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Syphilis Cases Rising In Northeast Ohio; Experts Urge Safe Practices And Regular Testing

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Syphilis cases are on the rise across Northeast Ohio, and health officials are urging the public to take precautions by using protection and getting tested regularly.

CLEVELAND — Syphilis cases are on the rise across Northeast Ohio, and health officials are urging the public to take precautions by using protection and getting tested regularly.

It's not a topic people often bring up at the dinner table, and many aren't likely to openly admit they have an STD—especially syphilis. But the reality is that many people are getting infected, and some still don't know they have it.

"There's a lot of stigma I think with especially sexually transmitted infections, in general, people don't want to talk about it," said Alisha Cassady, an epidemiologist with Cuyahoga County Board of Health.

Whether or not it's discussed, syphilis, a sexually transmitted infection, has been around for quite a while. Health officials across the state say they are seeing cases rise and believe it could be due to a variety of factors.

"Maybe people are having more partners and meeting up with people more often. A lot of our cases are occurring among like 18 to 29-year-olds," said Vinh Trinh, an Epidemiologist at Cleveland Department of Public Health.

"It basically comes down to there's more syphilis in the community, so it's easier to catch and it's easier to get through sexual contact," said Frank Catrone, a disease intervention specialist supervisor for the Canton Health Department.

In Cuyahoga County, cases have doubled from 402 in 2017 to 889 in 2022. Stark County, which has seen the largest increase, had 34 cases in 2019, and as of Oct. 31, 2024, already has 137.

"It's basically affecting every demographic group, every age group, every gender, and it's, it's just, it's spread throughout the entire community," said Catrone.

Symptoms of syphilis vary depending on the progression of the infection. There are several stages: primary, secondary, latent, and tertiary. Symptoms may include ulcers, rashes, and flu-like symptoms such as fever and swollen lymph nodes. The longer the infection goes untreated, the more serious the effects can be.

"It can cause heart issues. It can cause issues with your vision or your hearing, and then even like brain function as well," said Cassady.

Data shows that 80% of syphilis cases in Cuyahoga County are found in men, while 20% are in women. There is also an increase in cases of congenital syphilis, where untreated pregnant mothers are passing the infection on to their newborns.

"That's a big problem, because syphilis in infants, they don't have immune responses that are strong enough to right? So, they can lead to stillbirths. It can lead to death shortly after birth. It can lead to other severe complications on the infant," said Trinh.

Syphilis can be treated with antibiotics once diagnosed. Health officials emphasize that the best ways to prevent the spread of syphilis are using condoms and getting tested regularly.

"There's no need to be ashamed. Sexual health is part of all health. So it's important to take care of your body, from top of your head to the bottom your toes," said Catrone.

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'It's Pretty Bad': Why Are Syphilis Cases On The Rise In Stark County And Northeast Ohio?

The Canton Health Department is keeping track as Northeast Ohio and Stark County are experiencing a major syphilis outbreak. The eight-county area has gone from seeing 46 cases in 2019 to 191 so far this year.

CANTON − Stark County and much of Northeast Ohio is going through a syphilis outbreak, driven by people increasingly having unprotected sex with strangers they meet through the internet, a Canton Health Department official said.

"It's pretty bad," said Frank Catrone, a disease intervention specialist supervisor for the Canton Health Department. "I've been here 18 years. There were hardly any cases each year then, I think, around 2019, we had like 16 cases (in Canton alone). So, we've seen a significant, significant increase. The major issue with syphilis it can cause birth defects in children when they're born."

Catrone provided statistics for the past few years on the sexually-transmitted bacterial disease.

Sexual-transmitted disease: Soaring STI rate may be slowing, CDC says. One group is in 'crisis.'

The number of syphilis cases has gone up every year the past five years.

The Canton Health District had at least 16 confirmed cases of syphilis in 2019. This year the number has climbed to 77 cases as of Oct. 31.

Stark County had 34 cases in 2019. There's been 137 cases in 2024 as of the end of October.

The Canton Health Department, including Frank Catrone, disease intervention specialist supervisor, is keeping track as Northeast Ohio and Stark County are experiencing a major increase in syphilis cases.

