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Routine opt-out syphilis screening in the emergency department: A public health imperative.

The United States is experiencing a resurgence in syphilis cases, with a 71% increase in new diagnoses in the past 5 years1 . Left untreated, syphilis can lead to a host of medical complications, as well as increase the risk of HIV infection. Congenital syphilis rates are rising even faster than adult syphilis rates, with a 185% increase from 2014 to 2018, a change that has paralleled increases in primary and secondary (P&S) syphilis among reproductive-aged women1 . This dramatic rise in syphilis cases may be due in part to a "lack of screening by physicians [and] patients not asking for screening"2 .