Sexually Transmitted Infections – Syphilis But Is Monkeypox an STI?
The rise in rate of sexually transmitted infections (STIs) may raise concerns for you and your patients. This comes alongside the emergence of monkeypox here in the United States – a topic your patients may talk to you about.
After a dip in US reports of sexually transmitted diseases (STDs) early in the COVID-19 pandemic, cases have resurged, according to the CDC’s 2020 STD Surveillance Report¹. Nationwide, cases of syphilis increased 52% from 2016 to 2020, and congenital syphilis cases are up by 235%. The CDC data ranks Maryland 14th overall in reported cases of primary and secondary syphilis, and 15th overall in reported cases of congenital syphilis. Preliminary data for 2021² shows yet another increase of congenital syphilis, considered a sentinel event in the healthcare system.
MedPage Today addressed this resurgence in a recent article titled The Syphilis Surge Must Be Viewed as a Public Health Emergency.³ The CDC regularly updates their resources for physicians⁴ on testing, treatment, and reporting.
Monkeypox Transmission Via Sexual Contact
Monkeypox seems to be everywhere in the news these days. While it is not considered an STI since it can be spread through any physical contact – not just sexual contact – it is important to note that it appears as of this writing to be spread by sexual contact between men who have sex men (MSM)⁵. The CDC urges physicians to be alert for patients who have rash illnesses⁶ consistent with monkeypox, regardless of whether they have travel or specific risk factors for monkeypox and regardless of gender or sexual orientation.
Potential monkeypox infection is recognized by its clinical course similarity to that of ordinary discrete smallpox. After infection, there is an incubation period which lasts on average 7-14 days. The development of initial symptoms (e.g., fever, malaise, headache, weakness, etc.) indicates the beginning of the prodromal phase.⁷ Because of the theoretical risk of airborne transmission of monkeypox virus, airborne precautions should be applied whenever possible. At this time, there are no specific treatments available for monkeypox infection, but monkeypox outbreaks can be controlled⁸ through the use of the smallpox vaccine, cidofovir, ST-246, and vaccinia immune globulin (VIG).
- Kuehn BM. Resurgence of Sexually Transmitted Diseases in the US. JAMA. 2022;327(20):1951. doi:10.1001/jama.2022.7483
Preliminary 2021 Data: Syphilis. www.cdc.gov. Published May 23, 2022. Accessed June 3, 2022. https://www.cdc.gov/std/statistics/2020/preliminary2021.htm
Leston, MPH J, Reilley, MPH B. Opinion | The Syphilis Surge Must Be Viewed as a Public Health Emergency. www.medpagetoday.com. Published May 22, 2022. Accessed June 3, 2022. https://www.medpagetoday.com/opinion/second-opinions/98852?xid=nl_secondopinion_2022-05-24&eun=g2126124d0r
Centers for Disease Control. What Healthcare Providers Can Do About Syphilis | Syphilis | CDC. www.cdc.gov. Published September 18, 2019. https://www.cdc.gov/std/syphilis/CTAproviders.htm
Browne E. Monkeypox, sex and transmission: What we know, what we don’t. Newsweek. Published May 23, 2022. Accessed June 3, 2022. https://www.newsweek.com/monkeypox-sexual-spread-men-sex-msm-std-what-we-know-1709025
Centers for Disease Control. U.S. Monkeypox 2022: Situation Summary | Monkeypox | Poxvirus | CDC. www.cdc.gov. Published June 3, 2022. Accessed June 3, 2022. https://www.cdc.gov/poxvirus/monkeypox/outbreak/current.html
Centers for Disease Control. Clinical Recognition | Monkeypox | Poxvirus | CDC. www.cdc.gov. Published December 28, 2018. Accessed June 3, 2022. https://www.cdc.gov/poxvirus/monkeypox/clinicians/clinical-recognition.html
Centers for Disease Control. Treatment | For Healthcare Professionals | Monkeypox | Poxvirus | CDC. Centers for Disease Control. Published July 17, 2021. Accessed June 3, 2022. https://www.cdc.gov/poxvirus/monkeypox/clinicians/treatment.html