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These public health posters, produced as part of the Federal Art Project, encouraged the detection of syphilis during the Great Depression. The collection of national data on syphilis began in 1941. In the 1940s, the rate was as high as 450 cases per 100,000 inhabitants.
These public health posters, produced as part of the Federal Art Project, encouraged the detection of syphilis during the Great Depression. The collection of national data on syphilis began in 1941. In the 1940s, the rate was as high as 450 cases per 100,000 inhabitants.
WPA Illinois Art Project
Once on track to eradicate syphilis, the U. S. reversed course and cases of infectious diseases increased.
From a low of fewer than 32,000 cases in 2000, the number of people with syphilis has risen to more than 207,000 in 2022, the U. S. Centers for Disease Control and Prevention reported in January. U. S. That’s 62 cases per additional 100,000 people.
The crisis is hitting pregnant women and young children particularly hard. The maternal rate of pregnancies with syphilis fell from 87 per 100,000 births in 2016 to 280 per 100,000 births in 2022, the CDC reported Feb. 13. Without treatment, pregnant women can die from a syphilitic infection in the fetus. This can cause congenital syphilis and lead to miscarriages, stillbirth, premature birth, severe fitness disorders after birth, or death of the baby. More than 3,700 young children were born with syphilis in 2022, about ten times the number in 2012.
Testing is a very important step in finding cases. Syphilis is “the big contender,” says Allison Agwu, a physician and researcher of pediatric and adult infectious diseases at Johns Hopkins School of Medicine. “It can look like a lot of other things. ” The disease goes through several stages, with symptoms that are not unusual in other situations and without any symptoms.
People can get checkups (usually with a blood test) through their number one health care provider or at a public fitness clinic or urgent care center, for example. With syphilis rates so high, Agwu would like to see syphilis screenings removed from the stigma and made it less difficult to talk about it as part of a normal checkup. “If you’ve ever been sexually active, you’re tested for syphilis,” he says.
Science News spoke with Agwu about the current cases and what needs to be done better to prevent syphilis. The interview has been edited for length and clarity.
SN: What are some of the factors driving syphilis cases in the United States?
Agwu: It’s multifactorial. Syphilis is asymptomatic, so other people can have it for years without knowing it; They didn’t notice the symptoms when she was symptomatic. We have an entire public health infrastructure imploding with reduced access and investment. The effect is amplified in communities that have less access to start start and rely on clinics or places where investment is withdrawn. There’s a stigma. There have been shortages of medicines.
The infrastructure [built] to control syphilis, which nearly eliminated the disease a few decades ago, has collapsed. We are in a scenario where there is an accumulation of syphilis and, therefore, also of congenital syphilis.
SN: Where is there a shortage of syphilis tests?
Agwu: I’ve been running in the infectious disease field for a long time. We had an 80-year-old woman come in and she was either neurosyphilis [a complication of syphilis that affects the brain and nervous system], because I’ve never been treated for a syphilis infection. We deserve all of us to think about syphilis, especially considering the rates we’re seeing. Health care providers deserve to simply monitor people.
There are tests early in pregnancy. If a client is diagnosed with syphilis, she deserves to be treated during pregnancy. This is one of the times when it is surely mandatory to treat it to avoid transmission to the baby. I think part of the challenge with syphilis in pregnancy (in fact, all sexually transmitted infections during pregnancy) is that there are other people that society considers sexual beings and others that we don’t. I’ve talked to pregnant women who say, well, I’ve done my tests, but there’s been no discussion about how I can still be negative. So I think we could overlook the recommendation to remain negative.
We’ve had scenarios where the baby arrives and the mother or father giving birth to the baby hasn’t received any prenatal care. [In this case] we verify the time of delivery.
The maternal syphilis rate, explained as the number of live births to women with syphilis consistent with 100,000 live births, increased for all teams from 2016 to 2022. The largest increase (783%) occurred among American Indian and Alaska Native women who gave birth.
SN: What do you want to do about syphilis cases?
Agwu: It’s education and scaring people, but simply: here’s what you can have and the other tactics to get it, and here’s how you can check it, here’s where you can check it.
We want to normalize sexuality and sexual exploration, not defame them. We want to remove the stigma of the diagnosis so that other people are more likely to tell their partner, so they can also get tested and treated. Instead of asking them to attend that they want to undergo more tests, how about simply testing other people?Instead of creating stigma, well, do you want to get tested again?Recognize that other people are sexual beings, even when they are pregnant.
COVID-19 has highlighted the disruptions we had in our public fitness infrastructure. We want to think about how we can offer sexual fitness care and offer testing, prevention, and treatment, all in a way that is presented in a positive light. Bring it out of the darkness.
Syphilis, caused by the bacterium Treponema pallidum, is described in terms of stages.
At first, the only sign is one or more sores in the position where the user was infected, such as on the penis, around the vagina, on the anus, or in the mouth. The wounds are painless and last 3 to six weeks. During this second stage, other people may have a rash, headache, fever, muscle aches, or fatigue.
Once those symptoms subside, a user can remain asymptomatic for years. But other people progress to a fourth, potentially life-threatening level that damages many organs, including the brain, nerves and heart.
The guideline for asymptomatic adolescents and adults is to monitor those who have been sexually active and are at increased risk, including others with HIV or other sexually transmitted infections and men who have sex with men. Pregnant women should have checkups. for syphilis as soon as possible, preferably at your first prenatal visit.
Syphilis is treated with an injection of a special form of penicillin. There has been a shortage of this drug, which is the only effective remedy during pregnancy. People who are not pregnant can also take doxycycline, an oral antibiotic, to treat themselves.
E. C. W. Grégory and D. M. Ély. Trends and characteristics of maternal syphilis in pregnancy: United States, 2016-2022. National Center for Health Statistics fact sheet. Published February 13, 2024. es I: 10. 15620/cdc:145590.
R. McDonald et al. Vital Signs: Missed Opportunities to Prevent Congenital Syphilis — United States, 2022. Weekly morbidity and mortality report. Vol. 72, November 17, 2023, p. 1269. It’s what I do: 10. 15585/mmwr. mm7246e1.
Y. N. Alfonso et al. U. S. Public HealthU. S. Underserved: Stagnant or declining spending has left states ill-equipped to respond to COVID-19. Health issues. Vol. 40, April 2021, p. 664. Es what I do: 10. 1377/hlthaff. 2020. 01084.
Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance, 2004, September 2005.
Aimee Cunningham is the biomedical writer. She holds a master’s degree in science journalism from New York University.
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