Sexually transmitted disease rates climb: Minnesota Health officials cite increase in syphilis cases as a particular concern

Number of 2019 Gonorrhea Cases by County

The number of new sexually transmitted diseases continued to rise in 2019, according to the Minnesota Department of Health’s annual STD surveillance report. 

Of special concern were 1,127 syphilis cases reported in 2019, a 23% increase from 2018.

The past few years have shown a marked increase in syphilis cases in Minnesota as well as across the United States. With syphilis becoming more common, surveillance for the disease has also needed to change. State epidemiologists recently used a new method for outbreak detection that examines an average of syphilis rates over a longer period of time. This analysis allowed for a more nuanced picture of syphilis than before.

“Our improved analysis of syphilis data has shown a more detailed picture of how syphilis is impacting counties across the state,” MDH State Epidemiologist and Medical Director Dr. Ruth Lynfield said. “We are now able to identify hotspots earlier than before and complete a more real-time look into what is going on in these areas.”

With this new method, Minnesota health officials found that cases, particularly in females, pregnant people, and men who have sex with men, have continued to rise across counties. This is similar to what is happening in other states.

Minnesota will now be using this new, more sophisticated surveillance method to not only detect syphilis outbreaks but monitor disease trends around the state.

The syphilis outbreak in north-central Minnesota that has been going on since 2016 continues. Cases have also increased in the Twin Cities metropolitan area. New infections are particularly affecting:

Females, especially those who are pregnant or of childbearing age.

Males, particularly among men who have sex with men.

People who inject drugs.

People experiencing homelessness.

People co-infected with HIV and hepatitis A and C.

Additionally, cases of congenital syphilis are increasing in Minnesota. Congenital syphilis (syphilis in a fetus or infant at birth) can cause serious complications such as miscarriage, stillbirth, premature birth, birth defects and infant death. In 2019, 21 cases of congenital syphilis in infants were reported, representing a 110% increase from 2018. This is the highest Minnesota has ever reported.

“It’s important to let people know that syphilis is still a problem, but that screening and treatment can help avoid serious complications,” Lynfield said.

MDH recommends regular syphilis screenings for people who are sexually active and for pregnant females. The CDC’s screening recommendations and MDH’s treatment protocol provide detailed recommendations for health care providers, and we encourage people to talk to their provider to find out if they should be tested for syphilis.   

“Syphilis is a complicated disease that can cause serious health problems, but people often don’t recognize symptoms right away,” said Christine Jones, STD, HIV and TB section manager at MDH. “Luckily, there are many places people can be tested and treated for syphilis and other STDs across the state.”

2019 STD report key findings

There were 33,725 cases of chlamydia, gonorrhea, and syphilis reported in 2019 compared to 32,024 cases in 2018. There are disparities among communities of color and men who have sex with men.

Chlamydia, the number one reported infectious disease in the state, increased by 4% to 24,535 cases in 2019.

Gonorrhea remained the second most commonly reported STD in Minnesota with 8,063 cases reported in 2019, a 7% increase.

Syphilis overall increased by 23% with 1,127 cases in 2019. There were 385 primary and secondary syphilis cases reported in 2019, a 32% increase. Minnesota congenital syphilis cases increased in 2019 by 110% to 21 cases.

STDs are preventable through consistent and correct condom use during sex, getting tested regularly for STDs and HIV, and getting treated for positive results.

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