Revival of a Beast: The Challenges Facing the Management and Control of Syphilis in Missouri from 2000 to 2024

Syphilis is an old disease that remains to be a major threat in the modern world. In the last decade, we have seen an exponential rise in the number of new cases. While this surge is universal, some places appear to be more affected than others, such as the southern and midwestern states in the United States. In Missouri, the syphilis epidemic strikes almost everywhere, from rural to metropolitan areas, affecting various age groups and subpopulations. We conducted this narrative review focusing on published data regarding syphilis in Missouri, and discussing contemporary risk factors for such an unprecedented spread, and treatment and prevention options. While rurality, social stigma, and medication shortage play a role in this disease spread, new plans are being adopted in the state for mitigation of its burden.