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Q Health

Is it a syphilis outbreak or is it a syphilis tsunami?

It’s official: Salt Lake County has been experiencing increasing levels of syphilis such that we are now using the word “outbreak.” Yes, right here in little ol’ Salt Lake County. Syphilis is real, it’s here and it doesn’t seem to be going away.

There has been a steady increase in the number of syphilis cases identified in the county for a few years now, but alarm bells began to ring louder last year, as 2016 reached the highest recorded level to date. Those alarm bells are sounding louder already in 2017 as we are on route to surpass the number of cases diagnosed in 2016 and set yet another new record. From a public health perspective, the previously reported wave of new infections is in fact beginning to be more like a tsunami.

The good news, in some ways, is that we are not the only ones. The rest of the country is also seeing the same increases. The U.S. Centers for Disease Control and Prevention say that the “most recent findings report rates of primary and secondary syphilis — the most infectious stages of the disease — are at the highest that they have been in more than 20 years.” This is the result of data collected at the national level.

Most of the cases of syphilis diagnosed in Salt Lake County and in other areas of the country are among men who have sex with men (MSM). U.S. census data tells us that roughly 4 percent of the overall population is an MSM, but more than 60 percent of primary and secondary syphilis cases diagnosed throughout the U.S. in 2016 were in MSMs. In Salt Lake County, 92 percent of early stage syphilis were diagnosed in a man who has sex with men, and over 40 percent of cases were co-infected with HIV.

Syphilis is one of the most serious of the bacterial STDs. It is highly infectious in its earliest stages and in some cases it can cause neurological damage. Last year in Salt Lake County, three patients experienced vision loss and were diagnosed with a new classification of disease referred to as ocular syphilis. All three patients were likely infected in the previous six months. Ocular syphilis is a somewhat new manifestation of syphilis infection that is somehow able to affect the eye structure and impair vision.

Not all people infected with syphilis develop symptoms, but for those who do, symptoms usually occur within the first six months after the exposure. Common symptoms include sores or lesions that are usually found at the site of the exposure such as in the rectum, on the penis or inside the mouth. Other symptoms include skin rash or bumps, patchy hair loss, swollen lymph nodes in the groin area, and flu-like symptoms. Neurological symptoms can occur at any time and may present as blurry vision or vision loss, muscle spasms, head or neck pain, or changes in hearing or mental status.

Syphilis is treatable with antibiotic therapy, usually with a specific form of penicillin. After treatment, a patient can become exposed and infected again, and then would need more treatment. About one-third of all cases in Salt Lake County have been previously diagnosed and treated for syphilis.

So, what should you do? The Salt Lake County Health Department is recommending that MSMs receive routine screening for syphilis and all STDs at least once a year, although twice a year is preferable. Be sure to specifically ask your provider to run a syphilis test; many clinicians are not trained to look for syphilis and do not think to include it in an STD panel of tests.

Talk to your provider about your sexual health, including your risks. It is extremely important that you have a provider with whom you are comfortable talking about your sex life. If you have multiple sexual partners, you should be screened twice a year for all STDs, including syphilis. MSMs who are sexually active outside of a monogamous relationship have a higher risk of contracting STDs — it’s just a numbers thing. Catching and treating any infection at its earliest stage is essential for reducing the risk of long-term or permanent damage. If you do test positive for syphilis or any STD, it’s very important that all of your past sexual partners get tested and treated.

If you are looking for free screening services, the Salt Lake County Health Department now offers free rapid syphilis and HIV testing the first and third Wednesday of each month from 5-7 p.m. at our new location at 660 S. 200 East, 1st floor. For more information about STD testing, call 385-468-4222 or visit SaltLakeHealth.org/STD.

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Lynn Beltran

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