Why Syphilis Is Surging Again (and What You Can Do to Stay Safe)
Syphilis, a sexually transmitted infection many people associate with the distant past, is surging again in the United States. Health officials are particularly alarmed by a sharp rise in infections passed from pregnant people to their babies, with the Centers for Disease Control and Prevention (CDC) reporting that congenital syphilis cases are roughly 700% higher nationwide compared with a decade ago. New CDC mapping data highlight where the risk is greatest, but the reality is that no region is untouched.
If you’re feeling surprised—or even a bit scared—you’re not alone. The good news is that syphilis is still preventable and treatable, especially when caught early. This guide breaks down what’s happening, who’s most at risk, how to interpret the CDC’s latest data, and the specific, practical steps you can take to protect yourself, your partners, and your family.
Syphilis Is Back: How Big Is the Problem?
Across the country, health departments are reporting steep increases in syphilis cases, reversing decades of progress. New York, for example, has seen reported syphilis infections increase roughly five-fold since about 2013. Similar trends are being observed in many states, in both urban and rural areas.
- Congenital syphilis (infections in newborns) are up about 700% nationwide compared with a decade ago, according to the CDC.
- Primary and secondary syphilis—the most infectious stages—have risen sharply among adults of multiple age groups.
- Racial and socioeconomic disparities remain stark, with disproportionately high rates among people facing barriers to health care.
“When we see congenital syphilis levels like this, it tells us the system is failing people long before pregnancy—and then again during prenatal care.”
— Hypothetical public health clinician, summarizing current CDC concerns
The rise in congenital syphilis is especially troubling because it almost always reflects missed opportunities—missed testing, missed treatment, or missed follow-up. At the same time, the infection is entirely treatable with antibiotics when identified early, which makes each missed case particularly heartbreaking.
What the CDC Syphilis Map Shows About Where Risk Is Highest
The CDC’s latest syphilis maps highlight counties and states with the highest rates of infection, including congenital syphilis. While specific numbers vary by state, the overall picture is clear: syphilis is no longer limited to a few “hot spots.”
Historically, higher syphilis rates have clustered in:
- Large metropolitan areas with dense sexual networks.
- Southern states, which often have higher rates of many sexually transmitted infections (STIs).
- Communities with limited access to primary care, sexual health clinics, or consistent health insurance.
At the same time, increases are now being reported in smaller cities and rural counties that previously saw relatively few cases. That means you cannot assume that living outside a big city means you’re not at risk.
Why Syphilis Is Rising Again: A Perfect Storm of Factors
No single factor explains the spike. Instead, experts describe a “perfect storm” of social, economic, and health-system issues that together make it easier for syphilis to spread and harder to control.
- Reduced access to sexual health services. Budget cuts, clinic closures, and staffing shortages—especially after the COVID-19 pandemic—have made it harder for many people to get tested and treated promptly.
- Gaps in prenatal care. Not everyone has timely, consistent prenatal visits. Some may not be screened early or repeatedly in pregnancy, which can allow syphilis to go undetected until it affects the baby.
- Rising STI trends overall. Gonorrhea and chlamydia have been increasing too. Often, behaviors and social conditions that fuel one STI also fuel others.
- Stigma and misinformation. Shame, fear of judgment, or outdated beliefs about who “gets” STIs can keep people from seeking care or being honest with partners and clinicians.
- Structural inequities. Poverty, unstable housing, and lack of insurance make it harder to access routine care, testing, and treatment—all of which are crucial for preventing congenital infections.
“If someone can’t easily see a clinician, afford transportation, or take time off work, we shouldn’t be surprised when a fully preventable infection slips through the cracks.”
— Hypothetical infectious disease epidemiologist
Syphilis Basics: How It Spreads and Why Early Detection Matters
Syphilis is caused by a bacterium called Treponema pallidum. It usually spreads through sexual contact (vaginal, anal, or oral sex) when someone has a sore or rash, and it can also pass from a pregnant person to their baby during pregnancy or birth.
- Primary syphilis: Often begins with a painless sore (chancre) on the genitals, anus, mouth, or another exposed area.
- Secondary syphilis: Can cause a rash (sometimes on the palms and soles), fever, swollen glands, and other symptoms.
- Latent syphilis: Shows no symptoms, but the bacteria remain in the body.
- Tertiary syphilis: Years later, untreated syphilis can damage the heart, brain, and other organs.
The encouraging part: syphilis is curable with specific antibiotics (often penicillin). Early detection and treatment can prevent long-term complications and stop transmission to partners and babies.
