Syphilis cases are making a comeback in some communities across the country, largely driven by the heroin and methamphetamine epidemic as users trade sex for drugs, officials reported.

In Oklahoma City, 199 cases of the sexually transmitted disease have been connected to the drug epidemic this year. About half the patients are white and female, the New York Times reported.

In Philadelphia, which has seen a 36 percent increase in 2016, the disease is far more prevalent than in Oklahoma City, but is found mostly in gay and bisexual men.

"We've seen an increase in syphilis infections in Philly, but the demographics that we're seeing don't match up with what Oklahoma City is purported to be," said James Garrow, Philadelphia Department of Public Health spokesman.

Oklahoma has seen one of the fastest-growing outbreaks in the country, including three cases in a juvenile detention center.

In February, a prison inmate tested positive for the disease, which helped health investigators pinpoint the cause of the fast-spreading outbreak. He listed 24 sex partners, including girls passed around by gangs in exchange for heroin or methamphetamine, the New York Times reports.

Although syphilis mostly afflicts gay and bisexual men, rates among white women and their infants are rising. Nearly five times as many babies across the country are born with syphilis as with HIV, the Times reported.

There are four stages of the disease — primary, secondary, latent, and tertiary. The first symptom is usually an ulcer that appears 10 days to three months after exposure to the infected partner's ulcer. A skin rash marks the secondary stage. Over time the disease can cause heart damage, mental disorders, blindness, other neurological problems, and death, according to the Pennsylvania Department of Health.

Nationally in 2000 and 2001, there were 2.1 cases per 100,000 population of reported primary and secondary syphilis cases. That number rose 19 percent to 7.5 cases per 100,000 population during 2014-15, the highest since 1994, the Centers for Disease Control and Prevention reported.

Philadelphia's rate of 20.5 per 100,000 residents in 2015, the most recent year that numbers are available nationally, was nearly triple the U.S. average. Manhattan's was 50 percent higher, and many cities in the South were far higher than that. Oklahoma, on the other hand, had a rate of 12.1 cases per 100,000.