Syphilis Rates Rise In Minnesota
Health officials are expressing concern over a recent rise in syphilis cases in Minnesota. In 2008, early syphilis cases were up 40 percent compared to 2007. Early syphilis—infection of less than one year—is the most infectious stage of the disease and thus of greatest concern to public health.
"We initially saw a rise in syphilis cases among men who have sex with men (MSM) back in 2002 that has persisted over time," said Peter Carr, director of the STD and HIV Section, Minnesota Department of Health (MDH). "Although rates had been showing signs of leveling-off in recent years, we saw a dramatic rise in early syphilis cases in 2008."
MDH preliminary data show that 159 early syphilis cases were reported in 2008 compared to 114 cases in 2007. Of the 159 early syphilis cases, 97 percent (154 cases) were males. New infections continued to be centered within the Twin Cities metropolitan area. Seventy-three percent (113 cases) were among whites, 16 percent (25 cases) were among African-Americans and 5 percent (8 cases) were among Latinos.
"The biggest concern with this latest rise in cases is the increase in cases among young men," said Carr. "The biggest jump was seen among those 15 to 24 years of age."
Health officials reported that syphilis cases rose from 17 in 2007 to 37 in 2008 among 15- to-24- year-olds. Syphilis can be a dangerous and serious disease if left untreated. In the most severe cases, untreated syphilis can lead to blindness, brain damage, heart problems and even death.
The most common risk factors reported were meeting partners on the internet, anonymous sex, and no condom use. Syphilis is spread through direct contact with a painless sore called a chancre during unprotected oral, anal and vaginal sex. Latex condoms, when used consistently and correctly, can reduce the risk of spreading or acquiring syphilis and other sexually transmitted diseases including HIV infection.
"It is important that those at risk get tested," suggested Carr. "Syphilis remains a relatively rare disease for most Minnesotans, but not in certain communities." In 2008, MDH data show that 82 percent (131 cases) of early cases were among MSM.
Health officials noted that it is important for health providers to provide more screenings to their at-risk clients. The Centers for Disease Control and Prevention (CDC) recommends that MSM patients be tested at least annually. For those at highest risk with multiple partners, especially if they are HIV positive, CDC recommends testing as often as every three months. The Minnesota Medical Association (MMA) is calling for its members to be on the alert.
"While the numbers are small now, the rate of increase raises the alarming possibility of many more people becoming infected in the coming years," said Amy Gilbert, M.D., MPH, chair of the MMA Committee on Public Health and also the Medical Director at the Family Tree Clinic in St. Paul. "Doctors haven’t seen syphilis in a long time. We need to raise our awareness and remember to look for it."
Another concern for officials is that approximately 40 percent of people contracting syphilis are also HIV positive. "We know now that infected persons with syphilis can help spread or acquire HIV infection when the painless sores or chancres are present. In addition, we know that HIV infection can help acquire or spread syphilis," Carr said. "Plus, there is the greater potential for disease progression and treatment failures when someone with HIV gets syphilis."
Health officials noted that sexual partners need to be notified of their potential exposure and tested and treated accordingly. Persons can get re-infected with syphilis after treatment if they are re-exposed.