Topline
The Houston Health Department announced a 128% increase in syphilis among women and a “nine-fold rise” in congenital syphilis cases — when a mother passes the infection to her baby during pregnancy — and experts warn women may be confusing the disease’s symptoms with other more common, less deadly illnesses.
A photo of downtown Houston.
Key Facts
New infections increased by 57% from 2019 to 2022 in Houston and surrounding Harris County areas—there were 674 cases in women in 2022, 295 in 2019, according to a statement by the health department.
Congenital syphilis cases rose from 16 reports in 2016 to 151 in 2021, according to the release.
To address the outbreak, the health department is waiving all fees for STI treatment at medical clinics, expanding screening options and focusing on high risk areas.
Congenital syphilis happens when a mother with syphilis passes the infection to her baby during pregnancy in the womb—if left untreated, congenital syphilis can lead to miscarriage, prematurity or stillbirth.
Early screening and treatment of mothers during prenatal care can completely prevent transmission to babies, the U.S. Department of Health and Human Services reports.
When caught early on, syphilis is easily curable with one shot of penicillin, while late stage syphilis requires one shot of penicillin each week over the course of three weeks, the American Academy of Dermatology Association reports.
Big Number
176,713. That’s how many cases of syphilis at all stages—including congenital syphilis—were reported nationwide in 2021, according to the Centers for Disease Control and Prevention. Out of those cases, 2,855 were congenital syphilis, including 220 related stillbirths.
Key Background
Syphilis is a sexually transmitted infection (STI) spread through either oral, vaginal or anal sexual contact with an infected person, according to the Cleveland Clinic. Because the disease is caused by a bacteria, it’s treated with antibiotics and if left untreated, can lead to nerve damage, brain damage, heart damage and eye damage. There are four stages of syphilis if left untreated, according to a study published in the British Medical Journal. Primary syphilis occurs between nine and 90 days after infection and looks like a painless lesion at the site of contact. The sore may go away on its own after a few weeks or months, but this doesn’t mean the infection has gone away. Secondary syphilis happens four to eight weeks after primary syphilis is left untreated. It presents as a rough, bumpy rash that can cover the entire body, but doesn’t typically itch. The rash may be accompanied by a fever, swollen lymph nodes, muscle ache and fatigue. Latent syphilis is asymptomatic, though some people may experience flare ups. This stage can last up to 20 years and cause heart, bone, nerve and organ damage. Most people don’t progress past latent syphilis, but about 20% develop late syphilis, which can cause serious health problems, like heart disease, seizures, dementia, brain damage, vision problems and muscle diseases. The best way to prevent syphilis is to either abstain from sex or get tested regularly and practice safe sex, like using condoms, which lowers the risk of catching STI.
Tangent
Texas isn’t the first state this year that’s seen syphilis cases increase. The Minnesota Department of Health reported a 45% increase in congenital syphilis cases and North Carolina saw a 31% rise in congenital syphilis cases and a 133% spike in cases among women. According to CDC data, cases of congenital syphilis in the South grew 432% between 2016 and 2021. A study published in Archives of Sexual Behavior found heterosexual and bisexual women report higher numbers of STIs than their lesbian counterparts, and gay and bisexual men had higher rates than heterosexual men. The University of Washington School of Medicine reports women are more likely to be asymptomatic and when they appear, STI symptoms typically emulate other issues in women, like yeast infections or bacterial vaginosis, so it’s more difficult to catch. There aren’t typically dire consequences for men when certain STIs, like chlamydia, are left untreated, though other STIs like syphilis and HIV can lead to severe problems. Women can develop issues like pelvic inflammatory disease, cancer and pregnancy complications, with the school listing congenital syphilis as “the worst potential pregnancy-related risk.”
Surprising Fact
Syphilis was nearly eradicated in 2000, as over 80% of the nation’s counties were syphilis free. Syphilis rates declined to 2.1 cases per 100,000. Cases rose in 2001 for the first time since 1990 and have steadily risen since. Edward Hook, director of the STD Control Program for the Jefferson County Department of Health told Time the reason for the resurgence was due to stigma surrounding health and a lack of public health investment in the U.S. According to nonprofit the Commonwealth Fund, public health clinics rely more on funds from Medicare and Medicaid than federal grants.