CDC Responds to Rising Rates of Syphilis by Issuing Call to Action

April was STD Awareness month and the specific focus was on syphilis. It’s no wonder, being that researchers have been seeing steadily increasing rates of the sexually transmitted disease (STD) in recent years. Because of this, the Centers for Disease Control and Prevention (CDC) has issued a Call to Action—sharing with specific at-risk populations and healthcare providers alike what they can do to “stem the tide.”

The rates of primary and secondary syphilis have increased by 19% from 2014 to 2015. The CDC notes that preliminary data is suggesting that there was a “similar rate of increase in the first 6 months of 2016.” Although both men and women are experiencing increased rates of infection, a staggering 90% of all primary and secondary syphilis cases are men. Furthermore, the CDC reports that men who have sex with men (MSM) account for the majority (82%) of male cases.

In their call to action, the CDC shared that “increases in congenital syphilis (CS) have paralleled the national increase in primary and secondary syphilis among women of reproductive age.” In fact, from 2012 to 2015, rates of congenital syphilis increased each year.

Although syphilis can result in several severe—and sometimes deadly—complications, it is arguably easy to prevent and, unlike other diseases such as HIV, with the right treatment, it can be cured. The CDC reports that penicillin, first used to fight syphilis in 1943, remains the best drug available to fight the infection.

New Tools for Syphilis Prevention and Control Are Needed

The good news is the penicillin has remained effective in treating syphilis. The bad news? According to the CDC, “It is the only known antibiotic to treat syphilis during pregnancy. So, for pregnant women with a severe allergy to penicillin, or when there is a drug shortage, there are no alternative treatment regimens to turn to. The rest of our treatment and prevention tools are outdated.”

The CDC also shared that the tests currently available are unable to confirm syphilis “on the spot,” and that, “they require at least two sequential antibody tests in blood, rather than directly detecting the presence of syphilis-causing bacteria.” In addition, the results can be hard to interpret, which can result in a delay in needed treatment. Furthermore, these tests are not able to diagnose the infection in its early stages, underscoring the need for “modernized test development.”

Call for Increased Syphilis Screening for Pregnant Women and MSM

The CDC reports that there has been a “sharp increase in the number of babies born with CS in the United States.” Women who have syphilis and have not been treated can pass the infection on to her fetus through the bloodstream at any syphilis stage. Perhaps more troubling is that 40% of babies born to untreated women who have syphilis are stillborn or die from the infection. According to the CDC, lack of prenatal care accounts for about one quarter of CS cases, but even with this care, “detection and treatment of maternal syphilis often occur too late to prevent CS.” In fact, the CDC reports that almost half, or 42% of women who gave birth to an infant with CS had not been tested in time to prevent it.

Additionally, MSM account for the majority (two thirds) of male primary and secondary syphilis cases. Although the CDC recommends that MSM get tested on an annual basis, oftentimes, they remain unscreened. The CDC reports that from 2011 to 2015, syphilis cases among MSM experienced a sharp increase of 56%, and “in 2015, the rate of syphilis in MSM was 106 times higher than the syphilis rate among men who have sex with only women.” The CDC hopes that with increased screening, the numbers of MSM infected can be reduced.

To this end, the CDC has issued actions to be taken pertaining to the affected populations:

• Pregnant women: Visit your doctor and get tested for syphilis. If you test positive during your pregnancy, make sure you receive treatment immediately. Make sure that you schedule follow-up visits with your doctor to ensure that you and your baby stay healthy.
• Gay, bisexual, and other men who have sex with men: Talk to your doctor about your sexual history and get tested—not only for syphilis but for other sexually transmitted diseases as well. Consider ways to protect yourself and your partner from infection, and remember to always use protection during sexual intercourse.

The call to action also includes information for healthcare providers, public health departments, and decision makers and community leaders on how they can proactively reduce CS and syphilis among MSM. They also called on biomedical students, universities, and industry to channel their efforts into producing new tools that will strengthen syphilis prevention, detection, and treatment. For example, electronic medical record (EMR) developers should make sure that EMRs support syphilis screening and treatment.

The CDC is actively working to cut down on the numbers of infected women and babies and “reverse the increasing trend” of syphilis rates among MSM. Through awareness, collaboration, and action we can “stem the tide of rising syphilis in the United States.”