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Syphilis Rate Up for First Time Since 1990

Slight rise attributed to gay and bisexual men

THURSDAY, Oct. 31, 2002 (HealthDayNews) -- Bucking a decade-long slide in the incidence of syphilis in the United States, the rate of the sex infection rose by 2 percent between 2000 and 2001.

The federal Centers for Disease Control and Prevention, which released a report on the trends today, said that the syphilis rate went up for the first time since 1990. The increase appeared to occur in gay and bisexual men. The number of cases of syphilis in women continued to decline. Last year, there were 4,144 cases of the disease in men, up 15.4 percent from the 3,532 cases the year before. In women, 2001 saw 1,967 cases, off nearly 18 percent from the 2,445 cases in 2000.

The syphilis rate in American men climbed from 2.6 to 3 per 100,000, but fell from 1.7 to 1.4 per 100,000 for women. The overall rate was 2.2 cases per 100,000 people, up from 2.1 per 100,000 the previous year -- the lowest rate since tracking of the infection began in 1941, officials said. The 2001 figures remain well above the government's 2005 goal of 0.4 cases per 100,000 Americans, or fewer than 1,000 people infected annually.

"The absence of syphilis cases in the vast majority of U.S. counties serves as a reminder that syphilis elimination" is possible, said Dr. Ronald Valdiserri, who heads the CDC's HIV, tuberculosis and sexually transmitted diseases prevention programs. But the continued success of elimination efforts begun in 1999 will depend on the public health community's ability to target high-risk groups, such as gay and bisexual men and minorities. "It leads us to intensify our warning," he said.

Outbreaks of syphilis in gay and bisexual men are particularly worrisome, Valdiserri said, because they may augur a resurgence of HIV and AIDS in these groups. Syphilis infection has been shown to raise the risk both of contracting and transmitting the HIV infection.

The CDC has been sending "rapid response" teams to areas with outbreaks of syphilis, including Miami, Chicago, and Los Angeles. Valdiserri said the agency and its state public health partners need to work harder to educate gay and bisexual men about the importance of practicing safe sex.

Syphilis was 114 percent more common in men than in women in 2001, and 15.7 times more common in blacks than in whites. Blacks accounted for more than 62 percent of cases of the disease last year, off significantly from 2000, when they made up almost 71 percent of infections.

Last year, 20 counties and one city accounted for roughly half of all syphilis cases in the United States. Wayne County, Mich., which includes Detroit, had the highest number, with 379 cases, followed by the Chicago area, with 339. The highest rate of the disease was in impoverished Robeson County, N.C., whose 90 cases gave it a rate of 73 per 100,000 residents.

What To Do

For more on syphilis and other sexually transmitted diseases, try the Centers for Disease Control and Prevention or the American Social Health Association.

SOURCES: Ronald Valdiserri, M.D., M.P.H., deputy director, HIV, STD and TB prevention programs, U.S. Centers for Disease Control and Prevention, Atlanta; Nov. 1, 2002 Morbidity and Mortality Weekly Report
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