Texas has a sexually transmitted infection (STI) problem, and more and more data from state health agencies make it hard to look away.
According to the Texas Department of State Health Services (DSHS), total syphilis cases in Texas rose 22% from 21,328 in 2021 to 25,991 in 2022 alone. This upward trajectory has continued to build for years, and it is showing up in an alarming way among newborns.
Congenital syphilis cases – infections passed from mother to baby during pregnancy – rose from 166 in 2017 to 922 in 2022. At that time, Texas accounted for 25% of congenital syphilis cases in the country, despite representing only about 10% of total births in the U.S.
In 2024, DSHS Commissioner Jennifer Shuford called the numbers “heartbreaking,” adding that “They become even more heartbreaking when you consider that congenital syphilis is preventable when moms with syphilis receive timely testing and treatment either before or early during pregnancy.”
As of 2026, some STI rates continue to rise year over year, with Texas maintaining a disproportionate share of such a preventable public health crisis.
Dallas Hit Hard: 62% Syphilis Increase, Heavy Toll on Black and Hispanic Communities
The numbers hit close to home for Dallas residents. From 2018 to 2022, syphilis cases in Dallas County surged 62%, with Black and Hispanic populations disproportionately affected.
A 2025 Dallas County report found the economic burden of STIs reached $398.6 million in 2022, with congenital syphilis costs alone rising 33.8% that year to $8.6 million.
Nationally, CDC data from 2024 showed positive progress in some areas: combined chlamydia, gonorrhea, and syphilis cases have collectively declined 9% from 2023 (third straight year of decline), with over 2 million STIs still reported. However, congenital syphilis rose for the 12th consecutive year to nearly 4,000 cases.
In 2023 in Texas, however, the state reported 930 congenital syphilis cases (more than double the national rate) per the Texas Medical Association, and health officials report rates continuing to rise into 2025–2026.
STI trends reportedly hit young people hardest.
In Texas, 15-to-24-year-olds account for nearly half of gonorrhea cases.
Chlamydia remains the most commonly reported STI in Dallas County, with those under 25 historically making up the majority of diagnoses.
Response to the Crisis
The DSHS now requires syphilis testing at three points during pregnancy and has expanded resources, including a congenital syphilis dashboard, provider education, and infant morbidity review boards (including in Dallas). Officials continue to urge healthcare providers to screen pregnant women as high-risk, given the widespread problem across the Lone Star State.
For Dallas County residents, the DCHHS Sexual Health Clinic offers confidential STI testing and treatment regardless of income.
What Is Syphilis?
Syphilis is a sexually transmitted infection (STI) caused by the bacterium Treponema pallidum, per the CDC. It spreads primarily through direct contact with syphilitic sores during vaginal, anal, or oral sex, and it can also be passed from a pregnant person to their baby (known as congenital syphilis); rare transmission can occur through blood transfusions or shared needles.
If left untreated, syphilis progresses through four stages — primary, secondary, latent, and tertiary — and can cause serious long-term damage to the heart, brain, nerves, eyes, and other organs.
The good news is that syphilis is curable with antibiotics (usually penicillin) at any stage, though any damage that has already occurred in the late stages may not be reversible.
Note on the data: The statistics in this article reflect the most recent comprehensive reports available from the Texas Department of State Health Services (DSHS) and Dallas County Health and Human Services (DCHHS), which cover data through 2022 for the most detailed case counts and economic impacts. While congenital syphilis cases remained elevated in Texas in 2023 (930 cases) and continue to be a serious concern into 2025–2026, fuller statewide and local breakdowns for 2023–2025 have not yet been finalized and publicly released.