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Syphilis cases rise sharply in women as CDC reports an “alarming” resurgence nationwide
Nearly a quarter of syphilis cases in the U.S. were being diagnosed in women in 2022, the Centers for Disease Control and Prevention reported Tuesday, in a sign that the nation’s “alarming” epidemic of the sexually transmitted infection is increasingly spreading among heterosexual couples.
The number of syphilis cases reported in women climbed 19.5% in 2022. In all, there were 14,652 cases of primary and secondary syphilis, the first two stages of the disease, reported in women, making up roughly a quarter of the 59,016 cases nationwide. In 2018, just 14% of syphilis cases had been reported in women.
Men who have sex with men continue to make up a disproportionately large share of cases, the CDC says.
A worsening syphilis epidemic
Health officials have warned for years about the nation’s worsening syphilis epidemic. The CDC’s final figures for 2022 are the largest number diagnosed nationwide since the 1950s.
While tens of thousands of syphilis cases and deaths used to be reported every year in the 1940s, the rollout of penicillin led to steep drops in rates of the disease over the last century.
Cases last peaked nationwide in the 1990s, before a yearslong decline that health officials say was likely driven by changes in sexual behavior due to the HIV epidemic.
“Controlling syphilis and other sexually transmitted infections (STIs) requires robust public health systems and workforces, and prevention strategies that are tailored to the specific needs of affected communities. There are no shortcuts to syphilis control,” Dr. Jonathan Mermin, director of the CDC’s National Center for HIV, Viral Hepatitis, STD, and TB Prevention, said in an emailed statement.
Syphilis rates have increased every year since 2011, and remain disproportionately high especially among Black and American Indian populations.
Mermin said improving diagnosis and treatment efforts, as well as redoubling efforts to curb other factors like substance abuse that fuel risky behaviors enabling the bacteria’s spread, will be needed to stop the epidemic.
“We know that syphilis in the heterosexual population and drug use, particularly methamphetamine use, are intersecting epidemics, and syphilis has spread among heterosexual men and women for decades,” he said.
Symptoms of syphilis
Syphilis disease is caused by the bacteria T. pallidum. Signs of syphilis typically show up first as a single painless ulcer. Untreated syphilis can lead to more serious complications if it spreads to other parts of the body, like brain or nervous infections doctors call neurosyphilis.
Rates of congenital syphilis — a potentially life threatening form of syphilis, when the bacteria is passed to babies during pregnancy — have also continued to climb in recent years.
More than 102 cases were reported for every 100,000 babies born in 2022 across the U.S., the CDC tallies. That amounts to a rate multiple times worse than other peer countries.
Rates of other STIs
The increase in 2022 also now marks a divergence from some other sexually transmitted infections, or STIs. Chlamydia cases were roughly flat in 2022 compared to the year before. Gonorrhea rates have dropped, down 8.7% from 2021.
Mermin said the agency was “cautiously optimistic” about the gonorrhea slowdown and would be closely tracking 2023’s figures to see if that trend continues to improve.
“CDC is examining this finding closely and will be looking to final 2023 data to better understand if this signals a decline in infections and to better understand where, why, and among whom the decrease occurred with the hope we can expand on what’s working,” he said.
Shortages and funding cuts
The CDC’s final tally for 2022 comes as health officials are warning that 2023’s case counts of sexually transmitted infections could be worse, in the wake of funding cuts and shortages of a key treatment.
“The CDC’s latest STI data shows that our nation is facing a rapidly deteriorating public health crisis with real lives at stake. STIs – especially syphilis – will continue to spiral out of control until the administration and Congress provide communities with the funding they need,” the National Coalition of STD Directors said in a statement.
The group has previously voiced frustration over an ongoing monthslong shortage of Pfizer’s Bicillin L-A, the only recommended treatment for pregnant moms and their babies fending off congenital syphilis infections.
Multiple health departments have reported pregnant patients struggling to access the drug during the shortage, the group said last year. The CDC has blamed a majority of the nation’s recent congenital syphilis cases to gaps and delays in testing and treatment.
Earlier this month, the Food and Drug Administration greenlighted temporary imports of a version of the drug from Europe to address the shortage.
Hundreds of federally-funded public health workers tasked with helping to curb sexually transmitted infections are also being laid off, the group warned last year, urging Health and Human Services Secretary Xavier Becerra to mitigate cuts resulting from a deal struck with Congress last year.
A spokesperson for the Department of Health and Human Services did not immediately respond to a request for comment. In a release Tuesday, the department said it was mobilizing a new task force to respond to the syphilis resurgence.
“The syphilis crisis in our country is unacceptable. The Biden-Harris Administration is committed to addressing this urgent issue and using all available means to eliminate disparities in our health care system,” Becerra said in the statement.
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Whether you’re barreling down a mountainside or taking a leisurely ride along your local trail, a great mountain bike is key. But what exactly does a great mountain bike look like, in terms of features? It depends on the kind of terrain and riding style you do.
The best mountain bike for long, cross-country rides will have very different specs than a downhill bike. Some offer full suspension for a smooth ride on bumpy trails. Some have wider tires that are better at gripping wet or sandy terrain. Some are designed for maximum pedaling efficiency and serious stopping power so you can climb steep mountainsides without wearing yourself out. No matter where you and your new bike are headed this fall, we’ve rounded up the best mountain bikes for every rider and every terrain in 2024. Don’t forget to strap on your bike helmet.
