Tacy Grant, a nurse practitioner at Allegro Obstetrics and Gynecology in Columbus, has witnessed the effects of the nationwide rise in syphilis personally.
Just in the patients she screens, Grant said, she has probably seen about a 50-60% increase in cases over the last few years. But that screening is crucial to helping patients get the treatment they need before the disease develops.
“Initially, there’s not a lot of symptoms,” Grant said. “You may have a sore anywhere on your body, especially like your genital areas and your palms. But usually, there’s not a lot of early symptoms. Later syphilis, you start having neurological symptoms.”
Syphilis is a bacterial infection that is spread through sexual activity. It is a preventable and curable disease, typically treated with rounds of antibiotics like penicillin, according to a press release from the University of Mississippi.
But while the disease tends to start out with mild symptoms, if left untreated, symptoms can become much more serious, including blindness, heart damage, nervous system damage, mental health disorders and brain damage. Congenital syphilis, where the disease is passed from mother to child, can also result in babies being born prematurely and suffering from blindness, developmental delays, skeletal deformities or even death, the release said.
“It is a nationwide epidemic,” Kayla Stover, professor and vice chair of pharmacy practice at the University of Mississippi, said in the press release. “In Mississippi, we’ve seen an 80% increase in overall cases and a 1,000% increase in congenital syphilis.”
Reported syphilis cases are rising nationwide, with an increase of 80% in the United States between 2018 and 2022, according to a 2024 release from the Centers for Disease Control and Prevention. Mississippi ranked fifth in reported primary and secondary syphilis with a rate of 31.1 per 100,000 individuals in 2022, and the state ranked sixth in reported cases of congenital syphilis with a rate of 207.6 per 100,000 live births the same year, according to a 2024 release from the Mississippi Department of Health.
The Golden Triangle has also felt the effects of primary, secondary and congenital syphilis. Provisional numbers available on the MSDH website show Lowndes County went from five cases in 2015 to 25 cases in 2023. Oktibbeha County went from seven cases in 2015 to 21 cases in 2023. Clay County also saw an increase, from five cases in 2018 (the earliest year available) to eight in 2023.
Health department pushes back
Syphilis infection in pregnancy was explicitly added to the list of reportable diseases and conditions in spring 2023, meaning health care providers are now required to report cases to the MSDH by telephone within one business day of first knowledge or suspicion.
At the same time, syphilis testing became mandatory for all pregnant women in the first trimester and again in the third trimester to prevent congenital syphilis.
Kendra Johnson, director for the office of STD/HIV with MSDH, said once the disease is reported, the department notifies the patient’s sexual partners that they may have come in contact with the disease.
Health care providers are also required to verify to MSDH that a patient has obtained treatment, Johnson said. If the patient does not accept treatment from that third-party provider, Johnson said her department will “do what they can” to get them into a county health department clinic for treatment, where they can also get medication to prevent HIV.
“Just depending on what … other needs they have, we’ll go above and beyond,” Johnson said. “But the primary goal is to educate, ensure treatment and reduce the further spread to anyone else.”
Once a patient tests positive during a rapid test for the disease, Grant said, her clinic typically conducts a blood test to confirm the results. After that, she reports the disease to the health department, and she typically sends patients to the county health department clinic for treatment.
Johnson said in the wake of the COVID-19 pandemic, the agency also created a Syphilis Task Force. The task force evaluated its own programs to streamline treatment within MSDH county clinics, including timeliness of reporting, notification processes and screening practices, along with educating medical providers throughout the state on testing and treatment.
Those changes have made a difference, she said. As the statewide STD/HIV program has been working to finalize its 2024 numbers to report to the CDC, she said she has started to see a decrease in syphilis numbers from the year prior.
“It’s a decrease, however, we’re still more than likely will be in one of those top 10 states … when looking at the rates,” Johnson said. “However, we will take any positive that we can. So we know what we’re doing is working. And now we’re looking at what we can adjust.”
Johnson said the biggest challenge her office still faces is stigma, as cultural pressure can make patients hesitate to request testing for sexually transmitted infections. She said her office is working to educate the community as a whole and also working with medical providers, encouraging them to recommend testing.
Grant said she has started recommending more general screening for sexually transmitted diseases to patients, even though insurance providers typically cover yearly testing focused on gonorrhea and chlamydia. Testing more, she said, is part of what has led her to see an increased number of positive syphilis results.
“We’re also trying to be more proactive about safe sexual practices, using condoms,” Grant said.
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Quality, in-depth journalism is essential to a healthy community. The Dispatch brings you the most complete reporting and insightful commentary in the Golden Triangle, but we need your help to continue our efforts. In the past week, our reporters have posted 30 articles to cdispatch.com. Please consider subscribing to our website for only $2.30 per week to help support local journalism and our community.
