Syphilis remains a public health problem even though CDC has established the "National Plan to Eliminate Syphilis in the United States" in 1999. The goal was less than 1000 cases of syphilis each year.
- Through public health efforts, syphilis was at the lowest number of cases in 2000
- Cases and outbreaks have increased since then
- 5.3 cases per 100,000 in 2014, double that of 2000
- 85% of cases are in men who have sex with men
- Congenital cases declined by 92% between 1991 and 2004
- The Black/White disparity has also dropped from 29:1 in 1999 to 5.2:1 in 2013
New testing methods such as the automated EIA and CIA have changed laboratory practice in recent years
Serology is the primary method of diagnosis because:
- Inability to culture the organism
- Problems with microscopy
- Long periods of time when the disease is asymptomatic
