Sexually Transmitted Diseases  >  Tracking the Hidden Epidemics 2000 (1999 data)

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Syphilis

Syphilis is a bacterial sexually transmitted disease that progresses in stages. The disease is curable and progression of disease is preventable, but if untreated, it can cause cardiovascular and neurological diseases and blindness. Syphilis causes genital ulcers, which increase the likelihood of sexual HIV transmission two- to five-fold. Untreated, syphilis can be transmitted from a pregnant woman to her fetus.

In the United States, the reported rate of syphilis is at the lowest level since reporting began in 1941. In 1999, 79 percent of the 3,115 counties in the United States reported no cases of primary and secondary syphilis (P&S syphilis). The unprecedented low rate of syphilis overall, combined with cases concentrated in only 20 percent of U.S. counties, has created a unique but narrow window of opportunity to eliminate syphilis in the United States. In October 1999, CDC launched the National Plan to Eliminate Syphilis in the United States.

Since the introduction of penicillin and the organization of a national STD control program in the 1940s, the initial near elimination of syphilis in 1957 has been followed by cyclic national epidemics every seven to 10 years (St. Louis, CDC, 1998).

The most recent epidemic peaked in 1990 at 20.3 per 100,000 people. Since 1990, syphilis rates have declined 88 percent to 2.5 cases per 100,000 people in 1999 (CDC, 2000).

In 1999, 6,657 cases of p&s syphilis were reported to CDC, a decline of 22.2 percent from 1997 when 8,556 cases were reported. Cases of P&S syphilis reported to CDC are believed to represent about 80 percent of all recently acquired cases (Cates, 1999).

Congenital Syphilis

In 1999, 556 cases of congenital syphilis-infants acquiring infection from their mothers during pregnancy or delivery-were reported. Rates of congenital syphilis closely follow trends in P&S syphilis in women. Peaks in congenital syphilis usually occur one year after peaks in P&S syphilis in women. The congenital syphilis rate in the United States peaked in 1991 at 107.3 cases per 100,000 live births and declined 87 percent to 14.3 cases per 100,000 live births in 1999.

A Closer Look at Syphilis

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