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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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BST Hyde Park’s final day cancelled as Jeff Lynne’s ELO pulls out of headline slot

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July 13, 2025

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BST Hyde Park's final day cancelled as Jeff Lynne's ELO pulls out of headline slot

BST Hyde Park festival has cancelled its final night after Jeff Lynne’s Electric Light Orchestra pulled out of the headline slot.

Lynne, 77, was due to play alongside his band on Sunday but has been forced to withdraw from the event following a “systemic infection”.

The London show was supposed to be a “final goodbye” from ELO following their farewell US tour.

Organisers said on Saturday that Lynne was “heartbroken” at being unable to perform.

A statement read: “Jeff has been battling a systemic infection and is currently in the care of a team of doctors who have advised him that performing is simply not possible at this time nor will he be able to reschedule.

“The legacy of the band and his longtime fans are foremost in Jeff’s mind today – and while he is so sorry that he cannot perform, he knows that he must focus on his health and rehabilitation at this time.”

They later confirmed the whole of Sunday’s event would be cancelled.

“Ticket holders will be refunded and contacted directly by their ticket agent with further details,” another statement said.

Stevie Wonder played the festival on Saturday – now its final event of 2025.

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US rock band The Doobie Brothers and blues rock singer Steve Winwood were among those who had been due to perform to before ELO’s headline performance.

The cancellation comes after the band, best known for their hit Mr Blue Sky, pulled out of a performance due to take place at Manchester’s Co-Op Live Arena on Thursday.

ELO was formed in Birmingham in 1970 by Lynne, multi-instrumentalist Roy Wood and drummer Bev Bevan.

They first split in 1986, before frontman Lynne resurrected the band in 2014.

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2025 MLB Home Run Derby: The field is set! Who is the slugger to beat?

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July 13, 2025

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2025 MLB Home Run Derby: The field is set! Who is the slugger to beat?

Jul 11, 2025, 08:19 PM ET

The 2025 MLB All-Star Home Run Derby is fast approaching — and the field is set.

Braves hometown hero Ronald Acuna Jr. became the first player to commit to the event, which will be held at Truist Park in Atlanta on July 14 (8 p.m. ET on ESPN). He was followed by MLB home run leader Cal Raleigh of the Seattle Mariners, James Wood of the Washington Nationals, Byron Buxton of the Minnesota Twins, Oneil Cruz of the Pittsburgh Pirates, Junior Caminero of the Tampa Bay Rays, Brent Rooker of the Athletics and Jazz Chisholm Jr. of the New York Yankees.

On Friday, however, Acuna was replaced by teammate Matt Olson.

With all the entrants announced, let’s break down their chances at taking home this year’s Derby prize.

Full All-Star Game coverage: How to watch, schedule, rosters, more

2025 home runs: 17 | Longest: 434 feet

Why he could win: Olson is a late replacement for Acuna as the home team’s representative at this year’s Derby. Apart from being the Braves’ first baseman, however, Olson also was born in Atlanta and grew up a Braves fan, giving him some extra motivation. The left-handed slugger led the majors in home runs in 2023 — his 54 round-trippers that season also set a franchise record — and he remains among the best in the game when it comes to exit velo and hard-hit rate.

Why he might not: The home-field advantage can also be a detriment if a player gets too hyped up in the first round. See Julio Rodriguez in Seattle in 2023, when he had a monster first round, with 41 home runs, but then tired out in the second round.

2025 home runs: 36 | Longest: 440 feet

Why he could win: It’s the season of Cal! The Mariners’ catcher is having one of the greatest slugging first halves in MLB history, as he’s been crushing mistakes all season . His easy raw power might be tailor-made for the Derby — he ranks in the 87th percentile in average exit velocity and delivers the ball, on average, at the optimal home run launch angle of 23 degrees. His calm demeanor might also be perfect for the contest as he won’t get too amped up.

Why he might not: He’s a catcher — and one who has carried a heavy workload, playing in all but one game this season. This contest is as much about stamina as anything, and whether Raleigh can carry his power through three rounds would be a concern. No catcher has ever won the Derby, with only Ivan Rodriguez back in 2005 even reaching the finals.

2025 home runs: 24 | Longest: 451 feet

Why he could win: He’s big, he’s strong, he’s young, he’s awesome, he might or might not be able to leap tall buildings in a single bound. This is the perfect opportunity for Wood to show his talent on the national stage, and he wouldn’t be the first young player to star in the Derby. He ranks in the 97th percentile in average exit velocity and 99th percentile in hard-hit rate, so he can still muscle the ball out in BP even if he slightly mishits it. His long arms might be viewed as a detriment, but remember the similarly tall Aaron Judge won in 2017.

Why he might not: His natural swing isn’t a pure uppercut — he has a pretty low average launch angle of just 6.2 degrees — so we’ll see how that plays in a rapid-fire session. In real games, his power is primarily to the opposite field, but in a Home Run Derby you can get more cheapies pulling the ball down the line.

2025 home runs: 20 | Longest: 479 feet

Why he could win: Buxton’s raw power remains as impressive as nearly any hitter in the game. He crushed a 479-foot home run earlier this season and has four others of at least 425 feet. Indeed, his “no doubter” percentage — home runs that would be out of all 30 parks based on distance — is 75%, the highest in the majors among players with more than a dozen home runs. His bat speed ranks in the 89th percentile. In other words, two tools that could translate to a BP lightning show.

Why he might not: Buxton is 31 and the Home Run Derby feels a little more like a younger man’s competition. Teoscar Hernandez did win last year at age 31, but before that, the last winner older than 29 was David Ortiz in 2010, and that was under much different rules than are used now.

