Cases of a devastating STI are on the rise and newborns are at high risk for deadly complications.
The deadly and entirely preventable disease has claimed the lives of 42 babies in Australia, and a spike in cases in the US has experts worried about a potential uptick in domestic deaths.
Across the US, syphilis cases have risen sharply over the past decade. In states like New York, infections have increased fivefold since 2013, reflecting a broader nationwide trend.
Last month, several California counties reported particularly alarming rates.
Even more concerning, federal data shows congenital syphilis — when the infection is passed from a pregnant mother to her baby — has skyrocketed by 700% compared to roughly ten years ago.
“As a physician and former public health official, I have never been more concerned about those rates of congenital syphilis,” Jeffrey D. Klausner, a clinical professor of medicine at the Keck School of Medicine of the University of Southern California, wrote in an op-ed for STAT this week.
Left untreated, congenital syphilis can lead to miscarriage, premature birth, skeletal abnormalities, neurological problems, developmental delays, stillbirth or infant death shortly after birth.
In 2024, the CDC reported nearly 4,000 new cases of congenital syphilis, the highest case number since the mid-1950s.
In Australia, the disease has been the cause of 42 infant deaths in the past decade and a source of infection for countless others, leading the country’s Chief Medical Officer to deem it a “communicable disease incident of national significance.”
“It worries us a lot. It’s 100% important not to allow it to spread and to become endemic,” University of Adelaide Emeritus Professor Maciej Henneberg told the outlet.
Syphilis is spread by vaginal, anal or oral sex. Symptoms typically emerge 10 to 90 days after exposure, starting with a painless sore at the site where the bacterium Treponema pallidum enters the body.
The sore can heal on its own in three to six weeks, even as the infection persists.
In the next stage of infection, symptoms can include a rash, fever, fatigue, sore throat, swollen lymph nodes and hair loss.
If not addressed, it can devastate the brain, heart, and nervous system, leading to blindness, paralysis, and even death.
Syphilis is typically diagnosed with a blood test.
Despite progress in reducing other sexually transmitted infections like chlamydia and gonorrhea, congenital syphilis has continued to climb year after year in the US.
By 2024, it marked 12 consecutive years of increases, reaching its highest level since 1994.
According to the CDC, most cases of congenital syphilis are the result of pregnant women not being tested for syphilis or not being properly treated when they test positive.
Lack of insurance or access, fear of immigration detention, substance use and mental health problems can all create barriers to proper prenatal care and testing.
Even among women who do receive appropriate prenatal care, only 80% are tested for syphilis.
The disease can be effectively treated — and cured — with antibiotics such as penicillin, particularly when caught in its early stages.
“It is entirely preventable, so even if a pregnant person got syphilis, we can totally treat that pregnant person, and then the baby will not be at risk any longer,” Dr. Kelly Hosking, director of sexual health and blood-borne viruses strategy and policy for NT Health, told ABC News Australia.
In 2024, in response to rising syphilis rates, New York implemented a new requirement for syphilis screening.
Pregnant women must now be tested for syphilis at their first prenatal appointment, in their third trimester (between weeks 28 and 32), and at delivery.
Still, Klausner says there is more that can be done on a national scale to treat and prevent congenital syphilis, including making rapid point-of-care tests and same-day injectable penicillin treatment available in clinics and testing locations.
Klausner also underscored the importance of integrating prenatal care and substance abuse treatment to ensure high-risk populations have access to testing and treatment.
“Dead babies have no voice, and the families devastated by congenital syphilis are too stigmatized to speak up,” he said. “Physicians and those who care about children’s health must loudly advocate and demand attention from our public health leaders.”

Whenever it rains, Joseph, Gift and Alumbwe — ages 17, 15 and 12 — scramble to move their clothes to a dry corner of their home, deep in the Copperbelt Province of Zambia. That’s because rain streams through holes in the roof.
“The house is not okay. Even though we live here it’s only because we have nowhere else to go,” says Joseph, speaking in the local language Bemba. “When it starts raining, where we sleep becomes wet.”
