Wednesday, March 12, 2008

Syphilis rates rose again in 2007, largely reflecting outbreaks among men who have sex with men, the nation’s public health agency said today.

The news dampens hopes of eliminating the ancient sexually transmitted disease (STD), which in 2000 looked close to eradication in the United States.

“STDs remain a major threat to the health of gay and bisexual men, in part because having an STD other than HIV can increase the risk of transmitting or acquiring HIV,” said Dr. Kevin Fenton, director of the Centers on Disease Control and Prevention’s (CDC) National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention.

“The resurgence of syphilis among MSM (men who have sex with men) represents a formidable challenge to our STD prevention efforts, but one that is surmountable,” Dr. Fenton said at the agency’s STD prevention conference in Chicago.

Screening and treatment should be a central part of medical care for gay and bisexual men, as well as finding innovative ways to help them avoid STD infections, including HIV, in the first place, he said.

Based on preliminary data, the 2007 syphilis rate was 3.7 cases per 100,000 population, or 11,181 cases. This is 76 percent higher than in 2000, when the rate was 2.1 cases per 100,000.

The 2007 syphilis rate among females also increased, deepening concerns about a potential resurgence of the disease among women. But, as in recent years, the overall increase in the 2007 syphilis rate was largely due to men, especially men who have sex with men or MSM, the CDC said.

“While syphilis rates have increased recently for both men and women, the increases have been considerably larger for men,” the agency said. “This differs from the pattern seen in the late 1990s, when rates among males and rates among females were roughly equivalent.”

About 60 percent of syphilis cases in 2007 were among MSM, compared to an estimated 5 percent in 1999, the CDC said.

Among racial and ethnic groups, syphilis rates for black men and women were higher than the rates among whites.

Syphilis is arguably the world’s oldest known veneral disease. It is highly contagious in its early phases and deadly in its final stages, when it can cause blindness, deafness, strokes, sterility, dementia and death.

It is also often asymptomatic, and CDC officials said that many Americans who are diagnosed with it today are surprised by the news. “You can have it without knowing it,” said Dr. John M. Douglas Jr., director of the CDC’s Division of STD Prevention.

Syphilis is easily cured in its early stages with penicillin. Advanced syphilis can be cured as well, but the treatment cannot undo damage the disease has done to internal organs.

A separate study released today at the Chicago conference said that the CDC’s syphilis elimination plan, first funded in 25 states and three cities in 1999, seemed to pay off: The initially funded states had larger decreases or smaller increases in syphilis infections than states that received no funding or didn’t receive funding until later years.

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