Managing the Incidence of Syphilis

The U.S. syphilis rate increased for the seventh consecutive year in 2007 according to the CDC. This is a concerning finding given the potentially serious consequences of the disease if it goes untreated. Effective screening is essential and is a big focus for the CDC as well as many advocacy groups for at risk individuals. The disease is mostly spread through sexual contact, but can also be passed from the mother to child in utero. This can have devastating effects including stillbirth, death shortly after birth or death after a period of illness in infancy. In the adult, the disease can go undetected for many years if the lesions in the primary and secondary stages go unrecognized. They can then be in a latent stage for many years before progressing to the late stage where the disease can cause serious and extensive damage to the body. Syphilis has also been called “the great imitator” since it’s symptoms often resemble those of other diseases. Since the disease is highly treatable in the early stages, screening efforts have the potential for significantly decreasing these divesting occurrences. By treating the infected individual you have high probability of cure thus reducing the effects in the individual as well as preventing spread of the disease to others. Widening screening efforts can facilitate earlier identification of the disease. This is important since the secondary stage of the disease is the most contagious when the infectious lesions are more numerous on the body. The CDC put together a report in 2003 with recommendations for surveillance of the disease in an effort to advance a national plan to eliminate syphilis from the United States. In this report is a list of “priority populations” for routine screening efforts. This list includes arrestees, pregnant women, STD clinic patients and patients diagnosed with STDs in other settings, clients at drug treatment facilities, HIV counseling and testing clients, clients in certain specialty clinics (i.e., HIV, family planning, community based), homeless populations and emergency room patients. The next step in facilitating effective control measures is reporting. With adequate reporting epidemic patterns can be assessed and adequate treatment can be assumed to prevent sequelae of infection. It can also be used to identify cases in a timely fashion in order to interrupt the chain of infection by management of sexual contacts and behavioral risk reduction counseling.

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