SYPHILIS
Sexually Transmitted Disease Surveillance 2009
Division of STD Prevention
Syphilis—Reported Cases by Stage of
Infection, United States, 1941–2009
Primary and Secondary Syphilis—Rates by Sex and
Male-to-Female Rate Ratios, United States, 1990–2009
Rate (per 100,000 population) Rate Ratio (log scale)
25 16:1
Male Rate
Female Rate
20 Total Rate
8:1
Male-to-Female Rate Ratio
15
4:1
10
2:1
5
0 1:1
1990 1992 1994 1996 1998 2000 2002 2004 2006 2008
Year
Primary and Secondary Syphilis—Rates by Region,
United States, 2000–2009
Rate (per 100,000 population)
10
West
Midwest
8
Northeast
South
6
4
2
0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
Year
Primary and Secondary Syphilis—Rates by State,
United States and Outlying Areas, 2009
2.1
VT 0.0
0.4 0.6 0.3 NH 1.1
1.4
1.5 MA 3.7
0.8 RI 1.9
0.2 0.0 6.1
Guam CT 1.9
0.6 2.3 NJ 2.4
1.1 0.8 2.7
0.3 DE 3.1
3.5 3.1
1.1 5.8 MD 5.6
2.5
5.2 2.1 0.4 3.8 DC 27.5
1.1
2.9 2.2
6.3
2.7 6.5
3.6 3.1 9.6 Rate per 100,000
2.7
population
8.1 9.8
8.9 2.2 (n = 30)
Puerto Rico Virgin
2.6 5.7 Islands
0.0
NOTE: The total rate of primary and secondary syphilis for the United States and outlying areas (Guam,
Puerto Rico, and Virgin Islands) was 4.6 per 100,000 population.
Primary and Secondary Syphilis—Rates by County,
United States, 2009
Rate per 100,000
population
2.2 (n = 592)
NOTE: In 2009, a total of 2,194 (69.9%) of 3,141 counties in the United States reported no cases of primary
and secondary syphilis.
Primary and Secondary Syphilis—Rates by Age and Sex,
United States, 2009
Men Rate (per 100,000 population) Women
25 20 15 10 5 0 Age 0 5 10 15 20 25
0.0 10–14 0.2
6.0 15–19 3.3
20.7 20–24 5.6
18.5 25–29 3.6
15.8 30–34 3.0
13.3 35–39 1.9
13.7 40–44 1.6
8.3 45–54 1.0
2.9 55–64 0.2
0.5 65+ 0.0
7.8 Total 1.4
Primary and Secondary Syphilis—Rates by Age Among
Women Aged 15–44 Years, United States, 2000–2009
Rate (per 100,000 population)
6
Age Group
15–19 30–34
5
20–24 35–39
25–29 40–44
4
3
2
1
0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
Year
Primary and Secondary Syphilis—Rates by Age Among
Men Aged 15–44 Years, United States, 2000–2009
Rate (per 100,000 population)
25
Age Group
15–19 30–34
20 20–24 35–39
25–29 40–44
15
10
5
0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
Year
Primary and Secondary Syphilis—Rates by
Race/Ethnicity, United States, 2000–2009
Rate (per 100,000 population)
25
American Indians/Alaska Natives
Asians/Pacific Islanders
20 Blacks
Hispanics
Whites
15
10
5
0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
Year
Primary and Secondary Syphilis—Reported Cases* by
Stage, Sex, and Sexual Behavior, United States, 2009
Cases
6,000
Primary
5,000 Secondary
4,000
3,000
2,000
1,000
0
MSW† Women MSM†
* Of the reported male cases of primary and secondary syphilis, 20% were missing sex of sex partner information.
† MSW = men who have sex with women only; MSM = men who have sex with men.
Primary and Secondary Syphilis—Reported Cases* by
Sex, Sexual Behavior, and Race/Ethnicity,† United States,
2009
Cases
3,000
Whites
2,500 Blacks
Hispanics
2,000 Other
1,500
1,000
500
0
MSW‡ Women MSM‡
* Of the reported male cases of primary and secondary syphilis, 20% were missing sex of sex partner information;
1.7% of reported male cases with sex of sex partner data were missing race/ethnicity data.
† No imputation was done for race/ethnicity.
‡ MSW = men who have sex with women only; MSM = men who have sex with men.
Primary and Secondary Syphilis—Reported Cases by
Reporting Source and Sex, United States, 2000–2009
Cases (in thousands)
8
7 Non-STD* Clinic , Men
Non-STD Clinic, Women
6 STD Clinic, Men
STD Clinic, Women
5
4
3
2
1
0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
Year
* STD = sexually transmitted disease.
Primary and Secondary Syphilis—Percentage of Reported Cases*
by Sex, Sexual Behavior, and Selected Reporting Sources, 2009
Percentage Correctional Facility
50 HIV Counseling and Testing Site
Private Physician/HMO†
40 STD† Clinic
30
20
10
0
MSW† Women MSM†
* Of the reported male cases of primary and secondary syphilis, 20% were missing sex of sex partner information,
and 1.7% of reported male cases with sex of sex partner data were missing source of information data.
† HMO = health maintenance organization; STD = sexually transmitted disease; MSW = men who have sex with
women only; MSM = men who have sex with men.
Congenital Syphilis—Reported Cases Among Infants by Year of
Birth and Rates of Primary and Secondary Syphilis Among Women,
United States, 2000–2009
CS* cases (in thousands) P&S* rate (per 100,000 women)
0.8 4
CS Cases
P&S Rate
0.6 3
0.4 2
0.2 1
0.0 0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
Year
* CS = congenital syphilis; P&S = primary and secondary syphilis.
For more information please contact Centers for Disease Control and Prevention
1600 Clifton Road NE, Atlanta, GA 30333
Telephone, 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348
E-mail: cdcinfo@cdc.gov Web: www.cdc.gov
The findings and conclusions in this report are those of the authors and do not necessarily represent the official
position of the Centers for Disease Control and Prevention.
National Center for HIV/AIDS, Viral Hepatitis, STD & TB Prevention
Division of STD Prevention