PRO/EDR> Syphilis – USA (11): (AL) increasing cases, 2022


A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases

Date: Thu 8 Jun 2023
Source: [edited]

Alabama — specifically Montgomery County — has a syphilis problem.
The Alabama Department of Public Health [ADPH] this month [June 2023] issued new data on STDs in each Alabama county for 2022
[]. The state
saw an overall decline in all sexually transmitted diseases that year
[2022], but syphilis bucked that trend. There was a 40% increase in
syphilis cases from 2021 to 2022, and ADPH’s report
[] was topped with a graphic urging people to help “stop the rise of

Syphilis cases more than doubled in Montgomery County — home of the
state’s capital. [Data listed in this news article are the total case
counts for primary & secondary, early latent and late latent stages of
the syphilis. However, ADPH reports the cases counts for each of these
stages of syphilis stratified by county and the years, 2020, 2021, and
2022 at
– Mod.ML]. Overall numbers are relatively small — there were 421
reported cases in Montgomery County last year [2022]. But that’s a
huge increase from the 204 cases it saw the previous year [2021], and
an outsized percentage of the state’s overall caseload

Montgomery’s cases accounted for more than 14% of the state’s 2926
total syphilis cases in 2022. For reference, the county accounts for
less than 5% of the state’s population. In terms of raw case counts,
Montgomery trailed only Jefferson County, which is the most populous
county and home to nearly 3 times as many people as Montgomery.

In 2021, the last year data was available from the Centers for Disease
Control and Prevention, the United States saw the worst year for
syphilis since 1950
[]. There were
5.3 cases for every 10 000 people in the nation that year [1950]. In
2022, Montgomery County saw nearly 19 cases per 10 000 people.

But Montgomery County isn’t the only place where syphilis cases are on
the rise. In fact, several Alabama counties saw even faster increases
[]. Overall, 46 of the state’s
67 counties reported more syphilis cases in 2022 than in 2021.
Seventeen of those counties saw cases at least double, with a handful
of smaller counties seeing fivefold increases. DeKalb, Fayette and
Monroe counties each saw 400% increases in their syphilis case counts,
though the total number of cases in all those counties was small.

According to the CDC, syphilis occurs in several stages. Data listed
here counts all stages of the disease in Alabama. Syphilis is a
serious disease if untreated, and cause significant problems. You can
read more about the disease at

Even as syphilis cases rose in Alabama in 2022, the rate for other
leading STDs fell. Statewide, cases of gonorrhea fell by 18%, and
cases of chlamydia — by far the most common STD in Alabama — fell by

And just as Montgomery led the state in syphilis rate, it also led for
both of those other common STDs. And it wasn’t particularly close
[]. There were
113 cases of chlamydia per 10 000 residents in Montgomery County in
2022. That was about 8 in 10 000 more than No. 2 on the list,
neighboring Lowndes County. Similarly, Montgomery saw nearly 60 cases
of gonorrhea per 10 000 residents last year [2022], about 15 cases per
10 000 more than No. 2 Jefferson County — home to Birmingham. Even
with the high case counts, chlamydia and gonorrhea cases were actually
down in Montgomery in 2022 compared to the previous year [2021].

[Byline: Ramsey Archibald]

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