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They don’t have to move their mattresses, he explains, because they don’t have any — the boys sold them when they needed money. Instead, they sleep on a bamboo mat on the floor and share a blanket.
Their mother died in January, their father in February. Now these brothers are in the process of figuring out the basics of living alone.
NPR is not using the brothers’ last name because they are minors.
Both parents were HIV positive but had been able to survive because of the daily medications they took to prevent the virus from progressing. When the U.S. overhauled foreign aid at the start of President Trump’s second term, there were major cuts to global health — and disruptions to the U.S.’s flagship efforts to combat HIV/AIDS globally called PEPFAR or the U.S. President’s Emergency Plan for AIDS Relief.
The boys say that, in the overhaul, their parents could no longer get their HIV medications as the program that delivered medication to their remote area suddenly stopped. It took just about a year for both parents to succumb to the virus.
The phenomenon of child-headed households and orphans was a defining element of the early years of the AIDS epidemic in the 1980s and ’90s. But it diminished with major support efforts from the U.S. as well as the widespread availability of HIV medications that dramatically improved life expectancy.
It’s too early for official statistics to capture whether the shifting aid landscape has caused a spike in orphans and child-headed households. However, a reverend in Zambia — Billiance Chondwe — says he’s noticed a change.
NPR profiled Chondwe — affectionately known by his congregation as Pastor Billy — last year as his community dealt with the aid cuts and disruptions. At the time, he told NPR many of his community members had suddenly lost access to their HIV medication as the nearby PEPFAR-funded clinics they depended on had shuttered. Now, he reports, children are paying the price. In his community, he says, parents are dying of HIV. And that’s leading to the return of child-headed households.
He is trying to help 25 newly orphaned children, up from 11 a couple months ago. “There is a lot of stress and pressure,” Pastor Billy says, ticking off a long list of concerns. “They don’t have enough food. Where they are staying [is not suitable]. There’s no support.”
“God can take care of us”
As a teenager, Pastor Billy lost his twin sister to AIDS. “It brought me to my knees,” he remembers. In the decades since then it’s driven him to help others with the virus. Lately, that work has entailed tracking down people whose U.S. funded HIV-clinics closed overnight as a result of aid cuts last year.
Sometimes, he can help people connect with Zambian government clinics to get the medications they need — but not always. Increasingly, he says, he’s finding children scrambling to figure out what to do as their parents get sick without their HIV/AIDS medications. That’s what happened in January when a community member asked him to check on a family living in a remote area. When he got there, he found Joseph and his brothers along with their ailing father.
“There was so much fear in the faces of the boys. There was so much worry and panicking in the face of the father,” Pastor Billy recalls.
Because Joseph’s family lived three, almost four, hours walking distance from the nearest hospital, community health workers — paid for by a U.S. government aid program — had brought HIV medications to their home. U.S. funding cuts changed that.
“In the rural remote areas, there used to be mobile clinics and nowadays it is not there,” says Pastor Billy.
The boys watched as AIDS took hold and their parents grew weak and lost their appetite. Soon they were losing weight rapidly and struggling with diarrhea. They didn’t have the strength to walk to the hospital. So the family came up with a plan of action.
“We started selling things in the house,” Joseph says. “Whoever wanted to buy a mattress, we would sell. Whoever wanted pots, we would sell.”
The money was to pay for a motorcycle taxi to get to the hospital.
Each night the boys would kneel in the dark and pray for help. The final months were fraught and painful as their parents argued about how the virus had been introduced into their household and worried about what would happen as their condition worsened. Their mother ended up going back to her sisters’ place and dying there. Once their father died, Joseph says, he had no idea what to do.
“We started going to church so that God can take care of us,” he says.
“Creating orphans at a remarkably rapid rate”
When the HIV/AIDS epidemic first hit Africa, the virus was infamous for killing people in their child-bearing years — and “creating orphans at a remarkably rapid rate,” says Dr. Eric Goosby, the second director of PEPFAR from 2009 to 2014 and now a professor of medicine at University of California, San Francisco. That’s what he told NPR last year. “The community around [the kids] rejected them because the stigma for HIV was so severe.”
