'Get tested': NC reports dramatic increase in syphilis cases

The 81% increase in syphilis cases statewide from 2019 to 2022 has state health officials encouraging people to get screened for sexually transmitted infections.

Syphilis infections have swelled from 2,135 cases in 2019 to 3,875 cases last year.

Over the same time period, HIV infections have remained flat with 1,386 cases last year. Chlamydia and gonorrhea cases have dropped 14% and 8%, respectively, according to data from the North Carolina Department of Health and Human Services (NCDHHS).

“North Carolina is experiencing an increase in syphilis infections statewide and has been for the last several years,” DHHS said in a statement to WRAL Investigates. “We continue to work to inform clinicians and other people who care for patients about the syphilis increase.”

In Wake County, STIs have increased across the board since 2019. HIV infections have increased 42%, gonorrhea infections have increased 6% and syphilis cases have increased 25%.”

“We want people to get in and treated as quickly as possible,” said Alonza Pamplin, communicable disease supervisor for the Wake County Division of Public Health. “If you are not treated for syphilis you can go years without knowing you have it.”

Pamplin attributes the rise in STI cases to a decrease in condom use, a lack of testing during the pandemic, doctor discomfort in asking about patients’ sexual health and the stigma surrounding screenings.

“When it comes to STIs and HIV there is still a lot of stigma, so people will sometimes shy away from testing,” Pamplin said. “They may adopt the idea that if I can’t see anything or I can’t feel anything then there’s nothing wrong.”

Wake County Public Health offers no-cost STI testing and treatment.

Pamplin encourages parents to have early and frequent conversations with their kids about the risks of unprotected sex and how to find treatment if they are infected.

“If you don’t teach youth how to use condoms [and] about condom use, when they do engage in their first sexual experience then they are not technically going to be able to make an informed decision,” Pamplin said.

In December, NCDHHS sent a Public Health Alert to providers about an increase in female and congenital syphilis.

NCDHHS reports syphilis cases among women increased 538% from 2012 to 2021.

The number of babies born with syphilis increased nearly 200% in recent years, from 19 babies in 2018 to 56 babies last year.

North Carolina public health law requires providers to test pregnant women for syphilis three times: the first prenatal visit, between 28-30 weeks gestation and at delivery.

“There can be irreversible damage along the line if they are not treated in a timely manner,” Pamplin warned.

Health officials recommend people who are sexually active be screen for STIs annually or prior to engaging in sex with a new partner. Pamplin said people with multiple sexual partners should get tested every three to six months and whenever probable symptoms are present.