Alabama – and specifically Montgomery County – has a syphilis problem.

in 2022, according to newly released data from the Alabama Department of Public Health. But , as .

The Alabama Department of Public Health this month issued new data on STDs in each Alabama county for 2022. The state saw an overall decline in all sexually transmitted diseases that year, but syphilis bucked that trend. There was a 40% increase in syphilis cases from 2021 to 2022, and ADPH’s report was topped with a graphic urging people to help “stop the rise of syphilis.”

Syphilis cases more than doubled in Montgomery County – home of the state’s capital. Overall numbers are relatively small – there were 421 reported cases in Montgomery County last year. But that’s a huge increase from the 204 cases it saw the previous year, and an outsized percentage of the state’s overall caseload.

Montgomery’s cases accounted for more than 14% of the state’s 2,926 total syphilis cases in 2022. For reference, the county accounts for less than 5% of the state’s population. In terms of raw case counts, Montgomery trailed only Jefferson County, which is the most populous county and home to nearly three times as many people as Montgomery.

In 2021, the last year data was available from the Centers for Disease Control and Prevention, the United States saw the worst year for syphilis since 1950. There were 5.3 cases for every 10,000 people in the nation that year. In 2022, Montgomery County saw nearly 19 cases per 10,000 people.

But Montgomery County isn’t the only place where syphilis cases are on the rise. In fact, several Alabama counties saw even faster increases.

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Overall, 46 of the state’s 67 counties reported more syphilis cases in 2022 than in 2021. Seventeen of those counties saw cases at least double, with a handful of smaller counties seeing fivefold increases.

DeKalb, Fayette and Monroe counties each saw 400% increases in their syphilis case counts, though the total number of cases in all those counties was small.

According to the CDC, syphilis occurs in several stages. Data listed here counts all stages of the disease in Alabama. Syphilis is a serious disease if untreated, and cause significant problems. You can read more about the disease here.

Other STDs on the decline

Even as syphilis cases rose in Alabama in 2022, the rate for other leading STDs fell. Statewide, cases of gonorrhea fell by 18%, and cases of chlamydia – by far the most common STD in Alabama – fell by 2%.

And just as Montgomery led the state in syphilis rate, it also led for both of those other common STDs. And it wasn’t particularly close.

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There were 113 cases of chlamydia per 10,000 residents in Montgomery County in 2022. That was about 8 in 10,000 more than No. 2 on the list, neighboring Lowndes County.

Similarly, Montgomery saw nearly 60 cases of gonorrhea per 10,000 residents last year, about 15 cases per 10,000 more than No. 2 Jefferson County – home to Birmingham.

Even with the high case counts, chlamydia and gonorrhea cases were actually down in Montgomery in 2022 compared to the previous year.

Do you have an idea for a data story about Alabama? Or questions about Alabama that data may be able to answer? Email Ramsey Archibald at [email protected], and follow him on Twitter @RamseyArchibald. Read more Alabama data stories here.