Rate of new cases of syphilis declines

Once worst in nation, Baltimore bucks trend to fall to No. 5 spot

November 22, 2003|By Julie Bell | Julie Bell,SUN STAFF

Baltimore's syphilis rate continued to fall last year, bucking a national trend and pushing a city that was once the worst in the nation for new cases to the No. 5 spot.

City Health Commissioner Dr. Peter L. Beilenson attributed the improvement to the city's efforts to stem the spread of syphilis among drug users, including people who trade sex for crack cocaine. Among other steps, the city hired more clinicians at its sexually transmitted disease clinics, and it tested and treated people who were arrested and taken to Central Booking and Intake Center.

"It was an 82 percent drop from [1997] to 2002, which we think is the biggest [five]-year drop in any American city ever," Beilenson said of the decline in new syphilis cases, which went from about 662 in 1997 to 121 last year.

But Beilenson added that "two things are potentially of concern."

First, an increasing number of teen-age girls in Baltimore report that they got the disease from older male sexual partners, Beilenson said. Second, here and nationally, syphilis has been on the rise among men who have sex with other men.

In both cases, Beilenson said, those contracting the disease often don't know their sexual partners well, making it difficult for health officials to find the other party to offer testing and treatment.

He said that about 22 percent of Baltimore's syphilis cases last year involved men having sex with men, and about 10 percent involved females 15 to 29 years old.

Nationally, the number of new syphilis cases rose 12.4 percent, but shot up 85.2 percent among non-Hispanic white men and 35.6 percent among Hispanic men, according to statistics released Thursday by the Centers for Disease Control and Prevention in Atlanta.

The number declined slightly among black men, but they have the highest rate among men nationally, with 13.5 cases per 100,000 people.

The statistics were compiled through reports from local health departments.

Cases were counted for patients who exhibited symptoms of the primary or secondary stages of syphilis, which is spread through direct contact with a syphilis sore.

The first stage is usually marked by the appearance of a single sore, or chancre.

The second stage usually starts when one or more areas of the skin break into a rash.

Syphilis can be treated with penicillin, but it can progress to a latent stage and remain hidden for years while damaging internal organs, joints and the brain if left untreated.

Latent cases were not included in the statistics released yesterday.

Nationally, 2.4 new cases of syphilis per 100,000 people were reported last year, up from 2.2 cases in 2001. It was the second straight year the rate has risen nationally after a decade of decline. Officials at the CDC said the increase appeared to be largely among men, particularly those having sex with other men.

Cases among men increased 27.4 percent, compared with a 19 percent decline among women. The total number of cases rose 12.4 percent, to 6,862 from 6,103.

San Francisco had the highest rate of new syphilis cases last year, with 40.6 cases per 100,000 people, or 315 new cases. Detroit, Atlanta and Newark, N.J., also had higher rates of new syphilis cases than Baltimore's 18.6 per 100,000 people.

In 2001, Baltimore ranked third, behind Detroit and Atlanta.

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