Syphilis cases in Onondaga County have risen 800% since 2020, from 32 cases in 2020 to 301 in 2025. Onondaga County’s Senior Medical Director, Jim Alexander, said it’s a worrisome number “that keeps us up at night.”
In a briefing for Onondaga County legislators, Alexander detailed the ways in which the county attempts to find and treat sexually transmitted diseases such as HIV, chlamydia, gonorrhea and syphilis. The county maintains a Sexual Wellness Center in the basement of the Civic Center in downtown Syracuse where people can be tested and treated.
“For people who come in and don't have insurance, we're going to see them, we're going to test, and we're going to treat. And if they don't have money for medication, we're going to give them medication,” Alexander said, noting that a typical course of treatment costs about $2. “Gonorrhea and chlamydia and syphilis and HIV, as well as other things like mPox and MGen and trichomonas and other things that are out there have real costs. They have real costs relative to their threat to the community.”
A particular concern is syphilis in newborn babies. Alexander said that in 2025, seven babies were born with syphilis, which can cause organ and brain damage, deformities and other serious health problems. He said that may not sound like a lot but it’s a massive issue.
A significant part of the sharp rise in cases comes from people stuck at the margins of society – women who are homeless, in unstable homes, using drugs, have poor or no insurance and no transportation. He said the county’s street medicine teams “keep (their) ears to the ground” to find these people and get them help.
In a statement, the county Health Department says cases of syphilis this year are running about level with last year, though the numbers can change quickly. Those numbers, the statement says, “remain far too high.”
