NAMPA — In the midst of the COVID-19 pandemic, another germ has been on the rise locally. The region covered by Southwest District Health — Canyon, Owyhee, Washington, and Adams counties — has seen syphilis infections more than double in the past two years, with most cases appearing in Canyon County.
“Anyone that has had sex in their life is at risk of having an STD,” said Cate Lewis, an epidemiologist with the district. “The only way to know what your status is and to know if you’re healthy is to get tested. Especially now with this outbreak in our community, I really want to encourage as many people as possible to go get tested, especially since syphilis can cause such serious lifelong complications if left undiagnosed and untreated.”
Syphilis is a sexually transmitted disease caused by a bacterium, Triponema pallidum, according to the National Institutes of Health. A person can become infected when they engage in sexual activity with another infected person.
In 2017, the district counted 18 cases of syphilis; in 2018, 14 cases; in 2019, 15 cases, Lewis said. The beginning of 2020 started off with normal numbers, but by the end, 38 people had tested positive for the disease. The district declared an outbreak in February, Lewis said. Forty-three people had tested positive by the end of July, Lewis said.
The uptick in cases reflects a national trend of increasing syphilis cases over the past decade, according to the National Institutes of Health. Though cases in the past decade initially were seen in men who have sex with men, cases are rising in other groups, including premenopausal women, the Institutes’ website says.
Southwest District Health is initiating a campaign to raise awareness about the disease in hopes of slowing its spread. It will be setting up a dashboard to share information about syphilis case numbers in the area, and the public can access more information about testing and treatment on its website.
A rise in unsafe sex practices is a factor in increasing cases. People are using dating applications to meet “anonymous sex partners,“ or sexual partners that they did not know before, Lewis said. Becoming intoxicated or getting high can lower inhibitions, which can cause people choose to engage in unsafe sex practices, such as not using a condom, Lewis said.
The first stage of syphilis is characterized by a red bump, known as a chancre, that can appear where an infected person’s chancre made contact. For women in particular, a chancre may not be visible if their partner’s chancre made contact internally, Lewis said. Some people may experience swollen lymph nodes in the legs or throat, or have a sore throat, but some may have no symptoms at all, Lewis said.
In the second stage of syphilis, known as secondary syphilis, infected people may see a rash that is typically not itchy on the palms of their hands or soles of their feet, Lewis said. Other symptoms during this stage include muscle aches, hair loss, and swollen lymph nodes.
But it is the third stage of syphilis that is most devastating. Ten to 30 years after a person’s initial infection, major health complications can ensue, including damage to the heart, eyes, nerves, brain, and other organs, Lewis said.
Babies born from mothers who are infected with syphilis can develop complications too, so it is important that health care providers test pregnant women for the disease, Lewis said.
Testing for sexually transmitted infections, including syphilis, consists of a simple blood draw, Lewis said.
The health district alerts health care providers in the community to outbreaks so they can have a higher suspicion for certain diseases.
Jerrie Hammons, an infection prevention practitioner at St. Luke’s Nampa, is tasked with reviewing all of the positive microbiology cases that come through the hospital. She remembers learning during her nurse’s training that she would probably never see a syphilis case, and if she did, it would be extremely rare. But in the last few years, St. Luke’s Nampa has seen several cases come through, Hammons said, including a few secondary cases and a few congenital cases, or those diagnosed at birth, she said.
“We’re thankful for public health (Southwest District Health) letting us know about this because it really led to higher awareness here,” Hammons said.
When pregnant women first come in for prenatal care at St. Luke’s Nampa, they are screened for sexually transmitted infections, which include syphilis as well as gonorrhea and chlamydia, said Clarence Blea, a maternal fetal medicine specialist with the hospital.
Apart from the increase in the use of dating apps and the national rise of sexually transmitted infections, part of the reason these outbreaks could be happening is that Boise and the surrounding area have changed.
“I think probably the best way to put this is that Boise has grown up to a degree,” Blea said. Twenty-six years ago, when Blea moved here, the area was considered “bacterially naïve” and the population was more homogenous, he said. But times have changed.
“We’re no longer necessarily a small town or a large town, and I think the medical as well as social issues change with the size of a population,” Blea said.