SIOUX FALLS, S.D. (KELO) — Both South Dakota and Minnesota are reporting elevated rates of syphilis in their states, with Minnesota reporting a 33% rise from 2020 to 2021, and South Dakota reporting a 2183% rise over its 5-year-median of 29 cases.
Officials from the South Dakota and Minnesota Departments of Health weighed in on the issues in interviews with KELOLAND News.
Angela Cascio, Infectious Disease Director for the South Dakota DOH says that South Dakota’s increase began in 2020. “We’ve seen it nationally as well — South Dakota’s not immune to the increase.”
When it comes to the rise since 2020 in South Dakota, Cascio outlines a sharp increase. “In South Dakota, we had cases under 30 for many years, and then we noticed in December 2020, cases were increasing,” she said. As of July 12, South Dakota had a total of 662 reported cases of syphilis in 2022.
Cascio chalks this rise since 2020 up to the pandemic, at least in part.
“I think that’s a time when many routine program priorities were really impacted as a result of COVID across the nation,” Cascio said. “We know that there was a decrease in preventative healthcare visits throughout the early part of 2020.”
Christine Jones, Section Manager of the STD/HIV/TB section at the Minnesota Department of Health agrees that COVID impacted the STD rate.
“With COVID — last year we did see some weird kind of things happening,” said Jones. “Many of our STD clinics were closed, so people were not able to go in for regular screening.”
While an interruption to preventative healthcare certainly played a role in the spread of syphilis in recent years, both Cascio and Jones point to two additional culprits; drug use and, more importantly, anonymous sex.
“Anonymous sex we’ve seen increasing over the last decade,” said Cascio. “It’s not something that’s new, but I think with the combined illicit drug use and individuals not remembering their multiple partners, that’s one additional factor that contributes to the increase.”
And anonymous sex, for many, really means anonymous. “We are seeing that folks are having anonymous sex partners where they may not just know the person’s name, but [also] their contact information to be able to do follow-up with them,” said Jones.
The primary concern with anonymous sex in this instance is less one of morality and more of practicality.
“Our contact tracers are finding it difficult to illicit contacts from some of the individuals,” Cascio said. “That makes it difficult to do contact tracing, and to be able to bring people in for testing and treatment.”
This lack of ability or willingness to provide contacts for tracers is an issue because syphilis is a disease that can often go unnoticed for a time.
“Sometimes you will notice a sore, but that’s not always noticeable,” said Cascio. “Sometimes there will be a rash on the palms of your hands, or even your feet or other places on your body, but that’s not always noticeable — some of the symptoms are so minimal that individuals may take a look and say ‘well I’m not really very sick, and so this will go away.'”
An added complication Cascio mentions is that the sores that are sometimes present with syphilis go away over time, so a person can think that they got over it, even though it is still active in their body.
Jones does not expect to see a drop in cases in Minnesota in the near future. “We’re going to continue to see some increases,” Jones said. “The trend is continuing to increase.”
Cascio’s opinion is similar in terms of the outlook for South Dakota. “Based on our past trending, I would not expect a decrease in the immediate future.”
Despite the short-term pessimism, both Jones and Cascio are hopeful that with education and testing, rates will fall gradually over time.
Testing, of course, is the key.
“People really should be making sexual health part of their annual physical with their healthcare provider,” Cascio said. She said that more frequent testing is recommended for those with higher risk factors.
As to what might constitute a heightened risk factor, Jones offered an explanation.
“If people are having sexual activities with more than one partner, or not in a monogamous relationship — sex with anonymous partners — [they] should be tested regularly,” Jones said. “People should really be open with their care provider and talk to them about a testing schedule.”
One category of people who should be tested more frequently are pregnant women. “They should be tested for syphilis at three points in their pregnancy,” said Jones “for their own health, but also for the health of the baby.”
This is due to the occurrence of congenital syphilis, which can lead to birth defects and even death in severe cases.
If you are looking to get tested, you can reach out to your primary care physician. Beyond that, South Dakotans can find resources through the Department of Health, here.
Beyond testing and awareness, another way to prevent the spread of syphilis is simple; practice safe sex.
“Condoms are very effective if they are used correctly,” said Cascio. Resources on correct use can be found with the CDC.