Syphilis cases skyrocket in Woodbury County

SIOUX CITY — Syphilis is surging in Woodbury County, with cases of the sexually transmitted disease up 111% since last year.

Thirty-four cases of syphilis were reported in 2021. So far this year, 72 cases have been tallied, according to data from Siouxland District Health Department.

“We’ve had more syphilis in the last year or so than we’ve ever had in a number of years,” said Tyler Brock, the health department’s deputy director. “We’ve been definitely concerned about the syphilis numbers in our region. Not just Sioux City, but in our tri-state area.”

In 2018 and 2019, syphilis cases in the county were in the single digits, before increasing to 12 in 2020. Brock said he doesn’t have an exact explanation for the rise.

“Syphilis can be fairly silent,” he said. “We would just be speculating on exactly why. You might try to blame the lack of health care during the pandemic when people just kind of let things go. It wouldn’t explain why our area is higher than others.”

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Preliminary data from the Centers for Disease Control and Prevention shows 2.5 million cases of chlamydia, gonorrhea and syphilis nationwide in 2021. Syphilis cases jumped 26%, followed by chlamydia (3%) and gonorrhea (2.8%). David Harvey, executive director of the National Coalition of STD Directors, called the situation in the United States “out of control,” according to a report from the Associated Press.

The Iowa Department of Public Health said in a statement that syphilis has reached its highest numbers in the state in a generation. There were 554 diagnoses of infectious syphilis reported to the health department in 2021, a 55% increase from the preceding year. The majority of cases are being diagnosed in men, although diagnoses among women nearly tripled in a single year.

“The increased number of women affected has led to historic increases in congenital syphilis, which occurs when the infection is passed from a pregnant person to the fetus or newborn,” the statement said. “In 2021, there were 11 cases of congenital syphilis in Iowa — more than the last 20 years combined. Additionally, rates of syphilis among our Black and Indigenous populations, and populations of color overall, are increasingly disproportionate.”

Rachel Wurth, assistant medical director for Rosecrance Jackson Centers, is treating more cases of syphilis than she ever has. Rosecrance Jackson Centers offers behavioral health and addiction treatment services in Sioux City for children, adolescents and adults.

“In my 10 years here, I don’t remember treating syphilis. This year, we have treated many cases of syphilis,” she said.

Since pandemic restrictions loosened, Brenda Iliff said Rosecrance Jackson Centers’ men’s units have been full and that an increased number of women are also seeking addiction treatment services. Iliff, Rosecrance Jackson’s vice president of clinical services, said people with addictions have always been at significant risk for STDs.

“If someone’s not quite aware of what they’re doing or remembering, they’re just at greater risk for STDs,” she said.

Iliff said a representative from Planned Parenthood talks with patients in Rosecrance Jackson’s adult and adolescent units about STDs. She said she has noticed that the men in treatment seem more interested in the educational information being shared than in years past.

“The guys are asking for testing, which is a good thing,” Iliff said.

Siouxland District Health Department Deputy Director Tyler Brock conducts syphilis testing. The health department tests samples once a week, sometimes testing upwards of 20 samples.

Caitlin Yamada, Sioux City Journal

At this time, Brock said local health officials are more alarmed about the syphilis numbers than they are by the chlamydia and gonorrhea data. He noted that the spread of chlamydia and gonorrhea in the community is at “normal or even slightly below normal levels.”

So far this year, 605 cases of chlamydia and 262 cases of gonorrhea have been recorded in the county. From 2018 to 2021, annual cases of chlamydia ranged from 700 to 838 and gonorrhea from 343 to 426.

“The worse case scenario is worse with syphilis than it is with some of those others, that’s why it concerns us a little bit more than with chlamydia and gonorrhea,” Brock said.

Brock said syphilis is “fairly easy to treat” with a form of penicillin. But, he said the antibiotic is “very expensive” at the moment.

Sores on the genitals is one of the first signs of syphilis, however, Brock said the lesions can be missed if they are internal, particularly in females. If the disease goes untreated, he said a rash may appear on the hands, feet and other parts of the body. Then, neurosyphilis, a bacterial infection of the brain or spinal cord, can develop.

“Literally this organism gets into our nervous system,” he said. “It can cause all kinds of different neurological-type things.”

In the last year or two, Brock said there have been cases of congenital syphilis in Siouxland. Babies born to women who have the disease can become infected through the placenta or during birth. Congenital syphilis causes severe illness in infants, including premature birth, low birth weight, birth defects, blindness and hearing loss. It can also lead to stillbirth and infant death, according to the CDC.

Brock said Siouxland District Health Department has been educating local physicians about the need to test women for syphilis during the third trimester of their pregnancy, rather than just the first.

“As they’re getting closer to delivering the baby, test them again, just in case something has changed since that first visit,” he said. “We’ve really tried to raise awareness in our medical community about looking for it, testing for it and just trying to get that diagnosis before it turns into something serious.”