America’s surprising new hotspot for STDs: Alaska – where syphilis cases have surged 20-FOLD since 2016 and chlamydia rate is highest in the US

When you think of Alaska, you may think of glaciers, snowscapes and dog sleds.

But the state is becoming renowned for something very different – sexually transmitted diseases. 

Since 2016, cases of syphilis – a bacterial infection that causes sores around the genitals and mouth – have surged more than 20-fold.

In 2016, the state had just 20 cases of syphilis. In 2022, this had shot up to 424, according to federal data published by the Alaska Department of Health.

The rise gives Alaska ‘one of the highest rates of syphilis in the country’, according to Dr Anne Zink, the state’s chief medical officer, when population size is taken into account.

And it’s not just syphilis. In 2021 national data, Alaska had the highest rate of chlamydia and the fourth highest for gonorrhea. 

Rates of syphilis are increasing nationally, from less than 20 per 100,000 population in 2012 to 53 in 2021

In 2021, Alaska had one of the highest rates of syphilis in America of 26.5

Theories behind Alaska’s rise include tourism and travel to the state, as well as the use of online sites and dating apps which allow people seeking sex to find more partners, which can exacerbate transmission and lead to more casual sex.

Other likely contributors include a relatively young population – which makes up over 50 percent of all STD cases in the US. 

Much of Alaska is also remote, which limits the availability of healthcare, and the public health infrastructure is severely lacking.

Public health officials have also attributed rising STD rates to disrupted sexual health screening during pandemic lockdowns, which saw fewer in-person medical appointments, reduced detection and early interventions that usually help to stop infections spreading.

STDs have been on the rise across the US and showed ‘no signs of slowing,’ data from last year suggested.

There were 2.53million cases of chlamydia, gonorrhea and syphilis in 2021, according to the Centers for Disease Control and Prevention (CDC), up almost six percent from the figure in 2020 and a seven percent increase on 2017.

CDC figures showed there were 176,713 syphilis cases in 2021, the highest since the 217,558 cases reported in 1950 and up a third on 2020.

Cases of gonorrhea rose nearly five percent from 2020 to 2021, from 677,769 cases to more than 710,000, the highest yearly total in four years.

Chlamydia cases, which were more common to begin with at 1,579,885 in 2020, shot up to 1,644,416 in 2021. 

Total cases of STDs — chlamydia, gonorrhea and syphilis — have been trending upwards for the previous seven years. Infections fell in 2020, but CDC officials said it was likely cases had in fact continued to rise, but were not detected due to a drop in testing during the Covid-19 pandemic

Alaska’s health officials are also worried about the record number of babies born with congenital syphilis, which is when an infection is passed from an infected mother to a child

Despite this roughly four percent increase, total yearly cases of chlamydia have declined since 2019 when more than 1.8 million cases were reported.

Alaska’s Dr Zink said: ‘Everyone of reproductive age who is sexually active should be tested for syphilis if they are unsure of their syphilis status.

‘Everyone should get retested each time they have a new sexual partner, and every three to six months if they have multiple partners.’

Alaska’s health officials are also worried about the record number of babies born with congenital syphilis, which is when an infection is passed from an infected mother to a child.

The CDC is now recommending that adults aged 45 and under are tested for syphilis at least once a year.

Between 2017 and 2018, Alaska’s syphilis cases shot from 28 to 113. in 2019, they more than doubled to 242.

Nationally, the rate of syphilis cases has also increased, from 31.2 per 100,000 population in 2017 to 53 in 2021. 

Syphilis is a bacterial infection caused by the Treponema pallidum bacteria.

Primary syphilis which usually begins as a sore on the vagina and penis or around the mouth that, even if unmedicated, usually disappear after a few weeks.

It can develop into a rash on the palms of your hands and soles of your feet and can be cured in most cases with a single penicillin shot.

Early stage syphilis can be treated with antibiotics.

Secondary syphilis manifests as a rash, lesions and swollen lymph nodes.

In serious cases and if left untreated, syphilis can lead to organ failure, blindness and even death.

Years post-exposure, the infection can affect vital organs and the nervous system, according to the CDC, potentially causing blindness or dementia. 

Once infected, anyone can pass on syphilis.

Congenital syphilis is a preventable but serious condition occurring when a pregnant woman passes the infection onto their baby. It can lead to death of the child, premature birth and cause lifelong medical issues.

In 2022, 12 cases of congenital syphilis were diagnosed, mainly in babies born in Southcentral Alaska.

Before 2020, Alaska had an average of less than one case of congenital syphilis per year. 

Dr Joe McLaughlin, Alaska’s State Epidemiologist and Chief of Epidemiology in the Division of Public Health, said: ‘It is especially important for all expectant mothers to ask their doctor for syphilis screening testing as part of their prenatal care.

‘Testing is recommended during the first prenatal visit, during the third trimester and again at the time of delivery.’

Some 75 percent of mothers who gave birth to a child with congenital syphilis in Alaska in 2022 had less than four prenatal care visits and 42 percent had no prenatal care at all.