Once Common Disease Returns

Local syphilis cases on the rise

Syphilis was once so common that some people viewed the potentially fatal disease as a natural stage of life.

“It is unthinkable for a Frenchman to arrive at middle age without having syphilis and the Cross of the Legion of Honor,” said French writer Andre Gide in the early part of the 20th century.

Nowadays, most sexually active people think syphilis is a relic of the past and worry more about contracting viruses like HIV. But syphilis is back, and in a big way.

Cincinnati Health Department officials are combing the streets trying to educate the public on a recent outbreak that has plagued the city. Steadily increasing for the last 10 years, cases of syphilis in Cincinnati have reached an all-time high.

“In the year 1999-2000 we had 15 cases a year,” says Dr. Lawrence Holditch, medical director of the Cincinnati Health Department. “In 2007 we had 56 cases, in 2008 we had 72 cases and in 2009 the number jumped to 174 cases.”

In the first six months of 2010, the Cincinnati Health Department already has seen 81 cases.

“Right now there is a slight increase from the cases we had last year at this time,” Holditch says. “If this trend continues we will see an increase of 60 to 70 cases over last year.”

Currently, African-American males between the ages of 15 and 35 are most affected by the outbreak, say health officials.

They also have seen numbers, however, that suggest other demographics are steadily contracting the disease as well.

“I have seen cases from all over the board,” says Eric Washington, STD/HIV program manager for the Cincinnati Health Department. “I have seen mothers who have had this and passed it to their newborn babies, 16-year-olds who have contracted it from their partners and 70-year-old men who have gotten this.”

Health officials say there are many reasons for the outbreak, including area residents not being educated on what syphilis is. Syphilis, which dates back to the 15th century, is a sexually transmitted disease that can cause severe and sometimes fatal damage to a person’s body if left untreated. Famously known for infecting the rich and powerful, syphilis is better known for infecting the likes of Adolf Hitler, Al Capone and Ivan the Terrible than for its signs and symptoms.

There are three different stages of syphilis. The first stage is called primary syphilis and occurs about 10 to 90 days after the initial sexual contact.

“You will get a small, painless sore on the area where sexual contact was made,” Washington says. “This sore may look ugly, but it is painless. Many times people do not even realize it is there because they can not feel it.”

The next stage is called secondary syphilis and is characterized by a rash on the body. People suffering from secondary syphilis may also experience headaches, weight loss, fevers and sore throats.

The third stage is called latent syphilis and this stage causes the symptoms of the primary and secondary stages to disappear. Once at this stage, though, if the disease continues to go untreated it will cause severe damage to internal organs.

“Once you reach this stage if you continue to not get treatment you can cause irreversible damage to your brain, eyes, heart and nervous system,” Washington says.

Symptoms of the latent stage include paralysis, blindness, dementia and even death.

Besides residents not knowing what the signs and symptoms of syphilis are, health officials say area doctors are not properly diagnosing cases when they see it.

“Syphilis is known as the ‘Great Imitator’ because it can look like so many other diseases,” says Rocky Merz (pictured above), public information officer for the Cincinnati Health Department. “So, when patients are going to their doctors they are not being tested for syphilis because their doctors think they have something else.”

Because syphilis has been off area doctors’ radars for so long, doctors don’t think to test patients for it.

“Patients have to get a very specific blood test when they go to the doctors to be tested for syphilis,” Merz adds. “So, when doctors do not see the disease everyday for years, they tend to forget about it. However, the issue is that the disease is still out there circulating even if they are not seeing it all the time.”

As a result, the health department is taking steps to educate area doctors to help ensure tests are performed when patients come in.

“We have sent out alerts to area health care providers informing them there has been an increase in syphilis in the community,” Dr. Holditch says. “We also have had educational workshops for health care providers giving them a refresher about the symptoms of syphilis, what the latest trends in the disease are and how to treat it.”

The Cincinnati Health Department is also teaming up with the Ohio Department of Health to educate the general public about the disease.

“We have put up billboards, bus markers and posters throughout the city urging people to get tested,” Washington says. “We also plan to find areas of town that are at high risk for syphilis and educate the people that live in those areas about this disease.”

By educating the public, health officials hope people will exhibit safer behavior when they have sex.

“Many people are meeting over the Internet and engaging in anonymous sex,” Dr. Holditch says. “People are having sex without having any knowledge of their partners’ drug or sexual history and they are not using condoms.”

By educating the public on syphilis and safer sex, officials hope they can protect people from other STDs as well.

“Syphilis and HIV tend to run together,” says Dr. Jill Huppert, assistant professor of pediatrics, obstetrics and gynecology at the Cincinnati Children’s Hospital. “If you have a open sore and are having sexual contact you are more likely to get HIV from your partner.”

Because the sores people get with syphilis are painless most of the time, people become unaware they have them, Huppert adds. So, when they engage in sexual contact, the likelihood that HIV could get into the open sore is greater.

Area health officials hope the overall message to the public is to practice safer sex.

“In this day and age people need to be more conscience of their sexual health,” Washington says. “There are so many diseases out there, and if you let one go untreated it can be extremely dangerous.”

The Cincinnati Health Department is offering free confidential syphilis testing. For more information call 513-357-7300.

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