Syphilis: Deadly but easily treated disease on the rise
Joaqlin Estus
ICT
Syphilis has been on the rise for the past 10 years across the country, and Native American people have the highest rates at 67 cases per 100,000. The states most affected include South Dakota, New Mexico and Oklahoma.
One reason for the increase is that syphilis initially has symptoms that are easily overlooked but then it progresses with no symptoms for months or years. Also syphilis can be spread not just by vaginal sex, but oral and anal sex as well. And depending on the location of sores caused by syphilis, a condom may not offer full protection.
The disease in its early stages is easily treated with antibiotics but many people don’t know they have been infected. The first symptom is a painless lesion or sore on the genitals or in the mouth. Then weeks later, the infected person may get a rash on their hands or feet. Symptoms then disappear while the disease remains in the bloodstream.
Adults can develop severe symptoms even after months or years of having none. “If syphilis is left untreated it can result in serious health problems affecting the brain, nerves, eyes, heart, blood vessels, liver, bones and joints,” according to health professionals.
But perhaps the worst effects are those that occur when a pregnant woman with syphilis passes the disease on to their fetus. Congenital syphilis can cause fetal death, premature birth, death shortly after birth, or lifelong medical issues. As ICT recently reported, rates of Indigenous babies with syphilis are as high as one in every 40 in some communities.
Health professionals emphasize the best protections are to practice safe sex, get tested and get treated early for infection.
Recently the state of Alaska said in a statement that Alaska had just 20 cases of the deadly disease in 2016 but by 2022 that number had risen to 424. “Alaska currently has one of the highest rates of syphilis in the country,” said Dr. Anne Zink, Alaska’s Chief Medical Officer.
“Unfortunately Alaska Natives are overrepresented; 42 percent (of cases) were Alaska Native/American Indian,” said Lisa Rea, Internal Medicine Outpatient Specialty Clinic Nurse Manager for the Alaska Native Tribal Health Consortium.
“By testing and treating widely, we can cure syphilis before it causes severe disease or impacts newborns,” Zink said. “Everyone of reproductive age who is sexually active should be tested for syphilis if they are unsure of their syphilis status. Everyone should get retested each time they have a new sexual partner, and every 3-6 months if they have multiple partners.”
The CDC echoes those recommendations, saying adults under age 45 in Alaska should be tested for syphilis at least once this year.
HIV/STD Prevention Program Manager for the Alaska Native Tribal Health Consortium Hannah Gumlickpuk is Cup'ik from the Chevak Quissunamiut Tribe. She said the consortium reaches out at community-based spaces such as health fairs and tables at events to promote prevention of sexually transmitted infections such as HIV and syphilis.
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“Probably one of our most heavily utilized programs that we promote quite often, and we also ask our partners to do that too, to leverage this resource, is called ‘I know mine.’ It's a youth-focused holistic, whole person website where folks are able to get articles about HIV and sexually transmitted infections, and a range of topics related to the mind, body and spirit.”
Through Iknowmine.org people with an Alaska mailing address can get supplies such as condoms, dental dams and an oral HIV rapid self-testing kit, and information on how to connect with an Alaska health provider.
Consortium health providers also present talks to health professionals so they are better informed about the disease. “The last several months have been on syphilis, syphilis epidemiology, congenital syphilis, syphilis treatment,” Rea said.
As ICT recently reported, the Great Plains Tribal Leaders Health Board has implored U.S. Health and Human Services Secretary Xavier Bacerra to declare a public health emergency. The board represents 17 tribal nations and one health care service unit. The board is asking for more personnel, more funding, and better access to data to address the crisis.
Alyssa Jones, a spokesperson for the U.S. Department of Health and Human Services, told ICT in an email that the department is tackling the syphilis epidemic on several fronts. It has established the National Syphilis and Congenital Syphilis Syndemic (NSCSS) Federal Task Force
“The actions of the Task Force leverage federal resources to reduce rates, promote health equity, engage impacted communities and direct resources to support those most impacted.
"The Task Force will focus its efforts on Arizona, Arkansas, California, the District of Columbia, Florida, Georgia, Louisiana, Mississippi, New Mexico, New York, Ohio, Oklahoma, South Dakota, and Texas. Together, these jurisdictions make up nearly 75 percent of congenital cases and 50 percent of our nation’s syphilis cases,” said the department in a statement.
Jones said the department plans to look at flexibility in grants to enhance use of the funds for STI prevention and treatment. Actions taken by the Task Force include letters and information to Indian Health Service grantees and providers, dissemination of draft guidelines on how to use the common antibiotic doxycycline to prevent acquisition of syphilis, and STI Treatment Guidance for IHS, tribal, and urban Indian organizations concerning best practices for syphilis testing and treatment in Native communities.
The department is also meeting with tribes and providers on ways the agency can better support community efforts to improve health equity.
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