New syphilis cases more than doubled in Missouri from 2015 to 2021.
The 259% increase is dramatic, but not surprising. State and local health departments were concerned in 2019 after they saw spikes year after year. That year, Kansas City, Missouri, health officials announced a 71% increase from 2018.
Since 2019, the number of recorded cases across all of Jackson County has increased by an additional 15%.
An advisory from the Missouri Department of Health and Human Services sent to health care providers noted that cases were increasing across multiple groups — gay, bisexual, and other men who have sex with men; people who use drugs; and heterosexual men and women.
The same trends are playing out in Kansas — where the number of syphilis diagnoses between 2012 and 2021 increased 450% in Wyandotte County and 640% in Johnson County — and nationwide.
Syphilis is a sexually transmitted disease that, when left untreated, can cause severe complications for adults and newborn babies of infected mothers.
Initial symptoms of syphilis include a sore or rash that goes away after a few weeks, even without treatment. But severe health issues may emerge later without proper care with antibiotics, which can cure the disease.
However, many cases go undiagnosed and untreated, which can be especially concerning for those who are pregnant — the Missouri DHSS noted a significant increase in the number of congenital syphilis cases reported to health officials.
Congenital syphilis occurs when a parent passes the untreated infection on to their baby during pregnancy. This type of syphilis may cause miscarriages, premature births, stillbirths, or the death of newborn babies.
Babies born with congenital syphilis often experience serious health complications at birth or throughout life.
What's causing the rapid rise of syphilis?
Ashley Wegner, the health planning and policy chief for Clay County, said overwhelmed health systems and the stresses of the pandemic made things worse.
Syphilis cases recorded in Clay County nearly quadrupled from 25 cases in 2015 to 93 last year.
"Poor mental health and lack of access to resources fuel an increase in sexually transmitted infections," Wegner said. "There's this trifecta of poor mental health and then substance use and then increased risky sexual behavior. All of that is this perfect storm to an increase overall in infection rates."
Wegner also noted federal assistance for syphilis testing and treatment has generally fallen short.
In 1999, the U.S. Centers for Disease Control and Prevention requested $35 million to $39 million in federal funds to eliminate syphilis. But the federal government gave the agency less than half that. As cases rose and elimination became less feasible, the CDC moved the goalposts to focus on eliminating just congenital syphilis.
From 2015 to 2020, the CDC's budget for preventing STIs increased by 2.2%, but with inflation, that's actually a funding cut of 7.4%.
How to treat — and avoid — syphilis
State and local governments usually have minimal funding to address testing and treating syphilis. However, Clay County offers services beyond what those funds traditionally allow. Wegner said the Clay County Public Health Center has a fully functioning clinic that offers testing and treatment, including for people without insurance.
Wegner said they do see clients seeking services from outside Clay County.
For those especially at risk — men who have sex with men and those ages 15 to 24 — experts recommend wearing a condom and decreasing the number of anonymous sexual partners to reduce the chance of infection.
Because of the syphilis increase among women, the Kansas Department of Health and Environment recommends three screenings for syphilis during pregnancy, spokesman Matt Lara said in an email — specifically at a patient's first prenatal visit, at 28 weeks and at or just prior to delivery.
At-home tests are available for purchase online or at some pharmacies. Usually, the tests ask for a small blood sample from a finger prick. Some more thorough tests may require urine or swab samples.
For those looking for a more cost-effective route to testing, the Kansas City Health Department's Sexual Health Clinic offers free testing for STDs and provides treatment if needed, also free of charge.
The Unified Government Public Health Department also provides sexually transmitted infection counseling, testing and treatment by appointment only. To make an appointment, call (913) 573-8855.
Johnson County residents can seek treatment through the county health department, which offers STD testing and treatment at the Olathe and Mission sites on a walk-in basis.
A variety of Kansas City community-based clinics also offer low-cost testing, including Planned Parenthood.
