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Syphilis Nearly Eradicated

New cases of syphilis in the United States fell during 1996 to their lowest rate in 40 years, a decline that health officials said could make it possible to eliminate the sexually transmitted disease from this country in the near future.

New cases were heavily concentrated in a few dozen cities and counties, primarily in the South. Baltimore County, Md., with 629 new infections last year, was the U.S. county with the most cases, according to provisional 1996 figures collected by the federal Centers for Disease Control and Prevention.

At the same time, 73 percent of U.S. counties reported no new cases of syphilis during 1996. Half of the 11,624 cases reported last year occurred in just 37 counties in the country.

“We are now sitting … with a historic opportunity to move to eliminate transmission of this disease within the United States,” said Judith N. Wasserheit, director of the Division of Sexually Transmitted Disease Prevention at the CDC.

Syphilis has been curable with penicillin since 1947. The infection is caused by a bacterium, Treponema pallidum, that can damage tissues in many organs of the body, producing a wide range of problems.

Untreated, the infection can invade all parts of the body, causing pain and eventually leading to paralysis and death.

The recent decline is partly because of the cyclical nature of the disease and partly because of more aggressive treatment efforts by state and local health officials after the 1980s epidemic, said Michael St. Louis of the CDC.

The syphilis rate in blacks is almost 60 times higher than that in whites, reflecting a pattern of racial disparity that has persisted at least since the 1930s.

A recent study by researchers at Penn State University suggests the disparity originated with an epidemic among Southern blacks triggered by the social disruption caused by World War I.

The pattern of higher syphilis rates among blacks has been perpetuated, particularly in the South, by reduced access to health care and a lack of awareness of the disease and the availability of treatment, said St. Louis.