2025 home runs: 16 | Longest: 463 feet

Why he could win: If you drew up a short list of players everyone wants to see in the Home Run Derby, Cruz would be near the top. He has the hardest-hit ball of the 2025 season, and the hardest ever tracked by Statcast, a 432-foot missile of a home run with an exit velocity of 122.9 mph. He also crushed a 463-foot home run in Anaheim that soared way beyond the trees in center field. With his elite bat speed — 100th percentile — Cruz has the ability to awe the crowd with a potentially all-time performance.

Why he might not: Like all first-time contestants, can he stay within himself and not get too caught up in the moment? He has a long swing, which will result in some huge blasts, but might not be the most efficient for a contest like this one, where the more swings a hitter can get in before the clock expires, the better.

2025 home runs: 23 | Longest: 425 feet

Why he could win: Although Caminero was one of the most hyped prospects entering 2024, everyone kind of forgot about him heading into this season since he didn’t immediately rip apart the majors as a rookie. In his first full season, however, he has showed off his big-time raw power — giving him a chance to become just the third player to reach 40 home runs in his age-21 season. He has perhaps the quickest bat in the majors, ranking in the 100th percentile in bat speed, and his top exit velocity ranks in the top 15. That could translate to a barrage of home runs.

Why he might not: In game action, Caminero does hit the ball on the ground quite often — in fact, he’s on pace to break Jim Rice’s record for double plays grounded into in a season. If he gets out of rhythm, that could lead to a lot of low line drives during the Derby instead of fly balls that clear the fences.

2025 home runs: 19 | Longest: 440 feet

Why he could win: The Athletics slugger has been one of the top power hitters in the majors for three seasons now and is on his way to a third straight 30-homer season. Rooker has plus bat speed and raw power, but his biggest strength is an optimal average launch angle (19 degrees in 2024, 15 degrees this season) that translates to home runs in game action. That natural swing could be picture perfect for the Home Run Derby. He also wasn’t shy about saying he wanted to participate — and maybe that bodes well for his chances.

Why he might not: Rooker might not have quite the same raw power as some of the other competitors, as he has just one home run longer than 425 feet in 2025. But that’s a little nitpicky, as 11 of his home runs have still gone 400-plus feet. He competed in the college home run derby in Omaha while at Mississippi State in 2016 and finished fourth.

2025 home runs: 17 | Longest: 442 feet

Why he could win: Chisholm might not be the most obvious name to participate, given his career high of 24 home runs, but he has belted 17 already in 2025 in his first 61 games after missing some time with an injury. He ranks among the MLB leaders in a couple of home run-related categories, ranking in the 96th percentile in expected slugging percentage and 98th percentile in barrel rate. His raw power might not match that of the other participants, but he’s a dead-pull hitter who has increased his launch angle this season, which might translate well to the Derby, even if he won’t be the guy hitting the longest home runs.

Why he might not: Most of the guys who have won this have been big, powerful sluggers. Chisholm is listed at 5-foot-11, 184 pounds, and you have to go back to Miguel Tejada in 2004 to find the last player under 6 foot to win.

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On Buxton bobblehead day, All-Star hits for cycle

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July 12, 2025

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On Buxton bobblehead day, All-Star hits for cycle

  • Associated Press

Jul 12, 2025, 05:06 PM ET

MINNEAPOLIS — Minnesota Twins All-Star center fielder Byron Buxton admitted to feeling a little added pressure before Saturday’s game against the Pittsburgh Pirates. It was his bobblehead day, meaning the first 10,000 fans to walk through the gates at Target Field would receive a replica of Buxton doing his “Buck Truck” home run celebration.

“I’d be lying if I said I wasn’t nervous before the game started, just knowing it was bobblehead day,” Buxton said. “Obviously you want to come out and do something good.”

Buxton did more than something good. He became the first player to hit for the cycle at Target Field since the ballpark opened in 2010, helping ignite the Twins to a 12-4 win over the Pirates.

It was the 12th cycle in Twins history and the first since Jorge Polanco had one in 2019.

Buxton had three hits through three innings — a single in the first, a triple in the six-run second and a double in the third. After singling again in the fifth, he had one more opportunity in the bottom of the seventh.

Buxton, who will participate in next week’s Home Run Derby in Atlanta, crushed a 427-foot solo homer off Pirates reliever Andrew Heaney with two outs in the seventh to make it an 11-3 game and complete the cycle. That brought the Target Field crowd to its feet, with many fans celebrating with Buxton bobbleheads.

With his team holding a comfortable lead, Twins manager Rocco Baldelli almost took Buxton out of the game before his final at-bat, he admitted afterward. Thankfully for Baldelli — and Buxton — a few coaches reminded the skipper what was at stake.

“He was 4 for 4 at the time. But with everything going on during a game, sometimes I’ll be the one that might miss on a hitting streak or something that’s going on with a particular player,” Baldelli said. “But once they reminded me of that, he was going to stay in the game. He was going to get another at-bat, regardless of the score, and give him a chance to do something great.”

The homer was Buxton’s 21st of the season, tied for fifth most in the American League. With two runs driven in Saturday, Buxton now has 55 RBIs on the season — just one shy of his single-season high. He boasts an OPS of .921 and is 17 for 17 in stolen bases.

“It’s one of the greatest first halves I’ve ever witnessed,” Baldelli said.

Buxton was replaced in center field after the seventh inning, but not before getting a standing ovation curtain call from Twins fans. He also received a Gatorade bath courtesy of teammate Ty France, who was headed to the clubhouse before realizing that nobody had doused Buxton yet after the game.

“It’s special,” Buxton said. “To be able to come out on bobblehead day like this and have a day like this is something I won’t forget.”

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