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The Goodman Institute Health Blog

An Old Scourge is Back (several actually)

Posted on January 30, 2024 by Devon Herrick

Syphilis infections are soaring in the United States. Once thought to be nearly eradicated, it’s making a huge comeback, according to The New York Times:

More than 207,000 cases were diagnosed in 2022, the last year for which data are available. That represents an 80 percent increase since 2018, and 17 percent over the previous year’s tally, according to a new C.D.C. report.

Syphilis, once nearly eliminated in the United States, continues to resurge, reaching the highest rate of new infections recorded since 1950, the Centers for Disease Control and Prevention said on Tuesday.

Syphilis was the scourge of Europe in the early 16th Century. The French invaded Naples in 1495 and the army brought it back to France and from there it spread across Europe. The origins are debated but there is little agreement on the source. A common hypothesis is that sailors brought syphilis back from Christopher Columbus’ voyage to the New World. In the first part of the 16th Century syphilis was considered a “French disease,” although European countries all blamed it on each other. By some estimates it was the first sexually transmitted disease that was known as such, and it came with moral implications and stigma. According to t he History of Syphilis in Wikipedia:

Syphilis was the first “new” disease to be discovered after the invention of printing. News of it spread quickly and widely, and documentation is abundant. For the time, it was “front page news” that was widely known among the literate. It is also the first disease to be widely recognized as a sexually transmitted disease, and it was taken as indicative of the moral state (sexual behavior) of the peoples in which it was found.

Syphilis still bears a stigma, and in the United States it’s not necessarily found where one might expect. The states where syphilis is skyrocketing tend to be less cosmopolitan and poorer than other states. Native Americans have the highest rates of infection.

With more than 84 cases per 100,000 people, South Dakota had the highest rate of syphilis infections, more than double that in New Mexico, the state with the next highest incidence. (Arkansas, Oklahoma and Mississippi rounded out the top five.)

By the way, chlamydia is by far the most common sexually transmitted disease, while rates of gonorrhea have also risen but are relatively low. If you blame syphilis’ rise on an inadequate health care system keep in mind infections are also climbing in countries with national health services.

Syphilis has been increasing even in countries with national health care, because “sexual health services remain inadequate relative to the need pretty much everywhere,” said Dr. Jay Varma, chief medical officer at Siga Technologies and a former deputy commissioner of health for New York City.

“But it’s particularly a problem here in the United States,” Dr. Varma said.

“When you miss one case, you then end up with two more cases, and if you miss two cases, you then end up with four,” he added. “That’s how epidemics grow.”

There are no at home tests for syphilis yet. That may change in the next several years. Also, 86% of cases are identified outside of sexual health clinics (I didn’t realize they still existed). This is yet another example of numerous other old diseases that are on the rise in the U.S. These include leprosy, malaria, bubonic plague, measles, mumps, scarlet fever, tuberculosis.

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For many years, our health care blog was the only free enterprise health policy blog on the internet. Then, when the NCPA closed its doors, the health blog stopped as well.

During this five-year hiatus no one else has come forward to claim the space. So, my colleagues and I have decided to restart the blog in connection with the Goodman Institute. We invite you and others to use this forum to share your views.

John C. Goodman,

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