PEPFAR, which was created under President George W. Bush and grew to be a widely celebrated program, was committed to helping these children.
“We created a system of care that took care of almost 6 million kids every year,” Goosby explains. “It’s a largely unsung story for PEPFAR and it’s the only non-traditional medical intervention PEPFAR heavily funded.”
The system found local adults and provided stipends so they could care for the children and keep them in their home community. PEPFAR also paid for education, nutrition and medical care since about a quarter of the orphans and vulnerable children were HIV positive.
Pastor Billy says he saw how these efforts transformed children’s lives and futures. Now, much of that support network has disappeared. “Cutting [aid] this suddenly has taken us backwards to a place and a season of hopelessness. There is no clear direction, especially on how we can help child-headed homes,” he says.
Asked to comment on these assertions and the situation Joseph and his brothers find themselves in, the State Department sent NPR a statement saying that the U.S. is the most generous country with humanitarian assistance. “If there are such tragic cases happening around the world, it’s not because we’re not spending enough money. It’s because the rest of the world is not spending enough money,” the statement said.
The statement also said: “The United States has not cut health funding, including PEPFAR, for Zambia.”
While appropriations from Congress for HIV have not changed, the money is often not being spent. The Trump Administration is in the process of revamping how the U.S. does global health work and it is trying to hammer out new agreements with individual countries, including Zambia. The Foundation for AIDS Research or amfAR found an almost 20% drop in PEPFAR expenditures between 2024 and 2025 in Zambia and the loss of more than 5,000 PEPFAR staff in the country. In the Copperbelt Province in particular, the amfAR country report shows that thousands of HIV-positive people lost access to their HIV medications between 2024 and 2025.
“The children they left behind”
As his family life turned upside down, Joseph says he had no choice but to drop out of school and give up on his dream of becoming a doctor. Unable to pay rent, the boys moved several hours away to the small, dilapidated house with the leaky roof where rent is minimal.
“Sometimes the roofing sheets will start coming off because of the wind,” Joseph says.
Joseph got a job as a part-time security guard so he could provide a home for himself and his brothers — and so they can continue their schooling. As he puts on his uniform for work, his brothers head to school. Gift wants to be an engineer and Alumbwe a soldier. While school is free in Zambia, the boys struggle to pay for school books. But they still attend class.
When Joseph is not at work, he says, he’s either doing odd jobs to make additional money or trying to get medication for his two brothers, who are both HIV positive. Their clinic is still an hours-long walk away with a multi-hour wait once there.
Waiting in those lines, Joseph says, he’s realized how common his situation is. He says he sees many other children in similar circumstances. Sometimes Joseph doesn’t make it to the clinic before they run out of the drugs his brothers need, so they must go a day or so without their pills. Pastor Billy tries to help with the medication pick-up but he too lives far away.
About once a month their Uncle John travels from several hours away to check on the boys.
“It brings me sadness and heartache to see the children [my brother] left behind,” he says in Bemba. He says he feels guilty that he can’t house the boys but his household has not only his own five children but also his late sister’s six children.
Right now, he says, the best he can do is bring food when he visits. “I do some farming and when I harvest those crops I will then share with them,” he says.
“If my parents were still alive”
Joseph says playing soccer was the one reprieve he would get from the weight of his responsibilities.
“I love soccer,” he says.
But right now, he’s not playing.
His sneakers wore through. “If my parents were still alive, I would still be playing. They would have bought me shoes,” he says.
The best he can do now is watch other kids play soccer. He says it makes him happy that at least some kids get to keep being kids.

LOADINGERROR LOADING
The return of warm weather means the return of open-toed shoes, drawing attention to just how your feet look after a long fall and winter.
Beyond pumice stones and at-home foot peel masks, some people choose to focus on the aesthetics of another part of their feet: their toes. Specifically, their toe hair.
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The amount of hair on your toes depends on a variety of factors. In rare cases, your toe hair can even offer a peek into your health.
Below, doctors share what you should know about the hair on your toes and how to safely remove it if you choose.
