North Carolina: Health Department Tries to Stem Outbreak of Syphilis

Disease intervention specialists are trying to stop a rise in syphilis cases in Durham County, which has 23 documented cases of the STD so far this year, up from 16 in 2001. If the trend continues, Durham could have an even greater number of syphilis cases than in 1998, when there were 42, according to the county Health Department.

Since 1998, efforts to eliminate the disease kept the numbers below 20 -- until this year, said Brian Letourneau, health director with the Durham County Health Department. The numbers do not include people who have the disease in its latent stages. According to Letourneau, North Carolina has "had problems controlling syphilis, especially along the interstate corridor, at I-85 and I-40. Some people think it's related to commercial sex workers and how law enforcement encourages them to move along to other communities."

In the past four or five weeks, disease specialists have traced Durham's outbreak to a "circle of individuals" involved in the sex trade, said Stan Phillip Jr., a public health regional supervisor with the state Department of Health and Human Services. Those individuals have been tested and treated, but the department is still trying to track down their network of sex partners.

An added concern is that the genital sores caused by syphilis make it easier to transmit or acquire HIV, and Durham has one of the highest HIV infection rates in the state. There is a two- to five-fold increase of acquiring HIV when syphilis is also present, according to the CDC.

In North Carolina, the number of infectious syphilis cases declined from more than 2,000 in 1992 to 445 in 2001, according to the state Health Department. But it's not unusual for counties to see occasional surges, Phillip said. Wake County numbers continue to decline, but Orange County had an increase in 2001, he said.

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