Houston, we have a problem. The number of syphilis cases in Houston, Texas, among women has jumped by 128% from 295 in 2019 up to 674 cases in 2022. That and other similar syphilis statistics have prompted the Houston Health Department to declare an outbreak of this sexually transmitted infection (STI). During that same time period, the number of newly diagnosed infections has risen by 57% from 1,845 to 2,905. That’s clearly positive news in a bad way.
An outbreak is when the number of cases of something over time exceeds what you would normally expect. While an outbreak of avocado toast or happiness—which essentially are the same thing—may be OK, an outbreak of syphilis is definitely not OK. The word “syphilis outbreak” should rarely be followed by the words “OK” or “cool.” This means that the Treponema Pallidum bacteria that causes syphilis has been spreading and spreading in the Houston area. You can catch syphilis when having vaginal, anal, or oral sex with someone infected with this bacteria and coming into contact with one of that person’s sores. And as will be described later, syphilis can be a very sore subject.
In response to this outbreak, the Health Department is launching what they called in the announcement “a rapid outreach response that includes increasing screening opportunities, targeting hotspots and mobilizing community partners to curb new infections.” This will include making greater use of its HIV/STD mobile clinic to help with screening and raising awareness of this outbreak so that more testing and treatment occur. The Health Department is also “waving all clinical fees for sexually transmitted infections at its health centers.”
The Centers for Disease Control and Prevention (CDC) recommends that you get tested regularly for syphilis if you are sexually active and are a gay or bisexual man or are HIV positive or are taking pre-exposure prophylaxis (PrEP) for HIV prevention or have a partner or partners who have tested positive for syphilis. If you are pregnant, the CDC recommends that you get tested for syphilis at least once during your pregnancy. The Houston Health Department, though, is recommending getting tested more than once. They are suggesting at least three times: once during your initial prenatal visit, a second time during your third trimester, and a third time at the delivery of your baby.
A big concern about having syphilis while pregnant—besides the fact that you, you know, have syphilis—is passing this infection along to your fetus, resulting in what’s called congenital syphilis. Not all things with “genital” in them are fun. Congenital syphilis can lead to a miscarriage, a stillbirth, a premature delivery, the baby having low birth weight, or the baby dying shortly after birth. Even if your baby does survive birth, your baby may have deformed bones, severe anemia, an enlarged liver and spleen, jaundice, brain and nerve problems, skin rashes, or other problems. Indeed, from 2016 to 2021, the number of reported congenital syphilis cases in Houston has mushroomed by 844% from 16 to 151.
So, how can syphilis be a sore subject? Well, during the primary or first stage if syphilis, sores can develop around wherever the Treponema Pallidum bacteria had entered your body. This can be your penis, vagina, anus, rectum, lips or mouth because those are key body parts when you are doing the sexy time thing. These sores tend to be firm, round, and painless, which may mean that you may not even notice it, since you may not be in the habit of checking your body for sores. These sores can go away after three to six weeks even when you don’t receive any antibiotics as treatment. But that doesn’t mean that all is on fleek, so to speak. Forgoing antibiotic treatment can be a bad, bad idea because without treatment, this infection can then progress to the secondary stage.
Yep, it can be a rash decision to not get treated, figuratively and literally. The secondary stage of syphilis typically begins with a rash over one or more areas of your body. This non-itchy red or reddish-brown rash can appear on the palms of your hands. the soles of your feet, or both. You may have a fever, swollen lymph glands, a sore throat, hair loss, headaches, weight loss, muscle aches, and fatigue as well. As with the primary stage sores, these symptoms can also disappear without treatment. And similarly, untreated syphilis can then proceed to the next stage—the latent stage—and potentially in some cases further to the tertiary stage of syphilis.
The latent stage is where the bacteria remains in your body but doesn’t cause any obvious signs or symptoms. The tertiary stage—which doesn’t happen to all cases of untreated syphilis—is when syphilis begins affecting a range of different organ systems such as your heart, blood vessels, brain and nervous system. This is really bad stuff and can emerge 10 to 30 years after your initial infection. Tertiary syphilis can kill you.
Houston is not the only place in the U.S. dealing with rises in syphilis. Although other locations may not be having official outbreaks, syphilis and gonorrhea have been on the rise in general in the U.S. over the past decade. At the risk of sounding like a broken record, America has continued to break records when it comes to increasing cases of STIs, as I’ve reported previously Forbes. And will keep doing so until more is done about this problem.
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