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When Stephen Miller left his primary care practice to work in public health a little under two years ago, he said, he was shocked by how many cases of syphilis the clinic was treating.

This story also ran on WPLN. It can be republished for free.

For decades, rates of the sexually transmitted infection were low. But the Hamilton County Health Department in Chattanooga a midsize city surrounded by national forests and nestled into the Appalachian foothills of Tennessee was seeing several syphilis patients a day, Miller said. A nurse who had worked at the clinic for decades told Miller the wave of patients was a radical change from the norm.

What Miller observed in Chattanooga is reflective of a trend that is raising alarm bells for health departments across the country.

Nationwide, syphilis rates are at a 70-year high. The Centers for Disease Control and Prevention said Jan. 30 that 207,255 cases were reported in 2022, continuing a steep increase over five years. Between 2018 and 2022, syphilis rates rose about 80%. The epidemic of sexually transmitted infections especially syphilis is out of control, said the National Coalition of STD Directors.

The surge has been even more pronounced in Tennessee, where infection rates for the first two stages of syphilis grew 86% between 2017 and 2021.

But this already difficult situation was complicated last spring by a shortage of a specific penicillin injection that is the go-to treatment for syphilis. The ongoing shortage is so severe that public health agencies have recommended that providers ration the drug prioritizing pregnant patients, since it is the only syphilis treatment considered safe for them. Congenital syphilis, which happens when the mom spreads the disease to the fetus, can cause birth defects, miscarriages, and stillbirths. Email Sign-Up

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Across the country, 3,755 cases of congenital syphilis were reported to the CDC in 2022 thats 10 times as high as the number a decade before, the recent data shows. Of those cases, 231 resulted in stillbirth and 51 led to infant death. The number of cases in babies swelled by 183% between 2018 and 2022.

Lack of timely testing and adequate treatment during pregnancy contributed to 88% of cases of congenital syphilis, said a report from the CDC released in November. Testing and treatment gaps were present in the majority of cases across all races, ethnicities, and U.S. Census Bureau regions.

Hamilton Countys syphilis rates have mirrored the national trend, with an increase in cases for all groups, including infants.

In November, the maternal and infant health advocacy organization March of Dimes released its annual report on states health outcomes. It found that, nationwide, about 15.5% of pregnant people received care beginning in the fifth month of pregnancy or later or attended fewer than half the recommended prenatal visits. In Tennessee, the rate was even worse, 17.4%.

But Miller said even those who attend every recommended appointment can run into problems because providers are required to test for syphilis only at the beginning of a pregnancy. The idea is that if you test a few weeks before birth, there is time to treat the infection.

However, that recommendation hinges on whether the provider suspects the patient was exposed to the bacterium that causes syphilis, which may not be obvious for people who say their relationships are monogamous.

What we found is, a lot of times their partner was not as monogamous, and they were bringing it into the relationship, Miller said.

Even if the patient tested negative initially, they may have contracted syphilis later in pregnancy, when testing for the disease is not routine, he said.

Two antibiotics are used to treat syphilis, the injectable penicillin and an oral drug called doxycycline.

Patients allergic to penicillin are often prescribed the oral antibiotic. But the World Health Organization strongly advises pregnant patients to avoid doxycycline because it can cause severe bone and teeth deformities in the infant.

As a result, pregnant syphilis patients are often given penicillin, even when theyre allergic, using a technique called desensitization, said Mark Turrentine, a Houston OB-GYN. Patients are given low doses in a hospital setting to help their bodies get used to the drug and to check for a severe reaction. The penicillin shot is a one-and-done technique, unlike an antibiotic, which requires sticking to a two-week regimen.

It’s tough to take a medication for a long period of time, Turrentine said. The single injection can provide patients and their clinicians peace of mind. If they don’t come back for whatever reason, you’re not worried about it, he said.

The Metro Public Health Department in Nashville, Tennessee, began giving all nonpregnant adults with syphilis the oral antibiotic in July, said Laura Varnier, nursing and clinical director.

Turrentine said he started seeing advisories about the injectable penicillin shortage in April, around the time the antibiotic amoxicillin became difficult to find and physicians were using penicillin as a substitute, potentially precipitating the shortage, he said.

