The Covid-19 pandemic has required measures to prevent transmission such as washing hands, wearing masks and social distancing. These measures have typically reduced the transmission of infectious diseases such as the sexually transmitted disease (STD) chlamydia. However, this was not the case with syphilis.
The 2020 Sexually Transmitted Disease Surveillance document recently released by the US Centers for Disease Control and Prevention (CDC) illustrates the impact of the Covid-19 pandemic on common sexually transmitted diseases such as chlamydia, gonorrhea and syphilis. Despite Covid-19 and associated disease prevention measures, the number of syphilis cases in the US increased from 2019 to 2020, and the trend has continued into last year. GlobalData epidemiologists expect cases to continue to rise in the US unless major public health measures are imposed.
Syphilis is caused by the spirochete Treponema pallidum and is transmitted either through sexual contact or from mother to baby (congenital). Case numbers in the US fell dramatically after the introduction of penicillin treatment in the 1940s and 1950s, but are now rising again. Almost 100,000 diagnosed cases of syphilis were forecast for 2020, according to epidemiologists at GlobalData, but recent data suggests those estimates have been exceeded.
The CDC STD 2020 Surveillance found that there were 133,945 diagnosed cases of syphilis in the US in 2020, a 3.3% increase from 2019. This was primarily due to increases in primary and secondary syphilis in women (20.5%) and men (4.0%). ). Case numbers were lower from April to July 2020 than the same months in 2019, but by August 2020 cases had surpassed those of 2019 and the trend continued almost uninterrupted through December.
The increasing burden of syphilis in women is leading to an increase in congenital syphilis. With 2,138 cases reported, congenital syphilis cases increased by 14.6% from 2019 to 2020, while cases in women aged 15-44 increased by 24.1%. This increase is part of a trend: From 2011 to 2020, cases of congenital syphilis increased by 500%, according to the CDC. Infant mortality and stillbirths attributable to congenital syphilis increased from 130 in 2019 to 149 in 2020, while cases of symptomatic syphilis in infants increased from 711 in 2019 to 791 in 2020.
This increase in congenital syphilis is due in large part to a lack of prenatal screening. A growing number of women in the United States are not receiving adequate prenatal care, and this problem has been exacerbated by disruptions in testing and treatment due to the Covid-19 pandemic.
Preliminary data from the CDC suggests this trend of rising cases will continue. Cases of primary and secondary syphilis increased by 36.2% in women and 8.7% in men from 2020 to 2021. Data from March this year showed that 2,268 cases of congenital syphilis were reported in 2021, surpassing the 2020 case count. This has resulted in 166 infant deaths and stillbirths attributed to congenital syphilis.
Major public health efforts are needed to stem this increase. Educational programs must be implemented that emphasize condom use and other safer sex practices. Improved access to STD screening, treatments, and barrier protection can also help reduce transmission.