Nevada leads the nation in a dubious category — the rate of syphilis infections — officials announced Tuesday.
The state’s rate of the primary and secondary form of the sexually transmitted disease (STD) was highest in the nation in 2017, and the rate of congenital syphilis, life-threatening infections spread to an infant during pregnancy, was second highest, according to the federal Centers for Disease Control and Prevention.
The congenital form of the disease remains relatively rare, but rates have climbed in recent years, from nine reported cases in 2016 to 20 cases in 2017 and to 24 last year, the Southern Nevada Health District said. It can cause stillbirths, and infants born with the disease are at risk of death soon after birth, low birth weight and deformities.
It’s an alarming trend because syphilis, particularly the congenital form, is preventable, said the district’s chief health officer, Dr. Joe Iser. State law requires prenatal screening for the disease during the first and third trimesters of pregnancy.
“This is totally unacceptable,” Iser said. “We should not receive one report of congenital syphilis, yet we continue to see increasing reports of cases in our community.”
Officials drew attention to the high rates and urged testing and treatment of the bacterial sexually transmitted disease at a news conference marking “STD Awareness Month.”
In Clark County, there were 1,006 reported cases of syphilis last year, a 153 percent increase from 2013. And in 2017, the county saw primary or secondary infections at a rate of 24.1 people per 100,000 compared to the national average of about 9.5 per 100,000, according to the CDC.
But rates are rising nationally, particularly in other large cities, Iser said.
“We are not alone,” he said.
Communicable diseases like syphilis are often brought to Las Vegas by tourists or people moving to the city, Iser said. In the case of the congenital type, many who are pregnant don’t seek care in a timely fashion, and insurance or immigration status can play a role whether they seek care at all, he said. The homeless are often particularly at risk for STDs.
Condoms are required for sex in the state’s brothels, but there’s no way to regulate unprotected sex among illicit sex workers, Iser said.
The health district’s Office of Epidemiology and Disease Surveillance worked with the Nevada Division of Public and Behavioral Health to put together an educational resource packet for health-care providers and patients about the disease.
Information for patients, providers
They include facts and tips for providers that they hope will facilitate better conversations with patients about the prevention and treatment of the disease, epidemiology office manager Marlo Tonge said.
“We’re going to be teaching them to have these conversations because we really need to get the word out,” she said.
Public health is underfunded in the state, so efforts like the packets and the epidemiology office’s partnerships with local homeless and sexual health groups are important for tackling the high rates, she said.
Anyone having sex is at risk to contract the disease, but pregnant women, people between 15 and 34 and men who have sex with men are particularly at risk, the health district said.
Primary syphilis is characterized by sores at or near the site of infection, while secondary syphilis is accompanied by skin rashes, fever or swollen lymph nodes. Infected people may not show symptoms of the disease but can still be infectious.
Syphilis can be treated with antibiotics, but left untreated it can lead to a number of serious health issues like dementia, meningitis, blindness and hepatitis, said Dr. Alireza Farabi, with the University Medical Center’s Wellness Center.
“Don’t think about syphilis as just (an) STD,” he said. “It’s a systemic disease involved from head to toes.”
Clark County has had comparatively high STD rates in recent years, leading the nation in primary and secondary syphilis in 2014 and in congenital syphilis in 2006, health district spokeswoman Jennifer Sizemore said. In 2016, Nevada’s syphilis rate was second in the country.
Those who have sex should know their own and their partners’ sexual histories and use condoms to prevent the spread of STDs, Tonge said. And if you think you may have been exposed, testing can provide a definitive answer.
“Don’t wait,” she said. “Go get tested.”