Often referred to as “the great pretender” for its ability to evade detection, the sexually transmitted disease syphilis has been on a steady incline in Missouri over the past several years.
The number of reported syphilis cases in an early stage more than tripled from 2015 to 2021, according to a Health Update released by the Missouri Department of Health and Senior Services in June 2022. The agency reported 1,989 cases in 2021, up from just 554 cases six years earlier.
The number of congenital syphilis cases — in which a mother passes the infection to a baby during pregnancy — also skyrocketed during that time, from just two reported cases in 2015 to 63 cases in 2021.
The Health Update said this increase mirrors national trends, and although the initial case increases in Missouri were happening in urban areas like St. Louis and Kansas City, cases have also been sharply rising in rural counties and smaller metropolitan areas.
So, why are syphilis cases rising?
“That’s kind of the million dollar question,” said Dustin Hampton, chief of the Bureau of HIV, STD and Hepatitis at the Missouri Department of Health and Senior Services. “We have some theories and thoughts, but we don’t know why for sure.”
Hampton said these thoughts include the shutdown of some STD testing sites, like local public health agencies and county health departments, during the COVID-19 pandemic.
He also said the syphilis increase may be a result of people neglecting to get tested during the pandemic, as cases of other STDs had been rising during that time frame as well.
What is syphilis?
Syphilis is a sexually transmitted bacterial infection that can have serious health effects, according to the CDC.
“Syphilis has been known as the great pretender because its symptoms can really mask as a lot of other conditions, and if a provider is not thinking syphilis as far as diagnosis — or maybe hasn’t seen very many cases in their career, which is not uncommon — they may not be testing for it when they should be,” Hampton said.
The disease progresses in stages. The first stage is called primary syphilis, which consists of a sore that Hampton referred to as a “chancre.” Syphilis is spread through skin-to-skin contact with one of these sores.
“It’s raised, red, it looks really ugly,” Hampton said, “but the weird thing is, there’s no pain associated with it.”
Because the sore is not painful, the CDC says people may not even know they have one. The sores appear wherever the syphilis entered the infected person’s body, which is often on the genitals, rectum or mouth.
After the sore heals itself in a few weeks, secondary syphilis comes into play.
It takes the form of a rash, which Hampton said often appears on the palms of the hands and soles of the feet. The rash can appear elsewhere, though.
“The rash goes away again all on its own, and, in most cases, there are no other symptoms for maybe decades,” Hampton said.
While there may be no symptoms, the disease is silently causing internal damage that may lead to death. The final stage, or tertiary syphilis, can severely affect the heart, blood vessels, brain and nervous system, according to the CDC.
Hampton said the disease is easily treated if it is caught in time, but if left too long, health effects can be serious.
“A lot of times, syphilis isn’t on people’s minds,” Hampton said.
“It’s thought of as an old (disease.) It’s the original venereal disease, and so people don’t think about it, but it’s important that people start to think about it again, educate themselves and get tested.”
Syphilis can be treated and cured with the correct antibiotics, the CDC says.
Congenital syphilis
Congenital syphilis cases have also been on the rise in Missouri.
Congenital syphilis occurs when a mother with untreated syphilis passes the infection to a baby during pregnancy, according to the CDC. The disease can result in miscarriage, stillbirth, infant death and serious birth defects for surviving babies, including bone deformities, blindness and deafness.
Missouri has experienced a sharp increase in the number of cases over the past few years, according to a Health Alert from the Missouri Department of Health and Senior Services.
In 2015, only two cases of congenital syphilis were reported in Missouri. By 2021, the number had jumped to 63, the highest reported number since 1994.
“If mom’s treatment starts 30 days before delivery, congenital syphilis is completely preventable,” Hampton said. “The difficult thing is where we are seeing congenital syphilis, it tends to be moms not getting any prenatal care at all.”
The Health Alert warned that up to 40% of babies born to mothers with untreated syphilis will be stillborn or die in infancy and said all pregnant mothers in Missouri should be screened for the disease.
Syphilis hot spots in Missouri, risk factors
“A lot of the hot spots that we have been most concerned about over the past year have been in rural southern Missouri, although there have been hot spots or areas of concern elsewhere across the state,” Hampton said.
Hampton called these areas “vulnerable counties,” which are counties that are more susceptible to blood borne infection outbreaks and overdose deaths.
“Historically, we would see syphilis among men that had sex with men in metropolitan areas and urban areas, but really, during COVID and since, we’ve seen that demographic shift more towards rural areas and people using substances including injecting methamphetamine,” Hampton said.
Hampton said anyone who is having sex is at risk for any STD, including syphilis.
“I think that while we had specific population groups we had historically seen contracting and being tested for syphilis, that’s changing right now, so I think that anyone and everyone should be tested at least once … and if you have regular risk, also having regular testing,” Hampton said.
The CDC says the only sure way to prevent syphilis is sexual abstinence. Other methods include using condoms correctly and being in a long-term and mutually monogamous relationship with a partner who does not have syphilis.
Getting tested and treated
An interactive map of STD testing sites in Missouri can be found here.
Additionally, several options for STD testing are available in the Boone County area. Costs may vary by location, depending on health insurance coverage and other factors.
City of Columbia offers testing for gonorrhea, chlamydia, syphilis and HIV. Testing for Boone County residents and those with student IDs for Columbia College, Stephens College, MACC and MU costs $20. For non-residents, testing costs $40.
Quest, which has several locations in Columbia, offers syphilis testing for $49. This lab offers testing for other STDs as well, all of which can be bought online.
Discovered on: 2023-04-03 18:30:00
Source: What you should know about syphilis cases rising in Missouri | News
