A recent study leveraging real-world data from Truveta offers a promising sign in the fight against syphilis, a preventable and curable sexually transmitted infection (STI) that has been surging across the United States. Published in the American Journal of Preventive Medicine, the study reveals that after reaching its highest incidence since the 1950s in 2022, syphilis cases have finally begun to decline. This downturn is particularly notable among men and young adults, groups that have historically borne a significant burden of the disease.
The study analyzed electronic health records of over 56 million U.S. adults between January 2017 and October 2024, identifying over 21,000 first-time syphilis diagnoses. This extensive dataset allowed researchers to track monthly incidence trends and identify crucial shifts in the demographics of the epidemic.
Key Findings Highlight Shifting Transmission Patterns:
The most encouraging finding is the recent decline in syphilis incidence following the peak in 2022. This decrease is more pronounced among men, younger adults, individuals living with HIV, those residing in the Southern United States, and individuals identifying as Black. This suggests that public health efforts may be gaining traction in these traditionally higher-burden populations.
However, the study also reveals concerning trends before this recent decline. Between 2017 and 2022, syphilis incidence saw a substantial increase, more than tripling among women and American Indian/Alaska Native individuals, and more than doubling among those without recognized STI risk behaviors, such as PrEP use or a history of other STIs. This emphasizes the dynamic nature of the epidemic and the urgent need for precisely targeted interventions for populations that may not perceive themselves as being at high risk.
Dr. Duy Do, the lead author of the study and a principal applied research scientist at Truveta Research, emphasized the complexity of the situation. “What’s striking is that we observed a shift in trends over time. Overall, it’s encouraging that we’ve seen a decline in syphilis incidence in the past two years. However, prior to that decline, between 2017 and 2022, we found a significant increase in incidence within lower-burden populations – women and those without behaviors associated with STI acquisition, PrEP use, or HIV. So, it’s a complex picture: an encouraging recent decline, but a worrying earlier increase in a specific group.”
Understanding Syphilis
Syphilis is caused by the bacterium Treponema pallidum and progresses through distinct stages if left untreated. Recognizing the symptoms at each stage is crucial for early diagnosis and preventing severe complications.
Symptoms of Syphilis
- Primary Syphilis: The first sign is typically a painless sore called a chancre that appears at the site of infection (genitals, anus, rectum, mouth) usually within 10 to 90 days after exposure. The chancre will heal on its own within a few weeks, even without treatment, but the infection remains.
- Secondary Syphilis: If primary syphilis is not treated, secondary syphilis can develop within a few weeks to months. Symptoms can include a non-itchy rash that may appear anywhere on the body, including the palms of the hands and soles of the feet. Other symptoms may include fever, fatigue, sore throat, swollen lymph nodes, headache, and patchy hair loss. These symptoms will also eventually resolve on their own, but again, the infection persists.
- Latent Syphilis: This stage occurs after the symptoms of secondary syphilis disappear. There are no visible signs or symptoms, and this stage can last for years. However, the infection remains in the body and can still be transmitted during early latency.
- Tertiary (Late) Syphilis: If left untreated for many years, syphilis can progress to this severe stage, affecting various organ systems, including the brain, nerves, eyes, heart, blood vessels, bones, and joints. Tertiary syphilis can lead to serious complications such as neurosyphilis (brain and nerve damage), cardiovascular syphilis (heart and blood vessel problems), blindness, deafness, paralysis, and even death.
When to See a Doctor
It is crucial to see a doctor if you notice any of the following:
Early detection and treatment are essential to prevent the long-term complications of syphilis. Don’t hesitate to seek medical attention if you have any concerns.
Treatment of Syphilis
Syphilis is effectively treated with antibiotics, typically penicillin. The specific dosage and duration of treatment depend on the stage of the infection. Early syphilis (primary, secondary, and early latent) is usually treated with a single injection of penicillin. Late latent syphilis and tertiary syphilis may require multiple doses.
It is crucial to complete the entire course of antibiotics as prescribed by your doctor. Follow-up blood tests are necessary to ensure that the treatment has been successful. It’s also important to inform your sexual partners so they can get tested and treated if necessary, preventing further transmission.
Prevention Methods
The most effective ways to prevent syphilis and other STIs include:
- Practicing safe sex: Use latex or polyurethane condoms consistently and correctly every time you have vaginal, anal, or oral sex.
- Limiting the number of sexual partners: Having fewer partners reduces your risk of exposure to STIs.
- Getting tested regularly: If you are sexually active, talk to your doctor about regular STI testing, especially if you have new or multiple partners.
- Mutual monogamy with a tested partner: Being in a long-term, mutually monogamous relationship with a partner who has been tested and does not have an STI eliminates the risk of transmission.
- Open communication with partners: Talk openly and honestly with your sexual partners about your sexual health history and STI testing.
Conclusion
The findings from the Truveta study offer a hopeful sign that public health efforts may be starting to curb the decades-long rise in syphilis cases. However, the earlier increase in incidence among certain populations underscores the need for continued vigilance and targeted interventions. By understanding the symptoms of syphilis, knowing when to seek medical attention, adhering to treatment guidelines, and practicing effective prevention methods, you can play a crucial role in controlling this preventable and treatable infection and safeguarding your health and the health of your community.
