Some doctors have been forced to ration penicillin amid an alarming syphilis epidemic spreading across the US.
The number of cases of the sexually transmitted disease has risen by more than 2,000 percent, from 6,862 in 2002 to 203,500 in 2022, with national figures at their highest level in 70 years.
The situation was worsened last spring by a shortage of penicillin injection, the first treatment for the STD.
The shortage, which continues, has become so bad that public health authorities have advised providers to ration and save the drug for pregnant patients because it is the only syphilis treatment they can safely receive.
This condition can be fatal or lead to deformities in babies born to infected mothers.
The two maps show how the number of syphilis cases in the US has shifted since 2013
The above graph shows the rate per 100,000 people for the total number of syphilis cases recorded in the US since the 1940s. It shows that they are starting to tick again
But the rationing comes amid a wider drug shortage in America, as large numbers of children have been hospitalized with colds and flu after the lockdown made them more susceptible due to weakened immune systems.
Casual hookups and the ‘explosion’ in popularity of dating apps like Hinge and Bumble are partly blamed for the syphilis epidemic.
Some experts have also pointed to a decline in condom use among American men – nearly 30 percent since 2011, according to some studies.
The sudden return to socializing after the pandemic has led to a spike in sexually promiscuous behavior, experts say. Americans are spending more intimate moments together to “make up for lost time.”
Dr. Monica Gandhi, an epidemiologist at the University of California, San Francisco, previously told DailyMail.com: ‘We had initially reduced STD rates in this country after the lockdowns.
‘But there was also less testing and then there was a very clear recovery. The number of tests fell, the number of treatments fell, and that then fueled an epidemic.’
The CDC today urged doctors to be vigilant and pregnant women ask about syphilis as an attempt to curb the crisis.
The agency made recommendations for testing for syphilis, including serological testing, which checks for the presence of specific antibodies in the blood.
Congenital syphilis occurs when a mother transmits the disease to her unborn child, which can lead to birth defects, miscarriages and stillbirths.
Nationally, there were 3,755 cases of congenital syphilis in 2022 – a tenfold increase from a decade earlier.
From 2018 to 2022, cases in infants grew by 183 percent. A November CDC report attributed the increase to a lack of “adequate treatment during pregnancy.”
Penicillin is used to treat infections caused by bacteria, such as meningitis, pneumonia, gonorrhea, and syphilis.
In 2021, there were 46.4 million penicillin prescriptions in the US – the equivalent of 127,123 per day.
Rationing it could leave thousands of Americans without treatment for their throat infections, meningitis and other bacterial infections.
Two antibiotics are used to treat syphilis: the injectable penicillin and an oral drug called doxycycline
Congenital syphilis occurs when a mother spreads the disease to her unborn child, which can lead to birth defects, miscarriages, and stillbirths
Two antibiotics are used to treat syphilis, the injectable penicillin and an oral drug called doxycycline.
The World Health Organization strongly recommends that pregnant women avoid taking doxycycline as it can lead to bone and tooth deformities in babies.
Mark Turrentine, a Houston gynecologist, told me KFF Health News that he received advice in April about the shortage of injectable penicillin, which coincided with the antibiotic amoxicillin being difficult to obtain.
In 2022, a spike in respiratory illnesses forced drugstore chains to temporarily limit purchases of fever-reducing medications for children, contributing to a shortage of amoxicillin – a chemically modified penicillin antibiotic in tablet form.
Doctors used penicillin as a substitute, he said, which could have partially caused the shortage.
Pfizer, the shot’s manufacturer, cited “significant increases in demand” due to “an increase in syphilis infections” as an explanation for the shortage in a June 2023 letter to customers.
Erin Fox, associate chief pharmacy officer for the University of Utah Health Care System, told KFF that while penicillin is not a new drug, it is complicated to make because so many people are allergic to it.
She said, “That means you can’t make any other drugs on that production line.
“It’s not necessarily efficient – or necessarily profitable.”
Only pharmaceutical giants like Pfizer have the resources to oversee a specialized, separate facility.
In a statement, Pfizer said demand for penicillin injections had increased by about 70 percent.
But for now, Dr. Stephen Miller, a primary care physician in Chattanooga, Tenn., said his clinic was forced to come up with a strategy.
Each penicillin injection can cost hundreds of dollars. It must also be stored in the cold and has a shelf life of 48 months.
The National Coalition of STD Directors said the STD epidemic is “out of control,” and Tennessee has been particularly hard hit, with infections in the first two stages of syphilis increasing 86 percent between 2017 and 2021.
Syphilis is a bacterial infection spread through contact with sores that usually appear around the pubic area or mouth.
Symptoms appear within three to four weeks of an infection and often go unnoticed or dismissed as minor abrasions or heat rash.
The disease may then enter a second phase, where the ulcer disappears and is replaced by a rash that can last for weeks.
Without treatment, patients risk the disease spreading to the brain and spinal cord, which can cause complications including headaches, stroke and meningitis – or inflammation of the brain’s protective walls.
Meanwhile, a report last month warned that one in five Americans has been affected by crippling drug shortages.
Manufacturing problems, supply chain hiccups and natural disasters have left patients without access to the medical treatment they need, including life-saving drugs for cancer, epilepsy and type 2 diabetes.
The ripple effects of the series of supply chain problems that plagued 2022 could still be behind the current medical shortages, the report from LendingTree insurance subsidiary ValuePenguin.com suggested.
The pandemic was also likely a culprit, causing a historic decline in the manufacturing industry. Covid has also increased demand for many types of medicines and equipment, such as Paxlovid and N95 masks.