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Syphilis outbreak declared in Nevada county
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Public health officials declared an outbreak of syphilis in the Nevada county encompassing Las Vegas amid a 128% increase in reported cases since 2012.
The outbreak in Clark County mostly involves men, who accounted for roughly 89% of the 694 cases of syphilis diagnosed in 2015, according to the Southern Nevada Health District (SNHD).
“We are considering this an outbreak because disease rates in our community are continuing to climb, and we see no plateau at this point,” Joe Iser, MD, DrPH, MSc, chief health officer for the SNHD, said in a news release. “Our goal is to make people aware of the problem, encourage health care providers — especially those who treat men — to report cases to us so we can begin notifying partners, get them into treatment, and stop the spread.”
Nevada’s rate second-highest in country
The CDC reported in November that nationally overall cases of syphilis, chlamydia and gonorrhea all increased in 2014 for the first time since 2006. Reported cases of primary and secondary syphilis — the stages in which it is most infectious and can be treated — rose to 19,999 in 2014, a 105% increase since 2006, according to the CDC.
The federal agency reported that cases of primary and secondary syphilis were 12.8 per 100,000 population in Nevada in 2014 — second only to Washington, D.C. (17.9 per 100,000).
According to Edward W. Hook III, MD, chief of the division of infectious diseases at the University of Alabama at Birmingham, Clark County is being affected by a larger epidemic.
“I applaud what the people in Clark County are doing,” Hook told Infectious Disease News. “I also think what they’re seeing reflects what’s going on nationally.”
Syphilis a concern for MSM
Primary and secondary syphilis is a chief concern among men who have sex with men, who accounted for 83% of male cases of the disease nationwide in 2014 in which the sex of the sex partner was known, according to CDC data. Overall, men accounted for more than 90% of primary and secondary cases of syphilis in 2014, according to the agency.
“I think we have to be very cautious about generalizations,” Hook said, “but there are a subset of men who have sex with men, many of whom have HIV, who are living a lifestyle which is risky in terms of risk for getting sexually transmitted infections. And when you add to that this amplifying phenomenon [in which syphilis in patients with HIV is more likely to be transmitted in persons who do not have syphilis], it becomes really quite frightening.”
Hook said “social phenomena” like online dating websites or apps may affect the rates of syphilis.
“The fact of the matter is, if they are a group of people who are using those phenomena and have syphilis introduced, or have higher rates of syphilis, then syphilis is going to be spread in concert with the use of those techniques, but I don’t think it’s really limited to men who have sex with men,” he said. – by Gerard Gallagher
References:
CDC. Sexually transmitted disease surveillance 2014. http://www.cdc.gov/std/stats14/surv-2014-print.pdf. Accessed March 2, 2016.
CDC. STDs reported in the United States, 2014. http://www.cdc.gov/nchhstp/newsroom/2015/std-surveillance-report.html. Accessed March 2, 2016.
CDC. Primary and secondary syphilis – reported cases and rates of reported cases by state/area and region in alphabetical order, United States and outlying areas, 2010-2014. http://www.cdc.gov/std/stats14/tables/27.htm. Accessed March 2, 2016.
Disclosures: Hook reports no relevant financial disclosures. Iser is the chief health adviser for the Southern Nevada Health District.