Efforts to curb SD’s syphilis outbreak yield results, but public health advocate says work remains

South Dakota has about half the number of syphilis cases this year as it did at the same time last year, and about a third as many as the same time in 2022, when the outbreak peaked and the state reported the highest rate in the country.

About 160 cases were reported by the end of last month, according to the state Department of Health. Although that’s an improvement compared to the past few years, the number remains high compared to cases before 2020.

Syphilis is a bacterial infection most often spread through sex that can be cured, but can cause serious health problems without treatment and can be spread from mothers to unborn babies.

How the state, tribes and federal government are working to curb SD’s syphilis epidemic

Syphilis was close to being eradicated in the United States in the 1990s, but cases in South Dakota were increasing in the years prior to the COVID-19 pandemic. Syphilis infections nationwide climbed rapidly in recent years, reaching a 70-year high in 2022, according to the most recent data from the Centers for Disease Control and Prevention.

A majority of cases in South Dakota are among Native Americans. While the highest number of cases so far this year is in Pennington County, where Rapid City is located, the highest rates are in counties that include tribal lands, such as Buffalo, Dewey and Oglala Lakota counties.

There was a time not too many years ago when there were hardly any reported cases, said Meghan Curry O’Connell, chief public health officer at the Great Plains Tribal Leaders’ Health Board in Rapid City.

“We still have lots of work to do,” she said.

Tribal and state entities have partnered in the last few years to address the situation. Some tribal health care systems send nurses to find and treat patients in the Rapid City area and on reservations. The state Department of Health launched its Wellness on Wheels program last year as well. The program provides a mobile health care unit for rural communities, including STI testing, treatment, education, counseling and referrals to community resources.

Curry O’Connell said the work has had an impact on syphilis cases.

“They’re coming down, but we’re not where they need to be yet,” she said. “We’ll just have to continue working to contain the outbreak, treat people, and get the rates back to where they were.”

The disease can potentially persist for decades if untreated, which can lead to death. During pregnancy, it poses a dangerous risk to the baby; congenital syphilis can cause bone deformities, severe anemia, jaundice, meningitis and even death.

The state had the highest rate of congenital syphilis in the country in 2023 with 54 cases, which was 482.1 cases per 100,000 births. Congenital syphilis cases are below that pace this year but remain higher than 2020, with eight cases reported so far. 

While efforts to address syphilis among adults as a whole have yielded results, efforts to screen pregnant women have been less successful. That’s because some women are not receiving prenatal care, Curry O’Connell said, which means they aren’t getting screened and monitored leading up to birth.

Curry O’Connell said she worries potential cuts to Medicaid by Congress and the Trump administration will worsen access to maternal care in the state, which could affect work to screen and catch syphilis.