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A Rise of Syphilis in Niagara County

By Khalifah L. Glover, RN, Student Nurse
State University of New York at Buffalo
School of Nursing

April is Sexually Transmitted Disease Awareness Month. This is particularly important to note for the people of Niagara County because the increased occurrence of sexually transmitted diseases, especially Syphilis, indicates that we have to do better with education and prevention among our citizens.

Recent trends over the past few years point to a rise in Syphilis especially among the gay population, but heterosexuals are also affected. Syphilis was once thought to have been eradicated, but according to Leung-Chen (2008), there has been a resurgence in recent years, for reasons that are not yet well understood. According to Reinberg, The Centers for Disease Control and Prevention data show that in 1999, 79% of the 3,115 counties in the United States reported no cases per 100,000 people, the lowest since 1941, when reporting began. Primary and secondary Syphilis have been on the rise for seven consecutive years, from 2001 (three cases per 100,000 people) to 2006 (5.7 cases per 100,000), and to 6.4 cases per 100.000 in 2007. Transmission among men who have sex with men (MSM) may be largely responsible for these increases, although it was only in 2005 that the Centers for Disease Control began to request that case reports include the sex of patients’ sexual partners (Leung-Chen, 2008). In 2006, MSM accounted for 64% of primary and secondary syphilis cases (Leung-Chen, 2008).  

In 2004 the Niagara County Department of Health STD Clinic reported no cases of syphilis, in 2005 there was one case, in 2006 four cases, in 2007 no cases, and in 2008 it jumped back up to four cases. In the first two months of 2009 alone, four cases in Niagara County have already been reported. It is interesting to note here that our neighboring Erie County, according the CDC reported thirteen cases in 2004, nine cases in 2005, and twenty-eight cases in 2006. (Bureau of STD Control Data, 2004-2008).While these numbers might at first appear low, it is essential to note that they in fact reflect a marked increase. Sexual behavior patterns of some who are infected make it likely that their sexual partners will become infected, and that in turn the sexual partners of their partners will also become infected, with ever-increasing spread. Also, these numbers represent only those cases known to the local department of health. Education, case-finding, and treatment are essential to stop the spread.

According to Kevin Fenton, MD, director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, “STD’s remain a major threat to the health of gay and bisexual men, in part because having an STD other than HIV can increase the risk of transmitting or acquiring HIV”. Further, “The resurgence of syphilis among MSM represents a formidable challenge to our STD prevention efforts, but one that is surmountable.

The solution comes down to making STD screening and treatment a central part of medical care for gay and bisexual men, while finding innovative ways to help MSM avoid STD infections – including HIV – in the first place” (Chicago Tribune, 2008, March 12). Since 2002, CDC has recommended that sexually active MSM be tested at least annually for syphilis, chlamydia, and gonorrhea – at all anatomic sites of reported STD exposure. However, several other recent studies presented at the 2008 National STD Prevention Conference in Chicago found that the rates of STD screening among gay and bisexual men remain high. CDC also recommends at least annual STD testing for all individuals with HIV infection.

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