Skip to main content

News / Syphilis in Missouri: Prevention, Treatment and Trends

Syphilis in Missouri: Prevention, Treatment and Trends

Published Dec 4, 2024

Dr. Heidi Miller

Syphilis, a complex sexually transmitted disease (STD), is a growing public health concern in Missouri and across the nation. Syphilis cases have increased by 230% from 2016 to 2022 in Missouri, with congenital syphilis cases also rising steeply. However, thanks to robust public health interventions, we are beginning to see a slight decline in cases. 

As the Chief Medical Officer for the Missouri Department of Health and Senior Services (DHSS), I’m sharing insights into this preventable and treatable condition, the trends we’re seeing, and what patients and health care providers need to know. 

What Is Syphilis? 

Syphilis is an STD with potentially serious consequences if left untreated. Early symptoms include a sore or rash that often resolves without intervention, leading some to mistakenly think the problem has resolved. If untreated, syphilis can progress to affect multiple organ systems, including the brain, eyes, liver and heart. 

Key Information Patients Should Know 

  • Syphilis infections have increased multifold over the past decade. 
  • Anyone can get syphilis through sexual contact with a partner who has this infection. Rates have increased for all populations, including heterosexual men and women, as well a gay, bisexual and other men who have sex with men. Likewise, rural and smaller towns in Missouri have seen increases, especially among people who use drugs and their partners. 
  • You can have syphilis and not know it. Although most patients may recall a sore or rash, not all do. And some may erroneously assume that when the sore goes away, the problem is resolved. Simple routine blood testing can help diagnose syphilis. Testing is available at most local public health agencies, STD specialty clinics and most health care providers. 
  • Syphilis is curable. Syphilis is diagnosed with simple blood tests and can be effectively treated with antibiotics. Early diagnosis and treatment prevent complications. 
  • Transmission of syphilis is entirely preventable. Individuals should see their health care provider right away for a sore or rash to expedite early diagnosis and treatment before further transmission can occur. People who are sexually active can request routine blood testing to monitor for syphilis. Risk of transmission is reduced by assuring one’s partner does not have any sores and has been tested for STDs and by using condoms. In addition, some patients may be eligible for the new CDC recommended post-sex antibiotic for prevention, called Doxy-PEP. Refer to CDC guidelines for Doxy-PEP for Bacterial STD Prevention. 

Congenital Syphilis: What Pregnant Patients Need to Know 

Congenital syphilis occurs when untreated syphilis in a pregnant person is transmitted to their baby. This can lead to miscarriage, premature birth, stillbirth or severe health issues for the newborn. Surviving infants with congenital syphilis may experience multiorgan system damage that may present at delivery or later in life. 

Pregnant patients should arrange prenatal care as soon as they have a positive pregnancy test, and Missouri is currently recommending that they be screened for syphilis three times during their pregnancy: first trimester, third trimester and at delivery. 

Learn more on the DHSS Congenital Syphilis webpage and review our latest Missouri Health Update. 

What Providers Need to Know 

All health care providers need to brush up on syphilis, since many of us may not have diagnosed or managed a single case yet, and the testing and treatment recommendations have evolved. 

  • Consider syphilis in your differential diagnosis.  
  • Readily screen for syphilis, especially in your pregnant patients.  
  • There are many new developments in testing and treatment, including point-of-care testing, alternative sequences/technologies for testing, same-day treatment and presumptive treatment.  
  • The one thing that has not changed is the remarkable effectiveness of one of our oldest antibiotics — penicillin. Please note there is no longer a shortage of the injectable Bicillin LA, which is most effective and particularly necessary for pregnant patients.  
  • Don’t be shy about screening, testing, treating and asking for help. There are many great resources available to providers and patients, outlined below. 

Resources 

A Final Note 

Syphilis prevention and treatment require collective effort. By staying informed and proactive, we can reduce the burden of syphilis in Missouri and improve outcomes for all.  

Every health care provider in this state plays an important role in our Missouri public health ecosystem. We are grateful for your patient care, population health work and collaboration with DHSS. Thank you for your help with this important joint effort. 

About the Author 

Dr. Heidi Miller is a primary care doctor with more than 20 years of experience in internal medicine and public health. Her role as Chief Medical Officer for DHSS focuses on promoting preventive health care and improving public health outcomes. Through initiatives like the Bureau of HIV, STI and Hepatitis, she works to combat diseases like syphilis, ensuring early detection and treatment for better health outcomes in Missouri. 

Back

Topics