Prince George's County, for the first time, has surpassed Baltimore City to lead the state in the incidence of congenital and adult syphilis, and worried health officials say a new, broader definition of the disease continues to push the numbers higher throughout the state.
During the first eight months of this year, 918 cases of adult syphilis were reported in the county, up from 831 cases for the same period in 1989 and nearly triple the number reported in Baltimore this year.
Statewide, 29 infants were born with the disease, four of them in Baltimore and 18 in Prince George's. The county reported seven infants with congenital syphilis for the same period a year ago.
"It's alarming," said Diane Matuszak, chief of the state Health Department's Center for Clinical Epidemiology. "More and more women have syphilis and that means that more babies are going to be infected by their mother."
Two years ago, the definition of congenital syphilis was broadened to include infants born to syphilitic mothers but who do not exhibit any symptoms of the disease. Health care officials say this factor, and continued risky sexual behavior among youths and drug addicts, will account for a continued increase in the number of newborns with the disease.
Statewide, 77 percent of the afflicted infants are black, compared with 89 percent in the county. Matuszak said several outreach programs are in the black community and employ black health care workers.
"The syphilis cases are mostly young black mothers," she said. "There has been great effort to get to those in the community who need health care and also provide workers that the young people themselves can relate to."
An increase in sex-for-drugs prostitution and a disdain for condoms also contribute to the problem, health care workers said.
On an annual budget of $1.1 million, workers at the county's sole clinic for sexually transmitted diseases, in Cheverly, try to trace an infected person's sexual partners to stop the spread of the disease. Investigators prefer to tell people face to face that they may have come in contact with the disease. Thus, much of their time is spent searching for possibly infected persons.
Elin Gurtsky, director of epidemiology and disease control for the Prince George's County Health Department, said the county's 13 investigators often are stymied in their attempts because some patients give misinformation involving sexual liaisons.
Infants born with syphilis may exhibit chronic nasal discharge or they may exhibit no symptoms. Untreated, the disease can cause damage to the liver, bones and neurological system and even death.
Syphilis in adults and babies is 100 percent curable if treated early with antibiotics, said Matuszak.
But health care officials said the real task is letting people know that medical attention is readily available and free.
"We realize that a lot of people don't read the paper or watch television, so by taking education out into the streets, hopefully we'll get more people in for treatment," Gurtsky said of her department's efforts to go into the community to pass out literature and discuss treatment.
"We have a very severe problem, and I don't think it's getting better anytime soon," she said.