuteczny nadzór epidemiologiczny jest kluczowy dla monitorowania trendów epidemiologicznych kiły, zrozumienia wpływu obciążenia infekcją na populacje i infrastrukturę opieki zdrowotnej oraz lepszego ukierunkowania wysiłków profilaktycznych na poziomie populacji¹. Kiła jest chorobą podlegającą obowiązkowi zgłaszania w większości krajów, co umożliwia gromadzenie danych potrzebnych do opracowania skutecznych strategii zapobiegania i kontroli¹.

Systemy nadzoru w różnych krajach

W Stanach Zjednoczonych kiła jest zgłaszana przez wszystkie jurysdykcje i jest chorobą podlegającą obowiązkowi zgłaszania na poziomie krajowym, przy czym zgłoszenia przypadków są przekazywane do CDC za pośrednictwem National Notifiable Diseases Surveillance System (NNDSS)¹. CDC gromadzi, analizuje i rozpowszechnia dane dotyczące nadzoru nad diagnozami kiły¹. Aby umożliwić urzędnikom zdrowia publicznego konsekwentną klasyfikację i liczenie przypadków w różnych jurysdykcjach, przypadki kiły, w tym kiły wrodzonej, powinny być identyfikowane przy użyciu aktualnych definicji przypadków nadzoru CSTE (Council of State and Territorial Epidemiologists)².

W Unii Europejskiej Europejskie Centrum ds. Zapobiegania i Kontroli Chorób (ECDC) monitoruje przypadki kiły zgłaszane przez państwa członkowskie i publikuje coroczne raporty epidemiologiczne¹¹. W Kanadzie nadzór nad kiłą prowadzony jest za pośrednictwem Canadian Notifiable Disease Surveillance System (CNDSS), a w odpowiedzi na rosnące wskaźniki kiły wszystkie prowincje i terytoria przekazują również rozszerzone dane nadzoru nad kiłą zakaźną do Public Health Agency of Canada za pośrednictwem Syphilis Outbreak Investigation Coordinating Committee (SOICC)¹.

Systemy nadzoru nad kiłą ewoluują w odpowiedzi na zmieniającą się epidemiologię choroby. Na przykład w Korei Południowej kiła została podniesiona z choroby grupy 4 do choroby grupy 3 i objęta obowiązkowym systemem nadzoru od 1 stycznia 2024 roku, wymagając od wszystkich placówek medycznych zgłaszania przypadków kiły w ciągu 24 godzin od diagnozy¹. Zakres zgłaszania został rozszerzony na pięć typów, w tym wczesną kiłę utajoną i kiłę trzeciorzędową, oprócz trzech wcześniej zgłaszanych typów (kiła pierwotna, wtórna i wrodzona)².

Wyzwania w nadzorze nad kiłą

Nadzór nad kiłą napotyka różne wyzwania. W wielu krajach o niskich i średnich dochodach dostępne dane prawdopodobnie niedoszacowują prawdziwe obciążenie kiłą z powodu słabej dokumentacji i niedostatecznego zgłaszania¹. Ponadto, ze względu na model transmisji kiły w sieciach społecznych, nadzór stanowi wyzwanie, ponieważ ogniska epidemii mogą wystąpić, podczas gdy ogólne wskaźniki w populacji ogólnej pozostają względnie stałe¹.

Jakość nadzoru nad kiłą może się różnić w zależności od regionu. W badaniu oceniającym system nadzoru nad kiłą w szpitalu Mae Sot w Tajlandii stwierdzono, że czułość zgłaszania przypadków kiły do krajowego systemu zgłaszania chorób podlegających obowiązkowi zgłaszania wynosiła około 67%, podczas gdy pozytywna wartość predykcyjna zgłaszania osiągnęła 100%¹. W tym konkretnym przypadku większość uczestników uznała system zgłaszania przypadków kiły za użyteczny, akceptowalny, prosty i stabilny².

Znaczenie nadzoru dla zdrowia publicznego

Skuteczny nadzór nad kiłą ma kluczowe znaczenie dla zdrowia publicznego z kilku powodów. Po pierwsze, umożliwia ocenę trendów w schematach epidemii, zrozumienie wpływu obciążenia infekcją na populacje i infrastrukturę opieki zdrowotnej oraz lepsze ukierunkowanie wysiłków profilaktycznych na poziomie populacji¹. Po drugie, pomaga zapewnić odpowiednie leczenie zakażonych osób w celu skrócenia czasu zakaźności i zapobiegania następstwom infekcji, takim jak kiła układu nerwowego². Po trzecie, umożliwia identyfikację przypadków w odpowiednim czasie, aby przerwać łańcuch infekcji poprzez interwencje na poziomie pacjenta, takie jak zarządzanie kontaktami seksualnymi i doradztwo w zakresie zmniejszania ryzyka behawioralnego³.

Ponadto, dane nadzoru mogą pomóc w identyfikacji grup wysokiego ryzyka i populacji nieproporcjonalnie dotkniętych kiłą, umożliwiając bardziej ukierunkowane interwencje¹. Na przykład, dane o lokalnym rozpowszechnieniu kiły mogą pomóc klinicystom w określeniu, które osoby poddać badaniom przesiewowym¹. Departamenty zdrowia i świadczeniodawcy opieki zdrowotnej mogą wykorzystać dane na poziomie powiatu dotyczące kiły pierwotnej i wtórnej do ukierunkowania swoich wysiłków przesiewowych².

Czynniki ryzyka i grupy wysokiego ryzyka

Zrozumienie czynników ryzyka i grup wysokiego ryzyka ma kluczowe znaczenie dla opracowania skutecznych strategii profilaktyki i kontroli kiły. Choć kiła może dotknąć każdego, pewne grupy populacyjne są nieproporcjonalnie dotknięte z powodu różnych czynników ryzyka behawioralnych i strukturalnych¹.

Czynniki behawioralne

Promiskuityzm i zachowania seksualne odgrywają istotną rolę w przenoszeniu kiły, ponieważ choroba jest częstsza wśród osób z wieloma partnerami, osób biseksualnych i mężczyzn mających kontakty seksualne z mężczyznami (MSM)¹. Ryzyko zarażenia kiłą jest wyższe w przypadku niezabezpieczonego seksu¹. Prawdopodobieństwo przeniesienia kiły z pojedynczego analnego aktu seksualnego z pojedynczym partnerem w populacji MSM wynosiło 1,4%, a z seksu oralnego 1%². Ryzyko to wzrasta wraz z liczbą kontaktów seksualnych i partnerów³.

Zwiększone ryzyko kiły wiąże się również z używaniem narkotyków, szczególnie metamfetaminy¹. Równoległa epidemia kiły wśród heteroseksualistów została powiązana z używaniem narkotyków drogą pozajelitową¹. Dodatkowe czynniki ryzyka, odpowiedzialne za znaczny wzrost kiły wśród gejów i mężczyzn biseksualnych, obejmują zwiększone korzystanie z międzynarodowych partnerów poznawanych przez Internet oraz stosowanie sildenafilu (Viagra)².

Grupy wysokiego ryzyka

Pewne grupy populacyjne są nieproporcjonalnie dotknięte kiłą:

Mężczyźni mający kontakty seksualne z mężczyznami (MSM): MSM stanowią większość przypadków kiły w wielu krajach rozwiniętych. W UE/EOG 72% przypadków kiły z informacją o kategorii transmisji zgłoszono u MSM w 2023 roku². W USA wskaźniki kiły wśród MSM są znacznie wyższe niż w populacji ogólnej, a MSM stanowią ponad połowę (52%) wszystkich przypadków kiły pierwotnej i wtórnej².¹
Osoby żyjące z HIV: Istnieje znaczące nakładanie się epidemii kiły i HIV. Wśród MSM z kiłą w USA 47% ma również HIV¹. Kiła jest istotnym synergistycznym zakażeniem dla nabycia HIV i jest ściśle powiązana z zakażeniami HIV⁴.¹
Kobiety w wieku rozrodczym: Wskaźniki kiły wśród kobiet rosną, co prowadzi do większej liczby przypadków kiły wrodzonej. Kobiety w wieku 24 lat i młodsze doświadczyły największego wzrostu⁴. W USA liczba przypadków kiły u kobiet podwoiła się w latach 2013-2017 i wzrosła o kolejne 147% w latach 2016-2020¹.
Pracownicy seksualni: Wśród pracowników seksualnych światowy wskaźnik aktywnej kiły w 2019 roku wynosił 10,8%¹. Ta grupa jest szczególnie narażona ze względu na liczne kontakty seksualne i potencjalnie ograniczony dostęp do opieki zdrowotnej.
Osoby używające narkotyków: Używanie narkotyków, szczególnie metamfetaminy i heroiny, jest związane z wyższym wskaźnikiem zakażeń kiłą¹. Wzrost kiły wśród heteroseksualistów został powiązany z używaniem narkotyków drogą pozajelitową¹.

Dysproporcje w zapadalności na kiłę

Istnieją znaczące dysproporcje rasowe i etniczne w zapadalności na kiłę. W USA wskaźniki kiły pierwotnej i wtórnej są wyższe wśród osób czarnoskórych, latynoskich, rdzennych Amerykanów/mieszkańców Alaski oraz rdzennych Hawajczyków/mieszkańców wysp Pacyfiku³¹. Wskaźniki kiły pierwotnej i wtórnej wśród czarnoskórych nastolatków i dorosłych są prawie 5 razy wyższe niż wśród białych nastolatków i dorosłych¹.

Kiła wrodzona w USA występowała 8 i 3,9 razy częściej wśród niemowląt urodzonych przez matki czarnoskóre i latynoskie, w porównaniu do matek białych, przy czym prawie połowa wszystkich zgłoszonych przypadków pochodziła z Kalifornii i Teksasu⁵. Te dysproporcje wynikają głównie z uwarunkowań społecznych, takich jak ubóstwo, niski poziom wykształcenia i słaby dostęp do wysokiej jakości opieki zdrowotnej, które w nieproporcjonalny sposób dotykają społeczności kolorowe i utrudniają utrzymanie zdrowia seksualnego²³.

Czynniki wpływające na wzrost zachorowań na kiłę

Stały wzrost zapadalności na kiłę w USA i na całym świecie od 2000 roku sprawia, że jest to powracająca epidemia, która wymaga dodatkowej uwagi i zasobów do wcześniejszego diagnozowania i leczenia¹. Kilka czynników przyczynia się do tego odrodzenia.

Czynniki systemowe

Jednym z głównych czynników wpływających na wzrost kiły są niedostateczne zasoby przeznaczane na zapobieganie chorobom przenoszonym drogą płciową. W USA finansowanie federalne na zapobieganie STD zmniejszyło się o 40% w ciągu ostatnich 20 lat¹. Jak zauważył ekspert z Johns Hopkins Bloomberg School of Public Health, „jedyną główną rzeczą, która ma wpływ na wskaźniki, są pieniądze. Rząd USA za pośrednictwem CDC miał stosunkowo płaskie wydatki na zapobieganie STD w ciągu ostatnich 20 lat – a przy inflacji oznacza to znaczący spadek wydatków”¹.

Innym istotnym czynnikiem jest ograniczony dostęp do badań przesiewowych i opieki zdrowotnej. Badania przesiewowe są niewystarczające: podczas gdy niektóre kobiety są rutynowo badane na obecność STI podczas corocznych badań, mężczyźni znacznie rzadziej poddają się rutynowym badaniom przesiewowym². Ponadto wielu pacjentów z grupy ryzyka nie ma dostępu do opieki zdrowotnej, a wiele klinik zdrowia seksualnego zostało zamkniętych w ciągu ostatniej dekady³. Według danych CDC około 30% kobiet nie ma dostępu do opieki¹.

Przeszkody w odpowiednim badaniu i leczeniu kiły obejmują brak programów opieki prenatalnej, niewystarczające badania na kiłę, brak testów w miejscu opieki, pominięte wizyty prenatalne z powodu braku zasobów, problemy kulturowe, ubóstwo, bezdomność, stygmatyzację społeczną i kulturową, dyskryminację, brak ubezpieczenia zdrowotnego oraz używanie substancji, szczególnie metamfetaminy i heroiny².

Czynniki epidemiologiczne i behawioralne

Kilka czynników epidemiologicznych i behawioralnych przyczynia się do ponownego pojawienia się kiły:

Ulepszone leczenie HIV: Poprawione leczenie HIV sprawiło, że wydaje się „bezpieczne” zwiększenie kontaktów seksualnych i partnerów bez ochrony (kompensacja ryzyka)²².
Zwiększone korzystanie z internetu w celu umawiania się na randki: Internet ułatwił znajdowanie partnerów seksualnych, co może przyczynić się do zwiększenia liczby kontaktów seksualnych³.
Wzrost używania narkotyków: Rosnące wskaźniki używania narkotyków (szczególnie metamfetaminy) są związane z wyższą częstością występowania zakażeń kiłą⁴.
Poprawa akceptacji społecznej zachowań homoseksualnych: Szczególnie MSM, co prowadzi do większej widoczności i potencjalnie większej liczby diagnoz wśród tej populacji⁵.
Wzrost populacji światowej: Wyższa liczba młodszych osób, które zazwyczaj są bardziej aktywne seksualnie⁶.
Utrzymujące się ubóstwo i bezdomność: Czynniki te ograniczają dostęp do opieki zdrowotnej i badań przesiewowych⁷.
Ogólne postrzeganie kiły jako „starej” choroby: Kiła nie jest już istotna we współczesnej opiece zdrowotnej, nawet przez niektórych pracowników służby zdrowia⁸.
Brak znajomości choroby przez współczesnych pracowników służby zdrowia: Którzy mogą mieć ograniczone doświadczenie z kiłą, szczególnie jej objawami trzeciorzędowymi⁹.

Wpływ pandemii COVID-19

Pandemia COVID-19 miała złożony wpływ na epidemiologię kiły. Po krótkotrwałym spadku podczas pandemii, liczba przypadków kiły zaczęła ponownie rosnąć w 2022 roku we wszystkich grupach transmisyjnych. Ten wzrost utrzymał się w 2023 roku³. W Anglii, po tymczasowym spadku diagnoz w latach 2020 i 2021, odpowiadającym ograniczonym badaniom podczas zakłóceń związanych z COVID-19 w służbach zdrowia seksualnego, diagnozy odbiły do 9513 w 2023 roku¹.

Według ekspertów, „konsensus w społeczności zdrowia publicznego jest taki, że wzrost STI, w tym kiły, jest prawdopodobnie związany z zakłóceniem zasobów profilaktyki STI podczas pandemii”¹. Dysproporcje w dostępie do badań i usług przesiewowych STI są wśród czynników uważanych za napędzające wzrost przypadków kiły².

Implikacje dla zdrowia publicznego i strategie kontroli

Rosnąca zapadalność na kiłę stanowi poważne wyzwanie dla zdrowia publicznego, wymagające kompleksowych i skutecznych strategii kontroli. Opracowanie skutecznych interwencji wymaga zrozumienia wielowymiarowej natury problemu i zaangażowania różnych interesariuszy⁴.

Znaczenie badań przesiewowych

Badania przesiewowe są kluczowym elementem kontroli kiły. Identyfikacja bezobjawowych infekcji poprzez testy laboratoryjne lub szybkie testy oraz zapewnienie odpowiedniego leczenia przypadków pozytywnych zapobiegnie dalszej transmisji i powikłaniom, a także niekorzystnym wynikom ciąży, w tym kile wrodzonej¹. U.S. Preventive Services Task Force zaleca badania przesiewowe w kierunku kiły u osób z podwyższonym ryzykiem infekcji².

Przy podejmowaniu decyzji, które osoby poddać badaniom przesiewowym w kierunku kiły, klinicyści powinni wziąć pod uwagę rozpowszechnienie infekcji w społecznościach, którym służą, a także inne czynniki socjodemograficzne i behawioralne, które mogą być związane ze zwiększonym ryzykiem infekcji kiłą². Lokalne wskaźniki rozpowszechnienia mogą zmieniać się w czasie, dlatego klinicyści powinni być świadomi najnowszych danych i trendów dla swojej konkretnej populacji i obszaru geograficznego, które są dostępne za pośrednictwem stanowych i lokalnych departamentów zdrowia oraz nadzoru CDC³.

Departament Zdrowia i Usług Społecznych Wisconsin wydał notatkę do świadczeniodawców opieki zdrowotnej w stanie, wzywając do zwiększenia świadomości i badań w kierunku kiły¹. Badania wykazały, że duża liczba przypadków kiły wrodzonej wynikała z braku badań w kierunku kiły, późnych badań w czasie ciąży i braku opieki prenatalnej².

Interwencje ukierunkowane na grupy wysokiego ryzyka

Skuteczne strategie kontroli kiły wymagają interwencji ukierunkowanych na grupy wysokiego ryzyka. W krajach o wysokich dochodach ważne wskaźniki, takie jak badania przesiewowe podczas pierwszej wizyty prenatalnej i wskaźniki kiły wrodzonej, są wysokie, jednak obecne strategie kontroli kiły ignorują kluczowe populacje, tj. MSM, kobiety transpłciowe i pracowników seksualnych¹. Obecne badania pokazują, że zapadalność na kiłę rośnie w tych kluczowych społecznościach².

Dla wielu osób najważniejszym czynnikiem ryzyka kiły jest życie w społeczności o wysokich wskaźnikach kiły³. CDC zaleca oferowanie badań w kierunku kiły wszystkim aktywnym seksualnie osobom w wieku 15-44 lat w powiatach o wskaźniku kiły pierwotnej i wtórnej wśród kobiet w wieku 15-44 lat przekraczającym 4,6 na 100 000 osób⁴.

USPSTF zaleca badania przesiewowe w kierunku kiły co najmniej raz w roku dla grup wysokiego ryzyka¹. Badania kontrolne są zalecane sześć i dwanaście miesięcy po leczeniu, aby określić skuteczność leczenia².

Globalne i krajowe inicjatywy

Światowa Organizacja Zdrowia (WHO) ma globalną inicjatywę na rzecz eliminacji kiły wrodzonej w powiązaniu z eliminacją przenoszenia z matki na dziecko HIV i wirusowego zapalenia wątroby typu B². Cel Healthy People 2030 dotyczący zmniejszenia wskaźnika kiły pierwotnej i wtórnej (PS) wśród kobiet w wieku 15-44 lat wynosi 4,6 na 100 000 osób⁵.

W odpowiedzi na alarmujący wzrost przypadków kiły w USA, CDC utworzyło National Syphilis and Congenital Syphilis Syndemic Federal Task Force. Admirał Rachel Levine, asystent sekretarza ds. zdrowia i przewodniczący tego zespołu zadaniowego, stwierdził: „Radzenie sobie z ponownym pojawieniem się kiły i kiły wrodzonej wymaga wspólnego wysiłku”⁵.