The rise in syphilis has created demand for the injection that manufacturer Pfizer cant keep up with, according to the American Society of Health-System Pharmacists. There is insufficient supply for usual ordering, the ASHP said in a memo.

Even though penicillin has been around a long time, manufacturing it is difficult, largely because so many people are allergic, said Erin Fox, associate chief pharmacy officer for the University of Utah health system and an adjunct professor at the university, who studies drug shortages.

That means you can’t make other drugs on that manufacturing line, she said. Only major manufacturers like Pfizer have the resources to build and operate such a specialized, cordoned-off facility. It’s not necessarily efficient or necessarily profitable, Fox said.

In a statement, Pfizer confirmed the amoxicillin shortage and surge in syphilis increased demand for injectable penicillin by about 70%. Representatives said the company invested $38 million in the facility that produces this form of penicillin, hiring more staff and expanding the production line.

This ramp up will take some time to be felt in the market, as product cycle time is 3-6 months from when product is manufactured to when it is available to be released to customers, the statement reads. The company estimated the shortage would be significantly alleviated by spring.

In the meantime, Miller said, his clinic in Chattanooga is continuing to strategize. Each dose of injectable penicillin can cost hundreds of dollars. Plus, it has to be placed in cold storage, and it expires after 48 months.

Even with the dramatic increase in cases, syphilis is still relatively rare. More than 7 million people live in Tennessee, and in 2019, providers statewide reported 683 cases of syphilis.

Health departments like Millers treat the bulk of syphilis patients. Many patients are sent by their provider to the health department, which works with contact tracers to identify and notify sexual partners who might be affected and tests patients for other sexually transmitted infections, including HIV.

When you diagnose in the office, think of it as just seeing the tip of the iceberg, Miller said. You need a team of individuals to be able to explore and look at the rest of the iceberg.

This story is part of a partnership that includes WPLN, NPR, and KFF Health News.

Catherine Sweeney, WPLN: csweeney@wpln.org, @CathJSweeney Related Topics Pharmaceuticals Public Health States CDC Sxual Health Tennessee Contact Us Submit a Story Tip

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Woman missing for more than 60 years found ‘alive and well’

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Woman missing for more than 60 years found 'alive and well'

A woman in the US who has been missing since 1962 has been found “alive and well”, authorities have said.

Audrey Backeberg left her home in Reedsburg, Wisconsin, in July that year when she was 20 years old, Sauk County Sheriff’s Office said.

Investigators pursued numerous leads over the years but the case eventually went cold.

However, during a review of cold cases earlier this year, a detective reassessed all the case files and evidence, and re-interviewed several witnesses – and found Ms Backeberg.

The 82-year-old was “alive and well” – living outside of the state of Wisconsin, the sheriff’s office said.

Ms Backeberg was married and had two children when she disappeared on 7 July 1962, according to the Wisconsin Missing Persons Advocacy organisation.

She left her home to pick up her salary but never returned, causing her husband to ask family members where she was.

Shortly afterwards their 14-year-old babysitter claimed she and Ms Backeberg had hitchhiked to Wisconsin’s capital city Madison and then caught a bus to Indianapolis, Indiana.

The teenager said when she arrived she became nervous and wanted to go home, while Ms Backeberg refused to return and was last seen walking near a bus stop.

Ms Backeberg’s marriage was troubled and there were allegations of abuse, the Wisconsin Missing Persons Advocacy organisation said, with a criminal complaint having been filed days before she went missing.

Her relatives insisted she would never abandon her children, the organisation added, and her husband passed a polygraph test and maintained his innocence.

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‘We talked for 45 minutes’ – detective

Detective Isaac Hanson, who found Ms Backeberg, said her sister’s Ancestry.com account was vital in helping him locate her address.

“That was pretty key in locating death records, census reports, all kinds of data,” he told local news station WISN.

“So I called the local sheriff’s department, said, ‘Hey, there’s this lady living at this address. Do you guys have somebody, you can just go pop in?’

“Ten minutes later, she called me, and we talked for 45 minutes.”

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‘She sounded happy’

Mr Hanson said Ms Backeberg may have left home due to marital issues, but it was unclear why she had stayed away for so long.

He said he had promised to keep their conversation private.

