U.S. Syphilis Rate Grows for 7th Year in Row (HealthDay)

WEDNESDAY, March 12 (HealthDay News) -- For the seventh year in arow, rates of syphilis infection have increased in the United States,driven largely by cases among gay and bisexual men, according to a newfederal report.

"CDC's preliminary 2007 data indicate that the rate of primary andsecondary syphilis -- the earliest and most infectious stages of thedisease -- increased by 12 percent between 2006 and 2007," Dr. HillardWeinstock, of the U.S. Centers for Disease Control and Prevention'sDivision of STD Prevention, said during a Wednesday teleconference.Weinstock spoke at the CDC-sponsored 2008 National STD PreventionConference in Chicago.

The number of reported cases of syphilis increased from 9,756 in 2006to 11,181 in 2007, Weinstock said. "This is the seventh consecutive annualincrease in national syphilis rates," he said.

Continuing with recent trends, 2007 statistics showed that men who havesex with men accounted for the majority of syphilis cases in the UnitedStates and contributed significantly to the overall increase in thedisease among men, Weinstock said.

"The syphilis rate among men increased 14 percent from 2006. It was sixtimes higher than the rate among women. Men who have sex with mencomprised approximately 64 percent of reported syphilis cases in 2007," hesaid.

The increase in the syphilis rates among gay and bisexual men is asignificant health concern, Weinstock said. "Syphilis, like other STDs[sexually transmitted diseases], can increase the likelihood of HIVtransmission two- to five-fold. For individuals already infected with HIV,syphilis can increase viral load, which can accelerate HIV diseaseprogression and the potential for HIV transmission," he said.

The CDC recommends that gay and bisexual men be tested for syphilis andother STDs at least once a year. However, several other studies presentedat the meeting found that the rates of STD screening among gay andbisexual men remain low.

"A combination of strategies is needed to reduce the burden of STDsamong men who have sex with men," Dr. John Douglas, director of CDC'sDivision of STD Prevention, said during the teleconference. "Recognizingthat there is no simple solution to the complex factors driving risk andtransmission among men who have sex with men, CDC is taking a variety ofsteps," he added.

The agency is working with doctors and other public health officials topromote recommendations for STD and HIV testing. The CDC is also lookingto increase STD testing in places other than doctors' offices, such asbathhouses and other settings where gay and bisexual men meet, Douglassaid.

Although the majority of new cases of syphilis are among gay andbisexual men, syphilis is also increasing among women andAfrican-Americans, officials said.

"The syphilis rate among women increased between 2006 and 2007 for thethird consecutive year after a decade of decline," Douglas said. "The rateof syphilis among women increased 10 percent from 2006."

And, syphilis rates increased last year among African-Americans for thefourth consecutive year after more than a decade of decline. The rate ofsyphilis among African-Americans increased 22 percent from 2006 to 2007,Weinstock said.

Although the rate of syphilis infections among whites andAfrican-Americans is narrowing, there is still a disparity. "In 2007, thesyphilis rate among African-Americans was seven times higher than amongwhites. This represents a substantial decline from 1999 when the syphilisrate among African-Americans was 29 times that of whites," Weinstocksaid.

This decline represents a drop in cases among African-Americans and anincrease in infections among white gay and bisexual men, Weinstocknoted.

Syphilis is caused by the bacterium Treponema pallidum. Anestimated 36,000 cases of the disease were reported in the United Statesin 2006. The germ is passed from person to person through direct contactwith a syphilis sore, with sores mainly occurring on the externalgenitals, vagina, anus, or in the rectum, according to the CDC.

Early stages of infection are easily cured with the antibioticpenicillin. Late stages of the disease can develop in about 15 percent ofpeople who have not been treated. Untreated syphilis can eventuallydamage internal organs, including the brain, nerves, eyes, heart, bloodvessels, liver, bones, and joints. The damage can be serious enough tocause death, according to the CDC.

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