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Missouri sees steep rise in syphilis cases, especially among women and babies

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Treponema pallidum bacterium

This photomicrograph depicts a Treponema pallidum bacterium, which is the causative agent of syphilis. 

ST. LOUIS — Missouri has seen a steep increase in syphilis cases, including a form that is passed to newborns, which can have devastating consequences.

Cases of the sexually transmitted disease have been on the rise since 2015, and cases of congenital syphilis in babies have been especially troublesome since 2019, data shows.

Missouri’s increase in syphilis cases was initially observed among men who have sex with men, but cases have recently increased in other groups, including heterosexual women, according to a recent statewide health notice.

“While the initial increase in cases occurred primarily in the Kansas City and St. Louis metropolitan areas, other areas including smaller metropolitan areas and rural counties throughout Missouri are also experiencing a steep increase in cases, particularly among heterosexual women and people who use drugs and their partners,” the notice read.

From 2015 to 2021, the number of syphilis cases in Missouri increased by 259% — going from 554 to 1,989. Between 2019 and 2021, the number of congenital syphilis cases went from 19 to 63 — the highest since 1994.

The rise prompted public health officials with the city of St. Louis and St. Louis County last week to issue a joint warning, urging residents to get tested if they are sexually active.

Testing and treatment are available for free or at low cost at various clinics, including the North Central Community Center at 4000 Jennings Station Road and the Health Stop Testing and Referral Center at 1520 Market Street.

Syphilis can be treated and cured with antibiotics, but many cases go undiagnosed. Initial symptoms include a painless sore or sores around the mouth or near sex organs. A rash, sometimes very faint, can also develop. The signs disappear after a few weeks, but serious health issues can still emerge years later.

If left untreated, syphilis can spread to the brain, nervous system, eyes or ears and result in serious complications. Congenital syphilis can cause premature birth or stillbirth. Babies can also experience physical and neurological disabilities.

In 2021, the city of St. Louis and St. Louis County each reported 11 cases of congenital syphilis for a total of 22. In 2017, the county only saw three cases, and city only saw one, officials say. This correlates with a large increase in syphilis cases among women younger than 40, officials say.

“The rates of syphilis among women of childbearing age are rising faster than any other group — and this has led to the unfortunate rise in congenital syphilis as well,” said city health department director Dr. Matifadza Hlatshwayo Davis.

Davis and Dr. Faisal Khan, the acting director for the county health department, said their goal is to have zero new cases of congenital syphilis.

“A single case of congenital syphilis is heartbreaking because it is completely preventable,” Khan said. “Given the high rates of syphilis in the St. Louis region, I urge all those who are pregnant or considering pregnancy to get themselves and their partners tested immediately.”

Because the St. Louis region is a community with high syphilis rates, federal guidelines recommend all clinicians should screen pregnant patients for syphilis during the first trimester, at 28 weeks gestation and at delivery.

“We are committed to working with our public health and health care partners across the region to increase knowledge, screening, and treatment of syphilis to eliminate congenital syphilis,” Davis said.

The health leaders say their departments are taking action against the rise in cases, including:

• Partnering with local health providers and advocates to form a congenital syphilis review board that will examine every case and find opportunities for prevention.

• Increasing communication efforts aimed at young people, health providers and community groups to increase knowledge about the disease and how to treat it.

• Working with the state to increase the capacity to investigate sexually transmitted infections, improving prompt testing, treatment and notifying sexual partners.

The increasing rates of syphilis and congenital syphilis also mirror nationwide trends, federal data shows. In 2020, Missouri had the 15th highest rate of syphilis cases among states — with a rate of 13.5 compared to a national average of 12.7 per 100,000 people.

The state ranked 17th in congenital syphilis cases — with a rate of 41.6, compared to a national average of 57.3.

Posted at 5:15 p.m. Thursday, July 14.

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