Salt Lake County is seeing an increase in a sexually transmitted disease that public health officials once expected to be eradicated.
The number of syphilis cases has jumped dramatically during the past decade, from one in 2000 to 33 and counting this year.
The numbers are small compared with the more than 3,000 county residents infected with chlamydia each year. But because syphilis can be deadly, every case worries officials.
"It is a life-threatening disease if it goes untreated," said Lynn Beltran, who oversees STD programs for the Salt Lake Valley Health Department. She noted that national public health officials in the 1980s predicted syphilis would be eliminated. "Our hope is we can contain it somehow."
Beltran said most cases are in men who have sex with men, which is typical across the country.
However, the number of cases seen in women and infants is increasing. About 10 percent of Salt Lake County's cases are among women, who often get it from men who are secretly having sex with men, she said.
Left untreated, the bacteria can pass to a fetus during pregnancy and cause stillbirth or death soon after delivery. Infants who survive can have serious developmental problems.
Beltran knows of one Salt Lake County baby born with syphilis last year. She said the mother didn't have access to prenatal care, which would have led to proper treatment.
In addition, a person infected with syphilis has up to a fivefold increased risk of contracting HIV, because the ulcers caused by syphilis increase the infectiousness of and susceptibility to HIV, according to the CDC.
Beltran said one-third of patients with syphilis in Salt Lake County also have HIV.
HIV infection in the county is also up -- with 72 cases reported as of Nov. 30. The reason for jumps in both infections are the same, she said: Complacency and technology.
People are "tired" of hearing about HIV and have become complacent about their sexual health, she said.
Plus, "People can meet people online and randomly get together and not know anything about each other," she said.
That anonymity also makes it difficult for her staff to quell the outbreak by tracking down infected patients' partners to urge them to get tested and treated.
Beltran also blames the outbreak on the lack of education young people receive on how to prevent transmission.
The health department is letting doctors know syphilis is back and asking them to routinely test their patients who engage in risky sexual behavior such as having multiple partners and not using protection. Beltran said doctors have misdiagnosed the infection as eczema or other skin conditions.
She said people should know their partners' sexual history and get tested before having sex. They also should use condoms.
Lillian Rodriguez, the HIV-prevention coordinator for the Utah Pride Center, said gay men are working to spread the message about the importance of safe sex. She runs three programs for men ages 18 to 29 in which they talk about STDs and prevention.
"I want them to think about not just HIV but to think about syphilis, to think about gonorrhea, to think about herpes [and] things they can do to protect themselves."
What is syphilis? » The bacterium Treponema pallidum causes this STD, which is passed through direct contact with a syphilis sore. Sores occur on the genitals and on the lips and in the mouth. Pregnant women can pass it to their fetuses in utero.
Symptoms » Many infected people don't have symptoms for years and can pass the disease without being aware they are infected. The infection is called the "great imitator" because the signs and symptoms look like other diseases.
During the primary stage, there is usually a single sore at the infection site that is typically firm, round, small and painless. Without treatment, the infection progresses to the secondary stage, in which a rash develops. Other symptoms can include fever, swollen lymph glands, sore throat, patchy hair loss, headaches, weight loss, muscle aches and fatigue.
In 15 percent of people who do not get treated, the infection can damage internal organs and cause paralysis, numbness, gradual blindness, dementia and even death.
Treatment » Penicillin will kill the bacteria, though it won't repair damage already done.
Prevention » Abstinence or condoms can prevent syphilis.
Testing » Syphilis can be diagnosed with a blood test available at private doctor offices, the Salt Lake Valley Health Department and Utah AIDS Foundation.
Source » Centers for Disease Control
