Syphilis cases in Salt Lake County are rising — mostly among women

The ‘alarming’ increase is consistent with national trends, and heightens the risk of newborns being born with the disease, according to the county’s health department.

(Centers for Disease Control and Prevention) A darkfield micrograph of the bacterium that cause syphilis.

Salt Lake County women are being diagnosed with syphilis at “alarming” rates, the county’s health department announced Thursday.

From 2018 to 2022, the county saw an 800% increase in syphilis cases among women, multiplying from 3 cases in 2018 to 27 last year, said epidemiology supervisor Lynn Beltran. This year, that number is expected to double.

About 90% of those cases between 2018 and 2022 were in women ages 15-44, considered child-bearing age. That increase could exacerbate the risk of babies born with the disease, the department said.

Indeed, in 2022, the health department saw its first case of newborn syphilis since 2008, executive director Dr. Angela Dunn said in a news release.

“Newborn syphilis is especially unfortunate because it’s completely preventable,” she said. “We can keep newborns from suffering by ensuring women have affordable, convenient access to syphilis testing and treatment, as well as appropriate prenatal care.”

Beltran said the county has seen four more babies born with congenital syphilis since the initial case in 2022.

That increase aligns with national figures. The Centers for Disease Control and Prevention announced Tuesday that 3,761 babies were born with congenital syphilis in the United States in 2022, up from 335 in 2012.

Dr. Debra Houry, the CDC’s chief medical officer, said in a statement that cases have “skyrocketed at a heartbreaking rate.” The center said this increase can be attributed to mothers not getting the testing or treatment they need early in a pregnancy. Federal officials have formed a task force to address the problem.

“We’re calling on healthcare providers, public health systems, and communities to take additional steps to connect mothers and babies with the care they need,” Houry said.

Salt Lake County also saw increases in the general rate of syphilis cases. Between 2018 and 2022, the number of cases increased from 199 to 268, Beltran said. She said the department has already reported around 320 cases in 2023, and expects that number to rise to near 400 by year’s end.

In the past, most of the county’s syphilis cases were men, primarily men who have sex with men, but more recently epidemiologists have seen more cases in women and in the heterosexual population — “which is something that we had not been seeing for decades,” Beltran said.

Beltran said the county saw an “unprecedented” case earlier this week, when a woman — who has “virtually no risk factors, other than she is sexually active” — was diagnosed with syphilis.

Beltran added that the county has not seen many late-stage cases of syphilis in adults. Instead, they are seeing the biggest increase in early-stage cases, which means people have been recently infected and the disease is circulating.

Strangely, she said, some of these early-stage cases have caused damage that one might expect to see in longterm cases, and it’s unclear why.

Syphilis spreads via a spiral-shaped bacterium known as a spirochete. A person with syphilis may develop lesions or sores at the exposure site, typically around the genitals or mouth, according to the CDC.

When someone comes in contact with those sores, the spirochete can bore like a drill through intact skin and infect that person — and the spirochetes keep burrowing through the body, including into the brain and through the placental barrier to infect a fetus.

That damage can cause irreversible neurological problems and can lead to death if left untreated, according to the CDC. While the bacterium can be eradicated with antibiotics, damage from the spirochetes may not be reversible, especially if the person has been infected for a long time.

“The biggest concern of all,” Beltran said, is that babies born with the disease have worse outcomes than adults, even with treatment.

Many such babies are stillborn, born premature or with a low birth weight, or die soon after birth. A mother with syphilis carrying a baby may also have a miscarriage, the CDC said.

Beltran said using a condom during sex can help decrease risk of contracting the disease, as well as not sharing used needles. Providers should also screen all pregnant people — not just those with risk factors — for syphilis early in the pregnancy, and begin treatment if needed.

Those who have sex with multiple or anonymous partners should be tested regularly, according to the health department. That could mean every 3, 6 or 12 months, depending on number of partners and other risk factors.