03/04/10 — Health Department seeing increasing syphilis infections

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Health Department seeing increasing syphilis infections

By Phyllis Moore
Published in News on March 4, 2010 1:46 PM

There is a syphilis epidemic in Wayne County, Health Director James Roosen says -- one that if left untended, could become a widespread problem.

"We have a very high rate of syphilis -- probably among the highest in the state," he said this week.

It's a sensitive issue, one not typically discussed in polite society.

But as health director for the county, Roosen said he is willing to speak honestly about it, in hopes of preventing further outbreaks.

"About 12 years ago, we were talking in public health that (syphilis) was going to be eradicated," he said.

Instead, at least in Wayne County, it's on the rise.

Back in 2003 and 2004, the county only had three cases each year. In 2008, there were 20-something. And since the fiscal year began in July, there have been 63 cases.

Annette Von Wald and Sheila Warren, HIV/STD nurses in the Health Department's STD clinic, see more than 300 patients every month for sexually transmitted diseases, which include gonorrhea, syphilis, HIV, herpes and chlamydia, Roosen said.

The majority develop obvious symptoms -- a sore, an itch, lesions on the hands or feet -- which prompt them to visit the Health Department for treatment.

But it's the patients with no symptoms that become problematic.

The nurses mentioned cases of people being misdiagnosed and treated for "spider bites" by dermatologists. Elderly widows shocked to discover they tested positive for syphilis, transmitted by their late husbands years before.

In some cases, Ms. Von Wald said, it can seemingly "heal up on its own" even if the person goes untreated. But that doesn't mean they don't still have the disease and in fact, it continues to silently attack the body.

"It can affect the mind, the heart, it can affect the hearing, it can affect any part of your body," she said.

The diseases are generally transmitted sexually or by hand contact, when there are lesions, or open sores.

"But the lesion can be painless, so if (a woman shows symptoms internally), she won't know it," Ms. Warren added.

The diseases are becoming particularly prevalent among certain factions, Roosen said. For example, there has been an increase in cases of chlamydia among young people.

The same holds true for syphilis, he said.

"Right now we're seeing syphilis mainly among a special population -- prostitutes, gay people and also people that go to prostitutes," Roosen said. "So syphilis right now is contained in that population. But it could very well go into the rest of the population and that would be a very serious thing in a lot of ways."

The immediate goal is to increase public awareness, he said.

While free treatment is available at the Health Department, it is imperative to find ways to get the message, as well as testing, out into the community, he said.

Last year Health Depart-ment staff participated in the state's "Get Real Get Tested" campaign, administering the tests in at-risk areas of the county.

"We didn't find anybody that was positive that we didn't already know about," Roosen said.

Anyone that does test positive is required by law to seek treatment, and their partners also have to be treated, Ms. Warren said.

"We're willing to go out in the community and test, but we don't get a great response," she explained. "Just getting the people to get tested, just because they don't have symptoms, they think they don't have to be tested.

"What we need to do is get the so-called 'normal people' that don't think they have any (symptoms)."

Roosen said he is anxiously watching the scenario unfold in Wayne County, hopeful that the problem will not worsen.

"Right now it appears that it's just in the population that I talked about, but it may turn into the other STDs," he said. "Right now the goal is public knowledge. We're trying to let everyone know that we have got an epidemic going on. ...

"Public health needs to figure out how to test high-risk people. In other words, people that have been exposed to syphilis. Some way or another we need to test them."

The Health Department's STD clinic is set up to test each patient for the disease. Most regular health care providers and doctors are not, however, and that's something the nurses suggest could be beneficial.

"If they just included (syphilis testing) in a regular panel, as part of the routine physical, it would help," said Ms. Warren.

Short of that, anyone can be tested free of charge at the Health Department.

Appointments are available by calling 731-1005 and confidentiality is promised.

But there is no guarantee that will be sufficient, Roosen said, so his staff continues to seek creative ways to reach more of the population.

"One of the things we need to look at is different types of testing where we or other health providers actually go out into the community and hopefully test these high-risk people," Ms. Von Wald said. "Right now the only method we have is to test these people when they come into the Health Department, and there's a lot of them out there that are in the risky mode. Somehow or another we have to get out there."

"One of the problems that we have is that we're short-staffed at the Health Department so right now we only do testing out in the neighborhoods occasionally," Roosen said. "We need a better strategy for actually getting in contact with people that are high risk rather than waiting for them to go into the Health Department."