Syphilis cases hit all-time high

Public health officials say the number of new syphilis cases — especially among gay men — has increased at such an alarming rate in the past year they are calling it an epidemic.

Early-stage cases of syphilis increased by 25 percent in 2010 compared with the year before, according to the San Francisco Department of Public Health.

From January 2010 through November 2010, the number of early cases of syphilis reported was 582 — an all-time high in The City. At the height of the last syphilis epidemic in 2004, San Francisco had 552 reported cases, officials said.

“We’ve got one month left to calculate 2010 and we’ve already surpassed our most reported. It’s troubling,” said Kyle Bernstein, an epidemiologist for The City’s health department.

One of the most alarming facts of these cases is that it doesn’t appear that syphilis is emerging in a new population, which means more gay men are becoming infected with the disease, according to Bernstein.

There are no increases in women or heterosexual men, Bernstein said. A typical patient is a gay white man in his 40s or 50s.

Additionally, nearly one-third of all patients who tested positive reported using methamphetamine in the previous 12 months and 60 percent were HIV positive.

“When using meth, condom negotiation may not be easy,” Bernstein said.

Magnet,  a clinic that offers free testing for sexually transmitted diseases, also has seen an increase in the number of syphilis cases. Magnet clinical nurse manager Tim Ryan suggested carriers are unknowingly spreading the disease.

All too often, he said, a patient will see a primary care physician for a rash that appears during the secondary phase of syphilis and not be able to get a proper diagnosis.

“It’s not because the doctor is incompetent — it’s because they’ve not seen a case in maybe two years,” Ryan said.
Because of this epidemic, Bernstein said the health department plans to increase education and awareness. In 2004, during the last epidemic, The City launched a “Healthy Penis” campaign that promoted and encouraged men to get tested every three to six months. At that time, clinical visits did increase, but Bernstein said the department will need to revamp any future campaigns.

What that will look like, Bernstein said, is still unknown.

“I think the idea to get screened is more saturated in The City than previously,” he said. “But we do need to reinvent the campaign and promote screening.”

A ballooning epidemic

San francisco Department of Public Health

January 2009–November 2009: 465 cases

January 2010–November 2010: 582 cases


2008: 284 cases

2009: 284 cases
2010: 425 cases

Source: Department of Public Health, Magnet

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