States With the Highest Syphilis Rates in America

Recent data from the Centers for Disease Control and Prevention (CDC) reveals that South Dakota has the highest syphilis rate in the United States. The national average stands at 62.5 cases per 100,000 residents, but South Dakota’s rate has surged to 229 cases per 100,000—the only state surpassing the 200 mark.

At the other end of the spectrum, Vermont has the lowest syphilis rate, with just 3.2 cases per 100,000 residents. Other states with high rates include New Mexico (135.6) and Mississippi (115.7). Nationally, syphilis rates increased by 1% from 2022 to 2023, while South Dakota experienced a sharper 7% rise in the same period.

Causes of South Dakota’s Syphilis Spike

The rise in South Dakota’s syphilis rate is partially attributed to a dramatic increase in congenital syphilis cases, particularly within Native American populations. A 2024 study by the American Academy of Pediatrics highlighted systemic challenges faced by these communities, such as rural isolation, limited healthcare resources, systemic racism, historical trauma, and distrust in medical institutions.

The South Dakota Department of Health (DOH) reports a staggering 1,250% increase in congenital syphilis rates over the past five years. Congenital syphilis occurs when the infection is passed from mother to child during pregnancy, which can lead to severe complications, including stillbirth.

Recognizing and Treating Syphilis

Syphilis is a sexually transmitted infection (STI) that can be effectively treated with antibiotics if diagnosed early. However, symptoms can be subtle or mistaken for other conditions. Dr. Laura Bachmann, Chief Medical Officer of the CDC’s Division of STD Prevention, emphasizes the importance of vigilance.

“Syphilis can cause sores and rashes, but not everyone experiences these symptoms,” she explains. “In many cases, it can only be detected through a blood test.”

Bachmann encourages individuals to consult a healthcare provider if they notice unusual sores, rashes, or suspect exposure to an STI. Regular STI testing is essential, even for those without symptoms.

Preventing Congenital Syphilis

Dr. Bachmann outlines three critical steps to prevent congenital syphilis:

1. Prevention: Proper condom use and regular STI testing significantly reduce the risk of syphilis transmission.
2. Prenatal Testing: All pregnant individuals should be tested for syphilis during their first prenatal visit. Those at higher risk should also undergo testing in the third trimester and at delivery.
3. Treatment: Pregnant individuals diagnosed with syphilis require immediate antibiotic treatment. Their partners must also be treated to prevent reinfection.

Even after successful treatment, individuals remain susceptible to reinfection, making regular testing crucial.

Access to Testing

Testing for syphilis and other STIs is widely available at doctor’s offices, hospitals, clinics, and organizations like Planned Parenthood.

“Anyone can contract an STI,” Dr. Bachmann emphasizes. “Certain groups and regions face greater challenges due to barriers in accessing healthcare. If you’re sexually active, talk openly with your healthcare provider about whether you should get tested.”

By increasing awareness, improving access to testing, and ensuring timely treatment, public health officials aim to reduce the impact of syphilis nationwide.

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