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“ New syphilis infections plummeted in the U.S. starting in the 1940s when antibiotics became widely available. They fell to their lowest ever by 1998, when fewer than 7,000 new cases were reported nationwide. The CDC was so encouraged by the progress it launched a plan to eliminate syphilis in the U.S.

But by 2002, cases began rising again, largely among gay and bisexual men, and they kept going. In late 2013, CDC ended its elimination campaign in the face of limited funding and escalating cases, which that year surpassed 17,000.

By 2020, cases had reached nearly 41,700, and they spiked even further last year, to more than 52,000.

The rate of cases has been rising, too, hitting about 16 per 100,000 people last year. That's the highest in three decades.

Rates are highest in men who have sex with men, and among Black and Hispanic Americans and Native Americans. While the rate for women is lower than it is for men, officials noted that it's has been rising more dramatically — up about 50% last year.

That ties to another problem — the rise in congenital syphilis, in which infected moms pass the virus on to their babies, potentially leading to death of the child or health problems like deafness and blindness. Annual congenital syphilis cases numbered only about 300 a decade ago; they surged to nearly 2,700 last year. Of last year's tally, 211 were stillbirths or infant deaths, Mena said.

The increases in syphilis and other STDs may have several causes, experts say. Testing and prevention efforts have been hobbled by years of inadequate funding, and spread may have gotten worse — especially during the pandemic — as a result of delayed diagnosis and treatment. Drug and alcohol use may have contributed to risky sexual behavior. Condom use has been declining.

And there may have been a surge in sexual activity as people emerged from COVID-19 lockdowns. "People are feeling liberated," Saag said.”