Chicago Tribune - November 29, 2001
Crystal Yednak, Tribune staff reporter

With 326 cases reported in 2000, Cook County had more cases than any other county in the nation; however, the rate of cases per 100,000 people is lower than several other counties.

With virtual elimination of the sexually transmitted disease within reach, efforts to erase syphilis have intensified in areas with the highest numbers of new cases, including the Chicago area.

The U.S. Centers for Disease Control and Prevention tripled funding for syphilis elimination programs in Chicago this year. The Cook County Department of Public Health, which handles cases in the suburbs, received a CDC public health adviser and $100,000 to divvy up among suburban community groups that have been enlisted to increase awareness about syphilis.

"It's going to take a sustained effort. How soon we'll get there, I don't know, but I think we're on our way," said Dr. William Paul, deputy commissioner for the Chicago Department of Public Health.

Nationwide, there were almost 6,000 cases of primary and secondary syphilis reported in 2000, a decline of almost 10 percent from the year before, according to CDC officials.

Besides Cook County, counties that encompass urban areas such as Indianapolis, Detroit, Memphis, Atlanta and Nashville also made the list released Wednesday.

Through CDC's nationwide Syphilis Elimination program started in 1998, it aims to push the number of reported cases below 1,000 over the next few years. By public health standards, elimination does not mean the disease disappears entirely, but that the incidence rate is so low that there is no continued transmission.

Health officials point out that sexually transmitted syphilis is 100 percent preventable and treatable. They are also concerned about the link between syphilis and the HIV infection. The genital sores caused by syphilis make it easier to receive or transmit the HIV infection sexually.

Syphilis is found disproportionately in minorities, with the disease being 21 times more common in African-Americans and three times more common in Latinos than in white Americans, CDC officials said.

"It's one of the most glaring racial disparities in health care today," said Dr. Ronald O. Valdiserri, deputy director of the CDC's National Center for HIV, STD and TB Prevention.

While the Chicago area topped the list, the number of cases reported in the city of Chicago has been on the decline since reaching a peak of 2,045 cases in 1991. By 2000, that number was down to 292.

But there has been concern recently about syphilis outbreaks in gay communities in several urban areas, including Chicago. Of the 204 syphilis cases reported in Chicago so far this year, 83 were found in gay men, according to Chicago Department of Public Health numbers. In all of 2000, there were only 44 syphilis cases reported among gay men.

The spike in cases is blamed in part on a complacency about safe sex practices as treatment for HIV and AIDS has improved. In response to the increase, city public health officials have taken a mobile unit into gay neighborhoods and conducted on-site testing. They've also worked with community and social service organizations to encourage safe sex practices, especially the use of latex condoms. CDC is also developing a nationwide plan to address the outbreaks, Valdiserri said.

County and city public health officials say it will be a challenge to wipe out the last few hundred cases. Those affected with the disease are spread over a large geographic area and are typically found in areas where there is little awareness about the disease and little access to health care.

"But we are gaining momentum with syphilis elimination and we are poised to make even more progress in the coming years," Paul said.

Symptoms of syphilis differ depending on the stage of the illness. In the first stage, an infected person may notice a single, round, painless sore at the spot where syphilis entered the body. The second stage often brings a rash and can include fever, swollen lymph glands, sore throat, muscle aches, patchy hair loss and fatigue. Left untreated, the disease can cause cardiovascular and neurological disease.

The Chicago Department of Public Health offers free testing and treatment for syphilis and other sexually transmitted diseases at six locations, with more information available at 800-243-AIDS.

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