STATE: Syphilis cases rise in North Carolina, especially in women, babies

RALEIGH — Syphilis cases in North Carolina are on the rise, increasing 23% from 2021 to 2022, the North Carolina Department of Health and Human Services reported Wednesday as part of Sexually Transmitted Infection Awareness Week.

The increase is attributed to several factors, including partners not being tested for STIs prior to sexual encounters and lack of condom use. There are several strategies to reduce your risk for syphilis, such as being in a monogamous relationship, getting tested regularly, knowing the sexual activities of your partners and properly using condoms. Using one or several of these strategies can reduce your risk.

Cases among women jumped from 360 in 2019 to 837 in 2022, a 133% increase, according to preliminary data. This increase in syphilis infections among women is also causing an increase in syphilis in babies, called congenital syphilis (CS). Congenital syphilis increased 31% in 2022 (55 cases) compared with 2021 (42 cases). In 2012, there was one reported case of congenital syphilis.

“Congenital syphilis is preventable through the early detection and treatment of maternal infection during pregnancy,” said Victoria Mobley, M.D., HIV/STD medical director at the NCDHHS Division of Public Health. “Providers can prevent congenital syphilis, and the potential effects such as miscarriage and stillbirth, by testing at three points during pregnancy and providing timely treatment.”

North Carolina public health law requires health care providers to screen all pregnant women for syphilis during the first prenatal visit, between 28-30 weeks’ gestation and at delivery to ensure identification, treatment and prevention of congenital syphilis.

“The good news is that sexually transmitted infections are preventable,” said Evelyn Foust, NCDHHS Division of Public Health’s Communicable Disease Branch Chief. “We need to empower ourselves to learn about them, how to talk about them, when to test for them and where to go for care and treatment — and what better time to have conversations than during STI Awareness Week.”

Whole person health care includes sexual health care, and North Carolina residents can take charge of their sexual health by talking with their provider about what testing and care is right for them. People having unprotected sex or sex with partners whose STI status is unknown should contact their health care providers to schedule regular testing.

During the pandemic, many people delayed regular STI testing. NCDHHS continued to reach out throughout the pandemic to people who tested positive for syphilis to help ensure access to treatment for them and their partners. To find nearby, free STD testing sites, visit Medicaid expansion will give more people coverage for routine testing and treatment.

For more information on syphilis, visit the NCDHHS website. And to learn more about how public health reaches out to individuals who may have been exposed to an STI or other communicable diseases visit