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Letter to the editor

Health chief warns of syphilis rise

By MICHAEL A. MOHAMMED
Published June 8, 2007

A sharp increase in cases of syphilis infection during the first quarter of 2007 has prompted Hillsborough County's chief health official to issue an alert to health care workers.

Forty-six cases were reported, a 54 percent increase over the same period in 2006, wrote Hillsborough Health Department Director Douglas A. Holt in a recent letter to the county's health care providers.

Those include active infections and cases discovered after the bacteria has gone dormant in a person.

"A significant proportion of these cases have occurred among men who have sex with men," Holt said. He also cited another troubling trend. "For the first time in years, cases have increased among teens and African-American women."

Though Pasco County officials say they have noticed no change, Pinellas County Health Department statistics indicate a rise in syphilis cases, though they remain most common among men who have sex with men, said spokeswoman Jeannine Mallory.

The increase among teens, blacks and women worries George Hughes, head of the Hillsborough health department's STD program.

Babies born to infected mothers could die or suffer permanent disabilities if the disease is not treated, though Florida statues require expectant mothers to be tested upon their initial doctor's visit and again between 28 and 32 weeks of pregnancy.

Hughes said he suspects that bisexual black men could be responsible for the unexpected increase in cases among black women. In addition, several cases involved prison inmates and prostitutes.

Most of the increase in teens occurred among African-Americans, he said. The department is focusing on the neighborhoods around those patients' homes.

"We're trying to target those areas where those teens live, as far as outreach, education and screenings to identify new cases," Hughes said.

He also said that making condoms available through high school health offices could combat the trend.

"We've always had chlamydia in the teenage population," Hughes said. "It just amazes me that we can't put condoms in the school, at least in the nurse's office."

Though syphilis declined sharply nationwide during the 1990s, it began to bounce back between 2000 and 2004, according to National Institutes of Health statistics.

In raw numbers, the disease still ranks a distant third behind chlamydia and gonorrhea, but its mild initial symptoms make it difficult to detect.

And studies indicate a two- to five-fold increased risk of HIV infection for those infected with STDs. Syphilis sores provide "the perfect portal for the transmission of HIV," Hughes said.

"Our goal is to reduce it down to nothing," he said. "Since there was an increase in cases, it's still a concern."

Michael A. Mohammed can be reached at mmohammed@sptimes.com or (813) 226-3404.

REPORTED CASES OF ACTIVE SYPHILIS

Source: Florida Department of Health

Fast Facts: To get help
Here are numbers to call for testing or treatment:
Hillsborough: (813) 307-8022.
Pasco: (727) 869-3900
Pinellas: (727) 824-6900

Syphilis' effects
The syphilis bacterium, like those that cause gonorrhea and chlamydia, can be treated with antibiotics. But the symptoms are less visible than those of some other STDs:

• 9 to 90 days after infection, a small, painless ulcer forms at the infection site - usually the genitalia, sometimes the mouth area. It can occur inside the body and is easily overlooked, but offers a prime spot for other infections like HIV.
• The ulcer disappears about 2 to 3 weeks later, and a non-itchy rash or spots may form on the palms, soles of the feet, or the whole body. Other symptoms are hair loss and aching joints.
• Those symptoms disappear and the disease becomes latent, with a very low risk of infecting others.
• In a small portion of cases, latent syphilis flares up years later, ravaging the brain and internal organs, causing death or permanent damage.

Source: National Institutes of Health

[Last modified June 8, 2007, 00:35:55]