Feb 28, 2024 - News

Spike in syphilis cases prompts calls for more testing

Illustration of a syringe moving up and to the right like an upward trending arrow.

Illustration: Aïda Amer/Axios

Syphilis cases are reaching new heights nationally and in the Seattle region, according to UW Medicine and the Centers for Disease Control and Prevention (CDC).

Why it matters: The CDC's Sexually Transmitted Infections Surveillance report for 2022, released in January, said syphilis and congenital syphilis have reached epidemic proportions.

  • More women are being diagnosed, and many are asymptomatic, meaning they have no symptoms of the disease, said Meena Ramchandani, an infectious diseases specialist at UW Medicine.
  • "What that means, potentially, is that there's a large reservoir of undiagnosed infections circulating in the community," Ramchandani said.

What they're saying: "King County, and much of the U.S., is confronting the largest syphilis epidemic in heterosexuals we've seen in a generation," Matthew Golden, director of Public Health – Seattle & King County's HIV/STI/HCV Program, told Axios this week.

By the numbers: In Seattle and King County, the overall number of cases in 2023 was down slightly from the high of 2022, but rates remained significantly higher than in 2021.

  • Among women, cases in King County continued to rise last year, with 437 cases reported in 2023, up from 367 in 2022.
  • Locally, the highest percentage of infections were reported in people between the ages of 35 and 44, per PHSKC statistics.

Threat level: Effects of congenital syphilis, in which a mother passes the infection to her unborn child, include brain and nerve damage, miscarriage and stillbirth.

The bottom line: Symptoms include sores, a reddish-brown spotted rash on hands, feet, chest or back, skin growths and vision and hearing changes.

What's next: PHSKC has formed a task force and launched a public information campaign urging testing for pregnant women and sexually active people age 45 and under who have not been tested since January 2021.

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