And looking at the eight-county area of Stark, Wayne, Tuscarawas, Carroll, Holmes, Coshocton, Harrison and Jefferson counties, the region went from 46 in 2019 to 191 so far in 2024.

Catrone said the eight-county region had two cases last year where a baby got syphilis from the mother prior to birth and three cases of that this year.

Nearly 4,000 babies were born with syphilis last year in the U.S., an issue the CDC called an "unacceptable American crisis."

"It just correlates more with unprotected sex with multiple sex partners," said Catrone, citing what infected people are telling his staff in interviews.

"People are having sex with multiple people they meet online. They don't know their names. ... There's been a spike around the whole entire state and around the country. This year has been our highest numbers by far."

The health official said syphilis is affecting people of all demographics, ages, income level, races and sexual orientations.

It's spread by contact with sores, which a symptom of the acute phase of the disease, Catrone said.

Other symptoms of the acute phase include sores in the mouth, painless ulcers, rashes throughout the body on the soles of the feet and palms on the hand, hair loss and growths in the genital area.

The disease often then goes into a latency period of months to years where the bacteria is dormant and the symptoms go away.

If untreated, syphilis can emerge from dormancy and symptoms can then progress to paralysis, muscle weakness liver problems, mental health issues and permanent major organ damage including damage to hearing and vision, teeth and bones.

The Canton Health Department is keeping track as Northeast Ohio and Stark County are experiencing a major syphilis outbreak.

Mobster Al Capone was diagnosed with syphilis while imprisoned at Alcatraz, and the disease caused him permanent brain damage.

Catrone said the standard treatment involves penicillin shots. He said he's unaware of any strains of syphilis resistant to penicillin.

He urged people who suspect they have a sexually transmitted disease such as syphilis contact the Canton Health Department and schedule testing. Being tested for syphilis involves a blood draw and antibody test.

The health department has hired marketing company Innis Maggiore to help the department put on an informational campaign about syphilis and other sexually-transmitted disease.

Catrone said state law does not require a person who knows they're infected with syphilis to divulge the infection to a sex partner like with HIV.

Reach Robert at robert.Wang@cantonrep.Com.

This article originally appeared on The Repository: NE Ohio health officials battling dramatic rise in syphilis cases

It's Time To Get Tested For Syphilis: Health Campaign Launches As Cases Increase In B.C.

Fraser Health has launched a public awareness campaign encouraging pregnant people and people with syphilis symptoms to get tested for the sexually transmitted infection as cases continue to climb in British Columbia.

In 2019 the provincial health officer declared a syphilis outbreak in B.C. Based on rising case numbers.

Since then the entire province has seen a "dramatic" increase in cases, said Dr. Vincent Valdrez, a BC Centre for Disease Control sexually transmitted infection physician.

During the first six months of this year, B.C. Had 1,049 cases of infectious syphilis, up from 154 cases in all of 2010. There were 1,060 cases in 2019, and 1,964 in 2022, according to the 2023 BC Syphilis Action Plan Refresh.

A decade ago most syphilis cases were among men who have sex with men, but today two-thirds of syphilis cases occur in people who report having only heterosexual partners, and one-third of all cases are in women, he said.

To boost public awareness about syphilis and the importance of testing, Fraser Health has placed ads on buses and bus stops. They've also placed digital ads in Fraser Health facilities, online and on Facebook and Instagram, the health authority told The Tyee in an email.

Symptom-free phase can still be contagious

Valdrez said it's not clear why case counts are increasing and the demographics are significantly shifting, but it's important that people know that anyone who is sexually active has some risk of contracting an STI.

Testing is recommended for anyone who has never been tested, has a sexual partner who tested positive, is pregnant or has a new sexual partner, and, of course, anyone who is symptomatic. Regular testing at least every few months is recommended for anyone who has multiple sexual partners or engages in other activities that can increase the risk of exposure, such as sex work.

Syphilis is a bacterial infection that is usually transmitted through sexual contact, often through a lesion like a genital ulcer, but also can be transmitted when the infected person is asymptomatic, Valdrez said. A pregnant person can also transmit the infection to their developing fetus.

