Of all the sexually transmitted infections, syphilis typically falls pretty low on the list of concern. HIV/AIDS, HPV, and drug-resistant gonorrhea grab more headlines than an infection most of us consider a relic of history. You don’t often hear sex ed teachers warning students about a disease believed to have stricken the likes of Vincent Van Gogh and Al Capone.
But syphilis is making a comeback, according to government health officials. The Maine Center for Disease Control and Prevention recently Tweeted about rising rates of the disease in Maine and across the country:
— Maine CDC (@MEPublicHealth) April 7, 2017
Maine recorded 48 cases of the disease in 2016, according to the Maine CDC. That’s a 200 percent jump from 16 cases a decade prior.
While the overall number of cases is relatively small, syphilis was almost unheard of in the United States at the turn of the millennium. Following an outbreak in the early 1990s, the rate again fell to the lowest level since the U.S. began recording it in 1941.
Then in 2002, the outlook changed. Syphilis rates began inching up again, and they continue to rise today.
During 2014-2015, syphilis rates rose in every part of the country, among most age groups, and across almost every race/ethnicity. That’s according to the CDC, which warns about the disease’s resurgence in “Syphilis Strikes Back,” a public health campaign designed to evoke the WPA posters of the 1930s and 40s (but I can’t be the only one reminded of Star Wars.)
Here is one of the original WPA posters, dating to the late 1930s.
Syphilis is divided into three stages of disease, with the primary and secondary stages being the most infectious. In 2015, the U.S. experienced the highest number and rate of reported primary and secondary syphilis cases in more than 20 years, according to the CDC.
While Maine’s rate is likewise on the rise, at 2.1 cases per 100,000 residents in 2015 we rank a respectable 44th in the nation for the prevalence of syphilis.
Rates are higher among men, particularly gay and bisexual men, the CDC reports. But the disease is increasingly afflicting women, both in Maine and nationally.
Researchers haven’t pinned down exactly why syphilis is returning. But men who have sex with men face a combination of factors than can lead to higher levels of STI’s, including barriers to testing such as lack of access to quality health care and stigma, the CDC states.
One CDC epidemiologist told The Atlantic that people might be less vigilant about safe sex now that the threat of HIV/AIDS is less immediate, or that the precautions they are taking aren’t as effective for syphilis. Condoms, for example, reduce the chances of contracting syphilis, but only when they cover the area where the infectious sore has broken out.
Syphilis is easily treated with antibiotics if caught early, but diagnosing the disease can be tricky. Known historically as “the Great Imitator” for its ability to mimic other diseases, syphilis begins as a painless sore where the infection has entered the body, often on the genitals or anus or in the mouth. But it can take up to 90 days after the infection for the sore to appear, so people often don’t know they have it until after they’ve infected others.
In the second stage, a skin rash and other symptoms develop, including a fever, fatigue and sort throat.
Those symptoms disappear in the third, latent stage of the disease. If left untreated, syphilis can reemerge decades after the initial infection, leading to brain and muscle damage, blindness, and even death.
Pregnant woman also can transmit syphilis to their unborn babies, a dangerous situation that can lead to stillbirth. Thankfully, Maine has recorded no cases of congenital syphilis since at least 2011, according to the CDC.