By MIKE STOBBE

NEW YORK (AP) — Sexually transmitted disease rates for U.S. adults fell last year, but syphilis in newborns continued to rise, according to new government data posted Wednesday.

The Centers for Disease Control and Prevention provisional data for 2024 showed a third consecutive year of fewer gonorrhea cases, and the second year in a row of fewer adult cases of chlamydia and the most infectious forms of syphilis.

But congenital syphilis cases, in which infected moms pass the disease to their babies, aren’t seeing the same improvements. Such infections in infants can lead to deaths or lifelong health problems such as deafness, blindness, and malformed bones.

The number and rate of newborn cases has been rising since 2012, when about 300 were reported, and last year rose to nearly 4,000. The 2024 increases was not as steep as in other years — cases were up by less than 2% from 2023. But health experts say no cases should be happening, and any growth is worrisome.

“The continued rise in congenital syphilis is a distressing indication that we are not doing enough to protect pregnant women and newborns,” said Elizabeth Finley, interim executive director of the National Coalition of STD Directors, in a statement.

About 1.5 million chlamydia cases, 543,000 of gonorrhea, and more than 190,000 of syphilis were diagnosed and reported last year. Each was lower than the year before, and the more than 2.2 million total cases represented a 9% decline from 2023.

Overall decreases in sexually transmitted diseases in recent years have a lot to do with a general decline in young people having new partners, said Dr. Jeffrey Klausner, an infectious diseases researcher at the University of Southern California.

But the drop in adult syphilis cases is generally attributed to the growing use of the antibiotic doxycycline as a morning-after pill, specifically for gay and bisexual men and transgender women who recently had an STD diagnosis. Cases of primary and secondary syphilis, the disease’s most infectious stages, fell 22% last year, the CDC says.

The new data suggests that the improvement in some groups has not yet played out in obstetrics wards. There are several possible factors, but one could be that only 80% of pregnant women are getting screened for syphilis, according to a recent CDC study.

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

In a White House Press Conference on Monday, President Donald J. Trump said that the Amish have “essentially no autism.” An expert who has worked with the Lancaster Amish for 30 years disagrees. Read more

Braxton Mitchell has worked with the Amish for 30 years as co-director of the Amish Research Clinic in Lancaster. He can say for a fact that autism exists in the community, contrary to President Donald Trump’s statement Monday that the Amish have “essentially no autism.”

Trump’s remarks perpetuate a false belief that autism rates are lower among the Amish, a misconception that Mitchell says resurfaces periodically. The reality, he says, is that there is no good data on rates of the neurological disorder in the Amish.

Advertisement

But he knows firsthand from working with Amish people in the Lancaster area that they, too, struggle with autism.

“There have not been any good studies to ascertain what the frequency is, so we don’t really know, but anecdotally, yes, there is autism in the Amish,” said Mitchell, a genetic epidemiologist.

He conducted a literature search within the last six months and found only one study that did a systematic assessment of autism in the Amish.

The study screened 1,899 Amish children across two communities in Holmes County, Ohio, and Elkhart-Lagrange County, Indiana, according to preliminary data presented at the International Meeting for Autism Research in 2010. They found a rate of approximately 1 in 271 children.

That was lower than the general population’s estimated prevalence of 1 in 91 at the time; however, the difference could have been due to caregivers answering screening questions differently due to “cultural norms and customs,” the paper noted.

“It certainly dispels the myth that there is no autism in the Amish, at the very least,” Mitchell said.

Autism may be underdiagnosed among the Amish because they tend to handle health issues internally, within their communities, and seek professional medical care only for pressing problems, Mitchell said.

Some may not consider behavioral health issues such as autism an emergency medical concern. Many also do not have health insurance, which means they pay out of pocket any time they go to the doctor.

He added that it’s hard to compare the study’s prevalence rate with the general population because the study only looked at Amish children and did not use the same autism screening tool to assess the general population.

That would be like giving different tests to students in a class and then trying to rank them by their scores. The questions should be standardized to ensure an accurate comparison.

“What you would really need to do is administer that same questionnaire, maybe, to the general population, and see what you get,” Mitchell said.

Therefore, the data isn’t enough proof of there being lower rates of autism.

Administration zeros in on autism

At a White House news conference on Monday, the Trump administration announced sweeping actions to address rising rates of autism. Without presenting scientific proof, Trump said that Tylenol should not be used during pregnancy, claiming that it increases the risk of the child developing autism.

Medical societies and a Drexel scientist who conducted a large-scale study on the topic disagreed.

Trump also implied that vaccines and medications could be causes of autism.

“There are certain groups of people that don’t take vaccines and don’t take any pills, that have no autism,” Trump said.

“Does that tell you something?” he added.

He pointed to the Amish community as an example.

But many Amish people do get vaccinated and use Tylenol, Mitchell said.

