Montgomery County leads Alabama in latent syphilis cases

MONTGOMERY, Ala. (WAKA Action 8) – Usually being number one is a good thing, but not when it comes to sexually transmitted infections.

The latest report from the Alabama Department of Public Health is shedding light on the latest numbers of diseases and infections in Alabama.

“Syphilis is one of those diseases which is hard to understand and recognize, because the symptoms come and go really quick,” says Anthony Merriweather, the Director of the Division of Sexually Transmitted Infections with the ADPH.

According to the latest numbers, Montgomery County has the highest number of early and late latent syphilis cases in the state. So far in 2026, the county has 36 cases of early latent syphilis cases and 47 late latent syphilis cases.

In 2025, Montgomery County led the way with 218 early latent syphilis cases. Jefferson County followed with 121 cases. Madison County and Mobile County are next in line.

Latent stages are when there are no visible signs or symptoms. Without treatment, you can continue to have syphilis in your body for years.

Montgomery County also led in late latent syphilis cases for 2025.

For primary and secondary cases in 2025, Mobile County led the way with 162. They were followed by Jefferson County (160) and Montgomery County (146.)

Montgomery County is close to the top in primary and secondary syphilis cases this year. Primary cases develop within the first 21 days and turn into secondary cases if left untreated.

There is good news. Overall, health officials say Alabama is trending downwards for sexually transmitted disease cases overall.

“I’m happy to say that over the last three years, we’ve now begun to see a steady decline in STI cases in southern Alabama, particularly here in Montgomery County. In 2023, just for committee alone, we had just over 2700 cases and we are now under 2700 cases as of the end of 2025,” sayas Merriweather.

The ADPH report, which covers January 2022 through March 2026, breaks down race, age, gender, as well as the number of gonorrhea and chlamydia cases.

Merriweather says education goes a long way in helping keep the public informed about STI symptoms and prevention. He says it’s important for you to talk to your partner before engaging in sexual intercourse.

“People are not understanding that STI’s can be passed during sexual intimacy without even knowing your partner is positive with an STI,” says Merriweather. “Talk to their partners about their sexual preference. Making sure before you become intimate with somebody that both of you get tested for an STI as well as HIV. And if you are unsure, go to your primary care provider.”

Merriweather says a shortage of medical treatment are contributing factors in the numbers of syphilis cases in Alabama.

“Our major concern right now in Alabama and across the nation is the lack of medication that is available for treating syphilis. The only medication that can treat syphilis effectively, particularly in pregnant women, is Bicillin (Penicillin G Benzathine). We’ve had a shortage of Bicillin since last year due to contamination at the only manufacturing lab for Bicillin, which is owned by Pfizer,” says Merriweather.

Merriweather says that shortage of syphilis treatment will likely stretch into 2027.

Montgomery had the third highest STD rate of any city in the United States, behind Detroit and Philadelphia — according to the Centers for Disease Control and Prevention. The ADPH says that is based on 2023 results.

Merriweather says the ADPH has ramped up their efforts to educate the public through programs.

“One of the things we’ve done the last few years is we’ve been trying to educate communities across the state with our social media marketing campaigns where we are talking about STI prevention on our social media platforms, as well as billboards,” says Merriweather. “We are also educating providers on trying to mainstream and making testing for STI a standard part of care.”

The ADPH has started an at-home specimen collection kit program, where any Alabama residents can go online and order a free at home specimen collection for STI’s. The kit will be mailed to your mailbox, you’ll collect your own specimens, and the send it back. It’ll take 72 hours to get those results back. If they are positive, one of their Disease Intervention Specialist will contact you and refer to a county health department for testing and treatment.

The state health department has also implemented a fast track program in Montgomery, Jefferson, Houston, and Tuscaloosa counties. If you are Asymptomatic, you can walk in, get screened, and walk out with in 20 minutes.

You can find more information on sexually transmitted infections and symptoms here.

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