The number of syphilis cases in the United States has increased by five-fold since 2013, according to the Centers for Disease Control and Prevention (CDP) and has reached its highest point since 1994. The disease, considered congenital, can cause miscarriage, stillbirth or death after birth and can lead to miscarriages, miscarriage, and deformed babies. The CDC has set a goal of reducing syphilis rates in reproductive-age women to 4.6 per 100,000 people by 2030. The highest rates nationwide are found in two counties in South Dakota, Oglala Lakota County and Buffalo County, which are on Native American reservations. The most significant risk factor for syphilis is living in a community with high rates of the disease, with testing recommended for all sexually active people aged 15 and 44 years old to prevent the disease from spreading. Early treatment with penicillin and other antibiotics can cure the disease.