Hawaiʻi sees 600% increase in syphilis cases amongst females, 2018-2021

HONOLULU (KHON2) — Syphilis. It was once something we learned about in history class that was associated with pre-modern times when few people had access to healthcare.

For decades, we saw such a steady decline in syphilis cases that most believed we had built a society that defeated it.

But that has all come crashing down, and cases amongst females rose quickly with a 600% increase from 2018 through 2021. Between the year 2000 and 2019, Hawaiʻi had zero to four cases.

Congenital syphilis is when a parent passes the disease to their newborn. The baby is exposed to syphilis during pregnancy, and officials believe that this is an indicator of a greater problem for the public, in general.

In 2020, we had 12 cases in a single year; and that number is increasing each year with 20 cases in 2021, according to Tim McCormick who is the Branch Chief for the Hawaiʻi State Department of Health’s Harm Reduction Services Branch.

“If you look at the 20-year period from 2000 to 2019, we saw very low numbers of cases, about zero and four annually, in that entire 20-year period,” explained McCormick. “We saw a total of 14 cases. So, that’s a huge increase. Then, you know, in 2020, 2021, 2022, we’re seeing ongoing increases.”

Preliminary data indicates that there were at least 22 cases in 2022. This dramatic increase in congenital syphilis cases is associated with increasing infections in adults.

What the DOH is seeing is that people who are unable to access healthcare are not being tested regularly, and they are spreading the disease at a rapid pace.

For persons who become pregnant and become infected, they run the extremely high risk of passing it onto their unborn fetus, leading to infants being born with congenital syphilis. You can click here for information on pregnancy and syphilis.

“In addition to sexual transmission, pregnant people with syphilis can transmit the disease to their unborn fetus,” said McCormick. “And that’s referred to as congenital syphilis. This is particularly devastating and causes miscarriage, stillbirth, premature births, low birth weight or death shortly after birth. And for babies who are born and survive with syphilis, they can often have really significant impacts like deformed bones, severe anemia, central nervous system problems and other mental and physical problems.”

For those who do not seek treatment, syphilis can spread to the brain and into the nervous system. This is known as neurosyphilis; and when it spreads to the eye, it is known as ocular syphilis.

One of the problems that McCormick said is driving the hyper-increase in syphilis cases in Hawaiʻi is that most people do not realize their symptoms are telling them that they have contracted. it.

According to McCormick, early-stage syphilis is treatable, but few people recognize the symptoms. He said that in early-stage syphilis, people will experience a sore, known as a ‘chancre’, that goes away after a few days or weeks. Often times, these chancres are not painful; and sometimes, people do not even know they have them. But if someone comes into contact with this seemingly innocuous sore, then they contract the disease, too.

This is why regular testing is so very important.

If you are sexually active, especially with multiple partners, it is imperative that you have a regular testing schedule. If you do not have access to a primary care physician, the state of Hawaiʻi has you covered with community centers.

In particular, the Diamond Head Health Center is the place to go for sexually transmitted infections (STIs) testing. This is a free service with no judgement. They personnel only care that they help you not spread STIs.

While early-stage syphilis is completely treatable, there is not a vaccine that will protect you from contracting the disease again, making regular testing imperative.

Persons of childbearing age are encouraged to seek regular testing. If you are pregnant, then McCormick said it is important that you get tested for syphilis during pregnancy at three specific points: as early as possible during the first trimester, at 28 to 32 weeks of gestation, and again at the time of delivery.

“Because of the increase that we’ve seen over the last couple of years in congenital syphilis, the Department of Health, since 2020, has recommend screening three points during pregnancy” explained McCormick. “One thing for people to keep in mind is that having syphilis or being treated for syphilis does not protect against getting syphilis again. So, for anyone with syphilis, it’s really important that their sexual partners are also treated to prevent reinfection.”

Hawaiʻi is now ranked in the top ten states with the greatest increase in syphilis cases, said McCormick. This is behind states like Mississippi where there is a greater than 1,000% increase amongst pregnant persons and newborns.

You can click here for more information on syphilis and how to spot symptoms.

So, practice safe sex and set up a regular schedule for testing. Recognizing the symptoms of syphilis during the early stage can save your life as well as the lives of those you have sexual relations.