W Kanadzie w odpowiedzi na rosnące wskaźniki kiły, wszystkie prowincje i terytoria (P/T) składają również rozszerzone dane nadzoru nad kiłą zakaźną do Public Health Agency of Canada za pośrednictwem Syphilis Outbreak Investigation Coordinating Committee (SOICC)¹. Celem SOICC jest wymiana informacji o epidemiologii kiły oraz najlepszych praktykach i wyzwaniach związanych z reakcjami na wzrost wskaźników².

Rola wykładników zdrowia i systemów opieki zdrowotnej

Pracownicy służby zdrowia odgrywają kluczową rolę w kontroli kiły poprzez badania przesiewowe, diagnozowanie, leczenie i zgłaszanie przypadków. Przypadki kiły powinny być zgłaszane lokalnym agencjom zdrowia publicznego w celu nadzoru nad chorobami i powiadamiania partnerów³.

Systemy opieki zdrowotnej powinny priorytetowo traktować profilaktykę i kontrolę kiły poprzez zwiększenie dostępu do badań i leczenia, szczególnie dla grup wysokiego ryzyka. Jak zauważył CDC, „badania przesiewowe są niezbędne do leczenia osób zakażonych i zapobiegania dalszemu przenoszeniu. Jako świadczeniodawcy, możemy pomagać pacjentom podejmować decyzje o badaniach przesiewowych w oparciu o ich indywidualne ryzyko i uczulić ich na wszelkie objawy zakażeń przenoszonych drogą płciową, które wymagają natychmiastowej oceny”¹.

Klinicyści powinni znać obciążenie w swojej jurysdykcji: Używać mapy i tabeli danych, aby identyfikować powiaty w swoich stanach o wysokich wskaźnikach kiły i powiadamiać lekarzy w tych powiatach, aby zachęcać do większej liczby badań i skoordynowanego leczenia⁶.

Aktualne wyzwania i perspektywy

Pomimo znacznych postępów w zrozumieniu epidemiologii kiły i rozwoju skutecznych strategii kontroli, pozostają znaczące wyzwania, które wymagają pilnej uwagi⁴.

Utrzymujące się wyzwania

Jednym z głównych wyzwań w kontroli kiły jest utrzymujący się brak zasobów przeznaczanych na zapobieganie chorobom przenoszonym drogą płciową. W USA finansowanie federalne na zapobieganie STD zmniejszyło się o 40% w ciągu ostatnich 20 lat¹. Ten spadek finansowania ograniczył zdolność agencji zdrowia publicznego do skutecznego reagowania na rosnące wskaźniki kiły.

Innym wyzwaniem są dysproporcje w dostępie do opieki zdrowotnej. Wskaźniki kiły wrodzonej w USA były 8 i 3,9 razy wyższe wśród niemowląt urodzonych przez matki czarnoskóre i latynoskie, w porównaniu do matek białych⁵. Te dysproporcje wynikają głównie z uwarunkowań społecznych, takich jak ubóstwo, niski poziom wykształcenia i słaby dostęp do wysokiej jakości opieki zdrowotnej².

Jeszcze bardziej niepokojące było ustalenie, że odpowiednie leczenie matki w kierunku kiły nie zostało przeprowadzone w ponad 30% przypadków mimo wczesnej, terminowej diagnozy, co stanowi kolejną znaczącą utraconą szansę na poprawę stanu zdrowia publicznego³. Ten brak leczenia podkreśla potrzebę poprawy opieki prenatalnej i lepszej edukacji zarówno pacjentów, jak i świadczeniodawców.

Stygmatyzacja związana z zakażeniami przenoszonymi drogą płciową nadal stanowi istotną przeszkodę w badaniach przesiewowych i leczeniu. Stygmatyzacja społeczna i kulturowa, dyskryminacja oraz obawy o prywatność mogą zniechęcać osoby do poszukiwania badań i opieki⁴. Przezwyciężenie tej stygmatyzacji wymaga skoordynowanych wysiłków w zakresie edukacji publicznej i zwiększania świadomości.

Niedawne postępy i obiecujące interwencje

Pomimo tych wyzwań, istnieją powody do optymizmu. Niedawne badanie przeprowadzone w klinice zdrowia seksualnego w San Francisco wykazało stałe, znaczące spadki przypadków chlamydii i kiły wśród osób stosujących profilaktykę poekspozycyjną doksycykliną (doxy-PEP) prawie 2 lata po jej wprowadzeniu, z mniejszym wpływem na rzeżączkę¹. Wdrożenie tej interwencji opierało się na randomizowanym badaniu, przeprowadzonym w San Francisco i Seattle, które w 2023 roku wykazało znaczące spadki chlamydii, kiły i rzeżączki wśród użytkowników doxy-PEP w porównaniu z osobami, które otrzymały standardową opiekę².

Analiza wykazała znaczący spadek wszystkich indywidualnych STI w grupie doxy-PEP, najbardziej zauważalny (83%) dla łącznych wskaźników chlamydii i kiły (skorygowany iloraz szans [AOR], 0,17; 95% przedział ufności [CI], 0,12 do 0,25) i mniejszy dla rzeżączki (AOR, 0,56; 95% CI, 0,44 do 0,71)³. Te wyniki sugerują, że doxy-PEP może być obiecującą strategią zmniejszania zachorowalności na kiłę wśród grup wysokiego ryzyka.

Innym obiecującym podejściem jest zwiększenie wykorzystania podwójnych szybkich testów diagnostycznych HIV/kiły. Badania prenatalne w kierunku HIV są znacznie bardziej rozpowszechnione niż w kierunku kiły, głównie ze względu na zwiększone zainteresowanie i świadomość HIV ze strony lokalnych rządów i darczyńców, pomimo istnienia podwójnych szybkich testów diagnostycznych HIV/kiły³. Zwiększenie wykorzystania tych testów może znacząco zwiększyć badania przesiewowe w kierunku kiły o 100% do 200% w krajach wysokiego ryzyka⁴.

Perspektywy i kierunki przyszłych badań

Patrząc w przyszłość, kilka obszarów badań i interwencji może poprawić kontrolę kiły:

Lepsze systemy nadzoru: Ulepszenie systemów nadzoru do śledzenia kiły, szczególnie w krajach o niskich i średnich dochodach, może zapewnić dokładniejszy obraz globalnego obciążenia chorobą¹. W Korei Południowej przejście na obowiązkowy nadzór nad kiłą ma na celu identyfikację ogólnego występowania i trendów kiły w ROK poprzez rozszerzenie zakresu zgłaszania kiły i badań epidemiologicznych na całą populację³.
Ukierunkowane interwencje dla grup wysokiego ryzyka: Opracowanie interwencji dostosowanych do konkretnych potrzeb grup wysokiego ryzyka, takich jak MSM, kobiety w wieku rozrodczym i osoby używające narkotyków, może poprawić efektywność wysiłków kontrolnych³.
Integracja badań prenatalnych: Zwiększenie integracji badań prenatalnych w kierunku kiły z innymi usługami opieki prenatalnej może pomóc w identyfikacji i leczeniu zakażonych matek, zapobiegając kile wrodzonej¹. Obecne badania potwierdzają, że badania prenatalne w kierunku kiły ułatwiają leczenie w czasie ciąży i rekompensują przenoszenie wertykalne².
Innowacyjne strategie badań przesiewowych: Rozwój i wdrożenie innowacyjnych strategii badań przesiewowych, takich jak badania w oparciu o społeczność i badania w miejscu opieki, może zwiększyć wykrywalność kiły, szczególnie wśród populacji niedostatecznie obsługiwanych⁵.
Ograniczenie stygmatyzacji: Podjęcie wysiłków w celu ograniczenia stygmatyzacji związanej z kiłą i innymi STI może zachęcić więcej osób do poddania się badaniom i leczeniu. Strategie mogą obejmować edukację publiczną, kampanie zwiększające świadomość i szkolenia dla pracowników służby zdrowia³.

Jak zauważył ekspert cytowany w artykule BBC, „ścieżka do zwalczania kiły jest jasna – mamy już leki do jej zwalczania, ponieważ penicylina nadal pozostaje najlepszym leczeniem, pomimo rosnącej częstości występowania oporności na antybiotyki. Więcej testów, lepsze działania informacyjne przeciwdziałające stygmatyzacji związanej z chorobą, wraz z większą świadomością społeczną zachęcającą do bezpieczniejszych praktyk seksualnych, mają do odegrania znacznie większą rolę”⁴.

Podsumowanie nadzoru nad kiłą

Skuteczny nadzór nad kiłą jest kluczowym elementem kontroli choroby. Dane nadzoru informują o opracowywaniu ukierunkowanych interwencji, śledzeniu trendów epidemiologicznych i ocenie skuteczności wysiłków kontrolnych¹.

Systemy nadzoru epidemiologicznego

Różne kraje i regiony wdrożyły systemy nadzoru nad kiłą, aby śledzić zapadalność, rozpowszechnienie i wzorce choroby. W Stanach Zjednoczonych kiła jest zgłaszana przez wszystkie jurysdykcje do CDC za pośrednictwem National Notifiable Diseases Surveillance System (NNDSS)¹. CDC gromadzi, analizuje i rozpowszechnia dane dotyczące nadzoru nad diagnozami kiły, które są pozyskiwane ze wszystkich 50 stanów, Waszyngtonu i terytoriów USA².

W Unii Europejskiej ECDC monitoruje przypadki kiły zgłaszane przez państwa członkowskie i publikuje coroczne raporty epidemiologiczne¹¹. W Australii kiła jest chorobą podlegającą obowiązkowi zgłaszania na poziomie krajowym, a przypadki są monitorowane za pośrednictwem National Notifiable Diseases Surveillance System (NNDSS) i raportowane w kwartalnych krajowych raportach monitorujących kiłę¹.

Ważnym aspektem nadzoru nad kiłą jest stosowanie standardowych definicji przypadków. Aby umożliwić urzędnikom zdrowia publicznego konsekwentną klasyfikację i liczenie przypadków w różnych jurysdykcjach, przypadki kiły, w tym kiły wrodzonej, powinny być identyfikowane przy użyciu aktualnych definicji przypadków nadzoru CSTE². Definicje te pomagają zapewnić spójność w raportowaniu i umożliwiają dokładne porównania danych między różnymi regionami i okresami.

Zbieranie i analiza danych

Dane nadzoru nad kiłą są zbierane z różnych źródeł, w tym szpitali, prywatnych lekarzy, klinik publicznych i prywatnych, punktów poradnictwa i badań, laboratoriów i firm ubezpieczeniowych¹. Przypadki kiły mogą być również identyfikowane z innych rejestrów przypadków, takich jak rejestr statystyk życiowych².

Analiza danych nadzoru może dostarczyć cennych informacji o epidemiologii kiły, w tym trendach w czasie, rozkładzie geograficznym, charakterystyce demograficznej i czynnikach ryzyka. Na przykład niedawna epidemiologiczna analiza przypadków kiły wykrytych wśród personelu wjazdowego i wyjazdowego w porcie w Szanghaju w Chinach w latach 2014-2022 dostarczyła informacji o charakterystyce epidemiologicznej kiły w regionie¹. Badanie wykazało, że przenoszenie drogą płciową było główną drogą transmisji kiły wśród personelu wjazdowego i wyjazdowego oraz że występowanie kiły znacznie różniło się w zależności od regionu¹.

Dane nadzoru mogą również pomóc w identyfikacji populacji nieproporcjonalnie dotkniętych kiłą. W Anglii raporty nadzoru wykazały, że w 2023 roku 61% diagnoz kiły zakaźnej wśród MSM dotyczyło osób mieszkających w 2 najbardziej ubogich kwintylach obszarów, podczas gdy tylko 8% dotyczyło osób mieszkających w najmniej ubogim kwintylu¹. Dane te podkreślają, że kiła nadal nieproporcjonalnie dotyka MSM mieszkających na obszarach bardziej ubogich społecznie i ekonomicznie².

Wykorzystanie danych nadzoru do podjęcia działań

Dane nadzoru są używane do informowania o działaniach zdrowia publicznego w celu kontroli kiły. W USA CDC wykorzystuje dane nadzoru do opracowywania wytycznych dotyczących badań przesiewowych i leczenia, a także do identyfikacji populacji wysokiego ryzyka dla ukierunkowanych interwencji⁴. CDC zapewnia karty informacyjne, wytyczne dotyczące leczenia oraz krajowe i stanowe dane nadzoru nad kiłą⁵.

W Queensland w Australii Queensland Health tworzy raporty opisujące zgłoszenia kiły w Queensland, koncentrując się szczególnie na rozkładzie demograficznym i czynnikach ryzyka wśród przypadków kiły zakaźnej i wrodzonej¹. Te dane są wykorzystywane do informowania o działaniach profilaktycznych i kontrolnych.

W Kanadzie dane nadzoru nad kiłą są wykorzystywane do monitorowania trendów w czasie i między regionami, identyfikowania populacji wysokiego ryzyka i oceny skuteczności interwencji w zakresie zdrowia publicznego³. Dane nadzoru pomogły zidentyfikować znaczny wzrost kiły wśród kobiet w Kanadzie, co doprowadziło do zwiększonej czujności w zakresie kiły wrodzonej⁴.

Ważnym zastosowaniem danych nadzoru nad kiłą jest informowanie o lokalizacji i ukierunkowaniu badań przesiewowych. Departamenty zdrowia i świadczeniodawcy opieki zdrowotnej mogą wykorzystać dane na poziomie powiatu dotyczące kiły pierwotnej i wtórnej (PS), aby ukierunkować swoje wysiłki przesiewowe¹. CDC zaleca oferowanie badań w kierunku kiły wszystkim aktywnym seksualnie osobom w wieku 15-44 lat w powiatach o wskaźniku kiły pierwotnej i wtórnej wśród kobiet w wieku 15-44 lat przekraczającym 4,6 na 100 000 osób⁴.

Wyzwania i możliwości w nadzorze nad kiłą

Nadzór nad kiłą napotyka różne wyzwania, w tym niedostateczne zgłaszanie, opóźnienia w zgłaszaniu, brak informacji o kategorii transmisji i trudności w śledzeniu długoterminowych wyników¹. W wielu krajach o niskich i średnich dochodach dostępne dane prawdopodobnie niedoszacowują prawdziwe obciążenie kiłą z powodu słabej dokumentacji i niedostatecznego zgłaszania².

Pomimo tych wyzwań, istnieją możliwości poprawy nadzoru nad kiłą. Przejście na obowiązkowy nadzór, jak w przypadku Korei Południowej, może ułatwić obiektywny przegląd ogólnego występowania kiły⁴. Takie przejście umożliwia również zbieranie szerokiego zakresu informacji, w tym cech demograficznych, etapu i głównych objawów, drogi narażenia i kontaktów poszczególnych pacjentów poprzez badania epidemiologiczne⁵.

Inną możliwością jest integracja nadzoru nad kiłą z nadzorem nad innymi STI i HIV. W Wielkiej Brytanii od 2020 roku nadzór nad kiłą wrodzoną stał się częścią Infectious Diseases in Pregnancy Screening Programme¹. Dane są zbierane za pośrednictwem Integrated Screening Outcomes Surveillance Service (ISOSS), aby umożliwić programowi badań przesiewowych w kierunku chorób zakaźnych w ciąży monitorowanie wyników, przegląd wszystkich pozytywnych przypadków i identyfikację nowych obszarów do dalszych audytów i badań².

W Kanadzie w ramach projektu REACT-Syph tworzony jest ogólnokanadyjski program nadzoru nad kiłą w ciąży, który obejmuje przypadki od 2013 roku do chwili obecnej¹. Ten system nadzoru będzie bazował na ustalonej infrastrukturze i relacjach z regionalną i prowincjonalną służbą zdrowia publicznego, aby scharakteryzować przypadki kiły przedporodowej, w tym przypadki prowadzące do kiły wrodzonej, zidentyfikować bariery w opiece i luki w obecnych strategiach profilaktycznych oraz informować o przyszłych interwencjach².

