The rate of syphilis cases in the United States hit a historic low at the turn of the millennium, thanks to an emphasis on safe sex during the 1990s.
But the disease is surging again, especially among seniors and newborns. In Virginia, it's worst in Hampton Roads.
“The unsafe sexual practices are increasing, and so this is really why it's not a spike, but it's been a general trend moving up from the 2000s up until now, and it keeps going up,” said Norfolk Health Director Susan Girois.
In 2024, there were 642 reported cases of early syphilis in eastern Virginia and 330 late cases. Syphilis is categorized into four stages depending on how far it’s progressed.
To combat the rising numbers, a regional coalition led by the Virginia Department of Health, Stop Syphilis, will launch next month.
Local providers will offer more syphilis testing, education and treatment through Sentara Health clinics and emergency rooms for sexually active patients and pregnant people.
“I’m 100% convinced we can have zero babies born with syphilis in the next two years, if we all do our part,” Girois said.
The number of congenital syphilis cases has increased across the state since at least 2015, according to data from the Virginia Department of Health. Most of those congenital cases are in Hampton Roads.
“We're seeing it in babies now because it's rising among just the female population of reproductive age,” Girois said.
That usually means the mother wasn’t tested before or during pregnancy, Girois said. Congenital syphilis can cause preterm birth, birth defects or stillbirths.
On the other end of the life cycle, people older than 60 years old are emerging as a driving force in rising syphilis numbers.
“Maybe many are divorced, many are widows and certainly back in having relationships with other people and probably not using safe practices because the risk of pregnancy, for example, isn't there, but (the) risk of STDs is still high,” Girois said.
Dr. Larry Leslie is the Deputy Medical Director of the Emergency Department at Sentara Norfolk General Hospital. He said patients sometimes arrive not always knowing they have syphilis.
“Patients can present in the early stages where they may have a sore or just an ulcer. They may present in more advanced stages where they have a rash,” he said. Sometimes, patients come in for something else and be totally asymptomatic.
Without treatment, syphilis can damage major organs including the heart and brain. It can lead to death.
Treatment for the disease requires an antibiotic, according to a press release from Sentara about the Stop Syphilis Coalition.
Testing is widely available through the Virginia Department of Health city and county offices. For more information, visit the Norfolk Health Department online or the Virginia Health Department.
