Health care providers are warning about a concerning rise in syphilis diagnosed during pregnancy across the state, calling for more awareness, testing and treatment.

Syphilis is one of the most common sexually transmitted infections in Marion County, according to the county’s health department. It’s caused by bacteria, and its symptoms come in stages, typically starting with a sore. As the infection progresses, it can eventually damage nervous systems.

If untreated, syphilis during pregnancy can lead to miscarriage, fetal abnormalities, death or premature birth, the Oregon Health Authority said in a Tuesday news release.

When the infection is transmitted to the fetus, that’s called congenital syphilis. It doesn’t happen 100% of the time, said Dr. Pete Singson, the Oregon Health Authority’s medical director for sexually transmitted diseases.

“If syphilis can be diagnosed and adequately treated early enough during pregnancy, transmission to the baby can be averted,” he said in an email to Salem Reporter. Early stages of the infection also pose a higher risk of transmission.

Anyone who is sexually active is at risk for STIs, and should get tested regularly, according to the county. Marion County offers testing by appointment, and can be reached by phone at 503-588-5342. See a list of other places to get tested in the community here.

In Oregon, congenital syphilis cases increased twentyfold between 2014 and last year. In 2024, there were 45 cases diagnosed statewide, compared to two a decade prior.

The Salem area represented a quarter of the state’s cases last year. Ten of the 45 congenital cases were diagnosed in Marion County, and two in Polk County, according to county and state data. Marion County residents are about 8% of Oregon’s population.

In Marion County last year, 22 total pregnant people were diagnosed with syphilis, up from nine the year prior. 

The county is working to address the increase, said spokeswoman Melissa Gable.

“Our efforts have focused heavily on strengthening provider engagement, improving early detection and treatment and enhancing our data systems to support more timely and targeted public health responses,” she said. They’ve also expanded outreach and education efforts, she said.

This also includes encouraging health care providers to start treating likely syphilis cases without delay, even before test results come in. This helps people who may not come back for follow-up care, Gable said.

In 2023, 227 people in Marion County were diagnosed with syphilis, according to state data. Last year’s data was not yet posted on the Oregon Health Authority’s page.

In-line with state data, local syphilis infections disproportionately affect people of color. Indigenous and Black communities see the highest rates of infection in Marion County.

Singson, in a February letter to health care providers said that these rate disparities are due to the combined effects of systemic racism, poverty, homelessness, incarceration, substance use and stigma. In the letter, he said it’s important to remember the Tuskegee Syphilis Study, which denied hundreds of Black men from available treatment for four decades, through 1972, in order to study the disease’s impact on their bodies.

“This distrust endures and continues to impact healthcare access and outcomes. We must work to rebuild trust by ensuring equitable, culturally responsive care that confronts the social conditions that drive the current (congenital syphilis) crisis,” Singson said.

As of May 14, no new cases have been reported in Marion and Polk counties for 2025, said Singson in an email.

Learn more about congenital syphilis on the Centers for Disease Control’s website.

Contact reporter Abbey McDonald: [email protected] or 503-575-1251.

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Abbey McDonald

Abbey McDonald joined the Salem Reporter in 2022. She previously worked as the business reporter at The Astorian, where she covered labor issues, health care and social services. A University of Oregon grad, she has also reported for the Malheur Enterprise, The News-Review and Willamette Week.