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Materiały źródłowe

#1 An Update on the Global Epidemiology of Syphilis
https://pmc.ncbi.nlm.nih.gov/articles/PMC6089383/
Syphilis continues to cause morbidity and mortality worldwide. While syphilis infection is easily identifiable and treatable, rates of syphilis infection continue to increase among select populations in high-income countries and remain at endemic levels in low- and middle-income counties. […] Continued vigilance and investment is needed to address syphilis worldwide. The epidemiology of syphilis differs in high-income and low- and middle-income counties. […] In the late 1990s, the prevalence of syphilis plummeted in many countries with endemic syphilis, largely thought to be due to the introduction of syndromic management for STIs, behavioral changes, and the effect of AIDS mortality disrupting sexual networks. However, since the introduction of antiretroviral therapy (ART), rates of syphilis have increased, especially among MSM, perhaps due to the reconstruction of sexual networks and increased frequency of sexual contact.
#1
https://www.who.int/news-room/fact-sheets/detail/syphilis
WHO estimates that 8 million adults between 15 and 49 years old acquired syphilis in 2022. […] In 2022, WHO estimated that 8 million adults aged 1549 acquired syphilis globally. Some countries that systematically monitor syphilis are showing an important increase in syphilis cases among men who have sex with men, including congenital syphilis. […] In 2022, WHO estimated there were 700 000 congenital syphilis cases globally. These maternal syphilis cases led to an estimated 150 000 early fetal deaths and stillbirths, 70 000 neonatal deaths, 55 000 preterm or low-birth weight births, and 115 000 infants with clinical diagnosis of congenital syphilis. […] Some population groups are disproportionately affected by syphilis. For example, globally, an estimated 7.5% of gay men and other men who have sex with men have syphilis compared to 0.5% of men in the general population.
#1 Syphilis – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK534780/
The 2019 Global Burden of Disease Study indicated a worldwide prevalence of about 50 million syphilis cases, representing an alarming 60% overall increase from 1990 to 2019. […] The World Health Organization (WHO) estimated 7.1 million cases in 2020, with the highest incidence in sub-Saharan Africa, Southeast Asia, Latin America, and the Caribbean. […] According to the Centers for Disease Control and Prevention (CDC) statistics, the incidence of syphilis among adults in the US increased by 38% from 2008 to 2012, and by 80% between 2018 and 2022, with 88,042 new cases reported in 2016 and 207,255 in 2022. […] This is similar to what was reported by the European Center for Disease Prevention and Control, which reported almost 33,000 confirmed syphilis cases (roughly 8.5 cases per 100,000 population) in the European Union in 2022, reflecting a 34% increase from 2021.
#1 Syphilis – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK534780/
Syphilis is endemic in the developing world and is especially common among those who are poor and have limited access to health care, as over 60% of all new diagnoses come from low and middle-income countries. […] Prenatal screening for HIV is much more prevalent than for syphilis, primarily due to increased interest and awareness of HIV from local governments and donors, despite the existence of dual HIV/syphilis rapid diagnostic tests. […] This represents a significant missed public health opportunity to increase testing for syphilis by 100% to 200% in high-risk countries. […] The incidence of the disease in women doubled from 2013 to 2017 and increased another 147% between 2016 and 2020. […] This is attributed to a marked increase in parenteral drug abuse, while congenital syphilis cases multiplied 4-fold during approximately the same period.
#1 Epidemiology of syphilis – Wikipedia
https://en.wikipedia.org/wiki/Epidemiology_of_syphilis
Syphilis is a bacterial infection transmitted by sexual contact and is believed to have infected 12 million people in 1999 with greater than 90% of cases in the developing world. […] In the developed world, syphilis infections were in decline until the 1980s and 1990s due to widespread use of antibiotics. Since the year 2000, rates of syphilis have been increasing in the US, UK, Australia, and Europe primarily among men who have sex with men (MSM). […] A sexually transmitted infection (STI) Surveillance study done by the Centers for Disease Control and Prevention in 2016 showed that men who have sex with men only account for over half (52%) of the 27,814 cases during that year. Nationally, the highest rates of primary and secondary syphilis in 2016 were observed among men aged 20-34 years, among men in the West, and among Black men.
#1 Syphilis – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK534780/
This notorious study still causes lingering distrust and deep concern in the Black community regarding healthcare in general and particularly regarding participation in prospective clinical trials. […] A similar but lesser-known study was done in Guatemala from 1946 to 1948 and conducted by the US Public Health Service to determine if penicillin could prevent syphilis. […] Promiscuity and sexual behavior play an important role in the transmission of syphilis, as the disease is more common among people with multiple partners, bisexuals, and men who have sex with men (MSM). […] Men aged 20 to 29 generally have the highest rates of primary and secondary syphilis based on age, with the incidence among MSM in the US (229 cases/100,000) being astronomically higher at 214 times the rate for heterosexual men.
#1 National STD Curriculum Podcast – episode – hot-topic – cdc-2022-sti-surveillance-report-key-findings – National STD Curriculum
https://www.std.uw.edu/podcast/episode/hot-topic/cdc-2022-sti-surveillance-report-key-findings
In this episode, we’re going to review the CDC’s 2022 STI Surveillance Report. The CDC indicates that, all together, more than 2.5 million cases of chlamydia, gonorrhea, and syphilis were reported in the U.S. and it underscores that STIs must be a public health priority. […] Now, the most alarming concerns about this report center around the syphilis and congenital syphilis epidemics, which are worsening in the U.S. There were over 200,000 cases of syphilis in 2022, and this represented almost an 80% increase over the last five years. This is the greatest number of syphilis cases reported since 1950. […] The rates of primary and secondary syphilis increased in most racial/Hispanic/Latinx ethnicity groups, with the greatest increases were seen among American Indian and Alaska Native persons.
#1 Syphilis cases surge in the U.S., CDC says : NPR
https://www.npr.org/2024/01/31/1228195107/syphilis-cases-soar-in-us-cdc-says
The number of syphilis cases in the U.S. are on the rise. According to a new report from the Centers for Disease Control and Prevention, cases increased by nearly 80% to more than 207,000 between 2018 and 2022. […] In 2022, 3,755 cases of babies born with syphilis in the U.S. were reported, which reflects an alarming 937% increase in the past decade, the CDC said. […] The report continued that racial and ethnic minorities are most disproportionately affected due to „long standing social inequities that often lead to health inequalities.” […] The CDC said that its findings signal an urgent need for a closer look at public health efforts and prevention strategies. […] „Addressing the resurgence of syphilis and congenital syphilis requires a concerted effort,” said Admiral Rachel Levine, assistant secretary for health and chair of the National Syphilis and Congenital Syphilis Syndemic Federal Task Force, in a statement.
#1 Syphilis – Annual Epidemiological Report for 2023
https://www.ecdc.europa.eu/en/publications-data/syphilis-annual-epidemiological-report-2023
In 2023, 41 051 confirmed syphilis cases were reported in 29 EU/EEA Member States, with a crude notification rate of 9.9 cases per 100 000 population, representing a 13% increase in the crude notification rate compared to 2022, and a 100% increase compared to 2014. […] Reported syphilis rates were seven times higher in men than in women and highest in men aged 25-34 years (43 cases per 100 000 population). The majority (72%) of syphilis cases with information on transmission category were reported in men who have sex with men (MSM). […] Overall, the trend in syphilis notifications increased between 2014 and 2023, mainly due to an increase in the number of cases among MSM. […] After a brief decline during the COVID-19 pandemic, the number of syphilis notifications began increasing again in 2022 across all transmission groups. This increase continued in 2023.
#1 Recommendation: Syphilis Infection in Nonpregnant Adolescents and Adults: Screening | United States Preventive Services Taskforce
https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/syphilis-infection-nonpregnant-adults-adolescents-screening
After reaching a record low in 2000, rates of syphilis have been increasing over the past 20 years. […] Without treatment, syphilis can damage the brain, nerves, eyes, and cardiovascular system. […] Screening and follow-up treatment can cure syphilis and prevent complications. […] Reported cases of primary and secondary syphilis in the US increased from a record low of 2.1 cases per 100,000 population in 2000 and 2001 to 11.9 cases per 100,000 population in 2019. […] Men account for the majority of cases (83% of primary and secondary syphilis cases in 2019), and rates among women nearly tripled from 2015 to 2019. […] Men who have sex with men are disproportionately affected, accounting for a majority (57%) of all primary and secondary syphilis cases among men in 2019. […] The overall rate of primary and secondary syphilis among men who have sex with men was 106 times the rate among men who only have sex with women and 168 times the rate among women.
#1 Syphilis – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK534780/
The CDC has reported that more than 80% of syphilis cases in the US (primary and secondary) occur in the MSM population, of whom 47% also have HIV. […] It is estimated that 7.5% of all homosexual males worldwide have the disease compared to about 0.5% of all men in the general population. […] The probability of syphilis transmission from a single anal sexual act with a single partner in the MSM population was 1.4% and 1% with oral sex. […] This becomes compounded as the number of sexual encounters and partners increases. […] Syphilis is an important synergistic infection for HIV acquisition and has been closely linked with HIV infections. […] Patients with syphilis are more likely to become HIV positive even if they initially test negative for the virus because of similar behavioral high-risk factors for the 2 diseases.
#1 Rising syphilis rates in Canada, 2011â2020, CCDR 48(2/3) – Canada.ca
https://www.canada.ca/en/public-health/services/reports-publications/canada-communicable-disease-report-ccdr/monthly-issue/2022-48/issue-2-3-february-march-2022/syphilis-canada-2011-2020.html
Confirmed early congenital syphilis cases for 2020 increased considerably from prior years, with 50 cases reported in 2020, compared with 4 cases in 2016. […] Infectious and congenital syphilis rates are a growing concern in Canada and the nature of the syphilis epidemics across Canada appears to be evolving, as evidenced by recent trends. More data and research are needed to better understand the drivers associated with the recent changes in the epidemiology of syphilis in Canada. […] In Canada, rates of infectious syphilis started to increase steadily in the early 2000s, with substantial increases after 2017. Cases of congenital syphilis also increased during the same period. […] The aim of SOICC is to share information on the epidemiology of syphilis and best practices and challenges on responses to rate increases.
#1 Syphilis – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK534780/
Among sex workers, the worldwide incidence of active syphilis in 2019 was 10.8%. […] It is estimated that there are 1.5 million congenital syphilis births worldwide annually, mostly in low-income countries, although rates in Western nations are also increasing at alarming rates. […] The CDC reported that the national incidence of congenital syphilis in the US nearly quadrupled between 2015 and 2019 and increased 10-fold over the last 10 years. […] The 2021 rate was about 78 cases/100,000 live births, which is more than 30% greater than in 2020, and this trend continued through 2023 with an additional 32% increase in just one year. […] Women aged 24 years and younger have had the greatest increase. […] Congenital syphilis in the US was 8 and 3.9 times higher among infants born to Black and Hispanic mothers, respectively, compared to White mothers, with almost half of all reported cases coming from California and Texas.
#1 Why syphilis is rising around the world
https://www.bbc.com/future/article/20230706-the-troubling-rise-in-congenital-syphilis
Syphilis is one of the oldest known sexually transmitted infections. Once thought to be in decline, it is now resurging at an alarming rate. […] In January 2024, the Centres for Disease Control and Prevent (CDC) reported that cases of syphilis had reached their highest levels in more than a decade, with more than 203,500 cases of syphilis reported in the US in 2022, a figure that is nearly double that in 2018. The cases increased by 17% between 2021 and 2022, and surged by 32% between 2020 and 2021 to reach the highest number of reported incidences in 70 years. The epidemic is also showing no signs of slowing, the Centres for Disease Control and Prevention (CDC) warned. […] Congenital syphilis where a mother passes the infection to her child during pregnancy, often after contracting it from their partner has risen particularly sharply, with 3,755 cases in the US in 2022, an increase of 30% compared to 2021 and more than double the number of cases in 2018.
#1 Syphilis | Washington State Department of Health
https://doh.wa.gov/public-health-provider-resources/notifiable-conditions/syphilis
Rates have increased greatly since 1996, when 9 cases were reported. Recently over 1,000 primary and secondary cases have been reported annually. Rates are higher among males. […] To assess trends in epidemic patterns, understand the impact of the burden of infection on populations, the health care infrastructure, and to better target population-level infection prevention efforts […] To assure the adequate treatment of infected individuals in order to reduce the duration of infectiousness and prevent sequelae of infection. (e.g., neurosyphilis, gumma) […] To identify cases in a timely fashion in order to interrupt the chain of infection through patient-level interventions such as management of sexual contacts and behavioral risk reduction counseling.
#1 Syphilis guide: Key information and resources – Canada.ca
https://www.canada.ca/en/public-health/services/infectious-diseases/sexual-health-sexually-transmitted-infections/canadian-guidelines/syphilis.html
Syphilis is of considerable public health importance in Canada as evidenced by a steep increase in rates since 2014. […] Reported cases of syphilis among heterosexual populations, particularly among females, have significantly increased in recent years. […] Congenital syphilis has re-emerged with a record number of cases being reported each year from 2018 to 2020. […] Note: Syphilis infections are reportable to local public health authorities in all provinces and territories. […] For the most up-to-date surveillance information on syphilis and other STBBI, consult the Sexually transmitted and blood-borne infections surveillance webpage.
#1 Case-based Surveillance for Syphilis
https://learn.cste.org/courses-page/course/cdc-syphillis
Syphilis, a sexually transmitted infection caused by the bacterium Treponema Pallidum, is a reportable disease in all jurisdictions in the United States and is a nationally notifiable condition with case notifications provided to CDC through the National Notifiable Diseases Surveillance System (NNDSS). […] To enable public health officials to classify and count cases consistently across jurisdictions, syphilis cases, including congenital syphilis cases, should be identified using current CSTE surveillance case definitions. […] This course provides information on case-based surveillance for syphilis, including surveillance of congenital syphilis. […] The information provided in this course is based on the 2018 CSTE position statements that provides the syphilis case definition, as well as guidance from CDCs Division of STD Prevention.
#1 Early Non-Primary, Non-Secondary Syphilis from the Sexually Transmitted Diseases (STDs) Surveillance Data database shown in Rate Date Type: Year; Country: USA; Indicator: Rate per 100,000 Persons Sage Data. Sage Publishing Ltd Sage Data [electronic resour
https://catalog.libraries.psu.edu/catalog/47403447
Summary Reports counts and rates per 100,000 of early latent syphilis diagnoses. Syphilis is a sexually transmitted disease (STD) that progresses through a series of stages if it is not treated. […] The CDC collects, analyzes, and disseminates surveillance data on STD diagnoses. Data provided here are sourced from CDC’s NCHHSTP AtlasPlus based on case report data submitted from all 50 states, Washington, DC, and U.S. territories. […] Rates per 100,000 population are based on U.S. Census Bureau population estimates.
#1 Syphilis – Annual Epidemiological Report 2022
https://www.ecdc.europa.eu/en/publications-data/syphilis-annual-epidemiological-report-2022
In 2022, 35 391 confirmed syphilis cases were reported in 29 EU/EEA Member States, with a crude notification rate of 8.5 cases per 100 000 population, representing a 34% increase in the crude notification rate compared to 2021, and a 41% increase compared to 2018. […] Reported syphilis rates were eight times higher in men than in women and highest in 25-34-year-old men (40 cases per 100 000 population). […] The majority (74%) of syphilis cases with information on transmission category were reported in men who have sex with men (MSM). […] Overall, the trend in syphilis notifications increased between 2013 and 2022, mainly due to an increase in the number of cases among MSM. During the same period, there were very small fluctuations in syphilis notifications among heterosexuals at EU/EEA level, however 2022 marks the first year in the last ten with noticeable increases in syphilis among heterosexual men and women. […] In the five years between 2018 and 2022, the number of syphilis notifications in HIV-negative MSM increased by 59% (in the seven countries that reported consistently), continuing the increasing trend observed since 2015.
#1 Rising syphilis rates in Canada, 2011â2020, CCDR 48(2/3) – Canada.ca
https://www.canada.ca/en/public-health/services/reports-publications/canada-communicable-disease-report-ccdr/monthly-issue/2022-48/issue-2-3-february-march-2022/syphilis-canada-2011-2020.html
Syphilis rates are of public health concern in Canada, with multiple jurisdictions reporting outbreaks over the past five years. The objective of this article is to describe trends in infectious and congenital syphilis in Canada 20112020. […] Routine surveillance of syphilis is conducted through the Canadian Notifiable Disease Surveillance System (CNDSS). In response to rising rates of syphilis, all provinces and territories (P/Ts) have also submitted enhanced surveillance data on infectious syphilis to the Public Health Agency of Canada through the Syphilis Outbreak Investigation Coordinating Committee (SOICC) starting in 2018. Descriptive analyses of CNDSS and SOICC surveillance data 20112020 by age, sex, pregnancy status, male sexual orientation and P/Ts were performed. […] The national rate of infectious syphilis increased from 5.1 per 100,000 population in 2011 to 24.7 per 100,000 population in 2020. The rates increased in almost all P/Ts, with the Prairie provinces reporting the greatest relative increases from 2016 to 2020 (more than 400%). Rates in males were consistently higher than rates in females over the past 10 years; however, from 2016 to 2020, rates among females increased by 773%, compared with 73% among males.
#1 Introduction to the Transition of Mandatory Surveillance System in the Syphilis Monitoring
https://eng.phwr.org/journal/view.html?pn=search&uid=391&vmd=Full
According to the amendments in the IDCP Act, from January 1, 2024, syphilis will be elevated from a group 4 to a group 3 infectious disease and fall under mandatory surveillance system, thus, requiring all medical institutions to report syphilis cases within 24 hours of diagnosis. […] Mandatory surveillance for syphilis will be implemented from January 1, 2024, and the scope of reporting will be expanded to five types, including early latent syphilis, which is likely to be transmitted, and tertiary syphilis, which progresses to severe disease, in addition to the current three types (primary and secondary syphilis, and congenital syphilis). […] Transitioning to mandatory surveillance entails reporting all identified cases, facilitating an objective overview of the overall occurrence of syphilis in the ROK. This shift also enables the collection of a wide range of information, including demographic characteristics, stage and main symptoms, exposure route, and contacts of individual patients through epidemiological investigations. Therefore, this transition is anticipated to facilitate the development of more comprehensive prevention and management measures. […] The transition to mandatory surveillance of syphilis, as mandated in this amendment of the IDCP Act, aims to identify the overall occurrence and trends of syphilis in the ROK by expanding the scope of syphilis reporting and epidemiological investigation to all populations.
#1 An Update on the Global Epidemiology of Syphilis
https://pmc.ncbi.nlm.nih.gov/articles/PMC6089383/
General population prevalence data on syphilis are mostly limited to high-income countries. Especially among LMICs, currently available data likely underestimate the true burden of syphilis due to poor documentation and underreporting. […] Overall, the distribution of syphilis differs between LMICs and high-income countries. Many LMICs have poor rates of syphilis testing among women at their first antenatal care visit, with many LMIC having fewer than 25% of women attending their first antenatal care visit tested for syphilis. […] The proportion of LMICs that have over 100 syphilis cases per 100,000 births is higher than high-income countries, which is likely attributable to failures of testing at the first antenatal care visit, endemic rates of syphilis, and failure to treat those who are diagnosed with syphilis.
#1 Syphilis: Far from Ancient History | AAFP
https://www.aafp.org/pubs/afp/issues/2020/0715/p91.html
