The numbers aren't too great yet, but the rate of increase shows that the long, nasty history of this sexually-transmitted disease is far from over. Even worse, a rise in syphilis cases brings with it the possibility of an increase in AIDS infections.
With the development of penicillin more than 50 years ago, it was believed that syphilis would soon be relegated to history. It was so rare by 1998 that federal health officials planned to announce its elimination by 2005. Instead, the number of diagnosed cases started rising in 2005, and the first quarter of 2007 saw more than twice the number of cases as in the first quarter of 2006. The increase is primarily among men, but women are now contracting the disease after a decade in which almost no female cases were reported.
What is fueling the rise? There are several theories, and all of them may be contributing factors. More men are reporting bisexual activity, and many of them already have the disease, which means that women as well as men are now potential victims. Drug use, particularly crystal meth, which causes hypersexuality, is another factor. Drug users tend to be more sexually active, and much less concerned about either their own health and safety or that of their partners. There has also been an increasingly casual attitude about oral sex and about condom use, fueled by better treatments for H.I.V.
Syphilis is highly contagious and difficult to detect because it can pass for so many other diseases. The first signs, which show up between 21 and 90 days after infection, are usually small sores, which may heal on their own, leaving the victim with the illusion that the cause of the sores is also gone. The belief that syphilis is no longer a public health threat meant that routine testing for the disease declined, except for pregnant women. Since it can cause stillbirths, birth defects, and infant death, testing of pregnant women has continued.
Open syphilis sores mean that infection with H.I.V. is two to five time more likely, and some health officials are concerned about a possible spike in AIDS cases as syphilis numbers rise. Perry N. Halkitis, professor of applied psychology at New York University, is studying the connection between unsafe sex and highly addictive drugs. He says “Most certainly you are going to see an increase in H.I.V. transmission.”
The onset of syphilis is slow, and its effects build up over a lifetime, if untreated. "In the final stage, as long as 30 years after initial infection, it can cause severe damage to many internal organs, depression, blindness and fits of creativity, and ultimately, death." Antibiotics are highly effective, but people need to be educated once again about the dangers of the disease. The increase is nation-wide, but most marked in New York, where the health department has responded with free distribution of condoms, and confidential notification of the sexual partners of anyone diagnosed with syphilis.