New state data (in the US) show that syphilis cases continue to rise among gay and bisexual men in the United States, with South men, with the highest rates, according to a presentation at the DST 2016 prevention conference next week last in Atlanta. A related study found that half of gay and bisexual men in 20 US cities were selected for testing for syphilis during the past year, 11% of positive tests.
Alex Voux in the center of disease control and prevention (CDC) and colleagues calculated the estimates of primary syphilis rates and secondary syphilis among men who have sex with men (MSM).
Syphilis rates have increased in the US in recent years. During 2014 were reported over 63.000 new cases of syphilis, including 20.000 cases of primary and secondary syphilis, with more than 80% of the last occurring among MSM according to the CDC. Reported that syphilis cases increased 15% between 2013 and 2014 and other 19% of 2014 2015 to Dr of Voux he said.
Syphilis primary or initial infection, is marked by a only cancer(To learn more about other STDs with a similar demonstration, click cancer Mole)
or lesions in the genital or anal area, where bacteria Treponema pallidum enter the body. These wounds are usually painless, heal on their own and can not be noticed ever. If left untreated the infection progresses to the secondary stage, characterized by a rash on the skin and mucous membranes, including the palms and soles of the feet, sometimes accompanied by fever, swollen lymph nodes, fatigue and other symptoms of flu.
These symptoms also disappear without treatment, but the bacteria remain in the body and progress of untreated infection to the latent stage, which can last for years without symptoms. A minority of infected people go on to develop late-stage syphilis, which may involve damage to the heart, eyes (ocular syphilis), nervous system (neurosyphilis) and other organs.
Pregnant women with syphilis can pass it to their babies (congenital syphilis).
The Voux Dr team bases its estimates on data from case reports of syphilis in 2015 of notifiable diseases in the national system, together with the 2014 estimates, the number of gay men and bi adults by state. State of syphilis among gay men estimates were not previously possible because the state-by-state estimates of this population were not available, they observed. I was lacking common denominator that has been provided by recent estimates of the number of MSM in each state of researchers at Emory University.
The CDC researchers calculated rates for 44 States who reported sex partners; at least 70% of men diagnosed with primary and secondary syphilis during 2015 - representing 84% of all such cases - comparing rates among men with any male partners against these reporting relationships between female partners only.
Across the country had 17.887 cases of primary and secondary syphilis among men and 2030 cases among women in these 44 2015 States. Among men, the numbers of cases were 12.118 for MSM and 2866 2903 for heterosexuals and for men with unknown sex partners of men.
Alaska had the lowest rate of primary and secondary syphilis among MSM (73,1 by 100.000), while North Carolina had the highest rate (748.3 by 100.000). Three other states in the southeast were also among the nation's highest rates: Mississippi (658.9 by 100.000), Louisiana (601.8 by 100.000) and South Carolina (536,9 by 100.000).
Overall, almost half of men (49%) surveyed in 2014 said they had been tested for syphilis in recent months 12 above 38% in 2008 and 40% in 2011.
Syphilis testing rates in 2014 were similar among racial / ethnic groups in 50% for black men and 48% for whites and Latinos. Men who had seen a physician in the past year were more likely to have a syphilis diagnosis than those who were not selected (54 vs 25%), and those with insurance were also more likely than those without (51 vs 42%) .
Gay and men bi most at risk were more susceptible to test for syphilis, including HIV-positive men (vs 68 45% of HIV negative) and men over 10 sexual partners during the last 12 months (65 vs 45% among those with fewer partners).
Among sexually active men who were selecionados, the proportion who tested positive for syphilis was 11% in 2014 from 9% in 2008 and 8% in 2011. Although blacks were only slightly more likely to be tested, they had a substantially higher rate of diagnosis of syphilis (14%) than whites (8%) or Latino (11%) in 2014.
HIV-positive men were almost three times more likely to have syphilis than HIV-negative men (21 vs 8%) and men over 10 sexual partners were about twice as likely to contract syphilis as those with fewer partners (17 vs 9 %).
The largest increases in syphilis diagnoses were seen among black MSM (increased 9% by 2008 to 14% by 2014), men (15 the 21%) HIV-positive men with 10 or more sexual partners (11 the 17%) and young people (6 to 10%).
"Despite the recommendation for screening at least annually among sexually active MSM, less than half of MSM reported recent syphilis tests in 2014," the researchers concluded in their abstract. "While testing among MSM increased, more work is needed, especially due to increases in the diagnosis of syphilis among selected from the 2008 2014."
Finally, Anna Cope and Sarah Oliver, both the CDC, presented new data on ocular syphilis, a rare event, but serious.
Although syphilis rates have increased across the country from 2000, ocular syphilis clusters were only reported from 2014, Dr Oliver pointed out. Between December 2014 and 2015 March 1 dozen cases of ocular syphilis were reported in San Francisco and Seattle, and subsequent discovery identified more than 200 20 cases States reported in recent 2 years, according to the CDC.
Dr. Oliver and colleagues sought to systematically identify cases of ocular syphilis in North Carolina, determine risk factors and compare cases of syphilis with and without ocular manifestations.
Among 4234 syphilis patients identified during 2014-2015, a total of 63 (1,5%) had ocular syphilis. There 20 2014 and 43 cases where 2015 - 115% increased ocular syphilis, although total syphilis cases increased only 35%.
"The association between advanced age, low CD4 count and prevalence of ocular syphilis suggests that immune status may play a role in the development of ocular syphilis and highlights the importance of HIV testing in all patients with syphilis, especially those with ocular syphilis, "the researchers concluded.
These findings support the CDC's recommendation that clinicians should consider testing for HIV if they see a patient with ocular syphilis,issued earlier this year, after the outbreak in San Francisco and Seattle. Taken together, these studies highlight the importance of screening for syphilis and follow-up care for gay and bisexual men, as well as rapid diagnosis and complete antibiotic treatment can prevent health complications in the long term and break the chain of transmission of the disease that is the basic principle for the eradication of any infectious disease.
of Voux A et al.Rates of Primary and secondary syphilis by state Among men who have fri with men - United States, 2015. 2016 STD Conference, Atlanta, abstract 4B1, 2016.View abstract.
Wejnert C et al.Syphilis screening and diagnosis Among men who have fri with men, 2008-2014, 20 US cities. 2016 STD Conference, Atlanta, abstract 4B4, 2016.View abstract.
Oliver SIncrease in ocular syphilis - North Carolina, 2014-2015. 2016 STD Conference, Atlanta, abstract 4B2, 2016.View abstract.
Cope et al.Ocular syphilis and HIV coinfection: an opportunity to identify previously undetected HIV. 2016 STD Conference, Atlanta, abstract 3F1, 2016.View abstract.