Syphilis cases are on the rise in the United States, leading to concerns about the availability of the necessary treatment. The city of Houston, Texas, recently declared a syphilis outbreak, with a significant increase in cases among women and a rise in congenital syphilis. The Food and Drug Administration (FDA) has also warned of a potential shortage of Bicillin, the injectable penicillin used to treat syphilis.
Cases of syphilis have been increasing steadily for several years, with a 74% rise in all stages of the disease since 2017. In 2021 alone, there have been over 176,000 reported cases. The number of congenital syphilis cases, which occurs when a mother passes the infection to her baby during pregnancy, has also increased by 32%. Certain regions, like Texas, have seen even more dramatic spikes, with a 650% increase in congenital syphilis cases since 2016.
Dr. James Hodges, an internist in Waco, Texas, has witnessed a surge in syphilis cases among female inmates in two Texas prisons. He expressed concerns about the lack of testing and general awareness of the issue within the prison system. Additionally, the CDC provides guidance for medical screening examinations for immigrants and refugees entering the U.S., but it is unclear if syphilis testing is consistently conducted.
Pfizer, the only pharmaceutical company that manufactures Bicillin, has acknowledged that the drug is in constrained supply but denies an official shortage. Due to the convergence of other illnesses and a shortage of amoxicillin, doctors began prescribing Bicillin as an alternative treatment for strep throat and other bacterial infections in children, which contributed to the dwindling supply. Pfizer has focused on producing more Bicillin for adults, prioritizing pregnant women with syphilis and their contacts. The pediatric version is expected to run out eventually, but there will not be a stock-out of the adult drug.
Healthcare professionals have expressed concerns about the potential shortage of Bicillin, as the drug is crucial for pregnant women with syphilis and the early treatment of the infection. Efforts are being made to increase production and supply, but availability may be limited for the time being.