This transmission pattern makes surveillance a challenge because pockets of outbreaks can occur while overall rates in the general population remain relatively constant. […] Screening for syphilis is recommended at least annually for high-risk groups. […] The U.S. Preventive Services Task Force recommends that when assessing a patient’s risk of syphilis, clinicians should consider other factors associated with increased prevalence. […] Repeat serologic testing is recommended at six and 12 months after treatment to determine treatment effectiveness. […] Syphilis cases should be reported to local public health agencies for disease surveillance and partner notification.
#1
https://he02.tci-thaijo.org/index.php/OSIR/article/view/262930
Evaluation of the syphilis surveillance system was conducted at Mae Sot Hospital, Mae Sot District, Tak Province, Thailand during 13-16 Aug 2019. […] The sensitivity of reporting syphilis cases into Thailand’s national notifiable disease surveillance reporting system was about 67%, while the positive predictive value of reporting was reached 100%. […] The majority of participants found the reporting system of syphilis cases to be useful, acceptable, simple and stable. […] The Epidemiology Unit at the hospital should analyze Thai and foreign cases separately to represent the true situation in the border area. […] Cooperation amongst within-hospital units for better capture of syphilis cases in hospital is recommended.
#1 Recommendation: Syphilis Infection in Nonpregnant Adolescents and Adults: Screening | United States Preventive Services Taskforce
https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/syphilis-infection-nonpregnant-adults-adolescents-screening
When deciding which persons to screen for syphilis, clinicians should consider the prevalence of infection in the communities they serve, as well as other sociodemographic and behavioral factors that may be associated with increased risk of syphilis infection. […] Local prevalence rates may change over time, so clinicians should be aware of the latest data and trends for their specific population and geographic area, which are available through their state and local health departments and Centers for Disease Control and Prevention (CDC) surveillance. […] The CDC provides fact sheets, treatment guidelines, and national and state surveillance data for syphilis. […] The USPSTF has issued a separate recommendation for screening for syphilis infection in pregnant persons as well as screening recommendations for other STIs.
#1 County-level Syphilis Data | STI Statistics | CDC
https://www.cdc.gov/sti-statistics/county-level-syphilis-data/index.html
Health departments and healthcare providers can use county-level data of primary and secondary (PS) syphilis to direct their screening efforts. […] For many people, the most significant risk factor for syphilis is living in a community with high rates of syphilis. […] The Healthy People 2030 goal for reducing the rate of PS syphilis among women aged 15-44 years is 4.6 per 100,000 people. […] If practicing in a county where the syphilis rate is below the 4.6 per 100,000 people threshold noted above, screen patients who are not pregnant for syphilis per other criteria, as specified in CDC Sexually Transmitted Infections Treatment Guidelines. […] Know the burden in your jurisdiction: Use the map and data table below to identify counties in your states with high rates of syphilis and notify physicians in these counties to encourage more testing and coordinated treatment. […] Offer syphilis testing to all sexually active people aged 15-44 years in counties with a rate of primary secondary syphilis among women aged 15-44 years that is greater than 4.6 per 100,000 people.
#1 Recommendation: Syphilis Infection in Nonpregnant Adolescents and Adults: Screening | United States Preventive Services Taskforce
https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/syphilis-infection-nonpregnant-adults-adolescents-screening
Primary and secondary syphilis rates are highest among Black adolescents and adults, nearly 5 times the rate among White adolescents and adults. […] Elevated rates have also been reported in Hispanic adolescents and adults, Native American/Alaska Native adolescents and adults, and Native Hawaiian/Pacific Islander adolescents and adults. […] These disparities are primarily driven by social conditions such as poverty, low education levels, and poor access to quality health care, which disproportionately affect communities of color and make it harder to maintain sexual health. […] Differences in sexual network characteristics also play a role in disparities. Sexually active people may be more likely to become infected in communities with higher sexually transmitted infection rates. […] The USPSTF recommends screening for syphilis in persons who are at increased risk for infection.
#1 Syphilis – Symptoms and causes – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/syphilis/symptoms-causes/syc-20351756
Syphilis is contagious during its primary and secondary stages. Sometimes it’s also contagious in the early latent period, which happens within a year of getting infected. […] The risk of catching syphilis is higher if you have unprotected sex. […] Without treatment, syphilis can lead to damage throughout the body. Syphilis also raises the risk of HIV infection and can cause problems during pregnancy. […] For this reason, health officials recommend that all pregnant people be tested for the disease.
#1 Neurosyphilis: Overview of Syphilis of the CNS, Pathophysiology of Syphilis, Epidemiology of Syphilis
https://emedicine.medscape.com/article/1169231-overview
Resurgence of early syphilis contemporaneously with the global epidemic of AIDS has renewed interest in syphilis pathogenesis and the host response. […] It is important to address the significant occurrence of neurosyphilis among individuals with HIV/AIDS who acquire HIV through sexual contact. […] Syphilis also is associated with the use of crack cocaine. Added risk factors, accounting for the substantial increases in syphilis among gay and bisexual men, as reported by the San Francisco Department of Public Health, include increases in international partners meeting on the Internet, the use of methamphetamine, and, especially, the increased use of sildenafil (Viagra).
#1 Why is Syphilis Spiking in the U.S.? | Johns Hopkins | Bloomberg School of Public Health
https://publichealth.jhu.edu/2024/why-is-syphilis-spiking-in-the-us
Syphilis cases in the U.S. are skyrocketing even as rates for other STIs like gonorrhea and chlamydia are flat or declining. […] Alarming numbers released by the CDC are the latest marker in a decades-long rise of the disease, showing the highest case numbers since the 1950s. […] From 2018 to 2022, reported cases rose 80% in the U.S. […] The syphilis rates in the U.S. started going up in 2000 and have not stopped. […] Initially, this increase was mainly among men who have sex with men. […] Today, we have parallel epidemics in two sexual networks: one in MSM, and one among heterosexuals, which has been linked to drug use. […] The rise of syphilis cases among women is now surpassing the rise among men. […] We should be able to eradicate this entirely preventable disease through the basic tenets of infection control: widespread screening, testing, finding the sexual partners of infected individuals, treating those who have the disease, and educating the public.
#1 Syphilis epidemic – King County, Washington
https://kingcounty.gov/en/dept/dph/health-safety/disease-illness/hiv-sti-hcv/syphilis-epidemic
In 2023, there were 20 cases of congenital syphilis (parent to child transmission) in King County; a 67% increase from 2021. This preventable disease can cause devastating harm to infants. Syphilis cases have also risen among cisgender women and men who have sex with women, while remaining high among gay, bisexual, and other men who have sex with men. Rates are low (about 3%) among transgender and non-binary people. […] Public Health Seattle King County formed a Syphilis Task Force to review real time syphilis data and guide public health interventions. For the most accurate information, refer to the Annual STI Epidemiology Reports. […] Syphilis testing guidelines for other populations can be found in the 2024 Syphilis Screening Guidelines (431 KB).
#1 Epidemiology of syphilis – Wikipedia
https://en.wikipedia.org/wiki/Epidemiology_of_syphilis
Increased rates among heterosexuals have occurred in China and Russia since the 1990s. […] The number of HIV co-infections remains a prevalent issue with a worsening trend, especially in the „men who have sex with men” transmission category. […] In 2021, twenty-eight EU/EEA countries reported 25,270 confirmed syphilis cases, giving an overall notification rate of 7.0 per 100,000 population, up from 6.0 in 2015. […] The majority (77%) of cases with information on transmission category were reported in men who have sex with men (MSM), consistent with the global trend. […] According to a report from the Centers for Disease Control and Prevention, between 2000 and 2016, the rising rates of primary and secondary syphilis were attributed to men, mostly who have sex with men, no matter how they identify.
#1 Syphilis – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK534780/
At the same time, federal funding for STD prevention has decreased by 40% over the past 20 years. […] Even more disturbing was the finding that adequate maternal treatment of syphilis was not performed in over 30% of cases despite an early, timely diagnosis, which represents another significant missed public health improvement opportunity. […] Impediments to adequate syphilis testing and treatment include lack of prenatal care programs, insufficient syphilis testing, lack of point-of-care tests, missed prenatal visits due to lack of resources, cultural issues, poverty, homelessness, social and cultural stigma, discrimination, lack of health insurance, and substance abuse, particularly methamphetamines and heroin. […] The legacy of the infamous 1932 Tuskegee syphilis experiment is also a factor, where 399 mostly poor Black sharecroppers were deliberately denied treatment for their latent syphilis, even after 1947 when penicillin became the standard therapy, so that researchers could follow the course of the disease.
#1 Recommendation: Syphilis Infection in Nonpregnant Adolescents and Adults: Screening | United States Preventive Services Taskforce
https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/syphilis-infection-nonpregnant-adults-adolescents-screening
Recommendations made by the USPSTF are independent of the U.S. government. They should not be construed as an official position of the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services. […] The USPSTF recommends screening for syphilis infection in persons who are at increased risk for infection. […] This recommendation is consistent with the 2016 USPSTF recommendation. The USPSTF continues to recommend screening for syphilis in nonpregnant persons who are at increased risk for infection. […] Primary and secondary syphilis rates are higher in Black, Hispanic, Native American/Alaska Native, and Native Hawaiian/Pacific Islander persons. These disparities are primarily driven by social determinants of health such as differences in income level, education level, and access to coverage and care, which make it harder to maintain sexual health.
#1 Syphilis – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK534780/
The steady increase in the incidence of syphilis cases in the US and globally since 2000 makes it a resurging epidemic that requires additional attention and resources for earlier diagnosis and treatment. […] Factors contributing to this resurgence include the following: Improved treatment of HIV, making it seem „safe” to increase sexual contacts and partners without protection (risk compensation), the increased use of the internet for dating, increasing rates of drug abuse (particularly methamphetamines) are associated with a higher incidence of syphilis infections, the improved social acceptability of homosexual behavior (especially MSM), the increasing worldwide population with higher numbers of younger individuals who tend to be more sexually active, ongoing poverty and homelessness, the general perception is that syphilis is an „old” disease no longer relevant in modern healthcare, even by some healthcare professionals, and lack of familiarity with the disease by modern healthcare practitioners who may have limited experience with syphilis, especially its tertiary manifestations.
#1 Why is Syphilis Spiking in the U.S.? | Johns Hopkins | Bloomberg School of Public Health
https://publichealth.jhu.edu/2024/why-is-syphilis-spiking-in-the-us
We have good diagnostics, we know how its transmitted, theres 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. […] Plus, many at-risk patients dont have access to health care, and a lot of sexual health clinics have closed over the last decade. […] The one major thing that has an impact on the rate is money. The U.S. government through the CDC has had relatively flat spending on STD prevention over the last 20 yearsand with inflation, that amounts to a significant decrease in spending.
#1 PBS News Hour | U.S. sees concerning rise in STIs, congenital syphilis | Season 2023 | PBS
https://www.pbs.org/video/rising-cases-1681588505/
U.S. sees concerning rise in STIs, congenital syphilis with no signs of slowing […] New CDC data shows a surge of sexually transmitted infections in the U.S. in recent years. The most significant rise is in syphilis and congenital syphilis, which occurs when mothers pass on the infection to their babies during pregnancy. […] The most significant rise was in syphilis and congenital syphilis, which occurs when mothers with the infection pass it along to their babies during pregnancy. […] There’s been over a 30 percent increase in all cases of syphilis infection and particularly perinatal syphilis where a mother who is infected with syphilis can pass it to her baby. […] We’ve seen over a 30 percent increase in congenital syphilis cases in the last several years. […] According to the CDC data, about 30 percent of women don’t have access to care.
#1
https://www.gov.uk/government/publications/tracking-the-syphilis-epidemic-in-england/tracking-the-syphilis-epidemic-in-england-2013-to-2023
In 2023, 12,588 new diagnoses of syphilis (all stages) were made in sexual health services (SHSs) in England, 76% (9,513) of which were classified as infectious syphilis, comprising primary, secondary and early latent clinical stages. […] Between 2013 and 2019, infectious syphilis diagnoses increased by 140% (3,345 to 8,040). Following a temporary decline in diagnoses in 2020 and 2021, corresponding to reduced testing during COVID-19 related disruption to SHSs, diagnoses rebounded to 9,513 in 2023. […] The number of infectious syphilis diagnoses remained greatest among GBMSM, and people aged 25 to 34 years. […] Recent increases have been relatively higher among heterosexual people; between 2022 and 2023 infectious syphilis diagnoses increased by 29% (641 to 825) among WSM and 17% (967 to 1,133) among MSW, compared to 7% for GBMSM (6,081 to 6,527).
#1 Why syphilis is rising around the world
https://www.bbc.com/future/article/20230706-the-troubling-rise-in-congenital-syphilis
The highest numbers are seen among Black American and Hispanic women. […] „The consensus in the public health community is that the rise in STIs including syphilis is likely related to a disruption of STI prevention resources during the pandemic,” says Sundaram. […] Disparities in access to STI testing and screening services are among what is thought to be driving the increase in syphilis cases. […] For most health officials, the path to tackle syphilis is clear we already have the drugs to combat it as penicillin still remains the best treatment despite a rising incidence of antibiotic resistance. More testing, better outreach to counter the stigma attached to the disease along with greater public awareness to encourage safer sexual practices all have a much bigger role to play. […] But scientists have so far failed to arrive at a single theory on is why syphilis is rising faster than other STIs.
#1
https://www.who.int/news-room/fact-sheets/detail/syphilis
Identifying asymptomatic infection through laboratory or rapid tests and providing adequate treatment of positive cases will prevent further transmission and complications, as well as adverse pregnancy outcomes, including congenital syphilis. […] WHO has a global initiative for the elimination of congenital syphilis in association with the elimination of mother-to-child transmission of HIV and viral hepatitis B.
#1 Syphilis Cases Continue to Rise in Wisconsin-Affecting Babies, Teens, and Adults | Wisconsin Department of Health Services
https://www.dhs.wisconsin.gov/news/releases/101023.htm
The Wisconsin Department of Health Services (DHS) has issued a memo to health care providers in the state calling for increased awareness and testing for the sexually transmitted infection (STI) syphilis. Recently released 2022 surveillance data show a continued rise in cases in the state. Cases of syphilis increased 19% (1,608 to 1,916) from 2021 to 2022. Among those cases, congenital syphilis increased 81% (16 to 29) during this same time period. […] We found that a large number of congenital syphilis cases were due to a lack of syphilis testing, late testing during pregnancy, and a lack of prenatal care, said DHS Syphilis Surveillance Coordinator Craig Berger. Getting tested and treated early is critical to preventing congenital syphilis. […] For questions about syphilis, including reporting and surveillance in Wisconsin, visit the DHS sexually transmitted diseases webpage.
#1 An Update on the Global Epidemiology of Syphilis
https://pmc.ncbi.nlm.nih.gov/articles/PMC6089383/
Syphilis continues to persist among MSM and other groups who tend to have multiple sex partners, and could likely return in heterosexual populations without public health vigilance. […] In high-income countries, important metrics like screening at the first antenatal care visit and rates of congenital syphilis are high, however current syphilis control strategies are ignoring key populations, i.e., MSM, transgender women, and sex workers. Current studies show that syphilis incidence is increasing in those key communities. […] Among many LMICs, syphilis continues to remain at endemic levels in the general population; however better reporting data are needed to properly estimate prevalence of syphilis and its associated morbidity and mortality.
#1 National STD Curriculum Podcast – episode – hot-topic – cdc-2022-sti-surveillance-report-key-findings – National STD Curriculum
https://www.std.uw.edu/podcast/episode/hot-topic/cdc-2022-sti-surveillance-report-key-findings
Men who have sex with men continue to be disproportionately impacted by syphilis, but there is an expanding heterosexual syphilis epidemic in the U.S. And as one example, the rates of primary and secondary syphilis increased by 19% from 2021 to 2022 among women. […] With this expanding heterosexual-exposed epidemic, congenital syphilis has also increased. There was a 183% increase in congenital syphilis over the last five years. This has resulted in greater than 3,700 cases of congenital syphilis in 2022. In 2022, there were 282 congenital syphilis-related stillbirths and infant deaths. […] The increasing syphilis rates is a national concern and a public health priority. […] To conclude, I’d like to summarize some key points from this session: Syphilis is rising nationally and 2022 saw the highest number of syphilis cases since 1950. […] Congenital syphilis continues to increase with over 3,500 cases in 2022, resulting in 282 syphilis-related stillbirths and infant deaths.
#1 New data show sustained declines in chlamydia, syphilis among doxy-PEP users | CIDRAP
https://www.cidrap.umn.edu/antimicrobial-stewardship/new-data-show-sustained-declines-chlamydia-syphilis-among-doxy-pep-users
A study conducted at a sexual health clinic in San Francisco found sustained significant declines in cases of chlamydia and syphilis among those who used doxycycline post-exposure prophylaxis (doxy-PEP) nearly 2 years after it was introduced, with a smaller effect on gonorrhea, researchers reported yesterday in Clinical Infectious Diseases. […] Implementation of the intervention was based on a randomized trial, conducted in San Francisco and Seattle, that in 2023 showed significant declines in chlamydia, syphilis, and gonorrhea among doxy-PEP users compared with those who received standard care. […] The analysis showed a significant decline in all individual STIs in the doxy-PEP group, most notably (83%) for combined rates of chlamydia and syphilis (adjusted odds ratio [AOR], 0.17; 95% confidence interval [CI], 0.12 to 0.25) and less for gonorrhea (AOR, 0.56; 95% CI, 0.44 to 0.71). […] The study authors note that while gonorrhea rates did initially decline in users after starting doxy-PEP, they began to increase again toward the end of the analysis, which could indicate that gonorrhea resistance to doxycycline is increasing.
#1
https://www.pagepressjournals.org/index.php/mm/article/view/2368
Congenital syphilis (CS) is mainly a consequence of the lack of antenatal care and control of sexually transmitted infections. The bedrock of the prevention of CS is syphilis diagnosis by serological screening during pregnancy. Current Italian guidelines suggest that all the pregnant women should be tested in the first trimester. […] These observations confirmed that antenatal syphilis screening facilitates treatment during pregnancy and offsets vertical transmission; moreover, the use of IgM WB and careful CSF examination allowed the identification and treatment of high risk newborns.
#1 Syphilis | Australian Centre for Disease Control
https://www.cdc.gov.au/topics/syphilis
Syphilis is a nationally notifiable disease. […] We monitor cases through the National Notifiable Diseases Surveillance System (NNDSS) and report data in our quarterly national syphilis monitoring reports.
#1 Texas Health Data – Congenital Syphilis (CS)
https://healthdata.dshs.texas.gov/dashboard/diseases/congenital-syphilis
The Texas Congenital Syphilis surveillance program collects demographic, clinical and risk related information on infants born to mothers diagnosed with syphilis during or prior to their pregnancy. This information is used to support CS prevention, program planning, and policy development. […] Syphilis cases are reported to the Texas Surveillance program from a variety of sources, including hospitals, private physicians, public and private clinics, counseling and testing sites, laboratories, and insurance companies, and other case registries (e.g. vital statistics registry). Data are presented by calendar year based on the infant’s date of birth.
#1 Epidemiological analysis of syphilis surveillance among entry-exit population at Shanghai Port, China from 2014 to 2022 | Archives of Public Health | Full Text
https://archpublichealth.biomedcentral.com/articles/10.1186/s13690-023-01176-2