“I think she just was removed and, you know, moved on from things and kind of did her own thing and led her life,” he said.

“She sounded happy. Confident in her decision. No regrets.”

Sauk County Sheriff’s Office said Ms Backeberg made the choice to leave and her disappearance “was not the result of any criminal activity or foul play”.

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Sports

Jets-Blues Game 7 preview: Key players to watch, final score predictions

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Jets-Blues Game 7 preview: Key players to watch, final score predictions

It all comes down to this. The Presidents’ Trophy-winning Winnipeg Jets host the St. Louis Blues in the 200th Game 7 in Stanley Cup playoffs history Sunday (7 p.m. ET, TBS).

One team will advance to the second round, while the other will get an early start to the offseason — and try to fix what went wrong.

For the Blues, this is the club’s 19th all-time Game 7, the most of any non-Original Six team. They have gone 10-8 in Games 7s, with the most recent one being the 2019 Stanley Cup Final against the Boston Bruins, which they won 4-1.

This version of the Jets has much less Game 7 history on which to draw; their only Game 7 was a second-round victory over the Nashville Predators in 2018.

Who wins this one? We’ve gathered the ESPN hockey family to identify the key players to watch in the contest — as well as their final score predictions.

Who is the one key player you’ll be watching in Jets-Blues?

Ryan S. Clark, NHL reporter: If he plays, it’s Mark Scheifele. The hit in Game 5 from Brayden Schenn and/or Radek Faksa generated quite a bit of conversation about what is arguably the most physically demanding series in the first round. Scheifele’s play this season and this series prior to the hit reinforces what makes him a legit top-line center in this league. We saw how the Jets maneuvered around his absence for the final two periods of Game 5, while Game 6 proved why they need contributions from everyone if he can’t go.

But again, that’s if Scheifele plays. He skated Saturday in a tracksuit, with Scott Arniel saying the center will be a game-time decision Sunday.

Arda Öcal, NHL broadcaster: Connor Hellebuyck is the obvious answer here for me because he’s been “Vezina” at home (especially Game 2) and “Vezina from Temu” on the road.

Hellebuyck has allowed four or more goals in seven straight road playoff games, which ties the second longest such streak in Stanley Cup playoff history. But Game 7 is at home. The pressure is on but he’s in comfortable confines, surrounded by a “Whiteout.” Which version of Hellebuyck do we get Sunday night?

Kristen Shilton, NHL reporter: Connor Hellebuyck, of course. Has there been a Jekyll/Hyde performance like this in recent years?

The Vezina finalist can play lights-out at home and like a fish out of water on the road. Does that trend continue in Game 7? What version of the goalie shows up for this one?

But as a bonus, I’ll toss Pavel Buchnevich into this equation. He’s been driving the Blues’ offense, and if Hellebuyck is on his A-game then St. Louis is going to need Buchnevich to channel his hat trick energy from Game 3 to help the Blues pull off a stunning road win.

Greg Wyshynski, NHL reporter: Jordan Binnington renewed his title as one of the NHL’s most clutch goaltenders with his 31-save performance in Team Canada’s 4 Nations Face-Off championship win over the U.S. — including six saves in overtime. He first earned it in 2019, backstopping the Blues to the Stanley Cup with Game 7 wins over Dallas and Boston.

Now he’s got a chance to reestablish those credentials.

Binnington had a 0.82 goals-against average and a .968 save percentage in those prior Game 7s. While Hellebuyck has been terrible in St. Louis, Binnington hasn’t been much better in Winnipeg, generating an .861 save percentage and a 3.44 goals-against average and giving up four goals in two of the three games. But as 4 Nations showed, Binnington can meet the moment. (Although this time, Kyle Connor will actually be in the lineup for the opposition. Not that we’re bitter or anything.)


The final score will be _____.

Clark: 4-3 Jets. There have been a few themes in this series. The first being that offense hasn’t been an issue — the teams have combined to score more than six goals in all but one game. The second is that the home team has won every game; I say that continues, and the Jets advance.

Öcal: 6-5 Jets. Hellebyuck doesn’t have his best game, but the Jets outscore that challenge, and Kyle Connor scores another third-period goal in this series to win it.