Congenital Syphilis: Why Rising Rates Are So Concerning
Congenital syphilis occurs when the infection passes from a pregnant person to their baby during pregnancy or delivery. This can lead to miscarriage, stillbirth, prematurity, or severe health problems for the newborn, including bone deformities, neurologic issues, and organ damage.
The CDC’s finding that congenital syphilis has increased by about 700% over a decade is a major warning sign. Almost every case represents a missed opportunity:
- No or delayed prenatal care.
- Missed or incomplete syphilis testing during pregnancy.
- Positive test results that were not followed by timely treatment for the pregnant person and, when needed, the baby.
How to Protect Yourself and Your Partners: Practical Steps
You don’t need to live in fear—but you do deserve accurate information and clear steps you can take. These evidence-based strategies can significantly lower your risk of getting or spreading syphilis.
1. Make routine STI testing part of your health care
- Ask your clinician about a syphilis blood test if you’re sexually active—especially with new or multiple partners.
- People with HIV, men who have sex with men, sex workers, and those with other STIs are often advised to test more frequently.
- Testing is recommended even if you feel fine; remember that syphilis can be silent.
2. Use barrier protection consistently
- Condoms and other barriers (such as dental dams) can reduce the risk of syphilis, especially if they cover the sore or area of contact.
- Because syphilis can be spread from areas not covered by a condom, barrier use is important but not a 100% guarantee.
3. Talk openly with partners
- Share when you were last tested for STIs and what you were tested for.
- Agree on a regular testing schedule if you’re in a non-monogamous relationship.
- Encourage partners to get tested and treated if there’s any concern.
4. Act quickly if you notice symptoms or get exposed
- If you notice an unexplained sore, rash, or flu-like symptoms after a potential exposure, seek care promptly.
- If you’re told a partner has syphilis, get tested and follow your clinician’s advice, even if you feel well.
Extra-Important Steps During Pregnancy
For people who are pregnant—or might become pregnant—the stakes are higher, but so is the potential benefit of early action. Preventing congenital syphilis is very achievable with the right care.
- Start prenatal care as early as possible. Ideally in the first trimester.
- Ask specifically about syphilis testing. It’s often part of standard prenatal labs, but it’s okay to double-check.
- Ask whether repeat testing is recommended. In some states and for people at higher risk, repeat testing later in pregnancy is encouraged.
- Ensure partners are evaluated. If you test positive, your partners should be tested and treated too, to prevent reinfection.
- Keep all follow-up appointments. This helps your care team confirm that treatment worked and that your baby is protected.
Real-World Barriers—and How People Are Overcoming Them
For many people, knowing what to do isn’t the hard part—the barriers are. Transportation, cost, fear, stigma, and past negative experiences with health care can all make it difficult to get tested or treated.
Here are some ways individuals and communities are navigating those challenges:
- Mobile clinics and outreach vans that bring testing directly into neighborhoods.
- Peer navigators who help people schedule appointments, arrange rides, and understand their results.
- Telehealth visits to discuss symptoms and arrange local lab testing without an in-person clinic visit.
- Community education campaigns that frame syphilis as a public health issue—not a moral failing.
“Once I found a clinic where the staff treated me with respect and explained everything clearly, getting tested for STIs became just another part of taking care of myself.”
— Composite story based on common patient experiences
What the Science and Experts Say About Reversing the Trend
Public health agencies, including the CDC, emphasize that reversing the rise in syphilis—especially congenital syphilis—requires both individual actions and system-level changes.
- Scale up testing in primary care, emergency departments, prenatal care, and community clinics.
- Ensure a stable supply of penicillin and other key medications, especially for pregnant patients.
- Invest in contact tracing and partner services to reach people who may not seek care on their own.
- Address underlying inequities that make it harder for some communities to access timely, respectful health care.
None of this guarantees a quick turnaround, and experts are careful not to overpromise. But history shows that sustained, coordinated efforts can bring STI rates down—when testing, treatment, and prevention are widely available and stigma is reduced.
For further reading and current statistics, see:
Moving Forward: Small Steps That Make a Big Difference
Syphilis’s comeback in the U.S.—and the 700% rise in congenital cases—can feel overwhelming. But every test, every honest conversation, and every timely treatment is a real step toward turning the trend around.
You don’t need to change everything overnight. Consider choosing one concrete action you can take this week:
- Schedule an STI check, including syphilis, if it’s been a while.
- Ask your prenatal care provider about your syphilis screening status.
- Share a trusted resource about syphilis with a friend or partner.
Staying informed is not about fear—it’s about empowerment. With accurate information, accessible care, and compassion for ourselves and others, we can protect our health and support the people we care about, even in the face of rising numbers on a map.
