The number of people in the US diagnosed with a sexually transmitted disease in the past year has risen to the highest level ever.
About 2.5 million cases of sexually transmitted diseases were reported in 2018, including about 1,300 cases of congenital syphilis in newborns, according to the US Centers for Disease Control and Prevention (CDC).
Congenital syphilis occurs when the mother transmits the infection to the fetus in the womb.
There were still 78 births, as well as 16 child deaths, due to congenital syphilis last year.
STD rates increased year-on-year between 2014 and 2018, with syphilis cases increasing by 71% and gonorrhea cases jumping by 63%.
The number of people diagnosed with chlamydia increased by 19% over the same period.
US health officials blame a drop in funds at state and local levels for record rates.
CDC's annual prevention budget fell by 40% between 2003 and 2018.
Lower levels of funding have resulted in employee layoffs, clinic closures and less screening, meaning that it is more difficult to prevent the spread of STDs.
Gail Bolan, CDC's director of STD prevention, said: "The resurgence of syphilis, and particularly congenital syphilis, is not an arbitrary event but a symptom of deteriorating public health infrastructure and lack of access to health services. "
In 2018, the CDC reported nearly 1.8 million cases of chlamydia, 580,000 cases of gonorrhea, and about 115,000 cases of syphilis.
There were still 78 births, as well as 16 infant deaths, due to congenital syphilis.
Half of STD cases occur in people aged 15-24 and can lead to health complications.