Syphilis outbreak may be sign of re-emergence

An epidemic of syphilis in Jefferson County, Alabama, between 2005 and 2007 involved large increases in cases among heterosexuals, a population in which rates of infection had previously been falling, according to a new report.

"Public health officials in other areas should remain alert for similar epidemiologic shifts," Dr. E. W. Hook and associates advise.

Hook, from the University of Alabama-Birmingham, and co-authors report that the number of cases in the county had declined from 279 in 1995 to 9 in 2002. In 2005, the incidence began to increase sharply, with 238 cases in 2006 and 166 cases in 2007.

The proportion of cases involving heterosexuals rose from 54 percent during 2002-2004 to 88 percent during 2005-2007, the investigators report in the Morbidity and Mortality Weekly Report published by Centers for Disease Control and Prevention (CDC).

In response to this outbreak, the Jackson County Department of Health extended its STD clinic hours, increased the number of clinic staff working with syphilis cases, collaborated with a community-based organization to provide education and referral for screening, and launched a media campaign.

In an editorial note, the CDC advised that "STD programs should employ methods that have been successful in the past" to get the situation under control. Such measures include screening high-risk populations such as in prisons, facilitating access to treatment, and treating partners, "particularly those most likely to sustain transmission."

SOURCE: Morbidity and Mortality Weekly Report, May 7, 2009.