Syphilis Makes a Worrying Comeback in U.S.

Syphilis is making a big comeback in the United States, with cases nearly doubling since 2005, federal health experts reported on Thursday.

More than 90 percent of cases are among men, mostly gay or bisexual men, the Centers for Disease Control and Prevention team reported. Secrecy and a lack of follow-up are fueling the spread, the CDC team said.

“After being on the verge of elimination in 2000 in the United States, syphilis cases have rebounded," Dr. Monica Patton and colleagues reported in the CDC’s weekly report.

“During 2005–2013, the number of primary and secondary syphilis cases reported each year in the United States nearly doubled, from 8,724 to 16,663; the annual rate increased from 2.9 to 5.3 cases per 100,000 population,” Patton’s team wrote.

“Men contributed an increasing proportion of cases, accounting for 91.1 percent of all primary and secondary syphilis cases in 2013.”

Racial and ethnic differences are enormous, the CDC team found. The syphilis rate among black men was 5.2 times higher than the rate in white men, and rates among black women, while low overall, were 13 times higher than rates among white women.

“Many barriers to contacting and treating sex partners exist, including delays in reporting cases to the health department, anonymous partners, physicians who rely on patients to notify their partners, and the observed tendency of men who have sex with men to notify a smaller proportion of their sex partners than do heterosexuals,” they wrote.

Gay and bisexual men who have many different partners should be screened every three to six months for syphilis, CDC advises.

“Disclosure of sexual practices remains difficult for some men who have sex with men; therefore, providers are encouraged to elicit sexual histories of their patients in a culturally appropriate manner, including recognition of sexual orientation, gender identity, and the sex of patients’ sex partners.”

But there is a bright spot: Rates have gone down among black women, a finding that suggests targeted efforts aimed at African-American woman have worked and could work for other groups.