US syphilis rates soar: 10 states where they're highest

More than 207,000 syphilis cases were reported in the U.S. in 2022, the greatest number of cases since 1950 and an 80% jump since 2018, the CDC said in its annual report on sexually transmitted infection trends. 

Included in this total are more than 3,700 babies who were born with syphilis in 2022, "reflecting an alarming 937% increase in the past decade," the agency said. While rates of primary and secondary syphilis — the earliest and most infectious stages of the disease — increased across all age groups, among both men and women, and in all regions of the country, the data pointed to persistent health disparities among racial and ethnic minorities. 

For instance, 31% of all cases of chlamydia, gonorrhea, and primary and secondary syphilis reported in 2022 were among those who are Black or African American, even though they made up less than 13% of the country's population.  

"There are no shortcuts, and we have to meet people where they are," Lauren Bauchmann, MD, acting director of the CDC's division of STD prevention, said in a statement. "Some people face tremendous barriers to STI prevention and services. So, the most important work is often outside the clinic, whether it be reaching out out to communities with testing, interviewing patients to offer services to their partners, or delivering treatment directly to someone." 

Surging syphilis cases are a critical public health crisis in the U.S., HHS said in a Jan. 30 news release announcing new actions to curb the epidemic. So far this year, the FDA has allowed the temporary importation of a syphilis drug as the standard antibiotic used has been in short supply since last April. HHS also said it will develop considerations for point-of-care testing in areas with the greatest need and plans for testing, treatment services and STI counseling. 

"I have hope for innovative prevention tools — such as a pill after sex that prevents STIs, and better tests for syphilis — but they will only be successful if they reach the people who will benefit," Jonathan Mermin, MD, director of the CDC's National Center for HIV, viral hepatitis, STD and TB prevention, said in an HHS news release. "And that is going to require coordinated and sustained efforts at the federal, state, and local levels."

Below are 10 states with the highest rates of primary and secondary syphilis reported in 2022: 


South Dakota: 84.3 per 100,000 population

Cases in 2022: 767


New Mexico: 36.0

Cases: 761


Arkansas: 32.9

Cases: 1,001


Oklahoma: 31.8

Cases: 1,278


Mississippi: 31.1

Cases: 913


Arizona: 29.2

Cases: 2,151


Montana: 28.9

Cases: 325


Nevada: 28.4 

Cases: 902


Louisiana: 26.7

Cases: 1,225


Oregon: 26.3

Cases: 1,117 

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