Warning: Syphilis cases on the rise in Stark, Tusc region

• Increase in syphilis traced to pandemic.
• Doctors are urged to do more testing for syphilis.
• Untreated disease can have long-lasting effects.

CANTON − The COVID-19 pandemic has triggered another public health problem, namely an increase in syphilis .

The number of regional syphilis cases grew from 41 in 2020, to 68 in 2021, to 109 last year, said Diane Thompson, director of nursing for Canton City Public Health .

High-risk behavior such as substance abuse combined with unsafe sex are the two biggest culprits behind the rise in cases.

STDs in Ohio: Gonorrhea and syphilis cases spiking in Canton

According to Ohio Department of Health, syphilis, which is a bacterial infection, increased from 2,442 cases in 2019, to 3,956 in 2021, with 25- to 34-year-olds making up the largest number of cases.

Other sexually transmitted diseases such as gonorrhea and chlamydia also are seeing higher numbers since the pandemic. New figures from the U.S. Centers for Disease Control show that syphilis and gonorrhea infections hit an all-time high in 2021.

Post-COVID rise in STI's https://thehill.com/policy/healthcare/3944195-sexually-transmitted-infections-hit-record-high-in-2021-cdc-finds/

Worrisome rise in congenital syphilis in Ohio

But there's a particularly worrisome rise in congenital syphilis, which is transferred to unborn babies by their mothers. According to preliminary figures, there were three congenital syphilis cases last year.

In response, Canton City Public Health launched a billboard campaign earlier this year to encourage sexually active people to get tested and treated if necessary. The health agency tracks syphilis and HIV cases in eight counties: Carroll, Coshocton, Harrison, Holmes, Jefferson, Stark, Tuscarawas and Wayne.

Thompson said that after the first congenital syphilis case in the region was reported in 2020, Canton issued a statewide health alert via the Ohio Department of Health.

Statewide, the number of syphilis infections in infants to those age 9 jumped from 19 in 2019 to 50 in 2021.

Thompson said a woman who has syphilis prior to getting pregnant can transfer the organism to a fetus once she becomes pregnant.

"And it can occur at any time during pregnancy," she said. "It can happen at a sexual encounter during pregnancy. We've had some high-risk cases where people didn't know they were pregnant because they were deeply into their substance abuse, and so if they don't get prenatal care, obviously testing doesn't get done until they end up in labor and come into the hospital."

Effects of syphilis can be lifelong

The effects for a baby infected with syphilis can be lifelong.

"They could have some chronic medical conditions and have to be cared for throughout their life," Thompson said. "Bone issues, which can cause deformities. It can also cause stillbirth."

Thompson said the health agency has applied for an Innovative STI (sexually transmitted infection) Prevention & Strategies grant from the state.

"We are proposing to partner with the Multi-County Attention Center to do STI testing on their youth," she said. "We're also proposing to do STI testing with our needle exchange participants."

She said another challenge is many people don't know they're infected. One factor for transmission is high-risk individuals, people who have multiple sex partners or who engage in substance abuse.

"We catch some of our adults through blood donations," she said.

Thompson noted that some younger physicians have never seen a syphilis case.

"So, people end up going to the doctor and they get diagnosed with a dermatitis, or they think you're having a reaction to soap," she said.

Thompson said syphilis symptoms for adults occur in stages.

"They will go through a primary stage where a lesion may appear," she said. "And the reason people may not notice a lesion is because it can be in the mouth, it can be in the anal area, in can be inside the vaginal area so they may not see it, and this lesion is not particularly painful."

As the organism continues to attack the body, it goes into a secondary stage, Thompson said.

"The secondary stage is when you see loss of hair. You can see a rash that can be all over the body or on different parts of the body," she said. "What is classic for secondary syphilis is the rash on the palms of the hands and the soles of the feet."

Syphilis got Al Capone

Left untreated, syphilis will continue to attack the body for up to 12 months.

"After 12 months, if an adult doesn't get treated for it, that's when the organism lies dormant in the body for years and years and years," Thompson said. "It can travel to the brain and cause lots of damage. That's why Al Capone died."

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Thompson said a combination of risky behavior and a lack of testing makes it difficult to get a handle on transmissions.

"Years ago, we had a syphilis problem, but it was men having sex with men," she said. "So, you target that population of individuals and gear your testing in that population. When it's in your heterosexual population, it's very difficult to know how and where to target the message, which is why we've gone to the billboards."

Syphilis in adults and infants are treated with penicillin — the sooner, the better.

"If we can catch them in the first 12 months, it's one dose," she said. "But if we catch them after 12 months, it's three weekly doses. If we diagnosis an adult with neurosyphilis, it's I.V. penicillin for 10 days, and if we diagnose an infant with syphilis, it's also penicillin multiple times throughout the course of the day for 10 days."

Expectant mothers can be treated 30 days prior to delivery.

"But obviously, you have to infectious disease (experts) involved, and a pediatric neonatologist to assess that baby," Thompson said. "If we don't know mom has syphilis and the baby is born and transmission has occurred, mom could potentially present (the baby) to a pediatrician with broken bones because it does impact the bones."

The Canton City Public Health, 420 Market Ave. N, conducts free STI screening clinics from 8:15 to 11:15 a.m. by appointment only. Call 330-489-3322. If appointment slots are available, walk-ins are permitted. For more information visit https://www.cantonhealth.org/nursing/.

Reach Charita at 330-580-8313 or charita.goshay@cantonrep.com .

On Twitter: @cgoshayREP