Washington, DC, September 24, 2025 — The National Association of County and City Health Officials (NACCHO), the voice of the over 3,300 local health departments across the country, has issued the following statement in response to the provisional 2024 STI Surveillance Data report released today by the Centers for Disease Control and Prevention (CDC). In 2024, congenital syphilis cases increased by 2% to nearly 4,000 cases. As congenital syphilis in newborn cases continue to rise for the 12th year in a row, preventing new cases will require increased investment in the local public health workforce.
“The continued rising rates of congenital syphilis—a completely preventable condition—are alarming,” said Lori Tremmel Freeman, NACCHO CEO. “While the latest data are concerning, there are also encouraging signs in the report, with declining rates of gonorrhea, chlamydia, and primary and secondary syphilis. There is still work to be done, and we are deeply grateful for the dedication of our local health departments and disease intervention specialists to this important work. Every day, they work to ensure communities have access to timely care and treatment. Increased federal support for local public health activities is critical to sustaining outreach programs, treatment services, and staff who make this progress possible. Without local health department staff, there could not be reductions in STI rates, nor hope to reduce congenital syphilis rates.”
While STIs continue to pose a substantial burden on public health, the data reveal some signs of improvement. In 2024, more than 2.2 million STIs were reported in the United States, showing a 9% decline from 2023, but 13% higher than a decade ago. For a third consecutive year, new cases of gonorrhea have declined by 10%. Primary and secondary syphilis cases (the most infectious stages of syphilis) and chlamydia have declined for a second consecutive year, by nearly 22% and 8%, respectively. Unfortunately, the 2024 cases of congenital syphilis are nearly 700% higher than 10 years ago. Congenital syphilis is caused by syphilis passing on to a baby during pregnancy. Without proper treatment, congenital syphilis can have significant impacts on the health of the baby including miscarriage, stillbirth, and neonatal death. Congenital syphilis can be prevented with proper treatment during pregnancy – which includes regular prenatal care and multiple syphilis tests.
Local health departments play a key role in contributing to the decline of new STI rates by being the boots on the ground to test, track and treat STIs. In particular, disease intervention specialists have been and continue to be essential to STI prevention and control via partner services, case investigation, and provision of timely treatment. Yet, the public health workforce continues to shrink. According to NACCHO’s Forces of Change report, 19% of local health departments reported job losses due to layoffs or attrition, an increase over 2021 and 2022, and 17% of local health departments reported budget cuts in fiscal year 2024. The data reinforces that increased investment in workforce is needed and will ensure that local health departments have the capacity to respond to emerging and ongoing public health threats, including the STI epidemic.
NACCHO continues to work to support innovative STI prevention and treatment efforts in communities. Local health departments can consider using tools that allow for more testing and treatment outside of the clinic, including NACCHO’s point of care testing resource and working with partners, like pharmacies.
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About NACCHO
The National Association of County and City Health Officials (NACCHO) represents the over 3,300 local governmental health departments across the country. These city, county, metropolitan, district, and tribal departments work every day to protect and promote health and well-being for all people in their communities. For more information, visit www.naccho.org.
