Syphilis outbreak detected in Houston, Harris County

Clinic assistant Denita Johnson draws blood from a patient at the City of Houston's main STD facility at 1115 Braeswood, the Medical Center Clinic Monday, Aug. 27, 2007, in Houston. ( Sharon Steinmann / Chronicle ) less Clinic assistant Denita Johnson draws blood from a patient at the City of Houston's main STD facility at 1115 Braeswood, the Medical Center Clinic Monday, Aug. 27, 2007, in Houston. ( Sharon Steinmann / ... more Photo: Sharon Steinmann Photo: Sharon Steinmann Image 1 of / 6 Caption Close Syphilis outbreak detected in Houston, Harris County 1 / 6 Back to Gallery

Syphilis is spiking in Houston and Harris County, mostly the result of men having sex with men, local health officials said Wednesday.

Houston's health department reported a near doubling in the number of new infectious syphilis cases during the first eight months of 2012 compared to the same period last year. The increase reverses a trend of syphilis cases decreasing between 2008 and 2011.

"It's very alarming," said Lupita Thornton, program manager for sexually transmitted diseases for the Houston Department of Health and Human Services. "We hope it's alarming to the Houston-area community so people who know they're at risk get tested."

Thornton said no single factor caused the outbreak, and a health department spokeswoman said the figures may simply reflect the normal "waxing and waning" of disease statistics. But the top factors they cited were stepped-up surveillance efforts, such as city-sponsored hip-hop concerts that feature free screenings for STDs, and the use of social networking to arrange sexual encounters.

Thornton said the trend is most pronounced in urban areas around the country and predominantly affects gay and bisexual men.

Overall U.S. rate down

Numerous cities in the United States and around the world have reported syphilis spikes in recent years, but the overall rate nationally is down 1.6 percent since 2009, according to the U.S. Centers for Disease Control and Prevention.

In 1999, a time of historically low rates, the CDC launched a syphilis elimination effort, particularly targeted at the southern part of the country, where rates were the highest and racial health inequalities the greatest. The effort, not considered a success, is ongoing.

In an alert sent Wednesday, Houston health officials called for medical providers, particularly those who primarily treat men, to determine whether their patients are at increased risk for syphilis. It called for providers to offer testing to those at risk, treatment to people and their sexual partners who are found to be infected and to report any cases to local health departments.

Problems if not treated

Syphilis is caused by a highly contagious bacterium and spread by sexual contact, including kissing. It is easily treated with antibiotics, but if not treated it can progress from painless sores to damage the brain, nerves, eyes, heart, blood vessels, liver, bones and joints. It often goes undetected because symptoms are misinterpreted or not noticed.

Houston's health department, which collects data for all of Harris County, detected 318 infectious cases, known as primary and secondary syphilis, from January to August. A total of 174 such cases were reported through the same period in 2011 and 264 for the entire year.

The 2012 cases amount to 7.5 cases per 100,000 people, up from 4.2 for the first seven months of 2011. The recent high rate is 7.8 cases per 100,000 people in 2007.

Roughly 39 percent of people with infectious syphilis in 2012 also tested positive for HIV. A sore that develops at the site of sexual contact during syphilis' primary stage increases the risk of spreading HIV.

Syphilis disproportionately affects blacks. CDC statistics show a dramatic increase in the syphilis rate for young black men, particularly those who have sex with men, and the 2012 Harris County statistics show blacks account for most of the local cases. Men outnumber women in the new numbers nearly five to one.

Nearly 60 percent of the cases involve blacks, 23 percent Hispanics and nearly 16 percent whites.

Stepping up efforts

In response to the outbreak, the health department is intensifying syphilis detection and community field work and expanding the schedule of its HIV/STD mobile clinic. It is urging immediate testing for syphilis for men who have sex with men; people who engage in anonymous sex; anyone who has had multiple sex partners; and people who test positive for other sexually transmitted diseases.

The release of the new numbers comes a week after San Antonio health officials announced that because of the rising numbers of babies born with the disease there, they have begun assigning case workers to follow syphilis-infected women through their pregnancies to ensure proper treatment.

Although syphilis is mostly passed on by sexual contact, the untreated disease can be transmitted to a mother's fetus.

todd.ackerman@chron.com