Tuesday, February 4, 2014

Incidence and Cases of Syphilis Increase in South Dakota and United States

Badlands in South Dakota - Credit jaydantinne 02.16.2010
Officials at the South Dakota Department of Health are concerned about the number of syphilis cases seen in 2013.

48 cases of syphilis were reported in 2013, which was the most in 44 years. State Epidemiologist Lon Kightlinger called it "very disheartening".

Sioux Falls, the states largest city with a metropolitan population 237,251 reported the highest number of cases (23), while Corson County, which is located in the north central part of the state, with a population of 4,050 reported 14 cases.

The majority of the Sioux Falls cases involved men, while the Corson County cases were more evenly distributed between men and women.

In 2000, the incidence rate in the US of primary and secondary syphilis (the contagious stages) was 2.1 infections per 100,000 people. This represents the lowest point since syphilis reporting began in 1941. Since 2000, the incidence rate has more than doubled, and in 2011 was 4.5 per 100,000.

A link to some of my favorite old WWII-era public health posters.

Syphilis is caused by the spirochete bacterium Treponema pallidum. Primarily spread through sexual contact, it can also be passed vertically from mother to fetus. Signs and symptoms vary depending on which of the four stages it presents (primary, secondary, latent, and tertiary).

Electron micrograph of Treponema pallidum - Credit Dr. David Cox CDC 1980
Syphilis can be effectively treated with antibiotics, typically penicillin G, ceftriaxone, doxycycline, or azithromycin.

Syphilis is difficult to diagnose, and confirmation is either via blood tests or direct microscopy. Blood tests can be either nontreponemal or treponemal tests. Nontreponemal tests are used initially, in my lab we typically use venereal disease research laboratory (VDRL) tests. These tests can sometimes yield false positives, so confirmation is done with a treponemal test, such as treponemal pallidum partical agglutination (TPPA).

Lance D. Presser has a PhD in Microbiology and Immunology and currently is a Public Health Laboratorian.

Hire Lance as a consultant using Zintro.

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