To investigate the epidemiological characteristics of syphilis cases detected among entry-exit personnel at Shanghai ports from 2014 to 2022 and the changing trend of the syphilis epidemic in the region so as to provide data support for the scientific and effective prevention and control of syphilis at ports. […] From 2014 to 2022, a total of 918 cases of syphilis were detected among entry-exit personnel at Shanghai port, with a total detection rate of 154.68/100 000. The detection rate was the highest in 2015 and the lowest in 2022, showing a downward trend year by year since 2015. […] The detection rate of syphilis among entry-exit personnel at Shanghai port has been decreasing continuously in recent years. […] The study provides an analysis of the prevalence and epidemiological characteristics of syphilis in the entry-exit population at Shanghai port.
#1 Epidemiological analysis of syphilis surveillance among entry-exit population at Shanghai Port, China from 2014 to 2022 | Archives of Public Health | Full Text
https://archpublichealth.biomedcentral.com/articles/10.1186/s13690-023-01176-2
It highlights that sexual transmission is the primary route of syphilis transmission among entry-exit personnel, and the prevalence of syphilis varies significantly among different regions, with the highest detection rate in East Asia. […] The study reveals a declining trend in syphilis detection rate year by year from 2015 to 2022, suggesting that efforts to combat syphilis in the region have been relatively effective. […] The results of syphilis surveillance among entry-exit personnel at Shanghai port from 2014 to 2022 revealed that sexual transmission was the primary route of syphilis transmission, and the prevalence of syphilis varied significantly among different regions. […] Among the different regions, East Asia had the highest syphilis detection rate, but from 2014 to 2022, there was a declining trend in the detection rate year by year.
#1
https://www.gov.uk/government/publications/tracking-the-syphilis-epidemic-in-england/tracking-the-syphilis-epidemic-in-england-2013-to-2023
The geographical distribution of syphilis and comparisons by upper tier local authority can be explored further in the Sexual and Reproductive Health Profiles. […] Syphilis continues to disproportionately affect GBMSM living in more socioeconomically deprived areas. […] In 2023, 61% of infectious syphilis diagnoses among GBMSM were in those living in the 2 most deprived quintile areas; whilst only 8% were made among those living in the least deprived quintile. […] This report highlights the continued increases in syphilis diagnoses and positivity. Further insight is needed to help inform existing prevention, testing and treatment strategies, and the potential for new approaches, such as doxycycline post-exposure prophylaxis, to support syphilis control.
#1 Syphilis outbreak in Queensland | Queensland Health
https://www.health.qld.gov.au/clinical-practice/guidelines-procedures/sex-health/syphilis
Queensland Health produces reports describing notifications of syphilis in Queensland, focusing particularly on the demographic distribution and risk factors among infectious syphilis and congenital syphilis cases. […] The Multijurisdictional Syphilis Outbreak Working Group (no longer active), formed by the Communicable Diseases Network of Australia in April 2015, also produced regular surveillance reports summarising national epidemiological data from the outbreak for the period 2016-2020.
#1
https://www.gov.uk/government/collections/syphilis-surveillance-data-and-management
Syphilis: surveillance, data and management. […] From 2020, the surveillance of congenital syphilis has become part of the Infectious Diseases in Pregnancy Screening Programme. Data are being collected through the Integrated Screening Outcomes Surveillance Service (ISOSS) to allow the infectious diseases in pregnancy screening (IDPS) to monitor performance, review all positive cases and identify new areas for further audit and research. […] Syphilis: quarterly data for England. […] Tracking the syphilis epidemic in England.
#1 REACT-Syph: Maternal and Congenital Syphilis Surveillance – Reproductive Infectious Diseases Program
https://ridprogram.med.ubc.ca/towards-the-eradication-of-congenital-syphilis-in-canada-react-syph-canadian-maternal-and-congenital-syphilis-surveillance/
Despite the current screening and treatment guidelines for syphilis in pregnancy, our dramatically increasing and regionally high rates of syphilis are resulting in poor health outcomes for women and their infants. […] There is currently limited surveillance data on syphilis cases in pregnancy in Canada, which constrains our ability to inform best intervention strategies for the prenatal population. […] As part of this project, we are creating a pan-Canadian syphilis in pregnancy surveillance program that includes cases from 2013-present. […] This surveillance system will build on the established infrastructure and relationships with regional and provincial public health to characterize cases of antenatal syphilis, including cases that result in congenital syphilis, identify barriers to care and gaps in current prevention strategies, and inform future interventions.
#2
https://www.who.int/data/gho/data/themes/topics/topic-details/GHO/data-on-syphilis
Syphilis is a bacterial sexually transmitted infection (STI) caused by Treponema pallidum which results in substantial morbidity and mortality, and it is curable. […] Maternal syphilis, when untreated, treated late or not treated with penicillin, results in adverse birth outcomes (ABOs) estimated in 5080% of cases, depending on the stage of syphilis. […] These ABOs are often severe and include stillbirth (most commonly), neonatal death, prematurity, low birth weight, and congenitally infected infants. […] STI: Prevalent cases of active syphilis in 15-49 year olds (in thousands) […] STI: Prevalence of active syphilis in 15-49 year olds (%) […] STI: Incident cases of syphilis in 15-49 year olds (in thousands) […] STI: Incident rate of active syphilis in 15-49 year olds (per 1000)
#2
https://www.who.int/news-room/fact-sheets/detail/syphilis
WHO estimates that 8 million adults between 15 and 49 years old acquired syphilis in 2022. […] In 2022, WHO estimated that 8 million adults aged 1549 acquired syphilis globally. Some countries that systematically monitor syphilis are showing an important increase in syphilis cases among men who have sex with men, including congenital syphilis. […] In 2022, WHO estimated there were 700 000 congenital syphilis cases globally. These maternal syphilis cases led to an estimated 150 000 early fetal deaths and stillbirths, 70 000 neonatal deaths, 55 000 preterm or low-birth weight births, and 115 000 infants with clinical diagnosis of congenital syphilis. […] Some population groups are disproportionately affected by syphilis. For example, globally, an estimated 7.5% of gay men and other men who have sex with men have syphilis compared to 0.5% of men in the general population.
#2 Syphilis – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK534780/
The 2019 Global Burden of Disease Study indicated a worldwide prevalence of about 50 million syphilis cases, representing an alarming 60% overall increase from 1990 to 2019. […] The World Health Organization (WHO) estimated 7.1 million cases in 2020, with the highest incidence in sub-Saharan Africa, Southeast Asia, Latin America, and the Caribbean. […] According to the Centers for Disease Control and Prevention (CDC) statistics, the incidence of syphilis among adults in the US increased by 38% from 2008 to 2012, and by 80% between 2018 and 2022, with 88,042 new cases reported in 2016 and 207,255 in 2022. […] This is similar to what was reported by the European Center for Disease Prevention and Control, which reported almost 33,000 confirmed syphilis cases (roughly 8.5 cases per 100,000 population) in the European Union in 2022, reflecting a 34% increase from 2021.
#2 Syphilis – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK534780/
Syphilis is endemic in the developing world and is especially common among those who are poor and have limited access to health care, as over 60% of all new diagnoses come from low and middle-income countries. […] Prenatal screening for HIV is much more prevalent than for syphilis, primarily due to increased interest and awareness of HIV from local governments and donors, despite the existence of dual HIV/syphilis rapid diagnostic tests. […] This represents a significant missed public health opportunity to increase testing for syphilis by 100% to 200% in high-risk countries. […] The incidence of the disease in women doubled from 2013 to 2017 and increased another 147% between 2016 and 2020. […] This is attributed to a marked increase in parenteral drug abuse, while congenital syphilis cases multiplied 4-fold during approximately the same period.
#2 Epidemiology of syphilis – Wikipedia
https://en.wikipedia.org/wiki/Epidemiology_of_syphilis
Syphilis is a bacterial infection transmitted by sexual contact and is believed to have infected 12 million people in 1999 with greater than 90% of cases in the developing world. […] In the developed world, syphilis infections were in decline until the 1980s and 1990s due to widespread use of antibiotics. Since the year 2000, rates of syphilis have been increasing in the US, UK, Australia, and Europe primarily among men who have sex with men (MSM). […] A sexually transmitted infection (STI) Surveillance study done by the Centers for Disease Control and Prevention in 2016 showed that men who have sex with men only account for over half (52%) of the 27,814 cases during that year. Nationally, the highest rates of primary and secondary syphilis in 2016 were observed among men aged 20-34 years, among men in the West, and among Black men.
#2 Syphilis – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK534780/
This notorious study still causes lingering distrust and deep concern in the Black community regarding healthcare in general and particularly regarding participation in prospective clinical trials. […] A similar but lesser-known study was done in Guatemala from 1946 to 1948 and conducted by the US Public Health Service to determine if penicillin could prevent syphilis. […] Promiscuity and sexual behavior play an important role in the transmission of syphilis, as the disease is more common among people with multiple partners, bisexuals, and men who have sex with men (MSM). […] Men aged 20 to 29 generally have the highest rates of primary and secondary syphilis based on age, with the incidence among MSM in the US (229 cases/100,000) being astronomically higher at 214 times the rate for heterosexual men.
#2 Recommendation: Syphilis Infection in Nonpregnant Adolescents and Adults: Screening | United States Preventive Services Taskforce
https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/syphilis-infection-nonpregnant-adults-adolescents-screening
After reaching a record low in 2000, rates of syphilis have been increasing over the past 20 years. […] Without treatment, syphilis can damage the brain, nerves, eyes, and cardiovascular system. […] Screening and follow-up treatment can cure syphilis and prevent complications. […] Reported cases of primary and secondary syphilis in the US increased from a record low of 2.1 cases per 100,000 population in 2000 and 2001 to 11.9 cases per 100,000 population in 2019. […] Men account for the majority of cases (83% of primary and secondary syphilis cases in 2019), and rates among women nearly tripled from 2015 to 2019. […] Men who have sex with men are disproportionately affected, accounting for a majority (57%) of all primary and secondary syphilis cases among men in 2019. […] The overall rate of primary and secondary syphilis among men who have sex with men was 106 times the rate among men who only have sex with women and 168 times the rate among women.
#2 Rising syphilis rates in Canada, 2011â2020, CCDR 48(2/3) – Canada.ca
https://www.canada.ca/en/public-health/services/reports-publications/canada-communicable-disease-report-ccdr/monthly-issue/2022-48/issue-2-3-february-march-2022/syphilis-canada-2011-2020.html
Syphilis rates are of public health concern in Canada, with multiple jurisdictions reporting outbreaks over the past five years. The objective of this article is to describe trends in infectious and congenital syphilis in Canada 20112020. […] Routine surveillance of syphilis is conducted through the Canadian Notifiable Disease Surveillance System (CNDSS). In response to rising rates of syphilis, all provinces and territories (P/Ts) have also submitted enhanced surveillance data on infectious syphilis to the Public Health Agency of Canada through the Syphilis Outbreak Investigation Coordinating Committee (SOICC) starting in 2018. Descriptive analyses of CNDSS and SOICC surveillance data 20112020 by age, sex, pregnancy status, male sexual orientation and P/Ts were performed. […] The national rate of infectious syphilis increased from 5.1 per 100,000 population in 2011 to 24.7 per 100,000 population in 2020. The rates increased in almost all P/Ts, with the Prairie provinces reporting the greatest relative increases from 2016 to 2020 (more than 400%). Rates in males were consistently higher than rates in females over the past 10 years; however, from 2016 to 2020, rates among females increased by 773%, compared with 73% among males.
#2 Syphilis – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK534780/
Among sex workers, the worldwide incidence of active syphilis in 2019 was 10.8%. […] It is estimated that there are 1.5 million congenital syphilis births worldwide annually, mostly in low-income countries, although rates in Western nations are also increasing at alarming rates. […] The CDC reported that the national incidence of congenital syphilis in the US nearly quadrupled between 2015 and 2019 and increased 10-fold over the last 10 years. […] The 2021 rate was about 78 cases/100,000 live births, which is more than 30% greater than in 2020, and this trend continued through 2023 with an additional 32% increase in just one year. […] Women aged 24 years and younger have had the greatest increase. […] Congenital syphilis in the US was 8 and 3.9 times higher among infants born to Black and Hispanic mothers, respectively, compared to White mothers, with almost half of all reported cases coming from California and Texas.
#2 Syphilis cases surge in the U.S., CDC says : NPR
https://www.npr.org/2024/01/31/1228195107/syphilis-cases-soar-in-us-cdc-says
The number of syphilis cases in the U.S. are on the rise. According to a new report from the Centers for Disease Control and Prevention, cases increased by nearly 80% to more than 207,000 between 2018 and 2022. […] In 2022, 3,755 cases of babies born with syphilis in the U.S. were reported, which reflects an alarming 937% increase in the past decade, the CDC said. […] The report continued that racial and ethnic minorities are most disproportionately affected due to „long standing social inequities that often lead to health inequalities.” […] The CDC said that its findings signal an urgent need for a closer look at public health efforts and prevention strategies. […] „Addressing the resurgence of syphilis and congenital syphilis requires a concerted effort,” said Admiral Rachel Levine, assistant secretary for health and chair of the National Syphilis and Congenital Syphilis Syndemic Federal Task Force, in a statement.
#2 Case-based Surveillance for Syphilis
https://learn.cste.org/courses-page/course/cdc-syphillis
Syphilis, a sexually transmitted infection caused by the bacterium Treponema Pallidum, is a reportable disease in all jurisdictions in the United States and is a nationally notifiable condition with case notifications provided to CDC through the National Notifiable Diseases Surveillance System (NNDSS). […] To enable public health officials to classify and count cases consistently across jurisdictions, syphilis cases, including congenital syphilis cases, should be identified using current CSTE surveillance case definitions. […] This course provides information on case-based surveillance for syphilis, including surveillance of congenital syphilis. […] The information provided in this course is based on the 2018 CSTE position statements that provides the syphilis case definition, as well as guidance from CDCs Division of STD Prevention.
#2 Introduction to the Transition of Mandatory Surveillance System in the Syphilis Monitoring
https://eng.phwr.org/journal/view.html?pn=search&uid=391&vmd=Full
According to the amendments in the IDCP Act, from January 1, 2024, syphilis will be elevated from a group 4 to a group 3 infectious disease and fall under mandatory surveillance system, thus, requiring all medical institutions to report syphilis cases within 24 hours of diagnosis. […] Mandatory surveillance for syphilis will be implemented from January 1, 2024, and the scope of reporting will be expanded to five types, including early latent syphilis, which is likely to be transmitted, and tertiary syphilis, which progresses to severe disease, in addition to the current three types (primary and secondary syphilis, and congenital syphilis). […] Transitioning to mandatory surveillance entails reporting all identified cases, facilitating an objective overview of the overall occurrence of syphilis in the ROK. This shift also enables the collection of a wide range of information, including demographic characteristics, stage and main symptoms, exposure route, and contacts of individual patients through epidemiological investigations. Therefore, this transition is anticipated to facilitate the development of more comprehensive prevention and management measures. […] The transition to mandatory surveillance of syphilis, as mandated in this amendment of the IDCP Act, aims to identify the overall occurrence and trends of syphilis in the ROK by expanding the scope of syphilis reporting and epidemiological investigation to all populations.
#2
https://he02.tci-thaijo.org/index.php/OSIR/article/view/262930
Evaluation of the syphilis surveillance system was conducted at Mae Sot Hospital, Mae Sot District, Tak Province, Thailand during 13-16 Aug 2019. […] The sensitivity of reporting syphilis cases into Thailand’s national notifiable disease surveillance reporting system was about 67%, while the positive predictive value of reporting was reached 100%. […] The majority of participants found the reporting system of syphilis cases to be useful, acceptable, simple and stable. […] The Epidemiology Unit at the hospital should analyze Thai and foreign cases separately to represent the true situation in the border area. […] Cooperation amongst within-hospital units for better capture of syphilis cases in hospital is recommended.
#2 Syphilis | Washington State Department of Health
https://doh.wa.gov/public-health-provider-resources/notifiable-conditions/syphilis
Rates have increased greatly since 1996, when 9 cases were reported. Recently over 1,000 primary and secondary cases have been reported annually. Rates are higher among males. […] To assess trends in epidemic patterns, understand the impact of the burden of infection on populations, the health care infrastructure, and to better target population-level infection prevention efforts […] To assure the adequate treatment of infected individuals in order to reduce the duration of infectiousness and prevent sequelae of infection. (e.g., neurosyphilis, gumma) […] To identify cases in a timely fashion in order to interrupt the chain of infection through patient-level interventions such as management of sexual contacts and behavioral risk reduction counseling.
#2 County-level Syphilis Data | STI Statistics | CDC
https://www.cdc.gov/sti-statistics/county-level-syphilis-data/index.html
Health departments and healthcare providers can use county-level data of primary and secondary (PS) syphilis to direct their screening efforts. […] For many people, the most significant risk factor for syphilis is living in a community with high rates of syphilis. […] The Healthy People 2030 goal for reducing the rate of PS syphilis among women aged 15-44 years is 4.6 per 100,000 people. […] If practicing in a county where the syphilis rate is below the 4.6 per 100,000 people threshold noted above, screen patients who are not pregnant for syphilis per other criteria, as specified in CDC Sexually Transmitted Infections Treatment Guidelines. […] Know the burden in your jurisdiction: Use the map and data table below to identify counties in your states with high rates of syphilis and notify physicians in these counties to encourage more testing and coordinated treatment. […] Offer syphilis testing to all sexually active people aged 15-44 years in counties with a rate of primary secondary syphilis among women aged 15-44 years that is greater than 4.6 per 100,000 people.
#2 Syphilis – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK534780/
The CDC has reported that more than 80% of syphilis cases in the US (primary and secondary) occur in the MSM population, of whom 47% also have HIV. […] It is estimated that 7.5% of all homosexual males worldwide have the disease compared to about 0.5% of all men in the general population. […] The probability of syphilis transmission from a single anal sexual act with a single partner in the MSM population was 1.4% and 1% with oral sex. […] This becomes compounded as the number of sexual encounters and partners increases. […] Syphilis is an important synergistic infection for HIV acquisition and has been closely linked with HIV infections. […] Patients with syphilis are more likely to become HIV positive even if they initially test negative for the virus because of similar behavioral high-risk factors for the 2 diseases.
#2 Neurosyphilis: Overview of Syphilis of the CNS, Pathophysiology of Syphilis, Epidemiology of Syphilis
https://emedicine.medscape.com/article/1169231-overview
Resurgence of early syphilis contemporaneously with the global epidemic of AIDS has renewed interest in syphilis pathogenesis and the host response. […] It is important to address the significant occurrence of neurosyphilis among individuals with HIV/AIDS who acquire HIV through sexual contact. […] Syphilis also is associated with the use of crack cocaine. Added risk factors, accounting for the substantial increases in syphilis among gay and bisexual men, as reported by the San Francisco Department of Public Health, include increases in international partners meeting on the Internet, the use of methamphetamine, and, especially, the increased use of sildenafil (Viagra).
#2 Syphilis – Annual Epidemiological Report for 2023
https://www.ecdc.europa.eu/en/publications-data/syphilis-annual-epidemiological-report-2023
In 2023, 41 051 confirmed syphilis cases were reported in 29 EU/EEA Member States, with a crude notification rate of 9.9 cases per 100 000 population, representing a 13% increase in the crude notification rate compared to 2022, and a 100% increase compared to 2014. […] Reported syphilis rates were seven times higher in men than in women and highest in men aged 25-34 years (43 cases per 100 000 population). The majority (72%) of syphilis cases with information on transmission category were reported in men who have sex with men (MSM). […] Overall, the trend in syphilis notifications increased between 2014 and 2023, mainly due to an increase in the number of cases among MSM. […] After a brief decline during the COVID-19 pandemic, the number of syphilis notifications began increasing again in 2022 across all transmission groups. This increase continued in 2023.
