Syphilis, gonorrhea rise worries CDC

Males undertaking risky homosexual activity are fueling a sharp increase in the incidence of syphilis and a smaller but concerning rise in gonorrhea resistant to commonly used antibiotics, federal researchers said Tuesday.

Those increases come at a time when venereal disease rates among historically important risk groups, especially women and minorities, have been declining, according to a new report from the Centers for Disease Control and Prevention.

The diseases “are a significant and ongoing threat to millions of Americans,” said Dr. Ronald Valdiserri, acting director of CDC’s National Center for HIV, STD and TB Prevention. They cost the health care system $13 billion per year, he said.

Health authorities made major inroads into syphilis transmission during the 1990s, bringing the annual number of new cases during 2000 to the lowest level since recordkeeping began in 1941.

From 2000 to 2004, however, the rate rose by 29 percent to a total of 7,980 cases, with most of the increase occurring among men. Men engaging in homosexual activities accounted for 64 percent of the syphilis infections in 2004, compared to about 5 percent in 1999, said Dr. John Douglas, director of the CDC’s division of STD prevention.

The number of cases is relatively small, but the data is potentially alarming, experts said, because increases in venereal disease are generally assumed to be precursors of increases in the transmission of the AIDS virus, which is more difficult to combat.

Gonorrhea rates, in contrast, have fallen to 113.5 cases per 100,000 people in 2004 – about 330,000 cases – the lowest rate since 1941. Nonetheless, surveillance by CDC in selected cities has shown that resistance to fluoroquinolone antibiotics – the common first-line treatment for gonorrhea – increased from 4.1 percent in 2003 to 6.8 percent in 2004.

Last year, the CDC recommended that fluoroquinolones no longer be used to treat the disease in men having sex with men because of the rise in resistance.