Syphilis, an infection once thought nearly eradicated in the United States, has come roaring back in recent years, including in Maine.
At the Portland Public Health Center’s sexually transmitted disease clinic, Medical Director Dr. Christina DeMatteo said the city has seen an uptick in syphilis and gonorrhea that parallels state and national trends.
“We’re seeing an increase in the number of syphilis cases in Maine,” she said. “While the disease is treatable, it’s easy to miss the signs of infection so regular condom use and screenings are important for anyone who might be at risk.”
According to recent data from the Maine Center for Disease Control and Prevention, 84 cases of syphilis were reported in the state in 2017, up from 48 cases in 2016 and an average of 20 cases in each of the previous five years.
National numbers for 2017 are not yet available from the U.S. CDC, but the trend has been upward for the past several years. Rates are spiking most rapidly among men who have sex with other men, but cases are rising in other populations as well, including older adults who are sexually active.
Syphilis is a bacterial infection transmitted by contact with body fluids during sexual activity. Early symptoms include small, sometimes painless lesions around the anus, genitals or mouth. Later symptoms include body rash, swollen lymph nodes and fever.
Caught early, syphilis responds to penicillin and related antibiotics. Allowed to progress untreated, syphilis can cause serious illness, including damage to the heart, brain and other organs.
In 2016, there were 27,814 syphilis cases reported nationally, an increase of nearly 18 percent over 2015. That year, the number of reported cases was 23,872 and the U.S. CDC called for ramped-up interventions to reverse the trend.
Other sexually transmitted diseases, or STDs, are on the rise as well, including chlamydia, gonorrhea and hepatitis C. But, while the absolute number of syphilis cases is relatively small, its rapid spike has outpaced them all in Maine and the nation.
“Nationally, STD numbers are rising and Maine is unfortunately following that trend,” Emily Spencer, a spokeswoman for the Maine Department of Health and Human Services, which oversees the Maine CDC, said in an email Tuesday.
Newborn syphilis cases have shot up in the United States in recent years, so an expert panel is reaffirming the need to screen all pregnant women for the infection.
Syphilis is a sexually transmitted disease that can be passed from pregnant women to their babies -- in what doctors call congenital syphilis. Since 2012, U.S. government figures show, congenital syphilis has nearly doubled.
In 2016, 628 cases of congenital syphilis were reported -- the highest rate since 1998.
If a pregnant woman has the infection and it goes untreated, her baby can be born dead, deaf or blind, or with nerve damage or bone deformities, according to the U.S. Centers for Disease Control and Prevention.
The increase in congenital syphilis came after syphilis cases rose among women, the agency said.
Experts have long advised syphilis screening for all pregnant women, ideally at their first prenatal care visit. If a woman has the infection, antibiotic treatment is very effective at preventing newborn syphilis.
"It's easily detected, and it's easily treated," said Dr. Chien-Wen Tseng, an associate professor at the University of Hawaii School of Medicine. "So there's really no reason that rates of congenital syphilis should be going up."
Tseng is a member of a U.S. Preventive Services Task Force panel that is issuing new recommendations on prenatal syphilis screening. The task force is an independent panel of medical experts, funded by the U.S. government, that reviews research evidence and makes recommendations on preventive health care.
There is nothing new in the latest recommendations: They reaffirm the task force's 2009 advice, that all pregnant women be screened for syphilis.
But now there is even more urgency to get the word out, Tseng said.
Syphilis cases, overall, have been on the rise for years. According to the CDC, there were nearly 9 cases per 100,000 Americans in 2016 -- the highest rate since 1993. The majority of those infections were among gay men, but the rate among women has been increasing, too.
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