#2 Recommendation: Syphilis Infection in Nonpregnant Adolescents and Adults: Screening | United States Preventive Services Taskforce
https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/syphilis-infection-nonpregnant-adults-adolescents-screening
Primary and secondary syphilis rates are highest among Black adolescents and adults, nearly 5 times the rate among White adolescents and adults. […] Elevated rates have also been reported in Hispanic adolescents and adults, Native American/Alaska Native adolescents and adults, and Native Hawaiian/Pacific Islander adolescents and adults. […] These disparities are primarily driven by social conditions such as poverty, low education levels, and poor access to quality health care, which disproportionately affect communities of color and make it harder to maintain sexual health. […] Differences in sexual network characteristics also play a role in disparities. Sexually active people may be more likely to become infected in communities with higher sexually transmitted infection rates. […] The USPSTF recommends screening for syphilis in persons who are at increased risk for infection.
#2 Why is Syphilis Spiking in the U.S.? | Johns Hopkins | Bloomberg School of Public Health
https://publichealth.jhu.edu/2024/why-is-syphilis-spiking-in-the-us
We have good diagnostics, we know how its transmitted, theres 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. […] Plus, many at-risk patients dont have access to health care, and a lot of sexual health clinics have closed over the last decade. […] The one major thing that has an impact on the rate is money. The U.S. government through the CDC has had relatively flat spending on STD prevention over the last 20 yearsand with inflation, that amounts to a significant decrease in spending.
#2 Syphilis – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK534780/
At the same time, federal funding for STD prevention has decreased by 40% over the past 20 years. […] Even more disturbing was the finding that adequate maternal treatment of syphilis was not performed in over 30% of cases despite an early, timely diagnosis, which represents another significant missed public health improvement opportunity. […] Impediments to adequate syphilis testing and treatment include lack of prenatal care programs, insufficient syphilis testing, lack of point-of-care tests, missed prenatal visits due to lack of resources, cultural issues, poverty, homelessness, social and cultural stigma, discrimination, lack of health insurance, and substance abuse, particularly methamphetamines and heroin. […] The legacy of the infamous 1932 Tuskegee syphilis experiment is also a factor, where 399 mostly poor Black sharecroppers were deliberately denied treatment for their latent syphilis, even after 1947 when penicillin became the standard therapy, so that researchers could follow the course of the disease.
#2 Syphilis – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK534780/
The steady increase in the incidence of syphilis cases in the US and globally since 2000 makes it a resurging epidemic that requires additional attention and resources for earlier diagnosis and treatment. […] Factors contributing to this resurgence include the following: Improved treatment of HIV, making it seem „safe” to increase sexual contacts and partners without protection (risk compensation), the increased use of the internet for dating, increasing rates of drug abuse (particularly methamphetamines) are associated with a higher incidence of syphilis infections, the improved social acceptability of homosexual behavior (especially MSM), the increasing worldwide population with higher numbers of younger individuals who tend to be more sexually active, ongoing poverty and homelessness, the general perception is that syphilis is an „old” disease no longer relevant in modern healthcare, even by some healthcare professionals, and lack of familiarity with the disease by modern healthcare practitioners who may have limited experience with syphilis, especially its tertiary manifestations.
#2 An Update on the Global Epidemiology of Syphilis
https://pmc.ncbi.nlm.nih.gov/articles/PMC6089383/
Syphilis continues to cause morbidity and mortality worldwide. While syphilis infection is easily identifiable and treatable, rates of syphilis infection continue to increase among select populations in high-income countries and remain at endemic levels in low- and middle-income counties. […] Continued vigilance and investment is needed to address syphilis worldwide. The epidemiology of syphilis differs in high-income and low- and middle-income counties. […] In the late 1990s, the prevalence of syphilis plummeted in many countries with endemic syphilis, largely thought to be due to the introduction of syndromic management for STIs, behavioral changes, and the effect of AIDS mortality disrupting sexual networks. However, since the introduction of antiretroviral therapy (ART), rates of syphilis have increased, especially among MSM, perhaps due to the reconstruction of sexual networks and increased frequency of sexual contact.
#2 Why syphilis is rising around the world
https://www.bbc.com/future/article/20230706-the-troubling-rise-in-congenital-syphilis
The highest numbers are seen among Black American and Hispanic women. […] „The consensus in the public health community is that the rise in STIs including syphilis is likely related to a disruption of STI prevention resources during the pandemic,” says Sundaram. […] Disparities in access to STI testing and screening services are among what is thought to be driving the increase in syphilis cases. […] For most health officials, the path to tackle syphilis is clear we already have the drugs to combat it as penicillin still remains the best treatment despite a rising incidence of antibiotic resistance. More testing, better outreach to counter the stigma attached to the disease along with greater public awareness to encourage safer sexual practices all have a much bigger role to play. […] But scientists have so far failed to arrive at a single theory on is why syphilis is rising faster than other STIs.
#2 Recommendation: Syphilis Infection in Nonpregnant Adolescents and Adults: Screening | United States Preventive Services Taskforce
https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/syphilis-infection-nonpregnant-adults-adolescents-screening
Recommendations made by the USPSTF are independent of the U.S. government. They should not be construed as an official position of the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services. […] The USPSTF recommends screening for syphilis infection in persons who are at increased risk for infection. […] This recommendation is consistent with the 2016 USPSTF recommendation. The USPSTF continues to recommend screening for syphilis in nonpregnant persons who are at increased risk for infection. […] Primary and secondary syphilis rates are higher in Black, Hispanic, Native American/Alaska Native, and Native Hawaiian/Pacific Islander persons. These disparities are primarily driven by social determinants of health such as differences in income level, education level, and access to coverage and care, which make it harder to maintain sexual health.
#2 Recommendation: Syphilis Infection in Nonpregnant Adolescents and Adults: Screening | United States Preventive Services Taskforce
https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/syphilis-infection-nonpregnant-adults-adolescents-screening
When deciding which persons to screen for syphilis, clinicians should consider the prevalence of infection in the communities they serve, as well as other sociodemographic and behavioral factors that may be associated with increased risk of syphilis infection. […] Local prevalence rates may change over time, so clinicians should be aware of the latest data and trends for their specific population and geographic area, which are available through their state and local health departments and Centers for Disease Control and Prevention (CDC) surveillance. […] The CDC provides fact sheets, treatment guidelines, and national and state surveillance data for syphilis. […] The USPSTF has issued a separate recommendation for screening for syphilis infection in pregnant persons as well as screening recommendations for other STIs.
#2 Syphilis Cases Continue to Rise in Wisconsin-Affecting Babies, Teens, and Adults | Wisconsin Department of Health Services
https://www.dhs.wisconsin.gov/news/releases/101023.htm
The Wisconsin Department of Health Services (DHS) has issued a memo to health care providers in the state calling for increased awareness and testing for the sexually transmitted infection (STI) syphilis. Recently released 2022 surveillance data show a continued rise in cases in the state. Cases of syphilis increased 19% (1,608 to 1,916) from 2021 to 2022. Among those cases, congenital syphilis increased 81% (16 to 29) during this same time period. […] We found that a large number of congenital syphilis cases were due to a lack of syphilis testing, late testing during pregnancy, and a lack of prenatal care, said DHS Syphilis Surveillance Coordinator Craig Berger. Getting tested and treated early is critical to preventing congenital syphilis. […] For questions about syphilis, including reporting and surveillance in Wisconsin, visit the DHS sexually transmitted diseases webpage.
#2 An Update on the Global Epidemiology of Syphilis
https://pmc.ncbi.nlm.nih.gov/articles/PMC6089383/
Syphilis continues to persist among MSM and other groups who tend to have multiple sex partners, and could likely return in heterosexual populations without public health vigilance. […] In high-income countries, important metrics like screening at the first antenatal care visit and rates of congenital syphilis are high, however current syphilis control strategies are ignoring key populations, i.e., MSM, transgender women, and sex workers. Current studies show that syphilis incidence is increasing in those key communities. […] Among many LMICs, syphilis continues to remain at endemic levels in the general population; however better reporting data are needed to properly estimate prevalence of syphilis and its associated morbidity and mortality.
#2 Syphilis: Far from Ancient History | AAFP
https://www.aafp.org/pubs/afp/issues/2020/0715/p91.html
This transmission pattern makes surveillance a challenge because pockets of outbreaks can occur while overall rates in the general population remain relatively constant. […] Screening for syphilis is recommended at least annually for high-risk groups. […] The U.S. Preventive Services Task Force recommends that when assessing a patient’s risk of syphilis, clinicians should consider other factors associated with increased prevalence. […] Repeat serologic testing is recommended at six and 12 months after treatment to determine treatment effectiveness. […] Syphilis cases should be reported to local public health agencies for disease surveillance and partner notification.
#2
https://www.who.int/news-room/fact-sheets/detail/syphilis
Identifying asymptomatic infection through laboratory or rapid tests and providing adequate treatment of positive cases will prevent further transmission and complications, as well as adverse pregnancy outcomes, including congenital syphilis. […] WHO has a global initiative for the elimination of congenital syphilis in association with the elimination of mother-to-child transmission of HIV and viral hepatitis B.
#2 Rising syphilis rates in Canada, 2011â2020, CCDR 48(2/3) – Canada.ca
https://www.canada.ca/en/public-health/services/reports-publications/canada-communicable-disease-report-ccdr/monthly-issue/2022-48/issue-2-3-february-march-2022/syphilis-canada-2011-2020.html
Confirmed early congenital syphilis cases for 2020 increased considerably from prior years, with 50 cases reported in 2020, compared with 4 cases in 2016. […] Infectious and congenital syphilis rates are a growing concern in Canada and the nature of the syphilis epidemics across Canada appears to be evolving, as evidenced by recent trends. More data and research are needed to better understand the drivers associated with the recent changes in the epidemiology of syphilis in Canada. […] In Canada, rates of infectious syphilis started to increase steadily in the early 2000s, with substantial increases after 2017. Cases of congenital syphilis also increased during the same period. […] The aim of SOICC is to share information on the epidemiology of syphilis and best practices and challenges on responses to rate increases.
#2 New data show sustained declines in chlamydia, syphilis among doxy-PEP users | CIDRAP
https://www.cidrap.umn.edu/antimicrobial-stewardship/new-data-show-sustained-declines-chlamydia-syphilis-among-doxy-pep-users
A study conducted at a sexual health clinic in San Francisco found sustained significant declines in cases of chlamydia and syphilis among those who used doxycycline post-exposure prophylaxis (doxy-PEP) nearly 2 years after it was introduced, with a smaller effect on gonorrhea, researchers reported yesterday in Clinical Infectious Diseases. […] Implementation of the intervention was based on a randomized trial, conducted in San Francisco and Seattle, that in 2023 showed significant declines in chlamydia, syphilis, and gonorrhea among doxy-PEP users compared with those who received standard care. […] The analysis showed a significant decline in all individual STIs in the doxy-PEP group, most notably (83%) for combined rates of chlamydia and syphilis (adjusted odds ratio [AOR], 0.17; 95% confidence interval [CI], 0.12 to 0.25) and less for gonorrhea (AOR, 0.56; 95% CI, 0.44 to 0.71). […] The study authors note that while gonorrhea rates did initially decline in users after starting doxy-PEP, they began to increase again toward the end of the analysis, which could indicate that gonorrhea resistance to doxycycline is increasing.
#2
https://www.pagepressjournals.org/index.php/mm/article/view/2368
Congenital syphilis (CS) is mainly a consequence of the lack of antenatal care and control of sexually transmitted infections. The bedrock of the prevention of CS is syphilis diagnosis by serological screening during pregnancy. Current Italian guidelines suggest that all the pregnant women should be tested in the first trimester. […] These observations confirmed that antenatal syphilis screening facilitates treatment during pregnancy and offsets vertical transmission; moreover, the use of IgM WB and careful CSF examination allowed the identification and treatment of high risk newborns.
#2 Early Non-Primary, Non-Secondary Syphilis from the Sexually Transmitted Diseases (STDs) Surveillance Data database shown in Rate Date Type: Year; Country: USA; Indicator: Rate per 100,000 Persons Sage Data. Sage Publishing Ltd Sage Data [electronic resour
https://catalog.libraries.psu.edu/catalog/47403447
Summary Reports counts and rates per 100,000 of early latent syphilis diagnoses. Syphilis is a sexually transmitted disease (STD) that progresses through a series of stages if it is not treated. […] The CDC collects, analyzes, and disseminates surveillance data on STD diagnoses. Data provided here are sourced from CDC’s NCHHSTP AtlasPlus based on case report data submitted from all 50 states, Washington, DC, and U.S. territories. […] Rates per 100,000 population are based on U.S. Census Bureau population estimates.
#2 Texas Health Data – Congenital Syphilis (CS)
https://healthdata.dshs.texas.gov/dashboard/diseases/congenital-syphilis
The Texas Congenital Syphilis surveillance program collects demographic, clinical and risk related information on infants born to mothers diagnosed with syphilis during or prior to their pregnancy. This information is used to support CS prevention, program planning, and policy development. […] Syphilis cases are reported to the Texas Surveillance program from a variety of sources, including hospitals, private physicians, public and private clinics, counseling and testing sites, laboratories, and insurance companies, and other case registries (e.g. vital statistics registry). Data are presented by calendar year based on the infant’s date of birth.
#2
https://www.gov.uk/government/publications/tracking-the-syphilis-epidemic-in-england/tracking-the-syphilis-epidemic-in-england-2013-to-2023
The geographical distribution of syphilis and comparisons by upper tier local authority can be explored further in the Sexual and Reproductive Health Profiles. […] Syphilis continues to disproportionately affect GBMSM living in more socioeconomically deprived areas. […] In 2023, 61% of infectious syphilis diagnoses among GBMSM were in those living in the 2 most deprived quintile areas; whilst only 8% were made among those living in the least deprived quintile. […] This report highlights the continued increases in syphilis diagnoses and positivity. Further insight is needed to help inform existing prevention, testing and treatment strategies, and the potential for new approaches, such as doxycycline post-exposure prophylaxis, to support syphilis control.
#2 An Update on the Global Epidemiology of Syphilis
https://pmc.ncbi.nlm.nih.gov/articles/PMC6089383/
General population prevalence data on syphilis are mostly limited to high-income countries. Especially among LMICs, currently available data likely underestimate the true burden of syphilis due to poor documentation and underreporting. […] Overall, the distribution of syphilis differs between LMICs and high-income countries. Many LMICs have poor rates of syphilis testing among women at their first antenatal care visit, with many LMIC having fewer than 25% of women attending their first antenatal care visit tested for syphilis. […] The proportion of LMICs that have over 100 syphilis cases per 100,000 births is higher than high-income countries, which is likely attributable to failures of testing at the first antenatal care visit, endemic rates of syphilis, and failure to treat those who are diagnosed with syphilis.
#2
https://www.gov.uk/government/collections/syphilis-surveillance-data-and-management
Syphilis: surveillance, data and management. […] From 2020, the surveillance of congenital syphilis has become part of the Infectious Diseases in Pregnancy Screening Programme. Data are being collected through the Integrated Screening Outcomes Surveillance Service (ISOSS) to allow the infectious diseases in pregnancy screening (IDPS) to monitor performance, review all positive cases and identify new areas for further audit and research. […] Syphilis: quarterly data for England. […] Tracking the syphilis epidemic in England.
#2 REACT-Syph: Maternal and Congenital Syphilis Surveillance – Reproductive Infectious Diseases Program
https://ridprogram.med.ubc.ca/towards-the-eradication-of-congenital-syphilis-in-canada-react-syph-canadian-maternal-and-congenital-syphilis-surveillance/
Despite the current screening and treatment guidelines for syphilis in pregnancy, our dramatically increasing and regionally high rates of syphilis are resulting in poor health outcomes for women and their infants. […] There is currently limited surveillance data on syphilis cases in pregnancy in Canada, which constrains our ability to inform best intervention strategies for the prenatal population. […] As part of this project, we are creating a pan-Canadian syphilis in pregnancy surveillance program that includes cases from 2013-present. […] This surveillance system will build on the established infrastructure and relationships with regional and provincial public health to characterize cases of antenatal syphilis, including cases that result in congenital syphilis, identify barriers to care and gaps in current prevention strategies, and inform future interventions.
#3 An Update on the Global Epidemiology of Syphilis
https://pmc.ncbi.nlm.nih.gov/articles/PMC6089383/
Syphilis continues to cause morbidity and mortality worldwide. While syphilis infection is easily identifiable and treatable, rates of syphilis infection continue to increase among select populations in high-income countries and remain at endemic levels in low- and middle-income counties. […] Continued vigilance and investment is needed to address syphilis worldwide. The epidemiology of syphilis differs in high-income and low- and middle-income counties. […] In the late 1990s, the prevalence of syphilis plummeted in many countries with endemic syphilis, largely thought to be due to the introduction of syndromic management for STIs, behavioral changes, and the effect of AIDS mortality disrupting sexual networks. However, since the introduction of antiretroviral therapy (ART), rates of syphilis have increased, especially among MSM, perhaps due to the reconstruction of sexual networks and increased frequency of sexual contact.
#3 Syphilis – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK534780/
The 2019 Global Burden of Disease Study indicated a worldwide prevalence of about 50 million syphilis cases, representing an alarming 60% overall increase from 1990 to 2019. […] The World Health Organization (WHO) estimated 7.1 million cases in 2020, with the highest incidence in sub-Saharan Africa, Southeast Asia, Latin America, and the Caribbean. […] According to the Centers for Disease Control and Prevention (CDC) statistics, the incidence of syphilis among adults in the US increased by 38% from 2008 to 2012, and by 80% between 2018 and 2022, with 88,042 new cases reported in 2016 and 207,255 in 2022. […] This is similar to what was reported by the European Center for Disease Prevention and Control, which reported almost 33,000 confirmed syphilis cases (roughly 8.5 cases per 100,000 population) in the European Union in 2022, reflecting a 34% increase from 2021.
#3
https://www.who.int/news-room/fact-sheets/detail/syphilis
WHO estimates that 8 million adults between 15 and 49 years old acquired syphilis in 2022. […] In 2022, WHO estimated that 8 million adults aged 1549 acquired syphilis globally. Some countries that systematically monitor syphilis are showing an important increase in syphilis cases among men who have sex with men, including congenital syphilis. […] In 2022, WHO estimated there were 700 000 congenital syphilis cases globally. These maternal syphilis cases led to an estimated 150 000 early fetal deaths and stillbirths, 70 000 neonatal deaths, 55 000 preterm or low-birth weight births, and 115 000 infants with clinical diagnosis of congenital syphilis. […] Some population groups are disproportionately affected by syphilis. For example, globally, an estimated 7.5% of gay men and other men who have sex with men have syphilis compared to 0.5% of men in the general population.
#3 Syphilis – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK534780/