Having hair on your toes is perfectly normal, and just how much you have often depends on genetic factors.
Hair on toes is normal ― it’s neither “good” or “bad,” said Dr. Natasha Bhuyan, the vice president of in-office care and national medical director at Amazon One Medical.
“It really just indicates your genetics, your hormones, factors that you often can’t influence,” she said. The amount of hair you have on your toes may also vary depending on your ethnic background.
What “normal” toe hair looks like for one person can look completely different for someone else.
“Everyone’s normal is different, but hair on toes is normal,” said Dr. Michael Richardson, a family medicine doctor in Boston. “Just because you have hair on your toes doesn’t mean that’s abnormal.”
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Blood flow issues can cause a loss of toe hair.
“Toe hair is not going to be the first sign if something is going wrong,” Richardson said, “but if you’re noticing that it’s less than normal for you, that could be signs of something damaging that area.”
Loss of toe hair could be from contact damage, which can happen if there’s lot of friction against shoes. “I’ll see that in runners, for example,” said Richardson.
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“There are instances where the hair on your toes could change because of other factors, like if you’re taking a medication that influences hair growth … steroids can sometimes cause hair growth,” Bhuyan said.
Changes in blood flow can also affect the amount of hair on your toes, which is a concern.
“If there’s decrease in the vasculature, so any damage to the blood vessels — we’ll see this with peripheral artery disease — where the blood is just not circulating as well, the tissue isn’t as healthy and can’t grow hair,” Richardson said.
In the place of hair, the toes will have a smooth, shiny look, Richardson said.
You may also notice issues related to poor circulation, like cold feet or pain when walking, Bhuyan added. This tends to be more common in older adults and smokers.
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“But more often than not, toe hair is going to be normal. If you don’t know where to go, it’s always a good idea to talk to your doctor,” Richardson added.
If you do want to remove the hair, keep a few things in mind.
If you want to remove the hair on your toes, it’s perfectly safe to do so, as long as you follow the right methodology.
“I would say the safest method to remove hair when it’s sparse … just tweezing it is the best,” said Bhuyan, before adding that the tweezers should be cleaned before doing so.
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“Some people will do things like shaving. I think if you do the typical shave with warm water, use a gel, that’s fine, just to minimize ingrown hairs,” Bhuyan noted.
You can also try hair removal creams, but if you do that, do a small patch test first, “because some people can have reactions to hair creams on their skin,” she said. If you want a long-term solution, you could also do laser hair removal or electrolysis.
In the end, it’s OK to remove the hair on your toes; it doesn’t serve a health purpose, Bhuyan said.

If you’re looking to support healthy LDL cholesterol levels, what you eat for breakfast may make a real difference. One of the best breakfasts for that goal? Banana Overnight Oats. This make-ahead meal combines oats, chia seeds, nut butter, banana, almond milk and Greek-style yogurt into a fiber-rich, heart-friendly start to your day.
With 9 grams of fiber per serving, this breakfast delivers a substantial portion of your daily fiber needs, which is key for cholesterol management. Plus, it provides healthy fats and protein to fuel your morning. Read on to learn more about how this easy, make-ahead breakfast can kick-start your heart-health journey, plus other tips for supporting healthy cholesterol levels.
It’s a Strong Source of Fiber
The foundation of this recipe is rolled oats, an all-star ingredient when it comes to managing heart health. Oats contain a type of soluble fiber called beta-glucan, which has been studied for its ability to help reduce LDL cholesterol levels. “Soluble fiber forms a gel in the gut that helps bind to cholesterol and remove it through the stool,” explains Amanda Roll, M.S., RDN, CDN. This binding process can help reduce the amount of cholesterol your body reabsorbs, which may contribute to lower LDL levels over time.
But oats aren’t the only source of fiber in this recipe. “Chia seeds also contribute additional soluble fiber, which supports heart health and cholesterol management,” says Lisa Young, Ph.D., RDN. A meta-analysis of 14 clinical trials found that adding chia seeds to the diet may help reduce LDL cholesterol levels.
