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Syphilis cases in Allegheny County show sharp increase

The Allegheny County Health Department on Wednesday urged safer practices for sexually active men and women across Western Pennsylvania, citing a dramatic increase in syphilis.

County officials knew of 98 reported early-stage syphilis cases through Nov. 10, up from 56 county-wide at the same time last year. Men accounted for 90 percent of the infections, and the majority of them have sex with other men, according to the department.

“I think there is a concern that people are not necessarily protecting themselves,” said Dr. Karen Hacker, department director, who asked clinicians to be vigilant in screening at-risk populations for the disease. “It can have a very extensive, long-term impact.”

The regional trend mirrors statewide statistics — the most recent of which show 494 early-stage syphilis cases in 2012, up from 159 in 2003.

About five in 100,000 people nationwide have early-stage cases — more than double the all-time low recorded in 2000, according to the Centers for Disease Control and Prevention.

Public-health agencies don’t know for sure what’s driving the increase in Western Pennsylvania, but, “It’s obviously due to ongoing risky sexual behavior,” said Dr. Harold Wiesenfeld, director of the county Sexually Transmitted Diseases Program.

“People have major concerns about anonymous sexual activity. We have trouble identifying partners and implementing public-health strategies to bring people to treatment and reduce syphilis and other STDs,” Wiesenfeld said.

Doctors suggested that a decline in STD awareness and the rise of social media to arrange sexual encounters might contribute to the syphilis trend. They said smartphone apps encourage suggestive messaging as younger adults unfamiliar with the 1980s AIDS epidemic pursue new partners, some of whom shield their identities.

“Things like Twitter, Facebook and chat rooms allow many more opportunities for people to meet as opposed to the old days,” said Tony Silvestre, a professor in the Graduate School of Public Health at the University of Pittsburgh. “You don’t need too many with syphilis to spread it rapidly.”

Of men with reported syphilis infections this year in Allegheny County, 39 percent are HIV-positive, according to the health department. It noted that syphilis can increase a person’s chance of acquiring HIV.

Still, Hacker emphasized that “anyone engaging in risky sexual behavior is at risk.”

The department asks that sexually active men and women “follow safer sexual practices — reduce the number of sex partners, use latex condoms and have a long-term mutually monogamous relationship with a partner who has negative test results for STDs.”

Bacteria cause syphilis, which spreads through intimate contact. Early symptoms can include a rash on the palms of the hands or soles of the feet, or a sore in the mouth or on genitalia.

Untreated cases can be fatal and cause heart and nervous-system problems, mental health complications and impaired vision, although antibiotics can treat and cure the infection.

Adam Smeltz is a Trib Total Media staff writer. He can be reached at 412-380-5676 or [email protected].


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