Double whammy: Syphilis rose in Alaska in 2021, while people worked from home to avoid Covid

Not everyone was socially distancing during the Covid-19 pandemic, which started in Alaska in March of 2020, even if they were working at home to avoid Covid.

According to the State Department of Health, syphilis rates in Alaska continued to escalate, just as they have nationwide. The department notes in its epidemiological update that Covid pandemic policies likely contributed to the explosion of the venereal disease in Alaska, “including reduced field services and decreased access to in-person clinical services.”

A 24% increase in syphilis cases in Alaska were reported in 2021, compared to the previous year. That totals 447 cases, with five of the cases in newborns.

Of those cases, 336 — 73% — were in primary secondary or early latent stages, meaning the infected person had recently acquired the disease. Another 116 — 26% — were of unknown timeframe or had progressed to the late latent stage.

Syphilis is sexually transmitted and was spiking just as Covid was sweeping through Alaska and as more people were working from home in greater numbers than at any time in history. Syphilis is a bacterial infection usually spread by sexual contact. The symptoms start as painless sores on the genitals, rectum, or mouth, which heal. Then comes a rash. And then there are no symptoms until the final stage, which can occur years later, and can impact internal organs, brain, nerves, eyes, and heart. The disease is treated with penicillin.

The state’s syphilis outbreak started in 2018, with 114 cases reported that year. By the end of 2021, the cases had nearly quadrupled.

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The state breaks the numbers down for 2021:

• 235 (53%) were male. 162 (69%) of those males self-identified as heterosexual, 52 (22%) self-identified as gay, and 7 (3%) self-identified as bisexual;
• 207 (47%) were female. 185 (89%) of those females were of reproductive age (15–44 years), 180 (87%) self-identified as heterosexual, 12 (6%) self-identified as bisexual, and 1 (1%) self-identified as lesbian or gay;
• 434 identified as cisgender. This means they identify with their biological gender. 4 identified as transgender and 4 were of unknown gender identity;
• 187 (42%) were in Alaska Native/American Indian, 111 (25%) were white persons, 57 (13%) were black persons, 55 (12%) were multiracial persons, 31 (7%) were hispanic/latino persons (of all races), 14 (3%) were Native Hawaiian/Pacific Islander persons, 10 (2%), were Asian persons, and 8 (2%) identified as other or unknown race;
• 394 (89%) were residents of urban communities such as Anchorage, Mat-Su, Juneau, and Fairbanks;
• The age range was 16–70 years (52% were younger than 35 years); 
• 128 also had another sexually transmitted disease as well: 109 (85%) were simultaneously infected with with chlamydia or gonorrhea; 17 (13%) were co-infected with HIV, and 2 (2%) were co-infected with HIV and chlamydia or gonorrhea;
• 126 (29%) were identified as experiencing homelessness or were unstably housed.

Also notable is that roughly half of the 2021 cases were in women, and nearly 90% of those women were of reproductive age (5 cases of congenital syphilis were reported in 2021).

Racial/ethnic disparities persist in this epidemic, the department reports and drug use is a factor, specifically heroin/meth.

The CDC says that nationally the majority of reported male primary and secondary syphilis cases where the gender of of a sex partner is known are among men who have sex with men.

“Once nearly eliminated in the U.S., syphilis is increasing, especially among gay, bisexual, and other men who have sex with men,” the CDC reports.

Syphilis cases are also continuing to rise nationally. Factors contributing to the national epidemic are multifold, including substance use, poverty, stigma, and unstable housing, which can reduce access to STI prevention and care. 

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