Once Almost Forgotten, Syphilis Is Back

The combined infection rates for a trio of sexually transmitted diseases (STDs)—chlamydia, gonorrhea and syphilis—reached an all-time high in 2018, according to figures released in 2019 by the Centers for Disease Control and Prevention (CDC). The statistics show that cases of all three STDs together soared to 2.4 million in the United States that year, the highest annual figure recorded in this country since the government began keeping comprehensive records in 1991.

Of the three, perhaps most alarming is the rapid resurgence of syphilis. The United States has seen a 14 percent growth in the syphilis infection rate since 1991. So, what’s happening here?

Why is this so serious?

Syphilis is a sexually transmitted disease that often flies below the radar today. It makes sense: Not only is syphilis relatively uncommon and unknown these days, but a terrifying characteristic of the disease is that symptoms often lie dormant for a period of time, sometimes decades.

And that means an infected person can appear to be healthy but actually be an asymptomatic carrier who can unwittingly spread the syphilis disease to new partners for years.

You begin to see the concerns.

Syphilis in stages

Syphilis presents in four distinct stages: primary, secondary, latent and, rarely, tertiary.

Primary stage

The first stage occurs 10 days to three months after exposure. A chancre (pronounced shang-ker), or sore, appears near the spot where you were infected, including the last places you might look, such as actually inside the vagina or anus. This usually painless sore disappears after three to six weeks.

Secondary stage

Two to 10 weeks after the primary stage, secondary syphilis can present with any of these symptoms:

• Skin rash with small, reddish-brown sores
• Sores in the mouth, vagina or anus
• Fever
• Swollen glands
• Weight loss
• Hair loss
• Headaches
• Fatigue
• Muscle aches

Sometimes called “The Great Pretender,” this stage of syphilis can easily be misdiagnosed as many other diseases—and treated unsuccessfully as such—while the real culprit lies under the surface. Since at some point these symptoms may simply disappear, it would be assumed by patient and doctor alike that the ailment is cured.

Latent stage

Not all syphilis sufferers reach this stage, but they can, and all syphilis symptoms disappear. The disease may be dormant for years, though the person remains infected and may infect others.

Tertiary stage

If syphilis is never recognized and is left untreated, the tertiary phase of syphilis generally appears between 10 and 30 years after the initial infection.

While rare for a person to experience this stage, symptoms can be extremely serious at this point, including:

• Neurological problems
• Stroke
• Blindness
• Deafness
• Numbness
• Dementia
• Personality changes
• Aneurysm
• Heart valve disease
• Inflammation of blood vessels

Depending on the organs affected by this final phase of the disease, the effects vary, but tertiary syphilis often leads to fatal results.

Congenital syphilis also on the rise

Not only have more adults become infected with syphilis in recent years, but congenital syphilis rates are up dramatically in the U.S. as well.

Congenital syphilis refers to a pregnant person passing it on to her developing fetus. In Hawaii, for example, health officials have been sounding the alarm on reports that congenital syphilis cases rose each year from 2017-20.

Complications from congenital syphilis can include miscarriage, stillbirth and newborn death. Babies who survive may face lifelong physical and neurological disorders.

Why syphilis, why now?

Plenty of theories have been posed as to why syphilis and other treatable STD infection rates are growing.

Some experts have suggested that the opioid crisis has driven people to lower their inhibitions and have unsafe sex.

One study suggests that since adolescents and younger adults constitute half of the new cases, the increase may at least be partially blamed on reduced funding for sex education programs. The authors point to dire funding cuts to the CDC’s own STD prevention department—a 40 percent reduction since 2003—as well as massive cuts to state programs and the push for abstinence-only sex ed.

The main takeaway is that simply because effective, readily available treatments exist for STDs such as syphilis, people shouldn’t believe they’re free to forgo safe sex and count on antibiotics later. These diseases can have lasting and deadly effects, even after treatment.