Syphilis cases have quadrupled on Long Island in the United States, a worrying sign for public health

Syphilis cases have quadrupled on Long Island in the United States, a worrying sign for public health

Syphilis rates are rising sharply on Long Island and across the country, causing severe illness in thousands of people across the country and leading to a growing number of infant deaths.

Experts say syphilis was treatable 80 years ago, and the spread of the bacterial disease reflects underfunding in the public health system, decreased condom use, and a lack of testing.

“We don’t do a good job of screening people, even people who we think are at risk for syphilis,” says Dr. Khalil Ghanem, a professor of medicine at Johns Hopkins University in Baltimore and a former president of the American Institute. The Sexually Transmitted Diseases Association told Newsday.

The number of Long Island residents newly diagnosed with early syphilis, when the disease is most contagious, more than quadrupled between 2011 and 2021, from 118 to 508, according to state health department data.

what do you know

  • Number reported early Syphilis cases on Long Island more than quadrupled between 2011 and 2021, to more than 500, reflecting national and statewide trends.
  • Number of neonatal syphilis cases Cases increased 10-fold between 2012 and 2022, with more than 7% of the 3,761 cases in 2022 resulting in death, federal data showed.
  • Children who survived syphilis He may go blind, deaf, or develop other problems. Thousands of older adults with syphilis are diagnosed with serious medical complications each year.

Nationally, nearly 177,000 cases of syphilis were newly reported in 2021, the most recent year available, compared with about 46,000 cases in 2011.

Ghanem said these numbers are likely to be significantly underestimated due to undiagnosed cases.

Federal and state statistics show that rates of sexually transmitted diseases, such as gonorrhea and chlamydia, which are more prevalent than syphilis and can cause infertility in women, are rising, although less rapidly than syphilis.

More than a third of syphilis cases nationally are among gay and bisexual men, and rates are much higher among blacks and Native Americans than among whites, Latinos and Asians, according to the Centers for Disease Control and Prevention.

“It’s here on Long Island, it’s here in the city, and if you’re sexually active, it’s something that should be screened for,” said Diane Brosseau, clinical laboratory director for the Belmore-based PFY Group, which is part of the Belmore-based LGBTQ group. Long Island Crisis Center offers free syphilis testing.

High national rates among newborns

CDC data show that men are more likely to contract syphilis than women, but rates are rising more quickly among women. This has led to a 10-fold increase in cases of syphilis in newborns across the country, from 335 cases in 2012 to 3,761 cases in 2022, according to a report released by the Centers for Disease Control and Prevention on November 7. Of those 3,761 cases, known as congenital syphilis, Of these, 282 resulted in stillbirths or infant deaths, compared to 18 in 2012. The disease can also cause low birth weight, blindness, deafness, delayed growth and bone deformities in children.

The CDC found that lack of timely testing and appropriate treatment were factors in nearly 90% of 2022 congenital syphilis cases. Nearly 38% of mothers did not receive prenatal care.

The CDC says treatment with benzathine penicillin G is up to 98% effective in preventing congenital syphilis.

“It’s a matter of timely identification, and then it’s a matter of appropriate treatment,” said Dr. Sharon Nachman, chief of pediatric infectious diseases at Stony Brook Hospital.

She said that if the disease is discovered too late during pregnancy, even with treatment there is a risk of transmission to the baby.

A nationwide shortage of benzathine penicillin may exacerbate the increase in rates of birth defects, though most hospitals in New York have guidelines for reserving use of the drug for pregnant women, Nachman said.

New York State requires syphilis testing during the first prenatal checkup, and at birth. A new law that takes effect in May requires additional testing at weeks 28 to 32 of pregnancy, due to the possibility of syphilis infection after the first test.

The new requirement may help prevent some cases of congenital syphilis, said Martine Hackett, chief of population health and director of public health programs at Hofstra University.

Martine Hackett, Director of Public Health Programs at Hofstra Credit: Johnny Milano/Johnny Milano

But she said: “If pregnant women don’t go to antenatal care, the new testing schedules won’t be enough… These are people who are disconnected from the health care system.”

New Yorkers are more likely to have access to prenatal care than many other states, due to broader Medicaid coverage, which may be why rates of syphilis among newborns are higher. It’s lower in New York, Hackett said.

New York’s 2021 congenital syphilis rate — 19.5 per 100,000 live births — is nearly four times lower than the national rate, although the state is slightly higher than the national rate for primary and early secondary syphilis.

Nassau and Suffolk each had one case of congenital syphilis in 2021; There are 41 statewide, up from 29 in 2020, state data show.

Cutting federal funding for syphilis

Amid rising rates of syphilis, federal funding to combat the disease is being cut. As part of debt ceiling negotiations in June, Congress eliminated $400 million of $1 billion to hire additional staff for the STD program. This led some states to cut their STD budgets, although spokespeople for the New York, Nassau and Suffolk health departments said their STD budgets had not been reduced and that health care workers were still… They look for partners of those who have tested positive for the disease and inform them.

Hackett said cutting STD allocations “suggests there is no urgent need” for STD control and may reflect the stigma surrounding STDs, making it politically easier to cut funding.

Over the past two decades, federal funding for STDs has been cut by 40%, taking into account inflation, said Elizabeth Finley, spokeswoman for the National Coalition of STD Directors, which represents STD directors in states, territories and cities and is calling for an additional $1 billion. Funding for sexually transmitted diseases.

Syphilis decreased after penicillin

Syphilis, which may date back thousands of years, was a more common and dangerous disease due to a lack of effective treatment.

Among those believed to have contracted syphilis were Vincent van Gogh, Ludwig van Beethoven, Friedrich Nietzsche, and several royalty, some of whom, like Al Capone, are believed to have died from complications of the disease, according to a history of syphilis published in the magazine. Medicine and life.

Ghanem said that syphilis, if left untreated, can cause blindness, brain damage, strokes, deafness and other serious medical problems, most of which stem from damage to the central nervous system. In 2021, an estimated 5,100 to 8,600 Americans were newly diagnosed with serious nervous system complications due to syphilis, according to a study Ghanem co-authored and published in August in the Journal of Clinical Infectious Diseases.

Syphilis rates declined after penicillin was first used to treat syphilis in 1943, falling from more than 575,000 cases in 1943 to 31,618 cases in 2000.

By the late 1990s, optimism was widespread that syphilis could be eradicated, and in 1999, the federal government issued a plan to eradicate syphilis, Ghanem said.

Then rates began to rise, and in 2013 the government abandoned these efforts.

Reduced condom use is a factor

In addition to reduced funding Condom use due to decreased anxiety about contracting HIV — amid treatments and medications that prevent transmission — contributes to higher rates of syphilis, Broyso said.

Some people who used condoms for birth control no longer do so because of increased use of birth control methods such as IUDs, which the Affordable Care Act now requires insurance coverage, Finley said.

Increased use of injection drugs It may also be a factor, she said, because syphilis can be spread through needles.

“If you allocate enough money to this problem, syphilis rates will decrease,” Ghanem said.

He added that although an increasing number of children and adults develop serious health complications from syphilis every year, there is still no commitment to do so.

“When we start to believe as a society that these rates are unacceptable, we will have to increase funding for aggressive public health measures to control these infections,” he said.

(tags for translation) Child and Adolescent Health

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