By Cynthia T. Pegram

Published: March 6, 2008

Syphilis, a sexually transmitted disease that’s been scarce in the area for years, has surfaced in the Central Virginia Health District.

The number of cases, enough to be classified as an outbreak, has prompted the intervention of the Virginia Epidemiological Response Team of the state Department of Health.

The first-time infections appeared in 2005 in two patients, said Tangye Harris, regional supervisor for the epidemiological response team, or VERT.

New cases rose to seven in 2006, and to 26 by 2007. That’s considered an outbreak of the bacterial infection.

“That’s what the concern is in this area now,” Harris said.

Those new cases, explained Yvonne Walker, district lab manager, are among 58 cases positive for syphilis from October 2006 through February 2008 in the district, which includes Lynchburg and the counties of Amherst, Appomattox, Bedford and Campbell.

The other cases are people treated for syphilis in the past -either in the district or another area of the state - who have become re-infected, Walker said.

The response team came to Lynchburg in October.

The demographics show the positive cases are in patients ranging from 19 or younger to 79 years old. Most cases are occurring in women aged 20-29. The second-highest numbers are equal - men aged 30-39 and women aged 40-49.

In all, 32 females and 26 males were positive for syphilis.

So far, Harris said, no core group has been isolated.

“What we’re seeing is kind of strange,” Harris said. “Actually, there’s no one group that stands out. The cases don’t follow a pattern of young, old, prostitutes, black or white.”

VERT tries to target the core transmitters, perhaps those exchanging sex for money or drugs, and find the disease’s source.

“Right now we’re just following up on the positive labs and anyone who comes in symptomatic,” she said. “We follow up on all partners named by those who are infected and brought to treatment.”

When the infection is confirmed, they counsel about transmission - sexually transmitted means vaginal, rectal or oral sex, Harris said.

“We try to make it known how important it is to share with us who their partners are in order to stop the spread of the infection, she said.

Everything is confidential, she said. Anyone being named as a partner will not know the source.

The consequences of untreated syphilis are serious.

First stage, or primary syphilis, creates a sore or lesion, usually painless, and it goes away. Most often it’s on the genitals, anus, or in mucous membranes of the mouth.

The secondary stage is an infectious rash and multiple lesions of the mouth, she said. The latency stage has no symptoms but the disease continues to cause infection. It can move into serious health problems for the patient, especially in pregnant women.

Lynchburg is not alone in the rise.

“Virginia is having a problem with increasing syphilis all across the state,” Harris said.

VERT was created in 1999, when the federal government mounted an effort to eliminate syphilis and Danville was among 25 cities targeted with the highest syphilis rates.

The team worked there for a year, she said, and Danville was one of the few that eliminated the disease at that time.

Now, Harris said, “we’re in outbreak mode,” and that includes community screenings, contacts to media, and outreach with field counselors trying to find the people being named.

Patients who come to the health department’s diagnostic clinic with symptoms can get a screening blood test for syphilis.

“It is not a confirmatory test,” Walker said. “It is sent to the state lab for confirmation.”

People are seen free of charge at the diagnostic clinic, said Haley Phillips, nurse supervisor for Lynchburg and Bedford. Those diagnosed with syphilis, or gonorrhea or chlamydia receive treatment at no cost.

Syphilis can be treated at all stages with a single or series of injections of either penicillin or a similar antibiotic.

Harris noted that patients can go to their private doctors, but if they test positive, they can’t duck the VERT team interview. State law requires doctors to report syphilis to the health department.

“We need find the partners, where they got syphilis, and treat it adequately,” Harris said.