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Review
. 2015 Feb;13(2):161-8.
doi: 10.1586/14787210.2015.990384. Epub 2014 Dec 9.

Syphilis in the United States: on the rise?

Thomas A Peterman  1 , John Su, Kyle T Bernstein, Hillard Weinstock
Affiliations
Review

Syphilis in the United States: on the rise?

Thomas A Peterman et al. Expert Rev Anti Infect Ther. 2015 Feb.

Abstract

Syphilis rates and trends vary by population subgroup. Among men who have sex with men (MSM), rates of primary and secondary (P&S) syphilis are high throughout the USA (228.8 per 100,000 in 2013). P&S syphilis among women is much less common (0.9 per 100,000 in 2013) and occurs in isolated outbreaks plus in a few counties with persistent low levels of infection. Congenital syphilis trends closely follow P&S trends among women. These trends have implications for prevention. Routine screening among MSM can prevent tertiary syphilis, but despite interventions, rates of infection continue to rise among MSM and will soon approach those last seen in 1982 (estimate: 340.7 per 100,000). Control of syphilis among women is possible and important because it often leads to congenital syphilis. Outbreaks among heterosexuals can be halted by intensive screening, treatment and partner notification.

Keywords: congenital syphilis; epidemiology; men who have sex with men; prevention; surveillance; syphilis.

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Figures

1a.
1a.
Primary and secondary syphilis cases per 100,000 population, by sex, and the male:female rate ratio, United States, 1963–2013.
1 b.
1 b.
Estimated cases of Primary and Secondary Syphilis among men who have sex with men (MSM), men who have sex with women only (MSW), and women, United States, 1963–2013.
1 c.
1 c.
Estimated annual rate of primary and secondary syphilis among men who have sex with men (MSM), men who have sex with women only (MSW), and women, United States, 1963–2013. The curves for MSW and women overlap.
2.
2.
Women with primary and secondary syphilis and cases of congenital syphilis, by year, United States, 1995–2012.
3.
3.
Rates of primary and secondary among men and women, per 100,000, in the United States and select U.S. counties, 2003–2013 (with total number of cases). Scale varies.
4.
4.
Rates of primary and secondary among men and women, per 100,000, in select U.S. counties, 2003–2013 (with total number of cases). Scale varies.
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