It Provides Heart-Healthy Fats
Not all dietary fats affect LDL cholesterol in the same way. Consumption of saturated fat, found in abundance in foods like butter and many ultra-processed meats, has been linked to higher LDL levels. But the fat in these Banana Overnight Oats, by contrast, can have a positive impact on cholesterol. “This breakfast choice is low in saturated fats. Out of the 25 grams total fat per serving, only 3 grams are saturated fats,” says Patricia Kolesa, M.S., RDN. “This is likely because the majority of the ingredients are plant-based protein sources, which are known for their low saturated fat content,” Kolesa explains.
A significant portion of the fat in this recipe comes from the pecan or almond butter. “The pecan or almond butter provides heart-healthy unsaturated fats, which can help lower LDL cholesterol when they replace foods high in saturated fat,” says Young. Swapping a butter-laden breakfast for one built around plant-based fats can have a measurable impact over time. “This overnight oats recipe offers a more LDL-supportive fat profile than a breakfast centered around butter-heavy pastries or processed breakfast meats, and offers greater satiety as well,” shares Johannah Katz, RDN.
Greek-Style Yogurt Provides Probiotics
The Greek-style yogurt in this recipe provides a potential bonus for cholesterol health: probiotics. Greek-style yogurts contain probiotics, strains of bacteria that can support a healthy gut. Some research suggests certain probiotic strains can support healthy cholesterol metabolism by influencing gut health and bile acid metabolism, which affects how your body processes and eliminates cholesterol.
Bananas Add Heart-Healthy Nutrients
Bananas aren’t the primary LDL-lowering ingredient in this recipe, but they do contribute to the overall heart-healthy picture. They add fiber, helping increase overall daily fiber intake—one of the most consistent dietary levers for cholesterol management. They also provide potassium, a mineral linked to overall cardiovascular health. Plus, because bananas bring natural sweetness to the recipe, they help make the meal genuinely satisfying without relying on heavily sweetened toppings or processed breakfast foods that may work against your cholesterol goals.
Other Tips for Better Cholesterol
When it comes to managing cholesterol, your breakfast is just one piece of the puzzle. Here are three additional evidence-based strategies to support healthy cholesterol levels.
Focus on better sleep. Sleep can have a significant impact on cholesterol levels. To support your heart health and lower LDL levels, aim for about seven to nine hours of sleep per night.
Manage your stress. When you are feeling emotional stress, your body increases stress hormones like cortisol. When these hormones are chronically elevated, they can have a negative impact on how your body processes cholesterol. Try managing your stress through meditation, yoga and deep-breathing exercises.
Be active consistently each week. Aim for 150 to 300 minutes of exercise weekly, such as walking 30 to 45 minutes most days of the week. If you’re not active now, start with just a few minutes of light movement at a time and gradually build up.
Our Expert Take
Banana Overnight Oats earn their place as a top breakfast choice for people looking to support healthy LDL cholesterol levels, and the reasoning is grounded in solid nutritional science. The combination of soluble fiber from oats and chia seeds, a low saturated fat content and heart-healthy unsaturated fats from pecan or almond butter gives this meal multiple mechanisms for promoting healthy cholesterol. Compared to common breakfast options like pastries or certain ultra-processed meats, this recipe offers a notably more favorable fat profile.

A new study found that elderly nursing home residents who received at least one dose of the shingles vaccine known as Shingrix, the only shot of its kind available in the United States, were 24 percent less likely to develop dementia over a four-year period compared to those who were not vaccinated, according to results published this week in the peer-reviewed journal Annals of Internal Medicine.
The research adds to the growing body of evidence showing a connection between the viral infection and cognitive decline.
“The fact that this is a super high-risk population for dementia and we’re still seeing a potential benefit is really remarkable and important evidence for this population,” said Kaleen Hayes, the study’s lead author and an assistant professor at Brown University who studies the use of medications for chronic conditions in older adults.
It’s estimated that in the United States, 1 million people each year get shingles, which is caused by the same virus that causes chickenpox
The shingles vaccine has been shown to be 97 percent effective in preventing the disease in healthy adults 50 to 69 years old, according to the Centers for Disease Control and Prevention.