Amish people also aren’t immune to disease. They have higher rates of rare genetic disorders due to their community descending from only a few hundred settlers and being largely isolated.

The Clinic for Special Children in Lancaster was specifically founded in 1989 to help Amish and Mennonite people with these diseases, some of the most notable being a type of dwarfism called Ellis-van Creveld syndrome and metabolic disorders.

The Clinic for Special Children declined to comment on the topic of autism in the community, stating it focuses on specific, rare genetic disorders.

A 2009 case report found a genetic defect that causes autism and epilepsy in a cohort of Amish children, providing evidence of a hereditary source of autism in the community.

“That’s something that could be very meaningful,” Mitchell said.

“Genetics plays a big role in a lot of neurodevelopmental disorders, but specifically autism,” he added.

Steven Nolt, an Elizabethtown College professor who has researched and written about the Amish extensively, said he’s seen anecdotal evidence of autism in the Amish, including parents writing about their children with autism in Amish publications.

But he’s never seen robust research on the total number of children with autism, making it impossible to calculate a rate.

“I have never seen such numbers and I doubt they exist,” he wrote in an email, noting that the 2010 study was not large enough to be generalizable.

MATTHEW PERRONE, AP Health Writer

WASHINGTON (AP) — When President Donald Trump’s administration announced it would repurpose an old, generic drug as a new treatment for autism, it came as a surprise to many experts — including the physician who suggested the idea to the nation’s top health officials.

Dr. Richard Frye told The Associated Press that he’d been talking with federal regulators about developing his own customized version of the drug for children with autism, assuming more research would be required.

“So we were kinda surprised that they were just approving it right out of the gate without more studies or anything,” said Frye, an Arizona-based child neurologist who has a book and online education business focused on the experimental treatment.

It’s another example of the haphazard rollout of the Trump administration’s Monday announcement on autism, which critics say has elevated an unproven drug that needs far more study before being approved as a credible treatment for the complex brain disease.

A spokesperson for the Republican administration did not immediately respond to a request for comment Wednesday morning.

The nation’s leading autism groups and researchers quickly distanced themselves from the decision on leucovorin, a derivative of vitamin B, calling the studies supporting its use “very weak” and ”very small.”

“We have nothing resembling even moderate evidence that leucovorin is an effective treatment for autism symptoms,” said David Mandell, a psychiatrist at the University of Pennsylvania.

Mandell and other researchers say the evidence suggests autism is mostly rooted in genetics, with input from other factors, including the age of the child’s father.

Nevertheless, a growing number of doctors are prescribing the medication, repurposing versions used for chemotherapy or ordering new formulations from compounding pharmacies.

Many researchers agree the drug warrants additional study, particularly for patients with a deficiency of folate, or vitamin B9, in the brain that may play a role in autism. But for now, they say, it should only be taken in carefully controlled clinical trials.

“We often say our job is to stay between the yellow lines,” said Dr. Lawrence Gray, a pediatric developmental specialist at Northwestern University. “When people just decide to go outside of current guidelines, then they’re outside of that. And nobody knows what’s going to happen out there.”

Dr. Jay Bhattacharya, director of the National Institutes of Health, speaks in the Roosevelt Room of the White House, Monday, Sept. 22, 2025, in Washington, during an event with President Donald Trump. (AP Photo/Mark Schiefelbein)

Dr. Marty Makary, commissioner of the Food and Drug Administration, and Dr. Jay Bhattacharya, director of the National Institutes of Health, listen as President Donald Trump speaks in the Roosevelt Room of the White House, Monday, Sept. 22, 2025, in Washington. (AP Photo/Mark Schiefelbein) Show Caption 1 of 2 Dr. Jay Bhattacharya, director of the National Institutes of Health, speaks in the Roosevelt Room of the White House, Monday, Sept. 22, 2025, in Washington, during an event with President Donald Trump. (AP Photo/Mark Schiefelbein) Expand

The evidence for leucovorin isn’t settled

The case for leucovorin’s use in autism begins with established science but quickly veers into uncertain terrain.

When metabolized, the drug turns into folate, which is essential for healthy prenatal development and is recommended before and during pregnancy. But far less is known about its role after birth.

The issue caught the attention of Frye and others more than 20 years ago, when research suggested some people with autism had low levels of folate in the brain due to antibodies blocking the vitamin’s absorption.

The theory linking autism to folate levels was mostly abandoned, however, after research showed that the siblings of people with autism can also have low folates without any symptoms of the condition.

“I honestly thought this had died out as a theory for autism and was shocked to see its reemergence,” Mandell said.

In 2018, Frye and his colleagues published a study of 48 children in which those taking leucovorin performed better on several language measures than those taking a placebo.

Four small studies in other countries, including China and Iran, showed similar results, albeit using different doses, metrics and statistical analyses, which researchers say is problematic.

