Honestly, most of us grew up thinking of syphilis as some ancient, Victorian-era ghost story—the kind of thing that happened to poets in the 1800s or pirates on the high seas. For decades, it basically was. By the late 1990s, the disease was so rare in the United States that experts thought we were on the verge of total elimination.
But things changed. Fast.
If you’re wondering how common is syphilis in the us today, the answer is a bit of a gut punch. We are currently navigating a resurgence that has caught the public health world off guard. While newer provisional data from the CDC suggests we might finally be "turning a corner" on the most infectious stages, the raw numbers are still staggering compared to just ten years ago.
The Current State of the Numbers
In 2024, the United States saw over 190,000 cases of syphilis in total. That includes every stage, from the tiny painless sores of the primary phase to the more dangerous late-stage infections. To put that in perspective, the total syphilis count has jumped more than 40% in just five years.
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It’s not all bad news, though. There’s a weird silver lining in the most recent reports. According to the CDC’s provisional data released in late 2025, cases of "primary and secondary" syphilis—the stages where the disease is most likely to be passed to someone else—actually dropped by about 22% between 2023 and 2024.
That’s a huge win. It suggests that things like Doxy-PEP (taking a dose of doxycycline after unprotected sex) and better testing are actually starting to work. But don't let the "decline" fool you into thinking the problem is solved. The "unknown duration" or late-stage cases are still high, meaning many people are walking around with an infection they don't even know they have.
Why the Surge Happened (It’s Not Just One Thing)
So, how did we get here? Experts like David C. Harvey from the National Coalition of STD Directors often call syphilis the "canary in the coal mine." When syphilis goes up, it usually means the entire public health safety net is fraying.
- The Funding Gap: For years, the US has sort of divested from STI clinics. When a clinic closes or cuts its hours, people lose their "go-to" spot for a quick, low-cost checkup.
- The App Factor: Modern dating apps have changed how people meet. More partners and faster turnarounds make it harder for traditional "contact tracing" (where a health worker calls your recent partners) to keep up.
- The Substance Use Connection: There is a strong statistical link between the rise in meth use and the rise in syphilis. It's not that the drug causes the bacteria, but the behaviors associated with it often lead to less protection and fewer doctor visits.
- The "Invincible" Feeling: Because syphilis is so easy to cure with a shot of penicillin, some folks have stopped fearing it. But easy to cure doesn't mean it’s harmless.
The Tragedy of Congenital Syphilis
This is the hardest part to talk about. While adult cases of infectious syphilis are finally trending down, congenital syphilis—which is when a mother passes the infection to her baby during pregnancy—is still climbing.
In 2024, nearly 4,000 babies were born with syphilis in the US. This is the 12th year in a row that this number has gone up. It’s nearly a 700% increase since 2015.
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[Image showing the stages of syphilis from primary to tertiary]
It's a massive failure of the healthcare system because congenital syphilis is almost 100% preventable. If a pregnant person is tested early and given penicillin, the baby is usually fine. But if it’s missed? It can lead to stillbirth, bone deformities, or severe brain damage. In places like South Dakota and Mississippi, the rates have skyrocketed, often because people can't get to a doctor for prenatal care or because doctors simply aren't testing for it as often as they should.
Who is Most at Risk?
The disease doesn't discriminate, but the data shows it hits certain groups much harder.
Historically, the highest rates were among men who have sex with men (MSM). That is still true today—the CDC notes that rates in this group can be over 100 times higher than among men who only have sex with women. However, the fastest growing demographic over the last few years has actually been heterosexual men and women. This "spillover" into the general population is exactly why we're seeing so many more cases in newborns.
Geography matters too. If you live in the South or the West, you're statistically more likely to encounter it. States like New Mexico, Arkansas, and Oklahoma have seen some of the most dramatic increases in the last decade.
Breaking Down the Stages (And Why You Might Miss Them)
The reason syphilis is so "successful" as a bacteria is that it’s a master of disguise. It doesn't always hurt, and it often disappears on its own—even while the bacteria is still inside you.
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- Primary Stage: You get a sore (called a chancre). It’s usually firm, round, and painless. Because it doesn't hurt, people often mistake it for an ingrown hair or a zipper cut. It goes away in 3 to 6 weeks, whether you treat it or not.
- Secondary Stage: This is the "great imitator" phase. You might get a rash on the palms of your hands or the soles of your feet. You might feel like you have the flu. Again, these symptoms go away without treatment.
- Latent Stage: This is the scary part. You have zero symptoms. None. You feel totally fine, but the bacteria is slowly starting to damage your internal organs. This stage can last for years.
- Tertiary Stage: This happens 10–30 years after the initial infection if it was never treated. It can cause blindness, deafness, mental illness, and heart failure.
What You Can Actually Do
If you’re sexually active, the reality of how common is syphilis in the us means you need to be proactive. Waiting for symptoms is a bad strategy because, as we've seen, the symptoms like to hide.
- Get the right test: A standard "STI panel" doesn't always include syphilis unless you specifically ask for it. Make sure you request a "syphilis RPR" or "treponemal" blood test.
- Ask about Doxy-PEP: If you are in a high-risk group or have multiple partners, talk to your doctor about Doxycycline Post-Exposure Prophylaxis. It’s basically the "morning after pill" but for bacterial STIs.
- Prenatal Care is Non-Negotiable: If you are pregnant, you should be tested at your first visit. If you live in a high-rate area, many experts now recommend being tested again in the third trimester and right at delivery.
- Finish the Meds: Syphilis is cured with Bicillin L-A (a specific type of penicillin). If you’re allergic, there are other options, but you have to follow the doctor's orders to the letter to make sure it's actually gone.
The Bottom Line
We are living through a weird moment in history where a centuries-old disease is making a comeback in one of the most medically advanced countries on earth. The 2024–2025 data shows we're making progress in some areas, but the rise in baby-related cases is a loud reminder that we aren't out of the woods yet.
Staying safe basically comes down to regular blood work and open conversations. It's not the most fun dinner table topic, but it’s the only way to turn these statistics around.
Actionable Steps for Your Health
- Review your last screening: Check your medical portal to see if "Syphilis/RPR" was actually on the list of your last STI check. If not, schedule a follow-up.
- Locate a local clinic: Use the CDC’s GetTested search tool to find free or low-cost testing sites near you that offer comprehensive panels.
- Discuss partner notification: If you do test positive, use anonymous services like TellYourPartner.org to notify recent contacts without the awkwardness of a direct text, ensuring they get treated before they reach the latent stage.
- Update your prenatal plan: If you are expecting, explicitly ask your OB-GYN about their syphilis screening schedule to ensure you are tested at least three times during the pregnancy if you are in a high-incidence state.