The number of syphilis infections almost doubled in 2020 compared to the previous year, according to the Allegheny County Health Department.
Data released by the health department last week show there were 140 new syphilis cases in 2020. In 2019 there were just 71.
Rates of sexually transmitted infections have been increasing both locally and nationally prior to Covid-19. The health department’s Valerie Stallworth said she had anticipated numbers would continue to go up due to the pandemic.
Though it's unclear why Allegheny County’s syphilis rate nearly doubled, while the state’s increased by just 2% from 522 in 2019 to 535 in 2020. These numbers exclude Philadelphia.
“It is concerning because syphilis drives HIV,” said Stallworth, who runs the county’s HIV/STD program.
Syphilis increases a person’s risk of contracting other STIs. When Stallworth presented the data during September's board of health meeting, she noted that men who have sex with men are at heightened risk of contracting the infection. This is borne out in the data, as 133 of the county’s 140 early-stage syphilis cases reported in 2020 were among men. In 2019, men comprised 69 of the 71 cases.
There are also racial disparities in these county data, with African Americans being six times more likely to acquire Syphilis, compared to whites. Similar disparities are seen in HIV, gonorrhea, and chlamydia rates.
Stallworth said that she was concerned about what this increase in syphilis means for women, since an infection can greatly impact fetal development and result in serious health issues. These include deformities, developmental delays, blindness and stillbirth. However, there were no reported congenital cases of syphilis among Allegheny County newborns in 2020, which Stallworth said was “really lucky.”
Clinicians have also taken note of this rise in syphilis. UPMC’s Dr. Harold Wiesenfeld said he’s now getting almost daily calls from other physicians seeking guidance for how to manage this STI.
“Many physicians have gone years without seeing a case of syphilis...and are unsure how to treat the individuals,” said Wiesenfeld, who specializes in the treatment of reproductive infectious
Syphilis can be cured with antibiotics. The same is true for gonorrhea, which also saw a moderate increase in 2020. Though gonorrhea tends to be more antibiotic resistant.
Wiesenfeld isn’t sure why there’s been such a pronounced increase in syphilis but he thinks the strain the coronavirus placed on public health agencies might be partly to blame. Contact tracers were consumed with tracking the spread of Covid-19, and might not have had time for other diseases.
“Adequate funding is desperately needed in order to ensure that we provide good STD-related clinical services to the population,” he said.
One medical provider that has not seen as dramatic an increase in syphilis cases is the East Liberty-based Allies for Health + Wellbeing. In fact, the STI testing and education center reported a “mild drop” of positive syphilis tests in 2020. Though the clinic’s chief operating officer Mary Bockovich said this might be the result of a scaling back of services due to Covid.
“We did do less testing as a result of the pandemic,” said Bockovich, who noted that walk-in testing was suspended for more than a year. Also Allies staff stopped providing testing services to a number of organizations, such as emergency housing shelters or in-patient addiction treatment centers.
Like Stallworth, Bocokovich said she’s wary that the increase in syphilis might result in an increase in HIV.
“I’m hopeful that it won’t,” she said. “But given the significant rise... we’re going to see the long-term impacts, because not everyone is going to get treated.”
Additionally, late stage syphilis can result in organ failure and dementia. While the disease can still be treated at this point, the damage to the body cannot.
However, Bockovich said that the county’s data are fairly new. It may be a couple years before the consequences of this rise in syphilis are fully realized.
