Is Syphilis Elimination Still An Option? Primary and Secondary Syphilis, 2008-2010, Chicago, IL

Background: Despite syphilis elimination efforts, Chicago, IL continues to be a high morbidity area for syphilis. The primary and secondary (P&S) syphilis case rate in 2010 was 25.4/100,000 population (686 cases) which represents 61% increase in the number of cases compared to 2008 (425 cases).

Objectives: To assess the recent epidemiology of P&S syphilis in Chicago, IL.

Methods: Interview data for reported cases from 2008-2010 were analyzed.  Rates were calculated as cases/100,000 population using 2010 census data. All cases were defined based on the CDC surveillance case definition.

Results: Between 2008 and 2010, the rate of P&S syphilis among men increased from 28.3 to 46.02 and rate among women increased from 1.8 to 6.05, reaching the highest since 2000. Disparities between rates for P&S syphilis among blacks and whites has increased in 2010: blacks were 2.6 times more likely than whites to have syphilis (46.1 vs 17.8 cases), representing an increase from 2008 (1.6 times higher in blacks; 18.6 vs 11.2 cases). The increase is primarily being driven by a substantial rise in P&S syphilis cases among black men who have sex with men (MSM) and females. Between 2008 and 2010, the male to female rate ratio decreased from 15.6 to 7.6, which suggests that increases occurred among females, in whom 12% of syphilis cases occurred during 2010.

Conclusions:The findings in this report indicate an increasing proportion of P&S Syphilis among Black MSM & females.  The changing epidemiology of P&S syphilis highlights the need for new strategies for syphilis control tailored to reach out population most affected by syphilis.

Implications for Programs, Policy, and Research:Strengthen partnerships with healthcare providers and encourage them to report syphilis cases to the local health departments in a timely matter. Innovative intervention methods are urgently needed for disseminating health information and partner notification.