Surge in syphilis cases drives some doctors to ration penicillin

Vials of injectable penicillin in cold storage at the Metro Public Health Department in Nashville, Tenn. Injectable penicillin is the go-to treatment for syphilis and the only treatment considered safe for pregnant people with the disease.

When Stephen Miller left his primary care practice to work in public health a little under two years ago, he said, he was shocked by how many cases of syphilis the clinic was treating.

For decades, rates of the sexually transmitted infection were low. But the Hamilton County Health Department in Chattanooga — a midsize city surrounded by national forests and nestled into the Appalachian foothills of Tennessee — was seeing several syphilis patients a day, Miller said. A nurse who had worked at the clinic for decades told Miller the wave of patients was a radical change from the norm.

What Miller observed in Chattanooga is reflective of a trend that is raising alarm bells for health departments across the country.