The CDC has reported that more than 80% of syphilis cases in the US (primary and secondary) occur in the MSM population, of whom 47% also have HIV. […] It is estimated that 7.5% of all homosexual males worldwide have the disease compared to about 0.5% of all men in the general population. […] The probability of syphilis transmission from a single anal sexual act with a single partner in the MSM population was 1.4% and 1% with oral sex. […] This becomes compounded as the number of sexual encounters and partners increases. […] Syphilis is an important synergistic infection for HIV acquisition and has been closely linked with HIV infections. […] Patients with syphilis are more likely to become HIV positive even if they initially test negative for the virus because of similar behavioral high-risk factors for the 2 diseases.
#3 Syphilis – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK534780/
Among sex workers, the worldwide incidence of active syphilis in 2019 was 10.8%. […] It is estimated that there are 1.5 million congenital syphilis births worldwide annually, mostly in low-income countries, although rates in Western nations are also increasing at alarming rates. […] The CDC reported that the national incidence of congenital syphilis in the US nearly quadrupled between 2015 and 2019 and increased 10-fold over the last 10 years. […] The 2021 rate was about 78 cases/100,000 live births, which is more than 30% greater than in 2020, and this trend continued through 2023 with an additional 32% increase in just one year. […] Women aged 24 years and younger have had the greatest increase. […] Congenital syphilis in the US was 8 and 3.9 times higher among infants born to Black and Hispanic mothers, respectively, compared to White mothers, with almost half of all reported cases coming from California and Texas.
#3 Syphilis | Washington State Department of Health
https://doh.wa.gov/public-health-provider-resources/notifiable-conditions/syphilis
Rates have increased greatly since 1996, when 9 cases were reported. Recently over 1,000 primary and secondary cases have been reported annually. Rates are higher among males. […] To assess trends in epidemic patterns, understand the impact of the burden of infection on populations, the health care infrastructure, and to better target population-level infection prevention efforts […] To assure the adequate treatment of infected individuals in order to reduce the duration of infectiousness and prevent sequelae of infection. (e.g., neurosyphilis, gumma) […] To identify cases in a timely fashion in order to interrupt the chain of infection through patient-level interventions such as management of sexual contacts and behavioral risk reduction counseling.
#3 Epidemiology of syphilis – Wikipedia
https://en.wikipedia.org/wiki/Epidemiology_of_syphilis
Syphilis is a bacterial infection transmitted by sexual contact and is believed to have infected 12 million people in 1999 with greater than 90% of cases in the developing world. […] In the developed world, syphilis infections were in decline until the 1980s and 1990s due to widespread use of antibiotics. Since the year 2000, rates of syphilis have been increasing in the US, UK, Australia, and Europe primarily among men who have sex with men (MSM). […] A sexually transmitted infection (STI) Surveillance study done by the Centers for Disease Control and Prevention in 2016 showed that men who have sex with men only account for over half (52%) of the 27,814 cases during that year. Nationally, the highest rates of primary and secondary syphilis in 2016 were observed among men aged 20-34 years, among men in the West, and among Black men.
#3 Syphilis cases surge in the U.S., CDC says : NPR
https://www.npr.org/2024/01/31/1228195107/syphilis-cases-soar-in-us-cdc-says
The number of syphilis cases in the U.S. are on the rise. According to a new report from the Centers for Disease Control and Prevention, cases increased by nearly 80% to more than 207,000 between 2018 and 2022. […] In 2022, 3,755 cases of babies born with syphilis in the U.S. were reported, which reflects an alarming 937% increase in the past decade, the CDC said. […] The report continued that racial and ethnic minorities are most disproportionately affected due to „long standing social inequities that often lead to health inequalities.” […] The CDC said that its findings signal an urgent need for a closer look at public health efforts and prevention strategies. […] „Addressing the resurgence of syphilis and congenital syphilis requires a concerted effort,” said Admiral Rachel Levine, assistant secretary for health and chair of the National Syphilis and Congenital Syphilis Syndemic Federal Task Force, in a statement.
#3 Why is Syphilis Spiking in the U.S.? | Johns Hopkins | Bloomberg School of Public Health
https://publichealth.jhu.edu/2024/why-is-syphilis-spiking-in-the-us
We have good diagnostics, we know how its transmitted, theres 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. […] Plus, many at-risk patients dont have access to health care, and a lot of sexual health clinics have closed over the last decade. […] The one major thing that has an impact on the rate is money. The U.S. government through the CDC has had relatively flat spending on STD prevention over the last 20 yearsand with inflation, that amounts to a significant decrease in spending.
#3 Syphilis – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK534780/
The steady increase in the incidence of syphilis cases in the US and globally since 2000 makes it a resurging epidemic that requires additional attention and resources for earlier diagnosis and treatment. […] Factors contributing to this resurgence include the following: Improved treatment of HIV, making it seem „safe” to increase sexual contacts and partners without protection (risk compensation), the increased use of the internet for dating, increasing rates of drug abuse (particularly methamphetamines) are associated with a higher incidence of syphilis infections, the improved social acceptability of homosexual behavior (especially MSM), the increasing worldwide population with higher numbers of younger individuals who tend to be more sexually active, ongoing poverty and homelessness, the general perception is that syphilis is an „old” disease no longer relevant in modern healthcare, even by some healthcare professionals, and lack of familiarity with the disease by modern healthcare practitioners who may have limited experience with syphilis, especially its tertiary manifestations.
#3 Syphilis – Annual Epidemiological Report for 2023
https://www.ecdc.europa.eu/en/publications-data/syphilis-annual-epidemiological-report-2023
In 2023, 41 051 confirmed syphilis cases were reported in 29 EU/EEA Member States, with a crude notification rate of 9.9 cases per 100 000 population, representing a 13% increase in the crude notification rate compared to 2022, and a 100% increase compared to 2014. […] Reported syphilis rates were seven times higher in men than in women and highest in men aged 25-34 years (43 cases per 100 000 population). The majority (72%) of syphilis cases with information on transmission category were reported in men who have sex with men (MSM). […] Overall, the trend in syphilis notifications increased between 2014 and 2023, mainly due to an increase in the number of cases among MSM. […] After a brief decline during the COVID-19 pandemic, the number of syphilis notifications began increasing again in 2022 across all transmission groups. This increase continued in 2023.
#3 Recommendation: Syphilis Infection in Nonpregnant Adolescents and Adults: Screening | United States Preventive Services Taskforce
https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/syphilis-infection-nonpregnant-adults-adolescents-screening
When deciding which persons to screen for syphilis, clinicians should consider the prevalence of infection in the communities they serve, as well as other sociodemographic and behavioral factors that may be associated with increased risk of syphilis infection. […] Local prevalence rates may change over time, so clinicians should be aware of the latest data and trends for their specific population and geographic area, which are available through their state and local health departments and Centers for Disease Control and Prevention (CDC) surveillance. […] The CDC provides fact sheets, treatment guidelines, and national and state surveillance data for syphilis. […] The USPSTF has issued a separate recommendation for screening for syphilis infection in pregnant persons as well as screening recommendations for other STIs.
#3 County-level Syphilis Data | STI Statistics | CDC
https://www.cdc.gov/sti-statistics/county-level-syphilis-data/index.html
Health departments and healthcare providers can use county-level data of primary and secondary (PS) syphilis to direct their screening efforts. […] For many people, the most significant risk factor for syphilis is living in a community with high rates of syphilis. […] The Healthy People 2030 goal for reducing the rate of PS syphilis among women aged 15-44 years is 4.6 per 100,000 people. […] If practicing in a county where the syphilis rate is below the 4.6 per 100,000 people threshold noted above, screen patients who are not pregnant for syphilis per other criteria, as specified in CDC Sexually Transmitted Infections Treatment Guidelines. […] Know the burden in your jurisdiction: Use the map and data table below to identify counties in your states with high rates of syphilis and notify physicians in these counties to encourage more testing and coordinated treatment. […] Offer syphilis testing to all sexually active people aged 15-44 years in counties with a rate of primary secondary syphilis among women aged 15-44 years that is greater than 4.6 per 100,000 people.
#3 Syphilis: Far from Ancient History | AAFP
https://www.aafp.org/pubs/afp/issues/2020/0715/p91.html
This transmission pattern makes surveillance a challenge because pockets of outbreaks can occur while overall rates in the general population remain relatively constant. […] Screening for syphilis is recommended at least annually for high-risk groups. […] The U.S. Preventive Services Task Force recommends that when assessing a patient’s risk of syphilis, clinicians should consider other factors associated with increased prevalence. […] Repeat serologic testing is recommended at six and 12 months after treatment to determine treatment effectiveness. […] Syphilis cases should be reported to local public health agencies for disease surveillance and partner notification.
#3 Syphilis – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK534780/
At the same time, federal funding for STD prevention has decreased by 40% over the past 20 years. […] Even more disturbing was the finding that adequate maternal treatment of syphilis was not performed in over 30% of cases despite an early, timely diagnosis, which represents another significant missed public health improvement opportunity. […] Impediments to adequate syphilis testing and treatment include lack of prenatal care programs, insufficient syphilis testing, lack of point-of-care tests, missed prenatal visits due to lack of resources, cultural issues, poverty, homelessness, social and cultural stigma, discrimination, lack of health insurance, and substance abuse, particularly methamphetamines and heroin. […] The legacy of the infamous 1932 Tuskegee syphilis experiment is also a factor, where 399 mostly poor Black sharecroppers were deliberately denied treatment for their latent syphilis, even after 1947 when penicillin became the standard therapy, so that researchers could follow the course of the disease.
#3 New data show sustained declines in chlamydia, syphilis among doxy-PEP users | CIDRAP
https://www.cidrap.umn.edu/antimicrobial-stewardship/new-data-show-sustained-declines-chlamydia-syphilis-among-doxy-pep-users
A study conducted at a sexual health clinic in San Francisco found sustained significant declines in cases of chlamydia and syphilis among those who used doxycycline post-exposure prophylaxis (doxy-PEP) nearly 2 years after it was introduced, with a smaller effect on gonorrhea, researchers reported yesterday in Clinical Infectious Diseases. […] Implementation of the intervention was based on a randomized trial, conducted in San Francisco and Seattle, that in 2023 showed significant declines in chlamydia, syphilis, and gonorrhea among doxy-PEP users compared with those who received standard care. […] The analysis showed a significant decline in all individual STIs in the doxy-PEP group, most notably (83%) for combined rates of chlamydia and syphilis (adjusted odds ratio [AOR], 0.17; 95% confidence interval [CI], 0.12 to 0.25) and less for gonorrhea (AOR, 0.56; 95% CI, 0.44 to 0.71). […] The study authors note that while gonorrhea rates did initially decline in users after starting doxy-PEP, they began to increase again toward the end of the analysis, which could indicate that gonorrhea resistance to doxycycline is increasing.
#3 Syphilis – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK534780/
Syphilis is endemic in the developing world and is especially common among those who are poor and have limited access to health care, as over 60% of all new diagnoses come from low and middle-income countries. […] Prenatal screening for HIV is much more prevalent than for syphilis, primarily due to increased interest and awareness of HIV from local governments and donors, despite the existence of dual HIV/syphilis rapid diagnostic tests. […] This represents a significant missed public health opportunity to increase testing for syphilis by 100% to 200% in high-risk countries. […] The incidence of the disease in women doubled from 2013 to 2017 and increased another 147% between 2016 and 2020. […] This is attributed to a marked increase in parenteral drug abuse, while congenital syphilis cases multiplied 4-fold during approximately the same period.
#3 Introduction to the Transition of Mandatory Surveillance System in the Syphilis Monitoring
https://eng.phwr.org/journal/view.html?pn=search&uid=391&vmd=Full
According to the amendments in the IDCP Act, from January 1, 2024, syphilis will be elevated from a group 4 to a group 3 infectious disease and fall under mandatory surveillance system, thus, requiring all medical institutions to report syphilis cases within 24 hours of diagnosis. […] Mandatory surveillance for syphilis will be implemented from January 1, 2024, and the scope of reporting will be expanded to five types, including early latent syphilis, which is likely to be transmitted, and tertiary syphilis, which progresses to severe disease, in addition to the current three types (primary and secondary syphilis, and congenital syphilis). […] Transitioning to mandatory surveillance entails reporting all identified cases, facilitating an objective overview of the overall occurrence of syphilis in the ROK. This shift also enables the collection of a wide range of information, including demographic characteristics, stage and main symptoms, exposure route, and contacts of individual patients through epidemiological investigations. Therefore, this transition is anticipated to facilitate the development of more comprehensive prevention and management measures. […] The transition to mandatory surveillance of syphilis, as mandated in this amendment of the IDCP Act, aims to identify the overall occurrence and trends of syphilis in the ROK by expanding the scope of syphilis reporting and epidemiological investigation to all populations.
#3 An Update on the Global Epidemiology of Syphilis
https://pmc.ncbi.nlm.nih.gov/articles/PMC6089383/
Syphilis continues to persist among MSM and other groups who tend to have multiple sex partners, and could likely return in heterosexual populations without public health vigilance. […] In high-income countries, important metrics like screening at the first antenatal care visit and rates of congenital syphilis are high, however current syphilis control strategies are ignoring key populations, i.e., MSM, transgender women, and sex workers. Current studies show that syphilis incidence is increasing in those key communities. […] Among many LMICs, syphilis continues to remain at endemic levels in the general population; however better reporting data are needed to properly estimate prevalence of syphilis and its associated morbidity and mortality.
#3 Why syphilis is rising around the world
https://www.bbc.com/future/article/20230706-the-troubling-rise-in-congenital-syphilis
The highest numbers are seen among Black American and Hispanic women. […] „The consensus in the public health community is that the rise in STIs including syphilis is likely related to a disruption of STI prevention resources during the pandemic,” says Sundaram. […] Disparities in access to STI testing and screening services are among what is thought to be driving the increase in syphilis cases. […] For most health officials, the path to tackle syphilis is clear we already have the drugs to combat it as penicillin still remains the best treatment despite a rising incidence of antibiotic resistance. More testing, better outreach to counter the stigma attached to the disease along with greater public awareness to encourage safer sexual practices all have a much bigger role to play. […] But scientists have so far failed to arrive at a single theory on is why syphilis is rising faster than other STIs.
#3 Rising syphilis rates in Canada, 2011â2020, CCDR 48(2/3) – Canada.ca
https://www.canada.ca/en/public-health/services/reports-publications/canada-communicable-disease-report-ccdr/monthly-issue/2022-48/issue-2-3-february-march-2022/syphilis-canada-2011-2020.html
Syphilis rates are of public health concern in Canada, with multiple jurisdictions reporting outbreaks over the past five years. The objective of this article is to describe trends in infectious and congenital syphilis in Canada 20112020. […] Routine surveillance of syphilis is conducted through the Canadian Notifiable Disease Surveillance System (CNDSS). In response to rising rates of syphilis, all provinces and territories (P/Ts) have also submitted enhanced surveillance data on infectious syphilis to the Public Health Agency of Canada through the Syphilis Outbreak Investigation Coordinating Committee (SOICC) starting in 2018. Descriptive analyses of CNDSS and SOICC surveillance data 20112020 by age, sex, pregnancy status, male sexual orientation and P/Ts were performed. […] The national rate of infectious syphilis increased from 5.1 per 100,000 population in 2011 to 24.7 per 100,000 population in 2020. The rates increased in almost all P/Ts, with the Prairie provinces reporting the greatest relative increases from 2016 to 2020 (more than 400%). Rates in males were consistently higher than rates in females over the past 10 years; however, from 2016 to 2020, rates among females increased by 773%, compared with 73% among males.
#4
https://www.who.int/news-room/fact-sheets/detail/syphilis
WHO estimates that 8 million adults between 15 and 49 years old acquired syphilis in 2022. […] In 2022, WHO estimated that 8 million adults aged 1549 acquired syphilis globally. Some countries that systematically monitor syphilis are showing an important increase in syphilis cases among men who have sex with men, including congenital syphilis. […] In 2022, WHO estimated there were 700 000 congenital syphilis cases globally. These maternal syphilis cases led to an estimated 150 000 early fetal deaths and stillbirths, 70 000 neonatal deaths, 55 000 preterm or low-birth weight births, and 115 000 infants with clinical diagnosis of congenital syphilis. […] Some population groups are disproportionately affected by syphilis. For example, globally, an estimated 7.5% of gay men and other men who have sex with men have syphilis compared to 0.5% of men in the general population.
#4 Syphilis – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK534780/
The CDC has reported that more than 80% of syphilis cases in the US (primary and secondary) occur in the MSM population, of whom 47% also have HIV. […] It is estimated that 7.5% of all homosexual males worldwide have the disease compared to about 0.5% of all men in the general population. […] The probability of syphilis transmission from a single anal sexual act with a single partner in the MSM population was 1.4% and 1% with oral sex. […] This becomes compounded as the number of sexual encounters and partners increases. […] Syphilis is an important synergistic infection for HIV acquisition and has been closely linked with HIV infections. […] Patients with syphilis are more likely to become HIV positive even if they initially test negative for the virus because of similar behavioral high-risk factors for the 2 diseases.
#4 Syphilis – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK534780/
Among sex workers, the worldwide incidence of active syphilis in 2019 was 10.8%. […] It is estimated that there are 1.5 million congenital syphilis births worldwide annually, mostly in low-income countries, although rates in Western nations are also increasing at alarming rates. […] The CDC reported that the national incidence of congenital syphilis in the US nearly quadrupled between 2015 and 2019 and increased 10-fold over the last 10 years. […] The 2021 rate was about 78 cases/100,000 live births, which is more than 30% greater than in 2020, and this trend continued through 2023 with an additional 32% increase in just one year. […] Women aged 24 years and younger have had the greatest increase. […] Congenital syphilis in the US was 8 and 3.9 times higher among infants born to Black and Hispanic mothers, respectively, compared to White mothers, with almost half of all reported cases coming from California and Texas.
#4 Syphilis – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK534780/
The steady increase in the incidence of syphilis cases in the US and globally since 2000 makes it a resurging epidemic that requires additional attention and resources for earlier diagnosis and treatment. […] Factors contributing to this resurgence include the following: Improved treatment of HIV, making it seem „safe” to increase sexual contacts and partners without protection (risk compensation), the increased use of the internet for dating, increasing rates of drug abuse (particularly methamphetamines) are associated with a higher incidence of syphilis infections, the improved social acceptability of homosexual behavior (especially MSM), the increasing worldwide population with higher numbers of younger individuals who tend to be more sexually active, ongoing poverty and homelessness, the general perception is that syphilis is an „old” disease no longer relevant in modern healthcare, even by some healthcare professionals, and lack of familiarity with the disease by modern healthcare practitioners who may have limited experience with syphilis, especially its tertiary manifestations.
#4 Syphilis cases surge in the U.S., CDC says : NPR
https://www.npr.org/2024/01/31/1228195107/syphilis-cases-soar-in-us-cdc-says
