Va. Responds To Three-Year Resurgence in Syphilis Cases

By Susan Levine
Washington Post Staff Writer
Tuesday, May 8, 2007

With syphilis cases in Virginia more than doubling in only three years, state officials yesterday launched a campaign to increase public understanding of the disease and how it is spread.

As recently as 2003, when syphilis was at a historic low, "we were talking about actually eliminating the disease . . . as a public health problem," said Robert Johnson, director of outbreak response for the state Health Department.

But in 2004, the number of cases reported annually began rising by double-digit percentages. Last year, there was a 31 percent jump, to 352 cases. And in the first quarter of 2007, officials saw a 39 percent spike compared with the same period a year ago.

Virginia's experience parallels what is happening in much of the country, including the District. The city recorded 38 cases, its fewest ever, in 2000. By 2006, the total was 115.

"There's been a huge reemergence," said Bruce Furness, a doctor who volunteers at the Gay Men's Health and Wellness Clinic, run by the Whitman-Walker Clinic.

The rebound of syphilis is linked mainly to transmission among gay and bisexual men, health officials said. Some might already be infected with HIV or AIDS and no longer taking precautions during sexual activity; others simply might not be paying attention to safe-sex warnings, they said.

In Virginia, nearly two-thirds of those who tested positive last year were African American. In the District, cases were almost evenly divided between blacks and whites.

Maryland is bucking the steady-growth trend; in 2005, the last year for which statistics are available, it had 313 syphilis cases, down from 380 in 2004. Baltimore and several counties experienced marked decreases. Baltimore, which accounts for nearly two-thirds of Maryland's total, might show a second consecutive decline when 2006 figures are confirmed soon, said Joshua Scharfstein, city health commissioner.

"In a word, it's outreach," Scharfstein said yesterday, crediting "very aggressive" testing for syphilis and HIV nearly every weeknight across the city.

Syphilis is caused by a bacterium and spread through intimate contact. Many of its symptoms might not appear for years, and they mimic those of other conditions or diseases.

In its primary, infectious stage, one or more small, usually painless sores may occur around the genitals, on the lips or in the mouth. They disappear within weeks. Without treatment, other symptoms set in, typically a rough, red rash on the palms of the hands and soles of the feet.

For most people, syphilis can be cured quickly and effectively early on with a single shot of penicillin. Left untreated, however, it can cause brain damage, harm internal organs such as the heart and liver and even kill.

Virginia's figures might go up even more sharply if undiagnosed cases are detected as a result of public education efforts in Northern Virginia and in the Norfolk and Richmond areas. Signs encouraging testing are being posted in 125 buses that travel routes across Fairfax County and into Arlington. Announcements in English and Spanish will play on local radio and cable stations into June.

"Hopefully, we'll see a big jump" in detected cases, Johnson said.

The District pushed a similar campaign in 2003, warning that "syphilis is back." But sustained progress has been elusive. Whitman-Walker's clinic recently found a 24 percent infection rate among those people tested.

A second program is planned for later this year, Furness said.

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