March 26, 2003

New statistics from the Houston Department of Health and Human Services indicate infectious syphilis cases in 2002 in Houston and Harris County rose 7.5 percent and nearly doubled among gay and bisexual men, including those who don't identify as such.

The department urges immediate testing for syphilis to men engaging in anonymous unprotected sex.

"Anonymous sexual encounters hamper intervention efforts," said John Paffel, STD Prevention Program Manager with the department’s Bureau of HIV/STD Prevention. "Without the ability to notify anonymous partners, we are unable to provide testing and treatment to sexual contacts of people with the disease."

New infectious cases, known as primary, secondary and early latent -- or hidden --syphilis, jumped last year to 245 from 228 in 2001. The total number of syphilis cases, including people who have progressed to the late latent stage of the disease, reached 969 in 2002. The department received reports of 899 cases in 2001.

Among gay and bisexual men, the number of infectious syphilis cases in 2002 increased to 116 from 59 in 2001. Overall, the number of syphilis cases among gay and bisexual men more than doubled last year to 227 from 107 in 2001.

The local increase mirrors trends in other large urban areas such as New York, Chicago, San Francisco, Los Angeles and Miami, which are also reporting a hike in the cases of syphilis among gay and bisexual men.

The department urges medical providers, especially those with patient caseloads of gay and bisexual men, to conduct risk assessments to determine if their patients are at increased risk for syphilis, increase testing and ensure prompt treatment. The department also urges providers to report syphilis cases so it can provide testing and treatment to the sexual contacts of people with the disease.

Syphilis greatly facilitates the spread of HIV as a result of the painless sore that develops at the site of sexual contact during the disease’s primary stage.

Syphilis is easily treatable with antibiotics. However, without adequate treatment, syphilis infection progresses to the secondary stage when one or more areas of the skin break into a rash - usually non-itchy and most typically on the palms and soles. Other second stage symptoms can also include fever, swollen lymph glands, sore throat, patchy hair loss, headaches, weight loss, muscle aches and fatigue.

In most cases, syphilis goes undetected because the signs and symptoms are misinterpreted or simply unnoticed. If untreated, Treponema Pallidum, the bacterium that causes syphilis, remains in the body and begins to damage the internal organs, including the brain, nerves, eyes, heart, blood vessels, liver bones and joints. Untreated syphilis during pregnancy can result in a stillbirth or a baby's death soon after birth.

Syphilis cases peaked in Houston in 1991 when 4,726 cases were reported to the department, but by the year 2000 cases totaled 847, an 82 percent drop. The department reported decreases even as recently as early 2001 after a 38 percent drop in syphilis infections occurred between 1998 and 2000.

Information on testing sites is available by calling the department’s HIV/STD Information Hotline at 713-794-9020.