Syphilis is spreading in Oregon and the US

By Rolando Hernandez (OPB)
Nov. 22, 2023 12:27 a.m. Updated: Nov. 22, 2023 1:42 a.m.

Syphilis is spreading across the U.S. and Oregon.

Data from the Center for Disease Control and Prevention published earlier this year shows that Oregon ranks the 9th highest state for infection rates.

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Tim Menza, medical director for Oregon Health Authority’s STD/HIV/TB section, says that the change in Oregon has been gradual, but notable.

“Year over year, it has been slowly increasing little by little, and it’s been accelerating,” he said. “In 2022 the rate of syphilis in Oregon is really the highest it’s been in recent history with almost 2,500 cases.”

Syphilis is a sexually transmitted disease that’s been around for centuries. It can also spread to a fetus during pregnancy and can be diagnosed through a blood test, with treatment usually being antibiotics like penicillin.

Symptoms range from a painless ulcer to rashes that can break out all over the body, and these can even go away on their own. This poses a challenge for diagnosing.

According to Menza, doctors who received training during the 90′s and early 2000s can sometimes have trouble identifying the disease because rates were so low then. He says decades ago, some even thought the disease was eradicated.

“They just don’t necessarily recognize the presentation of syphilis,” he said. “It’s also been called the great imitator in that it presents in a wide variety of ways.”

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The state is currently training physicians so they can clinically diagnose the disease more effectively.

Menza says another challenge in addressing the trend is the lack of access or late access to prenatal care and the socioeconomic factors that contribute to the spread of the disease.

“Systemic racism, poverty, housing instability, substance use, mental health, mass incarceration … in general syphilis is really a symptom of the social and economic crises at play in Oregon and in the United States,” he said.

While men account for most infections, over the years the state has seen more cases among women. Studies have also shown more reported cases among heterosexual couples.

When someone who is pregnant is untreated or receives inadequate treatment for syphilis, that can lead to the baby contracting the disease — known as congenital syphilis, which is also on the rise in Oregon and across the nation.

In 2014, there were two reported cases of congenital syphilis in Oregon. Last year there were 37. This year there have been 27 as of early November.

If left untreated, congenital syphilis can lead to developmental issues and can even be fatal.

“Ten percent of babies with syphilis die, the majority are either stillborn and a smaller proportion die within the first year of life. By preventing congenital syphilis, we’re preventing the short and long-term health consequences of syphilis and babies,” he said. “We’re keeping babies alive and we’re ensuring pregnant people and their families don’t have to experience the trauma and sorrow of losing an infant.”

Tim Menza joined OPB’s “Think Out Loud.” You can listen to the full conversation here:

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Syphilis cases are on the rise across Oregon and the US

More than 3,700 babies were born with congenital syphilis in the U.S. last year, the highest count in more than 30 years. We'll hear from OHA on what syphilis currently looks like in Oregon and what's being done to address it.