A spike in Northeast Ohio syphilis cases has health officials concerned for moms and babies

Syphilis cases are rising nationally — including some sharp increases in Northeast Ohio. 

According to the Centers for Disease Control and Prevention, syphilis cases rose by nearly 80% across the country over the last five years. In Cuyahoga County, the syphilis rate increased at more than twice that rate — 174%.

Cases doubled last year in a part of Northeast Ohio that includes Ashtabula, Cuyahoga, Geauga, Lake, Lorain and Medina counties.

Dr. David Margolius, director of public health for the city of Cleveland, said cases have been rising in Cleveland ever since 2019.

"We attribute that to a number of things. Syphilis testing is not a routine test and it's not easy, so it's not top of mind for a lot of our standard guidelines for testing," he said.

It's also tougher than some sexually transmitted diseases to detect and diagnose.

"With gonorrhea and chlamydia, you can just pee in a cup and get a positive or negative test," Margolius said. "But with syphilis, a lot of times it needs to be a blood test, followed by another blood test. And then even then, it's difficult to interpret."

Cleveland recorded 466 syphilis cases in 2022, a 4.3% increase from the previous year. Of those cases, 75.6% were male and the highest concentrations of cases were in the Cudell and Kinsman neighborhoods.

Margolius said the department of public health is also facing a problem where people test positive for a test, but not coming back for treatment, which involves three weekly penicillin shots.

Neighborhood Family Practice, a medical provider located primarily on Cleveland’s West Side, also reported seeing more cases of the once-rare disease.  

Brittani Flory, a registered nurse at Neighborhood Family Practice, said doctors should be ordering more sexually transmitted disease tests for their patients.

“We just need to screen more, because I think there's some missed opportunities across the way, and I think that in healthcare in general, folks need to be more comfortable talking about sex," Flory said.

Flory added education about safe sex practices can go a long way toward prevention, if doctors are able to make time for it during their appointments. 

The spike in cases also has health officials concerned for pregnant women and their unborn babies. Syphilis during pregnancy can lead to stillbirth, miscarriage, infant death and maternal and infant morbidity, according to the CDC.

Last year, 14 babies were born with congenital syphilis in Cuyahoga County and seven were born with the illness in Summit County. Two stillbirths were reported in Northeast Ohio due to syphilis in the last two years.

Flory said there needs to be more syphilis screenings of mothers beyond the first prenatal visit. 

“It's still treatable in that third trimester," she explained. "We can still stop developing problems that might happen. One congenital syphilis case is too many.” 

Nearly half of expectant mothers in Cuyahoga County had their first prenatal care visit in the first trimester, but a majority of them did not receive repeat testing for syphilis at 28 to 32 weeks' gestation.

Syphilis is a sexually transmitted disease that can cause serious health issues if left untreated. The infection develops in stages, which can display differing signs and symptoms, according to the CDC.

The U.S. has experienced a steady increase in syphilis incidence since 2000, according to the American Society for Microbiology. Still, a CDC effort to eliminate syphilis ended in December 2013 due to lack of funding and a sharp increase in cases.

The Ohio Department of Health offers a free syphilis in pregnancy line that doctors can call for an expert consultation.