The number of syphilis cases in the U.S. are on the rise. According to a new report from the Centers for Disease Control and Prevention, cases increased by nearly 80% to more than 207,000 between 2018 and 2022. […] In 2022, 3,755 cases of babies born with syphilis in the U.S. were reported, which reflects an alarming 937% increase in the past decade, the CDC said. […] The report continued that racial and ethnic minorities are most disproportionately affected due to „long standing social inequities that often lead to health inequalities.” […] The CDC said that its findings signal an urgent need for a closer look at public health efforts and prevention strategies. […] „Addressing the resurgence of syphilis and congenital syphilis requires a concerted effort,” said Admiral Rachel Levine, assistant secretary for health and chair of the National Syphilis and Congenital Syphilis Syndemic Federal Task Force, in a statement.
#4 County-level Syphilis Data | STI Statistics | CDC
https://www.cdc.gov/sti-statistics/county-level-syphilis-data/index.html
Health departments and healthcare providers can use county-level data of primary and secondary (PS) syphilis to direct their screening efforts. […] For many people, the most significant risk factor for syphilis is living in a community with high rates of syphilis. […] The Healthy People 2030 goal for reducing the rate of PS syphilis among women aged 15-44 years is 4.6 per 100,000 people. […] If practicing in a county where the syphilis rate is below the 4.6 per 100,000 people threshold noted above, screen patients who are not pregnant for syphilis per other criteria, as specified in CDC Sexually Transmitted Infections Treatment Guidelines. […] Know the burden in your jurisdiction: Use the map and data table below to identify counties in your states with high rates of syphilis and notify physicians in these counties to encourage more testing and coordinated treatment. […] Offer syphilis testing to all sexually active people aged 15-44 years in counties with a rate of primary secondary syphilis among women aged 15-44 years that is greater than 4.6 per 100,000 people.
#4 Syphilis – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK534780/
At the same time, federal funding for STD prevention has decreased by 40% over the past 20 years. […] Even more disturbing was the finding that adequate maternal treatment of syphilis was not performed in over 30% of cases despite an early, timely diagnosis, which represents another significant missed public health improvement opportunity. […] Impediments to adequate syphilis testing and treatment include lack of prenatal care programs, insufficient syphilis testing, lack of point-of-care tests, missed prenatal visits due to lack of resources, cultural issues, poverty, homelessness, social and cultural stigma, discrimination, lack of health insurance, and substance abuse, particularly methamphetamines and heroin. […] The legacy of the infamous 1932 Tuskegee syphilis experiment is also a factor, where 399 mostly poor Black sharecroppers were deliberately denied treatment for their latent syphilis, even after 1947 when penicillin became the standard therapy, so that researchers could follow the course of the disease.
#4 Syphilis – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK534780/
Syphilis is endemic in the developing world and is especially common among those who are poor and have limited access to health care, as over 60% of all new diagnoses come from low and middle-income countries. […] Prenatal screening for HIV is much more prevalent than for syphilis, primarily due to increased interest and awareness of HIV from local governments and donors, despite the existence of dual HIV/syphilis rapid diagnostic tests. […] This represents a significant missed public health opportunity to increase testing for syphilis by 100% to 200% in high-risk countries. […] The incidence of the disease in women doubled from 2013 to 2017 and increased another 147% between 2016 and 2020. […] This is attributed to a marked increase in parenteral drug abuse, while congenital syphilis cases multiplied 4-fold during approximately the same period.
#4 Why syphilis is rising around the world
https://www.bbc.com/future/article/20230706-the-troubling-rise-in-congenital-syphilis
The highest numbers are seen among Black American and Hispanic women. […] „The consensus in the public health community is that the rise in STIs including syphilis is likely related to a disruption of STI prevention resources during the pandemic,” says Sundaram. […] Disparities in access to STI testing and screening services are among what is thought to be driving the increase in syphilis cases. […] For most health officials, the path to tackle syphilis is clear we already have the drugs to combat it as penicillin still remains the best treatment despite a rising incidence of antibiotic resistance. More testing, better outreach to counter the stigma attached to the disease along with greater public awareness to encourage safer sexual practices all have a much bigger role to play. […] But scientists have so far failed to arrive at a single theory on is why syphilis is rising faster than other STIs.
#4 Recommendation: Syphilis Infection in Nonpregnant Adolescents and Adults: Screening | United States Preventive Services Taskforce
https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/syphilis-infection-nonpregnant-adults-adolescents-screening
When deciding which persons to screen for syphilis, clinicians should consider the prevalence of infection in the communities they serve, as well as other sociodemographic and behavioral factors that may be associated with increased risk of syphilis infection. […] Local prevalence rates may change over time, so clinicians should be aware of the latest data and trends for their specific population and geographic area, which are available through their state and local health departments and Centers for Disease Control and Prevention (CDC) surveillance. […] The CDC provides fact sheets, treatment guidelines, and national and state surveillance data for syphilis. […] The USPSTF has issued a separate recommendation for screening for syphilis infection in pregnant persons as well as screening recommendations for other STIs.
#4 Rising syphilis rates in Canada, 2011â2020, CCDR 48(2/3) – Canada.ca
https://www.canada.ca/en/public-health/services/reports-publications/canada-communicable-disease-report-ccdr/monthly-issue/2022-48/issue-2-3-february-march-2022/syphilis-canada-2011-2020.html
Syphilis rates are of public health concern in Canada, with multiple jurisdictions reporting outbreaks over the past five years. The objective of this article is to describe trends in infectious and congenital syphilis in Canada 20112020. […] Routine surveillance of syphilis is conducted through the Canadian Notifiable Disease Surveillance System (CNDSS). In response to rising rates of syphilis, all provinces and territories (P/Ts) have also submitted enhanced surveillance data on infectious syphilis to the Public Health Agency of Canada through the Syphilis Outbreak Investigation Coordinating Committee (SOICC) starting in 2018. Descriptive analyses of CNDSS and SOICC surveillance data 20112020 by age, sex, pregnancy status, male sexual orientation and P/Ts were performed. […] The national rate of infectious syphilis increased from 5.1 per 100,000 population in 2011 to 24.7 per 100,000 population in 2020. The rates increased in almost all P/Ts, with the Prairie provinces reporting the greatest relative increases from 2016 to 2020 (more than 400%). Rates in males were consistently higher than rates in females over the past 10 years; however, from 2016 to 2020, rates among females increased by 773%, compared with 73% among males.
#4 Introduction to the Transition of Mandatory Surveillance System in the Syphilis Monitoring
https://eng.phwr.org/journal/view.html?pn=search&uid=391&vmd=Full
According to the amendments in the IDCP Act, from January 1, 2024, syphilis will be elevated from a group 4 to a group 3 infectious disease and fall under mandatory surveillance system, thus, requiring all medical institutions to report syphilis cases within 24 hours of diagnosis. […] Mandatory surveillance for syphilis will be implemented from January 1, 2024, and the scope of reporting will be expanded to five types, including early latent syphilis, which is likely to be transmitted, and tertiary syphilis, which progresses to severe disease, in addition to the current three types (primary and secondary syphilis, and congenital syphilis). […] Transitioning to mandatory surveillance entails reporting all identified cases, facilitating an objective overview of the overall occurrence of syphilis in the ROK. This shift also enables the collection of a wide range of information, including demographic characteristics, stage and main symptoms, exposure route, and contacts of individual patients through epidemiological investigations. Therefore, this transition is anticipated to facilitate the development of more comprehensive prevention and management measures. […] The transition to mandatory surveillance of syphilis, as mandated in this amendment of the IDCP Act, aims to identify the overall occurrence and trends of syphilis in the ROK by expanding the scope of syphilis reporting and epidemiological investigation to all populations.
#5 Syphilis – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK534780/
Among sex workers, the worldwide incidence of active syphilis in 2019 was 10.8%. […] It is estimated that there are 1.5 million congenital syphilis births worldwide annually, mostly in low-income countries, although rates in Western nations are also increasing at alarming rates. […] The CDC reported that the national incidence of congenital syphilis in the US nearly quadrupled between 2015 and 2019 and increased 10-fold over the last 10 years. […] The 2021 rate was about 78 cases/100,000 live births, which is more than 30% greater than in 2020, and this trend continued through 2023 with an additional 32% increase in just one year. […] Women aged 24 years and younger have had the greatest increase. […] Congenital syphilis in the US was 8 and 3.9 times higher among infants born to Black and Hispanic mothers, respectively, compared to White mothers, with almost half of all reported cases coming from California and Texas.
#5 Syphilis – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK534780/
The steady increase in the incidence of syphilis cases in the US and globally since 2000 makes it a resurging epidemic that requires additional attention and resources for earlier diagnosis and treatment. […] Factors contributing to this resurgence include the following: Improved treatment of HIV, making it seem „safe” to increase sexual contacts and partners without protection (risk compensation), the increased use of the internet for dating, increasing rates of drug abuse (particularly methamphetamines) are associated with a higher incidence of syphilis infections, the improved social acceptability of homosexual behavior (especially MSM), the increasing worldwide population with higher numbers of younger individuals who tend to be more sexually active, ongoing poverty and homelessness, the general perception is that syphilis is an „old” disease no longer relevant in modern healthcare, even by some healthcare professionals, and lack of familiarity with the disease by modern healthcare practitioners who may have limited experience with syphilis, especially its tertiary manifestations.
#5 County-level Syphilis Data | STI Statistics | CDC
https://www.cdc.gov/sti-statistics/county-level-syphilis-data/index.html
Health departments and healthcare providers can use county-level data of primary and secondary (PS) syphilis to direct their screening efforts. […] For many people, the most significant risk factor for syphilis is living in a community with high rates of syphilis. […] The Healthy People 2030 goal for reducing the rate of PS syphilis among women aged 15-44 years is 4.6 per 100,000 people. […] If practicing in a county where the syphilis rate is below the 4.6 per 100,000 people threshold noted above, screen patients who are not pregnant for syphilis per other criteria, as specified in CDC Sexually Transmitted Infections Treatment Guidelines. […] Know the burden in your jurisdiction: Use the map and data table below to identify counties in your states with high rates of syphilis and notify physicians in these counties to encourage more testing and coordinated treatment. […] Offer syphilis testing to all sexually active people aged 15-44 years in counties with a rate of primary secondary syphilis among women aged 15-44 years that is greater than 4.6 per 100,000 people.
#5 Syphilis cases surge in the U.S., CDC says : NPR
https://www.npr.org/2024/01/31/1228195107/syphilis-cases-soar-in-us-cdc-says
The number of syphilis cases in the U.S. are on the rise. According to a new report from the Centers for Disease Control and Prevention, cases increased by nearly 80% to more than 207,000 between 2018 and 2022. […] In 2022, 3,755 cases of babies born with syphilis in the U.S. were reported, which reflects an alarming 937% increase in the past decade, the CDC said. […] The report continued that racial and ethnic minorities are most disproportionately affected due to „long standing social inequities that often lead to health inequalities.” […] The CDC said that its findings signal an urgent need for a closer look at public health efforts and prevention strategies. […] „Addressing the resurgence of syphilis and congenital syphilis requires a concerted effort,” said Admiral Rachel Levine, assistant secretary for health and chair of the National Syphilis and Congenital Syphilis Syndemic Federal Task Force, in a statement.
#5 Syphilis – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK534780/
At the same time, federal funding for STD prevention has decreased by 40% over the past 20 years. […] Even more disturbing was the finding that adequate maternal treatment of syphilis was not performed in over 30% of cases despite an early, timely diagnosis, which represents another significant missed public health improvement opportunity. […] Impediments to adequate syphilis testing and treatment include lack of prenatal care programs, insufficient syphilis testing, lack of point-of-care tests, missed prenatal visits due to lack of resources, cultural issues, poverty, homelessness, social and cultural stigma, discrimination, lack of health insurance, and substance abuse, particularly methamphetamines and heroin. […] The legacy of the infamous 1932 Tuskegee syphilis experiment is also a factor, where 399 mostly poor Black sharecroppers were deliberately denied treatment for their latent syphilis, even after 1947 when penicillin became the standard therapy, so that researchers could follow the course of the disease.
#5 Recommendation: Syphilis Infection in Nonpregnant Adolescents and Adults: Screening | United States Preventive Services Taskforce
https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/syphilis-infection-nonpregnant-adults-adolescents-screening
When deciding which persons to screen for syphilis, clinicians should consider the prevalence of infection in the communities they serve, as well as other sociodemographic and behavioral factors that may be associated with increased risk of syphilis infection. […] Local prevalence rates may change over time, so clinicians should be aware of the latest data and trends for their specific population and geographic area, which are available through their state and local health departments and Centers for Disease Control and Prevention (CDC) surveillance. […] The CDC provides fact sheets, treatment guidelines, and national and state surveillance data for syphilis. […] The USPSTF has issued a separate recommendation for screening for syphilis infection in pregnant persons as well as screening recommendations for other STIs.
#5 Introduction to the Transition of Mandatory Surveillance System in the Syphilis Monitoring
https://eng.phwr.org/journal/view.html?pn=search&uid=391&vmd=Full
According to the amendments in the IDCP Act, from January 1, 2024, syphilis will be elevated from a group 4 to a group 3 infectious disease and fall under mandatory surveillance system, thus, requiring all medical institutions to report syphilis cases within 24 hours of diagnosis. […] Mandatory surveillance for syphilis will be implemented from January 1, 2024, and the scope of reporting will be expanded to five types, including early latent syphilis, which is likely to be transmitted, and tertiary syphilis, which progresses to severe disease, in addition to the current three types (primary and secondary syphilis, and congenital syphilis). […] Transitioning to mandatory surveillance entails reporting all identified cases, facilitating an objective overview of the overall occurrence of syphilis in the ROK. This shift also enables the collection of a wide range of information, including demographic characteristics, stage and main symptoms, exposure route, and contacts of individual patients through epidemiological investigations. Therefore, this transition is anticipated to facilitate the development of more comprehensive prevention and management measures. […] The transition to mandatory surveillance of syphilis, as mandated in this amendment of the IDCP Act, aims to identify the overall occurrence and trends of syphilis in the ROK by expanding the scope of syphilis reporting and epidemiological investigation to all populations.
#6 Syphilis – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK534780/
The steady increase in the incidence of syphilis cases in the US and globally since 2000 makes it a resurging epidemic that requires additional attention and resources for earlier diagnosis and treatment. […] Factors contributing to this resurgence include the following: Improved treatment of HIV, making it seem „safe” to increase sexual contacts and partners without protection (risk compensation), the increased use of the internet for dating, increasing rates of drug abuse (particularly methamphetamines) are associated with a higher incidence of syphilis infections, the improved social acceptability of homosexual behavior (especially MSM), the increasing worldwide population with higher numbers of younger individuals who tend to be more sexually active, ongoing poverty and homelessness, the general perception is that syphilis is an „old” disease no longer relevant in modern healthcare, even by some healthcare professionals, and lack of familiarity with the disease by modern healthcare practitioners who may have limited experience with syphilis, especially its tertiary manifestations.
#6 County-level Syphilis Data | STI Statistics | CDC
https://www.cdc.gov/sti-statistics/county-level-syphilis-data/index.html
Health departments and healthcare providers can use county-level data of primary and secondary (PS) syphilis to direct their screening efforts. […] For many people, the most significant risk factor for syphilis is living in a community with high rates of syphilis. […] The Healthy People 2030 goal for reducing the rate of PS syphilis among women aged 15-44 years is 4.6 per 100,000 people. […] If practicing in a county where the syphilis rate is below the 4.6 per 100,000 people threshold noted above, screen patients who are not pregnant for syphilis per other criteria, as specified in CDC Sexually Transmitted Infections Treatment Guidelines. […] Know the burden in your jurisdiction: Use the map and data table below to identify counties in your states with high rates of syphilis and notify physicians in these counties to encourage more testing and coordinated treatment. […] Offer syphilis testing to all sexually active people aged 15-44 years in counties with a rate of primary secondary syphilis among women aged 15-44 years that is greater than 4.6 per 100,000 people.
#7 Syphilis – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK534780/
The steady increase in the incidence of syphilis cases in the US and globally since 2000 makes it a resurging epidemic that requires additional attention and resources for earlier diagnosis and treatment. […] Factors contributing to this resurgence include the following: Improved treatment of HIV, making it seem „safe” to increase sexual contacts and partners without protection (risk compensation), the increased use of the internet for dating, increasing rates of drug abuse (particularly methamphetamines) are associated with a higher incidence of syphilis infections, the improved social acceptability of homosexual behavior (especially MSM), the increasing worldwide population with higher numbers of younger individuals who tend to be more sexually active, ongoing poverty and homelessness, the general perception is that syphilis is an „old” disease no longer relevant in modern healthcare, even by some healthcare professionals, and lack of familiarity with the disease by modern healthcare practitioners who may have limited experience with syphilis, especially its tertiary manifestations.
#8 Syphilis – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK534780/
The steady increase in the incidence of syphilis cases in the US and globally since 2000 makes it a resurging epidemic that requires additional attention and resources for earlier diagnosis and treatment. […] Factors contributing to this resurgence include the following: Improved treatment of HIV, making it seem „safe” to increase sexual contacts and partners without protection (risk compensation), the increased use of the internet for dating, increasing rates of drug abuse (particularly methamphetamines) are associated with a higher incidence of syphilis infections, the improved social acceptability of homosexual behavior (especially MSM), the increasing worldwide population with higher numbers of younger individuals who tend to be more sexually active, ongoing poverty and homelessness, the general perception is that syphilis is an „old” disease no longer relevant in modern healthcare, even by some healthcare professionals, and lack of familiarity with the disease by modern healthcare practitioners who may have limited experience with syphilis, especially its tertiary manifestations.
#9 Syphilis – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK534780/
The steady increase in the incidence of syphilis cases in the US and globally since 2000 makes it a resurging epidemic that requires additional attention and resources for earlier diagnosis and treatment. […] Factors contributing to this resurgence include the following: Improved treatment of HIV, making it seem „safe” to increase sexual contacts and partners without protection (risk compensation), the increased use of the internet for dating, increasing rates of drug abuse (particularly methamphetamines) are associated with a higher incidence of syphilis infections, the improved social acceptability of homosexual behavior (especially MSM), the increasing worldwide population with higher numbers of younger individuals who tend to be more sexually active, ongoing poverty and homelessness, the general perception is that syphilis is an „old” disease no longer relevant in modern healthcare, even by some healthcare professionals, and lack of familiarity with the disease by modern healthcare practitioners who may have limited experience with syphilis, especially its tertiary manifestations.