South Dakota has a syphilis problem.

It was syphilis. Close to destruction In the 1990s in the United States, but cases in South Dakota were on the rise in the years before the Covid-19 pandemic. Nationally, syphilis infections have risen rapidly in recent years and are expected to top 70 by 2022, according to data from the Centers for Disease Control and Prevention. That increase comes between Penicillin deficiency, a very effective treatment, due to the increase in syphilis cases nationwide. The shortage is predicted to continue Until the end of this year.

In 2020 and 2021, hospitals were overwhelmed with treatment for the coronavirus and patients were reluctant to get tested or treated for sexually transmitted diseases, said Meghan Curry O’Connell, a member of the Cherokee Nation and Chief Public Health Officer of the Great Plains Tribal Leaders Health Board in Rapid City.

Curry O’Connell, a family doctor by training, said: “The whole system of making sure people are tested and treated for STIs has been overwhelmed by Covid, just like everything else. “Additional challenges in South Dakota in particular include access to care in very rural areas, which can lead to an epidemic.”

Native American communities were hit hard

Native American communities were hit hardest by the epidemic in South Dakota and nationwide. In South Dakota, 90% of congenital syphilis cases are among Native Americans. According to the state health department.

Syphilis causes a variety of symptoms, including rashes, sores, and hair loss. But if the disease is left untreated, the infection may remain but symptoms may disappear, making it widespread unless sexually active people are educated about the disease, practice safe sex and get tested regularly, Curry O’Connell said.

If the disease is not treated, it can last for decades, which can lead to death. If pregnant people are infected, it poses a serious risk to their child; Congenital syphilis can cause bone defects, severe anemia, jaundice and meningitis and even death. In 2022 CDC registered Nationally, 231 stillbirths and 51 infant deaths were reported from 3,761 cases of syphilis born during the year.

Great Plains Tribal Leaders Board of Health and Tribal Leaders from North Dakota, South Dakota, Nebraska and Iowa they asked. The federal Department of Health and Human Services to declare public health emergencies in their states. press release It was expanding. Access to information on staffing, funding and contact tracing in their region.

“Treatment is important because we want to prevent any of these outcomes and it’s easy for people to do that,” Curry O’Connell said. “Most people only need one shot of penicillin if they’re newly infected.”

Rates of congenital syphilis infection among Native Americans ( 644.7 cases In the year (per 100,000 people in 2022) compared to the total US population in 1941.651.1Before doctors started using penicillin to treat syphilis According to KFF Health News.

The risk is especially high for people with limited health care.

“If you’re missing out on care or you don’t have regular contact with a doctor, those people are more likely to go untreated,” Curry O’Connell said. It can be lost.”

How SD entities are addressing the epidemic.

The Brogamer position is supported by funding from the Indian Health Service. His “boots on the ground” method is the most effective way for patients, even if it is “grinding,” Broghammer said.

Because of homelessness, financial or privacy issues, many patients struggle to find their way to Oyate Health on the west side of Rapid City, Broughhammer said. He meets patients anywhere: their homes, hotels or parking lots.

“Some days we get five to six phone calls, which is great. Other days we’re picking up the phone and trying to reach people, but we might not find anyone,” said Broughhammer. “It’s not as simple as making a phone call and meeting with them. We have a good size population where it is difficult to reach our homeless relatives – no phone or address. Sometimes we literally have nothing to go on.

Some other health care systems test for syphilis but do not go to the patient’s location.

“Underneath all of this is tremendous wealth, especially in rural areas,” Curry O’Connell said. “However, we do not yet know of a replacement. Boots on the ground, going out to talk to people, getting tested and doing what needs to be done is just basic public health work, and there really isn’t anything else that works better.

Some tribes and Indian Health Service areas are sending nurses to South Dakota reservations to meet and treat people. The state health department plans to launch the Wells on Wells program in May, with five vans traveling across the state to deliver basic health services to rural communities — including STD testing, treatment, education, counseling and community resources.

The vans offer pregnancy care services, safe sleep guidance and developmental screenings for children, WIC services, maternal depression screenings, immunizations and oral health.

“We hope to use these vans several times a week to reach our customers who cannot get to one of our physical locations,” department media spokeswoman Tia Kafke said in an emailed statement. “The vans work as much as possible in the winter, weather permitting.”

The state, tribes and tribal health boards have monthly meetings about syphilis, Curry O’Connell said. The IHS recommends that every patient age 16 and older be screened for syphilis at least once a year. Pregnant patients should be tested three times during pregnancy.

Broghamer often receives calls from state health departments with people who have tested positive for syphilis.

“They save me time and energy, so I know they’re working their tails off,” Broghammer said.

The State Department began piloting a rapid-testing partnership with a health care provider on the Rosebud Reservation mission in December. Eight of the 50 patients tested positive in the first three months and are being treated for the disease.

The move to rapid testing is an important development, experts agree, because patients can be treated immediately when results come back from labs days or weeks later. The department has seven regular examination centers in the state.

The number of syphilis cases in South Dakota has declined since peaking in 2022, although it is still at epidemic levels. Congenital syphilis can only be prevented by treating pregnant women. The number of syphilis cases born in South Dakota increased from 2022 to 2023.

Antenatal care, the key intervention to solve problems of congenital syphilis

While Broughhammer sees the results of the collaboration, he said there could be more entities working together to put more boots on the ground in the state.

Curry O’Connell said more efforts are needed to screen pregnant patients who do not receive prenatal care. In the year In the first half of 2023, one-third of all syphilis-related births did not receive prenatal care. According to the state.

Most women still interact with the health care system during pregnancy, even if they do not receive prenatal care. At that point they should be investigated quickly, Curry O’Connell said.

“If someone goes into urgent care or goes in for something unrelated to pregnancy, that’s probably the start because most women get some kind of care during pregnancy,” Curry O’Connell said. “It’s trying to maximize the screening capacity of those visits that are important.”

Education, Broughhammer, is an important tool.

“I think the biggest thing is just research,” Brogmer said. “If you’re asexual, bye: come clean and come clean. Be aware of your partners and practice safe sex.

South Dakota Searchlight It is part of State News Division, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. South Dakota Searchlight maintains editorial independence. Contact editor Seth Tupper for questions: info@southdakotasearchlight.com. Follow the searchlight of South Dakota Facebook And Twitter.