In1998, the Centers for Disease Control and Prevention
launched its plan to eliminate syphilis in the United States. The national
goal is to reduce the total number of primary and secondary syphilis
cases to 1,000 or fewer - 0.4 cases per 100,000 people - and to increase
the number of syphilis-free counties to 90 percent by 2005.
Five strategies:
The syphilis elimination plan outlines five strategies:
increase surveillance.
strengthen community involvement and partnerships.
rapidly respond to outbreaks.
improve and increase health promotion.
expand clinical and laboratory services.
Current Status:
In 2000, there were 5,979 cases
of primary and secondary (P&S) syphilis reported in
the United States. This represented a nine percent drop since
1999 and a 30 percent drop since 1997, the year before the
national plan was initiated.
Also in 2000, 529 cases of congenital syphilis
were reported to CDC, representing 13 of every 100,000 live births.
Congenital syphilis rates have dropped 51 percent since 1997.
Minority groups continue to be disproportionately
affected by adult and congenital syphilis. However, rates for P&S syphilis
among African Americans decreased by 41 percent from 1997 to 2000.
Challenges:
Rates for P&S syphilis actually
increased among Hispanics/Latinos by 12.5 percent from 1997
to 2000.
Since 1999, P&S syphilis has
increased among men who have sex with men, with outbreaks
occurring in several U.S. cities, including Los Angeles,
Seattle, New York City, Chicago, Miami Beach, among others.
This resurgence of syphilis may reflect
increases in risky sexual behavior.
Although recent increases are relatively
small, they do challenge CDC to enhance surveillance, health promotion,
and community partnerships in communities with higher rates of syphilis.
Because syphilis cases have reached an
all time low, with most cases concentrated in the South and urban areas,
there is a brief window of opportunity to eliminate syphilis from the
United States. One of the challenges in taking advantage of this window
will be maintaining support at the local, state, and federal levels
until elimination is achieved.