"It dawned on me, hey, syphilis is here to stay. Syphilis does not distinguish between straight and gay, rich and poor," said Lichtenstein, a Fresno OBGYN.
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Health experts believe a combination of drug use, lack of condoms, and risky sexual behavior caused the sudden spike. What's more concerning is the impact it has on pregnant women. Syphilis is one of the few STDs that can cause death, especially among newborns.
"If left unchecked, it will eventually progress to the central nervous system, cause significant damage and cause madness," said Lichtenstein.
In 2017, there were 60 cases of congenital syphilis in Fresno County.. Many of the babies were stillborn. A penicillin shot is all it takes to treat the disease.
"It's easy to cure, so why aren't women seeking help? Men seeking help? That's the big concern for public health," said Leticia Berber with the Fresno County Health Department.
RELATED: Number of STD cases hit record high in California
Number of STDs hit record high in California
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The health department is mounting an aggressive attack of the STD. It recently opened up a specialized clinic. The county is also working closely with OBGYNs to make sure diagnosed mothers are returning to get all their antibiotic shots.
"When we receive a positive test on a woman...we look for that woman and make sure they follow up with their prenatal care. If not we have a communicable disease specialist go out and getting that woman to their care and making sure they follow through," said Berber.
The county has also been purchasing penicillin and handing it out directly to doctors. There has been some success. The total number of syphilis cases are down in 2017 compared to 2016, but congenital syphilis cases are still on the rise.