The number of syphilis cases reported in the United States increased more than 12% from 2001 to 2002, marking the second straight year of an increase in the number of cases, according to CDC
statistics published in the Nov. 21 issue of the agency's Morbidity and Mortality Weekly Report
, the Washington Post
reports (Stein, Washington Post
, 11/21). CDC researchers analyzed national surveillance data reported to health departments for 2002 to look for the epidemiological trends of primary and secondary syphilis. Reported case data included patients' sex, stage of disease, race/ethnicity and age (CDC, MMWR
, 11/21). The researchers found that the number of reported primary and secondary syphilis cases increased 12.4% from 6,103 cases in 2001 to 6,862 cases in 2002, the Post
reports (Washington Post
, 11/21). According to the CDC, the number of syphilis cases among men nationwide increased 27.4% between 2001 and 2002, with an 85.2% increase among cases in non-Hispanic white men -- the largest increase of any demographic, the Atlanta Journal-Constitution
reports. The number of cases among Hispanic men increased 35.6% during the same period, according to the Journal-Constitution
(Guthrie, Atlanta Journal-Constitution
, 11/21). According to the report, the number of cases among African-American men dropped 2.6%, but black men maintained the highest syphilis incidence compared with other demographic groups, the Wall Street Journal
reports. The incidence of syphilis among black men was 13.5 cases per 100,000 population, compared with 4.5 cases per 100,000 population among Hispanic men and 2.2 cases per 100,000 population for non-Hispanic white men, according to the Journal
The number of syphilis cases among all women in the United States fell 19% between 2001 and 2002, and the drop was even greater -- 22% -- among African-American women, according to the report (Chase/Mckay, Wall Street Journal, 11/21). Although the CDC does not break down the data according to sexual orientation, officials estimate that more than 40% of the syphilis cases occurred among men who have sex with men, the Post reports. According to the report, San Francisco in 2002 had a higher syphilis rate than any other U.S. city, with 40.6 cases per 100,000 population, a 126.6% increase over the previous year, according to the Post. In addition, New York City had the most reported cases of syphilis with 435 in 2002, followed by Detroit, Los Angeles and Chicago (Washington Post, 11/21). By state, Georgia ranked highest with 439 reported syphilis cases in 2002 and an incidence of 5.4 cases per 100,000 population, followed by Michigan, Maryland, Florida and Illinois, according to the Journal-Constitution.
Dr. Ronald Valdiserri, deputy director of the CDC's National Center for HIV, STD and TB Prevention, said, "The campaign against syphilis is now being waged on two fronts. We are working on one front to sustain the progress made among populations hardest hit by syphilis, including African Americans. On the second front, we're combating new challenges among gay and bisexual men" (Atlanta Journal-Constitution, 11/21). Valdiserri added, "We're dealing with issues of prevention burnout and skepticism" among MSM. CDC officials said that the increase in the number of syphilis cases is "raising alarms" about a possible increase in HIV cases, according to the Post. Valdiserri said, "We are extremely concerned about that possibility." Eric Ciasullo, board chair of the National Association of People With AIDS, said, "I hear far too often from folks living with HIV and AIDS that our doctors don't ask if we need STD testing. Since it can be hard for some of us to ask for this essential health care service, I think health care providers should ask us" (Washington Post, 11/21). AIDS Project Los Angeles Executive Director Craig Thompson said, "Nationally, now is not the time to get skittish about adopting creative responses targeting gay and bisexual men. We need to act assertively, not ideologically." He added, "There are no quick fixes, and the clear link between syphilis and HIV transmission demands our immediate attention and sustained action" (APLA release, 11/20). The CDC report "underscores the acute need for additional research to explore the factors that have led to this resurgence in syphilis," New York-based AIDS advocacy group Gay Men's Health Crisis said in a release. "It is imperative that the CDC empower local community-based organizations to stem the tide of new syphilis and HIV infections," GMHC Executive Director Ana Oliveira said, adding, "In order to be effective, prevention efforts need to be tailored to the specific populations at risk, particularly men who have sex with men and people of color" (GMHC release, 11/20).
The CDC on Thursday also released data from the "2002 Sexually Transmitted Disease Surveillance Report," according to a CDC release. The report, which includes data on gonorrhea and chlamydia cases in the United States, found that the national incidence of gonorrhea dropped 2.7% to 125 cases per 100,000 population, a rate lower than in the previous four years. The report also found that chlamydia remained the most commonly reported STD in the United States, with 834,555 cases reported in 2002 (CDC release, 11/20).
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