Best mountain bike for beginners: Giant Talon 29 1
Mike’s Bikes
The Giant Talon 29 1 is a solid entry-level mountain bike at a reasonable price point. With its balanced frame geometry and high-traction tires, it’s great for a comfortable, stable ride on most trails. While that means it’s not specialized for uphill climbs or cross-country speed, the balanced design is great for beginners or casual riders who aren’t planning to tackle those more challenging technical trails just yet.
With 80mm to 100mm of suspension travel, this hardtail mountain bike strikes that perfect balance of pedaling efficiency and shock absorption.
Riders can also adjust the suspension within that range by adjusting the air spring and the rebound damping. That gives you improved steering precision and a better ride feel since you can tailor it to your needs. If you’re a beginner, it may take some trial and error to fine-tune those settings, but playing around with them is a great way to learn how suspension impacts your ride.
Get this reliable entry-level mountain bike at Mike’s Bikes for $950.
Top features of the Giant Talon 29 1:
- Grippy tires offer great traction in any trail conditions.
- The balanced frame geometry makes this a comfortable bike for most riders.
- The adjustable suspension fork allows you to fine-tune this mountain bike for your needs.
Best trail bike: Santa Cruz Tallboy C R
Backcountry
A full-suspension mountain bike with 120mm and 130mm suspension travel on the rear and front, respectively, it doesn’t get cushier than the Santa Cruz Tallboy C R (at least, not at this price point). Built for cross-country or trail riding, this bike’s design allows you to glide through rocky terrain almost as if you were just cruising on a paved road. That suspension also helps cushion the impact on pops and short drops so you can build up speed while navigating the trail with confidence.
With that said, it can be a little sluggish on uphill climbs. But if you typically stick to more straightforward trails, you won’t have to deal with that issue. For those just-for-fun weekend trail rides, this is the mountain bike you want.
Get this comfortable, agile trail bike at Backcountry while it’s on sale for $3,849 (reduced from $4,799).
Top features of the Santa Cruz Tallboy C R:
- Boasting full suspension, this mountain bike is a comfy ride no matter how bumpy the terrain.
- The carbon C frame is both lightweight and stiff for better control and improved agility.
- The four-piston brakes offer excellent stopping power.
Best fat tire mountain bike: State 6061 Trail+
State Bicycle Co.
For wet or sandy trails, traction is everything, which means you need a fat tire bike like the State 6061 Trail+. With 4.5-inch wide tires that can handle running even at low PSI, this mountain bike can grip the trail no matter how loose or slippery.
Whether you want to cruise along sandy beaches or power through snowy mountain trails, the stability of this fat tire bike is the key to doing so safely and confidently. You won’t be building up much speed, but you’ll have a lot of fun plowing through trails that a standard trail bike couldn’t even touch.
Get this fat tire bike directly from State Bicycle Co. for $1,000.
Top features of the State 6061 Trail+:
- Thick 4.5-inch tires provide extra grip for wet or loose terrain like snow, sand and mud.
- With low PSI capabilities, you can lower the tire pressure to widen the surface area even further to maximize your grip on soft, slippery trails.
- The alloy frame is stiff and strong without adding any more bulk than necessary.
Best mountain bike under $500: Huffy Stone Mountain
Amazon
The Huffy Stone Mountain is a hardtail mountain bike that is lightweight and offers good traction for navigating trails. The budget-friendly bike is missing a lot of the features you’ll find on the more advanced mountain bikes listed above. However, if you’re just starting out and just want to get out on a trail to see if you like mountain biking, this is a good bike to start with.
While you can’t take it on any serious trails, it’s got the basics you need for easy local bike trails. Use it to get a feel for the sport and then upgrade to a mountain bike better suited to the kind of trails you want to tackle. Then, pass this Huffy Stone Mountain on to a friend or teen who’s curious about mountain biking.
A bestseller on Amazon, this budget mountain bike is available for as low as $200.
Top features of the Huffy Stone Mountain:
- This budget entry-level bike is great for casual rides on easy bike trails.
- A wide variety of frame and wheel sizes allows you to get the right fit for your height.
- The lightweight, high-traction design is just enough to let you get a feel for mountain biking before committing to a higher-priced mountain bike with more advanced features and customizability.
Shop more top-rated mountain bikes:
What type of mountain bike should a beginner get?
The best mountain bike for a beginner is a balanced, versatile one. Since you’re probably not tackling steep inclines and declines yet, opt for a trail bike that offers great traction, strong brakes and easy maneuverability along bumpy, muddy trails. That means grippy tires and responsive steering so you can confidently control your bike over tree roots, up hills and on descents.
If the trails you’re eager to go on are largely uphill, look for a bike that’s lightweight with a firmer pedaling platform. Those two features will improve climb efficiency so you’re not wearing yourself out on those uphill stretches.
Do I need a full-suspension mountain bike?
You don’t need a full-suspension mountain bike, but they are nice to have. Unlike hardtail mountain bikes, which only have suspension in the front, full-suspension mountain bikes have suspension in both the front and rear. That extra suspension helps absorb shock, cushioning the impact as you hop over bumps or navigate downhill jumps and drops.
That cushier feel can be nice even on milder trail rides, but they tend to be significantly more expensive and require more maintenance than a hardtail mountain bike. So it might not be worth the extra expense and care if you don’t usually do technical trails or downhill riding.
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