The incidence of syphilis is rising rapidly on Long Island and across the country, causing severe illness in thousands of people across the country and leading to an increase in infant deaths.
Syphilis has been treatable for 80 years, and experts say the spread of the bacterial disease reflects an underfunded public health system, declining condom use and a lack of testing.
Dr. Khalil Ghanem, professor of medicine at Johns Hopkins University in Baltimore and immediate past president of the American Football Club, said, “We continue to screen people, even if they seem to be at high risk of contracting syphilis.” It’s not going well.” The Sexually Transmitted Disease Association told Newsday.
The number of Long Islanders newly diagnosed with early syphilis during the disease’s most contagious period more than quadrupled from 118 to 508 between 2011 and 2021, according to state health department data. increased to
What you need to know
- Early reported numbers The number of syphilis cases on Long Island more than quadrupled between 2011 and 2021, to more than 500, reflecting national and statewide trends.
- Number of neonatal syphilis cases The number of infections increased tenfold between 2012 and 2022, with more than 7% of the 3,761 people infected in 2022 dying, according to federal data.
- baby surviving syphilis You may become blind, deaf, or experience other problems. Every year, thousands of elderly people with syphilis are diagnosed with serious complications.
Nationally, there were nearly 177,000 new cases of syphilis reported in 2021, the most recent year available, compared to about 46,000 in 2011.
Ghanem said these numbers are likely to be a significant underestimate because of undiagnosed cases.
Rates of sexually transmitted diseases gonorrhea and chlamydia, which are more prevalent than syphilis and can make women infertile, are also rising, although not as much as syphilis, according to federal and state statistics.
More than one-third of syphilis cases nationwide are among gay and bisexual men, and the prevalence is much higher among blacks and Native Americans than among whites, Latinos, and Asians. according to Centers for Disease Control and Prevention.
“It’s here on Long Island, it’s here in the city. If you’re sexually active, you should be tested,” said Diane Brusseau, clinical laboratory director for the Bellmore-based LGBTQ group PFY. he says. The Long Island Crisis Center offers free syphilis testing.
Neonatal morbidity rate rising nationwide
Men are more likely to be infected with syphilis than women, but the incidence of syphilis is increasing more rapidly in women. CDC data is shown. As a result, the number of neonatal syphilis cases nationwide increased tenfold, from 335 in 2012 to 3,761 in 2022. CDC report An article published on November 7 states: Of these, 3,761 cases are known as congenital syphilis. 282 cases resulted in stillbirth or infant death. compared to 18 In 2012. This disease may also cause Low birth weight, blindness, hearing loss, growth retardation, and bone deformities in babies.
The CDC found that lack of timely testing and appropriate treatment will be a contributing factor in nearly 90% of congenital syphilis cases in 2022. Almost 38% of biological mothers did not receive prenatal care.
According to the CDC, treatment with benzathine penicillin G is up to 98% effective in preventing congenital syphilis.
“Timely identification is an issue, and then appropriate treatment becomes an issue,” said Dr. Sharon Nachman, director of pediatric infectious diseases at Stony Brook Medicine.
If the disease is detected late in pregnancy, there is a risk of transmitting it to the baby, even with treatment, he said.
Nachman said most hospitals in New York state will reserve the use of benzathine penicillin for pregnant women, although the national shortage of benzathine penicillin could make the increase in congenital rates even worse. He said he has established guidelines.
New York State requires syphilis testing at the first prenatal exam and at the time of delivery. new law The law, which takes effect in May, will require additional testing between 28 and 32 weeks of pregnancy, as it is possible to contract syphilis after the first test.
Martin Hackett, dean of population health and public health program director at Hofstra University, said the new requirements could help prevent some cases of congenital syphilis.
Martin Hackett, Hofstra Public Health Program Director. Credit: Johnny Milano/Johnny Milano
But, she added, “these new testing schedules will not be enough if pregnant people are not receiving prenatal care…These people are being cut off from the health care system.” said.
Because of broader Medicaid coverage, New Yorkers are more likely to receive prenatal care than in many other states, which may be the reason for newborn syphilis prevalence That percentage is lower in New York, Hackett said.
new york 2021 rates Although the rate of congenital syphilis (19.5 per 100,000 live births) is nearly one-fourth lower than the national rate, The condition is slightly better National prevalence of early primary and secondary syphilis.
Nassau and Suffolk each had one case of congenital syphilis in 2021. There were 41 cases statewide, up from 29 in 2020, according to state data.
Federal Syphilis Funding Reductions
Federal funding to combat syphilis is being cut as infection rates rise. As part of debt ceiling negotiations in June, Congress canceled $400 million of the $1 billion to hire additional STD program staff. This has led some states to cut their STD budgets, but spokespeople for health departments in New York, Nassau, and Suffolk said their STD budgets have not been cut and health care workers have It said it is still searching for people who have tested positive for sexually transmitted diseases and notifying their partners.
Mr Hackett said the cut in funding for sexually transmitted diseases “demonstrates a lack of urgency” to fight sexually transmitted diseases, could reflect stigma against sexually transmitted diseases and could be a politically funded move. He said that reductions are becoming easier.
Elizabeth Finley, a spokeswoman for the National Federation of Sexually Transmitted Disease Officers, which represents state, territory and city sexually transmitted disease chiefs, said federal STD funding had been cut by 40% over the past 20 years to account for inflation. The company said it is seeking an additional $1 billion in funding. STD funding.
Penicillin administration dramatically reduces syphilis
Syphilis may date back thousands of years, but it was once a much more common and dangerous disease because there was no effective treatment.
Vincent van Gogh, Ludwig van Beethoven, Friedrich Nietzsche and various other kings are thought to have contracted syphilis and, like Al Capone, are thought to have died from complications of syphilis. There are some people. According to the history of syphilis Published in the Journal of Medicine and Life.
If left untreated, syphilis can lead to blindness, brain damage, stroke, hearing loss and other serious medical problems, most of which result from damage to the central nervous system, Ghanem said. . An estimated 5,100 to 8,600 Americans will be newly diagnosed with serious neurological complications from syphilis in 2021, according to a study co-authored by Ghanem and published in Clinical Infectious Diseases in August. .
The incidence of syphilis has fallen sharply. Since penicillin was first used to treat syphilis in 1943, the number of cases has fallen from more than 575,000 in 1943 to 31,618 in 2000.
Ghanem said there was widespread optimism that syphilis could be eradicated by the late 1990s, and in 1999 the federal government announced the plan To eliminate syphilis.
Interest rates then began to rise, and in 2013 the government gave up trying.
This is due to a decrease in condom usage.
In addition to decreased funding, Brussaux said that with treatments and medications available to prevent HIV infection, less concern about HIV infection and condom use are contributing to the rise in syphilis rates.
Additionally, some people who used to use condoms for contraception no longer do so due to increased use of contraceptive methods such as IUDs, which are now required to be covered by insurance under the Affordable Care Act. Finley said.
Increased use of injection drugs Syphilis can be spread through needles, so that could also be a factor, she said.
Ghanem said syphilis rates would go down “if we put enough money into this problem.”
But efforts to do so have yet to be made, he said, even though the number of infants and adults who develop serious health complications from syphilis is increasing every year.
“Once we begin to believe as a society that this infection rate is unacceptable, we will have to increase funding for aggressive public health measures to control this infection,” he said.
