Colorado officials address rise in syphilis cases

DENVER — Syphilis cases are rising quickly in Colorado – prompting officials with the Colorado Department of Health and Environment (CDPHE) to issue a public health order declaring it as an epidemic amidst rising cases in our state and across the country.

“Syphilis was once a rare disease. We are very concerned about this growing epidemic, both in the state and nationally. It is devastating for babies, but there is an effective treatment if caught in utero. The public health order that I am issuing will help us catch more of these cases prior to birth,” said Jill Hunsaker Ryan, executive director of CDPHE.

According to a CDPHE release, cases of syphilis have more than tripled in Colorado from 2018 (1,084) to 2023 (3,266). It’s even worse when it comes to congenital syphilis when a pregnant mother passes the disease onto her unborn baby. Those cases also spiked more than seven times in Colorado, from seven cases in 2018 to 50 cases in 2023.

As of April 18, 2024, there’ve been 25 reported cases of congenital syphilis, including five stillbirths and two neonatal deaths.

CDC numbers show that 40% of babies with untreated congenital syphilis may be stillborn or die from the infection.

Those are all numbers the state is hoping to change, by expanding access to syphilis testing during pregnancy. The state health department is also taking further steps like testing pregnant inmates for syphilis, staffing an after-hours line for urgent needs, meeting community groups, and making sure testing is covered under most Coloradans insurance.

“All expecting parents hope for the same thing — a healthy and happy baby. This statewide, coordinated response will help provide more consistent testing and care for those who are pregnant to help save lives and protect public health,” said Governor Polis in the announcement.

Syphilis is a sexually transmitted infection (STI) that can cause health issues without treatment. Each phase of infection can present itself differently, with different signs and symptoms.

“It can kind of house itself and not get treated for a long time. So really one of the best ways to diagnose syphilis is to go looking for it, and that applies, you know, to patients who have high sexual contact, anyone who may have had a blood transfusion from an infected person,” said Dr. Payal Kohli, 9NEWS medical health expert. “So because it’s such a sort of can be an indolent infection sometimes has no symptoms or sometimes just has some sort of non-specific viral type of symptoms like fatigue and sore throat, mucous membrane inflammation, lymph nodes and such that it can often get missed.”

According to the health order, infection is preventable through timely testing and treatment during pregnancy and now requires all healthcare providers to provide syphilis testing:

• In the first trimester of pregnancy (between 1-12 weeks), or at the patient’s initial prenatal visit.

• In the third trimester (between 28-32 weeks).

• At the time of birth.

• If there’s a miscarriage after 20 weeks or stillbirth.

• If someone who is pregnant goes to an urgent care center or emergency room, at the intervals and events described above.

• Prisons and jails must also provide these tests. 

According to CDPHE, testing for syphilis is covered without co-pays for a wide majority of Coloradans without commercial insurance, as well as Coloradans with Medicaid coverage through Health First Colorado. Free and low-cost testing is also available for those who do not have an existing healthcare provider. Residents can also order a free at-home test kit.

According to 9NEWS medical expert Dr. Payal Kohli, the most important thing is not to panic.

“Antibiotics are obviously the mainstay of treatment. Penicillin is what we generally use, and there are options for patients that are allergic to penicillin and depending on where your stage of course of syphilis is, the infectious disease doctor may recommend different,” said Kohli. “For the most part, syphilis is very curable and treatable with penicillin, especially in the early stages. So you definitely want to make sure you get connected with the doctor very quickly if you get a diagnosis of syphilis so that you can initiate treatment right away. That of course includes pregnant women as well who might be carrying a baby.”

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