City ranks No. 1 in syphilis Rate of reported cases here triples since 1990

rise linked to drug use

Other cities' rates decline

Mayor calls outbreak public health crisis

HIV increase feared

January 09, 1998|By Robert Guy Matthews | Robert Guy Matthews,SUN STAFF

Persistent outbreaks of syphilis have given Baltimore the unwelcome distinction of being tops in the nation in the rate of reported cases of the sexually transmitted disease, according to the U.S. Centers for Disease Control and Prevention.

Unlike most cities around the country, which are reporting fewer cases of syphilis, the recently released statistics show that Baltimore more than tripled in 1996 its rate of reported cases in 1990.

City health officials say that the syphilis outbreak is linked to drug use.

"We think it is because of the crack-for-sex trade," said Elias Dorsey, the city's deputy health commissioner. Officials say the outbreak is concentrated in poorer neighborhoods and the average age of those infected in Baltimore is 35.

Mayor Kurt L. Schmoke said the outbreak has become a public health crisis. He said he will shift more money and resources to combat syphilis.

City health officials have asked the mayor to pay for more clinicians at health clinics to educate and treat people.

"We want to increase the hours in some clinics and hire more doctors," Dorsey said.

According to the government's statistics, Baltimore has nearly twice the rate of reported syphilis cases as the No. 2-ranked city, Memphis, Tenn. For every 100,000 people in Baltimore, health officials reported 80 cases of syphilis in 1996. Memphis' rate was 46 per 100,000.

Richard Dunning, director of the city's Bureau of Disease Control, said he expects the syphilis outbreak to increase the number of HIV cases in the city as well.

Syphilis results in lesions or open sores, which make it easier to transmit or catch the virus that causes AIDS.

"We are worried about the fallout of a big increase of HIV infections because of this," Dunning said. As yet, Dunning said that the city hasn't seen a spike in reported cases of the human immunodeficiency virus.

"It is a little bit early," he said. "I think everybody is predicting that there will be some increase in HIV."

If caught early, syphilis can be easily treated with penicillin and cured. But people can catch syphilis again. If left untreated, syphilis can eventually damage vital organs such as the heart and brain.

The disease can also be passed from pregnant women to their children, who are at risk of suffering blindness and birth defects. Some of the babies can be stillborn.

The CDC rankings sampled 64 U.S. cities with populations of more than 200,000.

The statistics show that overall most of those cities reported dramatic declines in syphilis cases since 1990.

In 1990, seven cities reported higher rates than what Baltimore, at No. 1, reports today. The most infected city in 1990 -- Atlanta -- reported a rate of 221.8 cases per 100,000 population. By 1996, Atlanta's reported rate had dropped to 35.3 cases per 100,000. Over the years, other cities, too, have cut their rates dramatically and now report less than half the number of cases of Baltimore, statistics show.

While not wanting to downplay the syphilis problem, city health officials said that Baltimore might be ranked No. 1 because of its increased efforts to track the disease.

Officials said that when someone tests positive for syphilis, clinicians search for past sexual partners of the person and test them for the disease.

"We go through this labor-intensive research like it was a health epidemic," Dorsey said. "Because of our successes, the city is made to look like we have a lot of that. I question why we should be ranked No. 1."

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Pub Date: 1/09/98

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