But multiple large-scale studies have also suggested a connection between getting vaccinated against shingles and reduced risk of dementia.
One study of more than 100 million people in the US looked at Shingrix and Zostavax, an older vaccine made from a weakened version of the live varicella-zoster herpes virus that was discontinued in the US in 2020. It found that both shots reduced the chances of getting shingles and dementia, according to results published in October in the peer-reviewed journal Nature Medicine.
People had a 27 to 33 percent lower risk of developing dementia over three years after getting vaccinated, according to the study. But researchers noted that people who received two doses of Shingrix had an 18 percent lower risk of dementia five years after vaccination compared to those who got a single dose of Zostavax.
The new research not only studied people who received the vaccine that is available in the US, but it also examined the effect of the shot on nursing home residents — a vulnerable population that is often understudied, Hayes said. She noted that people who are admitted to skilled nursing facilities typically aren’t included in drug or vaccine clinical trials.
“This is a population that is at the worst end of the seesaw,” Hayes said. “They’re who get the most drugs and vaccines, but they also have a dearth of evidence on what’s safe and effective for them.”
Hayes and her research team analyzed health records and Medicare claims from more than half a million people age 66 and older who entered nursing homes for short- or long-term care between 2017 and 2022. The Shingrix vaccine, a two-dose regimen, became available in the US in 2017.
Using a method designed to mimic a randomized clinical trial, which is considered the gold standard for evaluating medical treatments, the researchers compared people who received at least one dose of the vaccine to those who were not vaccinated. They found that 18.8 percent of vaccinated people developed dementia within four years compared with 24.6 percent of the unvaccinated group.
“That translates to about one in 17 cases of dementia potentially being prevented,” Hayes said.
It’s still unclear what may be driving the lower rates of dementia among vaccinated people. Some experts suggest getting shingles may increase one’s risk of cognitive decline, so preventing it helps. Others say the vaccine itself may carry a benefit.
The new research was bankrolled by GlaxoSmithKline, the maker of Shingrix, but Hayes said the study was designed without the company’s input and submitted for funding. GSK reviewed a preliminary version of the study’s manuscript for factual accuracy about the vaccine but did not have control over design, data collection or analysis, or the decision to publish the paper, she said.
“This was a very interesting and thoughtful study that took advantage of large amounts of available data and used innovative methods,” Dr. Sharon Curhan, an epidemiologist at Mass General Brigham and Harvard Medical School, who was not involved in the new research, wrote in an email.
While studies suggest an association between the shingles vaccine and dementia, their findings aren’t proof, said Dr. Richard Dupee, a primary care physician and chief of geriatrics service at Tufts Medical Center.
“We’ve got four or five studies that are suggesting this, that there is a relationship,” Dupee said. “So then the question comes, well, do we give Shingrix to prevent dementia? And I don’t think we’re even close to that yet.”
Scientists are increasingly finding a connection between getting shingles and an increased risk of developing cognitive decline and dementia.
One theory is that the varicella-zoster virus, which causes shingles, lives inside people and could be causing damage to blood vessels in the brain or the body, even without triggering a full-blown case of the disease, Hayes said. Research has linked shingles to increased risk of cardiovascular issues, such as stroke and heart disease.
The virus could also be causing inflammation that has a negative effect on the brain, or directly damaging brain cells, experts said.
“There is growing evidence that supports that shingles vaccination may reduce the risk of developing cognitive decline and dementia, whether by preventing shingles, by providing benefits to neuroimmune function, or both,” said Curhan, who has also researched shingles.
A GSK spokesperson said in a statement that the company is conducting additional research to better understand the association and how the shingles vaccine might be reducing the risk of dementia and cardiovascular events.
In the meantime, experts recommend that people get vaccinated if they are eligible. Beyond the painful rash, people who have shingles can develop lingering nerve pain that may be severe and difficult to treat.
“Get it for the shingles and get it because you might have some help in preventing dementia,” Dupee said.