The first stage usually consists of a painless sore or sores on the genitals, lips, mouth or anus. The infection then spreads to the rest of the body. At the second stage, symptoms can include a non-itchy rash on the chest, belly, genitals, palms or soles of the feet, having a headache, fever, hair loss or swollen lymph nodes, and having bumps or patches inside the mouth, anus and genitals, according to the SmartSexResource, a service provided by the BC Centre for Disease Control.

Syphilis is called the "great mimicker" because these symptoms are non-specific and can be mistaken for other conditions, Valdrez said. It's important for individuals but also clinicians to be aware of the symptoms and to include syphilis testing when trying to diagnose an illness.

The third stage is called the "dormant" or "latent" phase, Valdrez said. It doesn't have symptoms but can still be contagious.

Within as little as a year after infection, syphilis can spread to different organ systems, such as the nervous system, he said. An infection can make people "go blind, [or] people can lose their hearing and it can spread to the brain and people can get strokes or seizures," which are caused by inflammation around the brain, Valdrez said.

"It's very important to catch syphilis early and to treat it early to prevent these longer-term effects," Valdrez said.

Congenital syphilis

An increase in infections in people assigned female at birth is doubly concerning because of the risk of congenital syphilis, in which a pregnant person can transmit the infection to a developing fetus, Valdrez said.

Congenital syphilis can mean "babies are quite sick when they're born, and it can lead to long-term health effects, in their immediate future but also later in life," he added.

Congenital syphilis can result in premature birth, low birthweight and other serious debilitating conditions, including stillbirth, according to Fraser Health.

In 2022, over 90 per cent of women with infectious syphilis were between the ages of 15 and 49, according to the 2023 BC Syphilis Action Plan Refresh.

There were 355 cases of infectious syphilis in females aged 15 to 49 during the first half of this year, according to the BC Centre for Disease Control. Twenty-three of those cases were diagnosed during prenatal screening.

There were 21 cases of congenital syphilis in 2023, up from two cases in 2020, Fraser Health said.

In 2019 B.C. Introduced a new guideline for pregnant people to test for syphilis during the first trimester or at the first prenatal visit, and again during delivery.

Valdrez said a syphilis blood test ideally happens during the first trimester so there are at least four weeks between when they get treatment and when they deliver. This "would ensure a treatment of the syphilis infection in both the pregnant person and the prevention of transmission to the baby," he said.

Unfortunately people aren't always interacting with the health-care system during their first trimester of pregnancy, he said. There are complex reasons why people don't access medical care at regular intervals, he added. For example, a person may be unhoused and learn they are pregnant and have syphilis only when they seek emergency care for an unrelated issue, he said.

Late is better than never, he said.

The good news: syphilis is curable

The good news is that testing and treatment for STIs is free in B.C., and that syphilis can be cured with antibiotics at any stage of the infection. Further good news is that, so far, there haven't been any antibiotic-resistant cases of syphilis found in the province, Valdrez said.

British Columbians can speak with their doctor about getting tested for STIs, or use other free and confidential testing services like the BC Centre for Disease Control's GetCheckedOnline.

GetCheckedOnline allows people to make a lab form that they can take to participating labs for free STI testing. Participants don't need to provide their name or have a Medical Services Plan number — you just need to provide an email and phone number. There are participating labs in Vancouver, Maple Ridge, Victoria, Duncan, Kamloops, Kimberley and Nelson.

Vancouver is also home to the BC Centre for Disease Control's STI clinic, located near City Hall and open six days a week. The STI clinic offers free and confidential testing and treatment, and patients are not required to be enrolled in B.C.'s provincial health care.

Options for Sexual Health has 60 clinics across the province that provide free STI testing and treatment for people enrolled in MSP. Those without MSP coverage may be charged up to $200, depending on the service, and Options for Sexual Health does not offer anonymous testing like GetCheckedOnline or the BC Centre for Disease Control STI clinic.

Syphilis can be treated for free in B.C. With penicillin injections. Urgent and primary care centres, emergency departments, sexual health clinics, community health centres and public health centres will generally have these stocked, or a doctor could order and administer the treatment regardless of where you live in B.C., Valdrez said. Alternative antibiotics are available for people with penicillin allergies; people should discuss options with the doctor who is treating them.

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