The combined total of syphilis, gonorrhea, and chlamydia cases reached a record high in the United States for 2018, the Centers for Disease Control and Prevention said Tuesday.
The number of syphilis cases exceeded 115,000, and the number of primary and secondary syphilis cases — the most infectious stages of the disease — reached 35,000, the highest number reported since 1991. That amounts to a national rate of 10.8 cases per 100,000 people.
In Philadelphia, the rate of primary and secondary syphilis cases was more than twice that high, at 26 cases per 100,000 people. Health experts have connected the city’s numbers in part to men who have unprotected sex with men, though the rates in women have climbed lately. Drug use and poverty also are factors.
The city’s rates of gonorrhea and chlamydia also far exceeded the national rates in 2018. Philadelphia’s rate of chlamydia was 1,278 cases per 100,000, more than double the rate of 540 per 100,000 in the U.S. The city’s rate of gonorrhea was 456 per 100,000, compared with 179 cases per 100,000 nationally.
All three diseases can be treated with antibiotics, though some such drugs have started to lose their potency amid overuse.
When sexually transmitted diseases are untreated, they can lead to serious consequences such as infertility, the CDC says.
Syphilis is especially worrisome in pregnant women, as it can lead to miscarriage or newborn death. Even children who survive with congenital syphilis can suffer lifelong physical and neurological complications, such as abnormal bone growth and learning disability, said Judith A. O’Donnell, a professor at the University of Pennsylvania’s Perelman School of Medicine.
“It’s a devastating infection for a newborn,” said O’Donnell, a specialist in infectious diseases.
Nationally, the number of reports of congenital syphilis rose 40% from the year before, to more than 1,300 cases, from which 94 children died.
While the rates of sexually transmitted disease are perennially high in Philadelphia and some other large cities, it is not exclusively an urban problem, O’Donnell said. The diseases are increasingly common in rural areas due to lack of access to health care, she said.