Frye struggled to get funding to continue within the traditional academic system.

“I decided to move out of academia to be more innovative and actually do some of this stuff,” he said.

Researchers saw an opening to approach Trump’s top health officials

Earlier this year, Frye and several other researchers formed a new entity, the Autism Discovery Coalition, to pitch their work to Trump administration officials including Health Secretary Robert F. Kennedy Jr.

“After Kennedy got in, we thought they’d hopefully be friendly to autism scientists,” he said.

An August meeting with National Institutes of Health Director Jay Bhattacharya quickly led to further discussions with the Food and Drug Administration about testing a proprietary, purified version of leucovorin.

A new formulation of the decades-old drug would mean new patents, allowing Frye and his yet-to-formed drug company to charge far more than the cheap generics currently on the market.

“We have a lot of investors who are excited about leucovorin and want to do something high quality for kids with autism,” he said.

But the FDA’s announcement Monday may have scuttled that plan. Instead of previewing a new version, the agency said it would simply update the label on the generic drug to mention use in boosting folate brain levels, including for patients with autism. That’s expected to encourage more doctors to prescribe it and insurers to cover it.

Promising autism treatments often fail after more study

Specialists who have spent decades treating autistic patients say it’s important to proceed carefully and methodically.

Gray recalls other experimental treatments that initially looked promising only to fail in larger studies.

“Small studies often find populations that are very motivated,” Gray said. “But when those therapies are moved into larger studies, the initial positive findings often disappear.”

Among the challenges facing leucovorin: There isn’t agreement about what portion of autism patients have the folate-blocking antibodies supposedly targeted by the drug.

Frye screens his patients for the antibodies using a test developed at a laboratory at the State University of New York. Like many specialty tests, it has not been reviewed by the FDA.

Gray says the only way to definitively test for the antibodies would be by extracting cranial fluid from children with autism through a spinal tap.

“That’s a big limiting factor in having these large, randomized controlled trials,” Gray said.

Online sources are driving interest from parents

While the Trump administration discusses fast-tracking leucovorin, interest in the drug continues to swirl online, including in forums and social media groups for parents of children with autism.

Brian Noonan, of Phoenix, found out about the drug earlier this year after asking ChatGPT for the best autism drug options for his 4-year-old son.

The FDA has never approved any drug for the underlying causes of autism, but the chatbot directed Noonan to Frye’s research.

After an evaluation and confirmatory blood test, the boy started on a formulation of the drug from a compounding pharmacy in June.

Within days, Noonan says, he saw improvement in his son’s ability to make eye contact and form sentences.

“He’s not cured, but these are just areas of improvement,” Noonan said. “It’s been a big thing for us.”

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

Does autism not exist in Amish populations, as the president alluded earlier this week in a news conference? The answer is no, anecdotally, but more research would need to be done for accurate numbers, experts say.

In this week’s announcement from the White House linking Tylenol to autism without reference to specific scientific proof, President Donald Trump also made some claims about autism rates among Amish populations.

“I think I can say that there are certain groups of people that don’t take any vaccines or don’t take any pills that have no autism,” Trump said, before immediately asking his health officials, “Is that a correct statement, by the way?”

Acetaminophen, under the brand name Tylenol, for decades has been the most commonly recommended pain reliever for pregnant women based on studies about its impact on the fetus and the mother, and medical experts are challenging the claim.

Health and Human Services Secretary Robert Kennedy Jr. cited the Amish, as a response to Trump’s question on his statement, prompting the president to say they have virtually no autism and that neither do Cubans.

Two experts who work closely with the Plain communities say that while their experience with the Amish has proven to them autism does occur in children, not enough research has been performed to give an accurate picture of its prevalence.

“We know that that statement is untrue simply because … Amish parents will write about their children with autism (in Amish publications). They use that word,” said Steven M. Nolt, interim director at the Young Center for Anabaptist and Pietist Studies and professor of history and Anabaptist studies at Elizabethtown College.

There “has been very little systematic data collected about autism in the Amish community,” says Braxton Mitchell, who has worked with the Amish as co-director of the Amish Research Clinic in Lancaster County. The clinic is associated with the University of Maryland School of Medicine.

But like Nolt, Mitchell said autism does exist in the Amish community — his group has asked Amish people this question.

As for vaccines, which have been falsely linked to autism, Mitchell said some Amish vaccinate their children while others don’t. And many Amish people in Lancaster use Tylenol.

The Amish tend to take care of health issues without seeking professional care except for emergency problems, Mitchell told the Philadelphia Inquirer, and some may not consider behavioral health concerns an emergency. Many also lack health insurance, he said.

Autism rates

As for the rates of autism in the Amish community, Nolt said he doesn’t think there is enough data to determine them.