Shilton: 5-4 Jets. The Jets have been too good on home ice to let this one slip away. That’s not to say a St. Louis win would be surprising, but even if Hellebuyck is off, Winnipeg’s offense should be able to provide enough buffer that the Jets can squeak through with a narrow victory to advance.

Wyshynski: 5-3 Jets. The Jets would be toast if this game were played in St. Louis because it’s a demonstrable fact that Hellebuyck is a disaster on the road in the playoffs. He’s slightly below replacement at home in the postseason, but Winnipeg will take that considering his three removals on the road.

The Blues are first in the playoffs in 5-on-5 offense and goals-for percentage at home. But Winnipeg is second in both categories. Hellebuyck calms down, and the offense gets ratcheted up at home, especially now that Nikolaj Ehlers has a game under his belt, having not played since April 12 due to a foot injury.

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Environment

Meet Bodo – the 35 mph electric golf cart that thinks it’s a G-Wagen

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Meet Bodo – the 35 mph electric golf cart that thinks it's a G-Wagen

With a fully-enclosed, G-Wagen-inspired body and an 80 mile electric range, the Bodo G-Wagon golf cart is the NEV you need when you decide it’s time to get serous one-upping the rest of the Palm Beach country clubbers.

If you love the look of the $230,000 Mercedes-Benz G580 off-roader, but think the 579 hp, 6,800 lb. electric 4×4 is probably overkill for occasional trips to the golf course and country club, this G-Wagen-inspired golf cart might be just what you’re looking for.

The shiny black 2024 Bodo G-Wagon sold at Mecum Auctions last month for $31,900, which seems like it might not be a lot of money to the sort of person who decides to take a flyer on a goofy, limited-use EV that ships with real, metal doors, power windows, heating and air conditioning, fully digital instrument cluster and infotainment, and a “posh,” caramel leather interior.

It even has windshield wipers, power steering, and a rear-seat entertainment system that’s built into the front headrests!

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It’s really nice in there

Under the hood, the Bodo packs a 15 kW (20 hp) electric motor drawing power from a 10 kWh li-ion battery that won’t deliver a scorching 0-60 mph time (it only goes 35), but will deliver you and your buddies from one end of any golf course in North America and back several times over, thanks to the G-Wagon’s 80 mile range.

The official Mecum Auctions listing goes into a bit more detail, and I’ve included it here, in case it gets deleted after a while and you’re just finding this for the first time in 2027:

Be the envy of any country club or golf community showing up with this 2024 Bodo G-Wagon Golf Cart. Perhaps more appropriately known as an E-Wagon, this baby G-Wagon is powered by a 15kW motor with a 10kWh lithium battery. Boasting an 80-mile range and a 35 MPH top speed, the Bodo is an enclosed, luxury golf cart that pampers occupants with heating and air conditioning, rear-seat entertainment, power windows, power locks and a posh, caramel-colored interior. With the Bodo fitted with power steering and 4-wheel power disc brakes with brake boost, drivers will think they’re in a full-size G-Wagon, thanks to the multiscreen entertainment cluster, the rearview camera, windshield wipers, turn signals, running lights and so much more.

Finished in black with the right amount of brightwork, the overall vibe is one of jaw-dropping, smile-inducing fun. While the Bodo would be an excellent choice for any golf community, it should also prove to be hugely popular around a race track or car condo community as well, or maybe even a neighborhood with its own airplane runways. Over the past decade in particular, the demand for unique, luxury golf carts has been on the rise, and understandably so. The number of luxury communities with specific interests in sports, aero and auto has also been on the rise, with people buying homes in these exclusive locations to better engage with like-minded people. All too often a golf cart is the perfect way to get around these gated neighborhoods, and this one is enclosed, comes with the amenities of a full-size car and is infinitely more stylish.

MECUM AUCTIONS

You can check out a few more photos of the 2024 Bodo G-Wagon golf cart that sold at Mecum, below – and if you want one for yourself, you’re in luck! I found this brand-new 2025 “G600 E-Wagon” (in white) for $23,900 at Gulf Carts in Santa Rosa Beach, Florida. Head on down to the comments and let us know if you buy it.

SOURCE | LOTS MORE PHOTOS: Mecum Auctions.


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