Syphilis cases surge in Houston

Syphilis is surging in the Houston area, and the city's public health department is treating the disease as an emergent outbreak issue.

State of play: Syphilis cases in Texas have climbed, mirroring a national trend of cases rising to their highest levels since the 1950s , per federal data.

• Texas had 246.8 cases of congenital syphilis — when the infection passes from mother to child — per 100,000 births in 2022, the fourth-highest rate in the country.

Context: The nation's long-running rise in syphilis cases worsened in 2022 and rates of other sexually transmitted infections remained elevated as the COVID-19 pandemic further strained public health programs, Axios' Jason Millman reports .

By the numbers: In 2022, about 207,000 cases of syphilis were reported nationally, an increase of 17% from 2021, according to an annual Centers for Disease Control and Prevention report.

• Nearly 6 in 10 cases were reported in just five states: Texas, California, Arizona, Florida and Louisiana, per the CDC.
• In the Houston and Harris County area, women accounted for 674 cases in 2022, up from 295 cases in 2019, per the Houston Health Department.

Zoom in: The health department has been waiving all clinical fees for sexually transmitted infections at its health centers since it declared the outbreak in July and has expanded its HIV/STD mobile clinic.

• Since July, the four health centers have conducted more than 7,000 screenings, per Marlene McNeese-Ward, bureau chief of HIV/STD and Viral Hepatitis at the health department.

Threat level: There were 3,755 cases of congenital syphilis in 2022 nationally, resulting in 282 stillbirths and infant deaths from a disease that is typically preventable with early detection and treatment.

• In Houston, congenital syphilis soared from 16 cases in 2016 to 151 cases in 2021, per the department.
• Of note: Syphilis often goes undetected because the signs and symptoms are misinterpreted or go unnoticed.

There has been a push from the health department and UTHealth to educate health care providers and mothers to test for syphilis during prenatal screening.

• McNeese-Ward said many providers were previously unaware of the guidance around treating and testing for syphilis.
• "That's been the most encouraging part of our response so far, because the more we engage providers, the more they have begun to recognize, 'Oh, OK. This is the work that we need to ensure that we intensify and follow the guidance that's out there,'" McNeese-Ward says.

The bottom line: Irene Stafford, a maternal-fetal medicine physician at UTHealth Houston, recommends that people get tested for STIs regularly and that if someone is pregnant, they should self-advocate to get tested.

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