Five state health investigators are joining in to help stop the spread of syphilis is San Diego County, where there’s been nearly a 1,200 percent rise in syphilis cases between 2000 and 2007.

“We’re very concerned about the syphilis epidemic in San Diego County because the statistics are really skyrocketing,” said Terry Cunningham, chief of the Health and Human Services Agency’s HIV, STD and Hepatitis Branch in San Diego.

Cunningham and other public health officials have seen the number of syphilis cases in San Diego County go from a record low of 28 in 2000 to 342 last year – much higher than the state’s other large urban counties of San Francisco, Los Angeles, Orange and Alameda.

“San Diego’s increase is a cause for concern because we’re just not understanding why it’s being transmitted in the frequency that we’re seeing,” said California communicable disease control chief Douglas Hatch.

The bulk of new cases were reported among MSM (men who have sex with men). The majority of MSM who contracted syphilis were HIV-positive.

“We’re concerned that people who are sero-sorting, meaning HIV-positive men who are having sex with other HIV-positive men, are not engaging in safer sexual practices because they feel as though they don’t have to worry about HIV, yet they are transmitting other STDs,” Cunningham said.

For the last several years public health officials have increased public outreach efforts to try and stop the increasing numbers. To do so they have attempted to battle the spread of the potentially fatal, yet curable communicable disease, from all sides.

The state team dispatched to San Diego County will contact people diagnosed with syphilis to locate their sexual partners so they can be tested.

As a top official, Cunningham got involved in such efforts on the front lines, going out into the cruising areas of Balboa Park, to see first hand the efforts of outreach teams and investigators.

“Some of those investigations continue to go on because not all people can be located,” he said, noting there is extreme difficulty in locating partners. Often the only contact information officials have to work with is a screen name from a social networking site. “They are lucky when they get a first name and phone number,” he said.

Additionally, the county health agency launched a radio and television ad campaign in February to increase awareness and hopefully reverse the spike in syphilis and other sexually transmitted disease infections.

But health officials know that such attempts are not going to have immediate results. Despite such efforts they fear that numbers will continue to grow.

“If we thought the statistics were bad last year, this year is even worse,” Cunningham said. “San Diego has reported at least one case per day, with at least 80 cases so far.”

San Diego, however, is not alone in the climbing infection rates. The U.S. syphilis rate rose for the seventh consecutive year in 2007, the U.S. Centers for Disease Control and Prevention said at its National STD Conference last month. The number of syphilis cases nationwide jumped to 11,181 in 2007 from 9,756 in 2006, with men accounting for six times as many cases as women. Rates for men and women had been roughly equivalent a decade ago.

“There are several barriers to people not being tested or treated,” said Elaine Pierce, from the San Diego Public Health Department.

“We’re also concerned about people who are not talking to their providers about their sexual practices so that the medical providers can order the appropriate tests to see if they are positive for syphilis,” she said.

Syphilis is sometimes called “the great imitator” because its signs and symptoms are similar to other diseases.

In the first stage, primary syphilis, the infection causes a painless ulcer at the site of the infection, called a chancre. It can be in the throat, mouth, rectum, penis or vagina.

“People often times don’t know that they have it and its not like with gonorrhea, where there is a discharge,” Pierce said.

Even the secondary symptoms of syphilis – a body rash, a rash on the soles of the feet or palms of the hands – can be misdiagnosed and it subsides after a while, she said.

If left untreated, syphilis bacteria can severely damage the body’s organs as it travels throughout the body.

The final stage, called late syphilis, can result in mental illness, blindness, other neurological problems, heart disease and death.

Under normal circumstances, it can take decades for syphilis to develop to late syphilis, but doctors said that in HIV-positive people it is much more rapid.

The CDC recently recommended that physicians be more diligent in encouraging gay and bisexual men to be routinely tested for syphilis once a year. For those who are HIV-positive it is suggested that the test be built into routine viral load check-ups every three to four months.

Rosecrans Public Health Center

3851 Rosecrans St.

San Diego, CA 92110

Phone : 619-692-8550

Monday-Friday (7:30-11:30 a.m.) and (12:45-4 p.m.)

Southeast Public Health Center

3177 Ocean View Boulevard

San Diego, CA 92113

Phone : 619-231-9300

Monday, Wednesday, Friday (10-6 p.m.), Thursday (11 a.m. to 7 p.m.)

Family Health Centers of San Diego

Tuesday Night Clinic

3544 30th St.

San Diego, CA 92104

Tuesday (5-9 p.m.)