The number of reported syphilis cases increased 79 percent in the United States between 2018 and 2022, and congenital syphilis cases increased 183 percent in the same period. In response, one emergency department began offering syphilis testing to all patients. Harvard Public Health spoke with the study’s first author, Kimberly A. Stanford, associate professor of medicine at the University of Chicago, about what the researchers learned.
Why study this topic?
I noticed a lot of folks coming through the emergency department with untreated sexually transmitted infections, with symptoms of these infections, and with pregnancy and no plan for prenatal care. We had this unique opportunity in the emergency department to find folks with syphilis early and get them linked to treatment.
What did you find?
About 3.5 percent of the patients who were coming in were getting screened for syphilis before our program began, and that went up to almost 25 percent. Only 6 percent of pregnant women coming through the emergency department were getting screened, and after we began offering testing, 50 percent were getting screened. We could have increased our screening rates and not actually found any syphilis—but we found a huge increase. In our overall population, we went from diagnosing 161 infections in the two years before we started screening to 624 infections over the two years after we started the testing program.
What would you like to see happen based on the study’s results?
I anticipate that we are going to see official guidelines about screening for syphilis in emergency departments in the next year, and I hope that will spur activity. A lot of places have HIV screening in place, which has long been recommended, and once you have built that infrastructure, it is not that hard to add syphilis screening.
—Sarah Muthler
(Study in Open Forum Infectious Diseases, September 2024)
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