Oregon campaign addresses syphilis epidemic

Oregon is in a syphilis epidemic, with the rate of incidence growing 1,500 percent between 2007 and this year. The state health department is launching a campaign in hopes of stemming the spread.

Syphilis is a sexually transmitted disease that can easily go undetected because of its vague symptoms. When that happens, it can cause serious complications, including blindness, dementia and death.

The main group at risk are men who have sex with men, but the growth is also spilling over to women and their babies.

Symptoms of syphilis include a small, painless sore that usually appears on the genitals, anus or mouth a few weeks after exposure. A few weeks later, infected people may develop a non-itchy rash on the palms of the hand and soles of the feet. Without treatment, syphilis goes into latent stages. People with latent syphilis are no longer infectious, but the disease could cause other health problems later.

Reported cases have spiked from fewer than 30 in 2007 to 450 so far this year. Only primary and secondary cases of syphilis, or infections that are less than a year old, are included in the numbers.

Babies being born with congenital syphilis, passed on through their mothers, are increasing, too. After seeing one case per three years for a decade, two were reported in 2014 and five in 2015, said Dr. Sean Schafer, medical epidemiologist with the Oregon Health Authority. One of the two cases in 2014 was a stillbirth.

The Oregon Health Authority is launching an awareness campaign called Syph Aware aimed at the public and health care providers. Ads will start cropping up on TriMet buses; and a website, SyphAware.org, offers information about the disease.

Schafer said that while it's impossible to know why syphilis has increased so much, he had a few ideas.

In the network of men who have sex with men, safe-sex practices have waned as the threat of HIV has decreased with improved treatments, he said.

"People are savvy, so people with HIV know that their medicines are effective at reducing the risk of transmission to others, so they’re less careful about using condoms," Schafer said. "Even if you don’t transmit HIV, you can transmit syphilis and gonorrhea."

Condom use in general has declined in the past 15 years, he said.

In addition, with the help of smartphone apps and websites, the ease of meeting people for anonymous sex is playing a role in the spread of the disease, Schafer said. The anonymity then makes it harder for public health officials to find people who might have been infected and who may be unknowingly spreading syphilis.

Ninety percent of Oregon's cases are seen in men, 70 percent are found in men who have sex with men, and about half occur in people with HIV, Schafer said. In the cases found in women, meth use is common.

Syphilis is increasing in the U.S. as a whole, according to data from the Centers for Disease Control and Prevention, though not as dramatically as it is in Oregon. The national rate rose from 4.6 cases per 100,000 population to 5.5 cases per 100,000 population in 2013. The latest nationwide data available from CDC date back to 2013.

In 2013, Oregon ranked eighth-highest for syphilis rates. According to the Syph Aware ads, Oregon now ranks fifth.

Schafer said he didn't think anything unique was happening in Oregon, but big cities are more likely to experience severe epidemics.

"They might come to Portland specifically to have a good time, as you will," he said. "They might be on holiday or vacation and more likely to have more hook-ups or anonymous hook-ups. That’s potentially why more urban areas are harder hit."

The campaign's target audience is the public, as well as health care providers, Schafer said. Health care providers should know about the epidemic, who the high-risk groups are and whom their patients are having sex with.

syoo@StatesmanJournal.com, (503) 399-6673 or follow at Twitter.com/syoo.

People recommended for screening

Men who have sex with men.

People with HIV.

People who use illicit drugs, such as methamphetamine, cocaine and opioids.

Sex workers.

People who have or have had other sexually transmitted infections.

People who have been exposed to syphilis.

People at risk for syphilis who have multiple sex partners should be screened every three months

Pregnant women should be tested for syphilis three times during an epidemic: at the first prenatal visit, at the beginning of the third trimester and at delivery.

MORE INFORMATION: syphaware.org