A sharp increase in syphilis so far in 2016 led the Alabama Department of Public Health to issue a health advisory syphilis in north Alabama.

The ADPH said there has been a 90 percent increase in reported cases of the sexually-transmitted disease over 2015 in Madison County.

The health department said 54 cases have been reported in Madison County in 2016.

Infection with syphilis can occur after a person has direct contact with a syphilis sore during vaginal, anal or oral sex, according to the ADPH. Sores can be found on the penis, vagina, anus, in the rectum, or on the lips and in the mouth. Syphilis can also be passed from a pregnant woman to her baby.

Persons who contract syphilis may develop a sore or may have a rash, but many people do not notice these symptoms, and will not be aware of infection unless they are tested.

"Most sexually transmitted disease cases continue to go undiagnosed and untreated," Assistant State Health Officer Dr. Scott Harris said in the announcement. "We are especially concerned about the resurgence of congenital syphilis, and syphilis and gonorrhea increases among men who have sex with men."

The ADPH said patients with syphilis can be divided into many stages, including primary, secondary, latent and late forms, but it is the primary and secondary stages that are especially concerning, because these are the stages in which the disease can be transmitted sexually, or from a pregnant woman to her newborn.

The health department is implementing a program of enhanced screening and outreach to those groups who are most at risk, using its disease interventionists and medical staff. In most cases, syphilis can be cured by antibiotics that are given by injection or by mouth.

Click here to see the full advisory from the ADPH.