Nolt pointed to a 2010 study that screened a limited number of Amish children in eastern Ohio and northern Indiana, which he said estimated that one in 271 Amish children met the criteria for autism. But the study had its limitations: it was small-scale and didn’t use screening tools calibrated to Amish social norms. The study’s results were preliminary and “probably sort of an undercount,” Nolt said.

A 2008 study of Pennsylvania’s Amish population published in the Journal of Autism and Developmental Disorders found rates comparable to that of the general population. In the general population, an estimated one in 31 8-year-olds have autism, the Centers for Disease Control and Prevention said.

“I am unaware of studies that are large enough and culturally calibrated enough to provide broad generalization to the entire Amish population, which is currently about 411,000 in the U.S. and Canada,” Nolt said by email.

The Lancaster County area is home to the largest Amish settlement, according to the Young Center’s website, with an estimated Amish population of 44,765.

Autism treatment

The Trump administration’s announcement earlier this week that it would repurpose the old, generic drug leucoverin, a derivative of vitamin B, as a treatment for autism drew quick reaction from researchers looking to distance themselves from the decision.

“We have nothing resembling even moderate evidence that leucovorin is an effective treatment for autism symptoms,” David Mandell, a psychiatrist at the University of Pennsylvania, told The Associated Press.

Mandell and other researchers have said evidence suggests autism is rooted in genetics with influence from some other factors, including the father’s age, many researchers agree the drug warrants additional study – particularly for patients with a deficiency of folate, or vitamin B9, in the brain that may play a role in autism, The Associated Press reported.

When metabolized, the drug turns into folate, which is essential for healthy prenatal development and is recommended before and during pregnancy, according to the AP, but less is known about its role after birth.

“I honestly thought this had died out as a theory for autism and was shocked to see its reemergence,” Mandell said.

The Federal Drug Administration’s announcement Monday would update the label on the generic drug to mention use in boosting folate brain levels, which could encourage more doctors to prescribe it and insurers to cover it, according to the AP.

Staff writer Lucy Albright contributed to this report.

President Donald Trump speaks in the Roosevelt Room of the White House, Monday, Sept. 22, 2025, in Washington, as Health and Human Services Secretary Robert F. Kennedy Jr., left, and Centers for Medicare & Medicaid Services administrator Dr. Mehmet Oz listen. (AP Photo/Mark Schiefelbein) AP

WASHINGTON (AP) — President Donald Trump on Monday used the platform of the presidency to promote unproven ties between Tylenol, vaccines and autism without giving new evidence.

Speaking from the White House, Trump said women should not take acetaminophen, also known by the brand name Tylenol, “during the entire pregnancy.” He said the Food and Drug Administration would begin notifying doctors that the use of acetaminophen “can be associated” with an increased risk of autism, but did not immediately provide any medical evidence for the FDA’s new recommendation.

Trump also raised unfounded concerns about vaccines contributing to rising rates of autism, which affects 1 in 31 U.S. children today, according to the CDC. Health Secretary Robert F. Kennedy Jr said that at Trump’s urging he is launching an “all-agency” effort to identify all causes of autism, involving the National Institutes of Health, the FDA, the Centers for Disease Control and Prevention and the Centers for Medicare and Medicaid Services.

Scientists, doctors and researchers have attributed increased rates of autism to greater awareness of the disorder and the newer, wide-ranging “spectrum” used to issue diagnoses for people with milder expressions of autism. It’s hard to tell if there may be additional factors behind the increase.

The Trump administration has been under immense pressure from Kennedy’s diverse Make America Healthy Again movement to provide answers on the causes of the marked increase in autism cases in the U.S. in recent years.

Experts say the rise in cases is mainly due to a new definition for the disorder that now includes mild cases on a “spectrum” and better diagnoses. They say there is no single cause to the disorder and say the rhetoric appears to ignore and undermine decades of science into the genetic and environmental factors that can play a role.

The announcement is the latest step the administration, driven by Kennedy and his supporters, has taken to reshape America’s public health landscape.

Beyond cutbacks at federal health agencies, the Centers for Disease Control and Prevention has been roiled by disagreements over Kennedy’s vaccine policies. An influential immunization panel stocked by Kennedy with figures who have been critical of vaccines last week changed shot guidance for COVID-19 and other diseases.

Trump on Sunday evening teased Monday’s announcement as a big one, telling reporters, “I think we found an answer to autism.” Experts say that oversells what would be possible from a presidential administration in its first year. They insist more research is needed to conclusively identify whether and how environmental factors may play a role in the disorder.

Kennedy for years has promoted debunked theories that vaccines could be responsible for rising rates of autism, which affects 1 in 31 U.S. children today, according to the CDC. Scientists, doctors and researchers have attributed that increase instead to greater awareness of the disorder and the newer, wide-ranging “spectrum” used to issue diagnoses for people with milder expressions of autism. It’s hard to tell if there may be additional factors behind the increase.