Prather Pediatric and Allergy Center - Ask Doctor Brent

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Title: Syphilis Declared Major Public Health Emergency in Louisiana

Category: Child Care


A few weeks ago I ran an article which I had actually written some six months ago about Louisiana leading the country in cases of syphilis. Now just this month we are hearing from our state's health secretary, Rose Forrest that the syphilis epidemic in Louisiana has become an emergency. They are warning all physicians and citizens to take as many steps as possible to stop the spread of this disease. The syphilis rates in Louisiana have been going up since 1989 and with rates over 70 per 100,000 we are about 7 times higher than the US Public Health Service objective for the year 2,000. Despite the aggressive attempts to find cases and treat them and follow them up, there has not been a significant decrease in recent years. The epidemic is now taking place in every single area of our state.

One of the major reasons we are seeing a lot more syphilis and AIDS is because of congenital syphilis. Last year we had over 150 cases in our state. When I was in training, some fifteen years ago, we rarely saw one case per year. Syphilis sores make it much easier to transmit the HIV virus. The present spread of syphilis is directly tied to a later spread of HIV virus. There are many new cases of AIDS occurring daily due to this syphilis and our youth will be the ones to suffer in the next decade.

We must do all we can to control the spread of syphilis by notifying partners, screening cases better, better public education, and better clinical services including better access to care, treatment and follow-up. Many people with syphilis do not know they have it and will show up in a doctor's office for other reasons. Doctors must be thinking syphilis and doing proper blood testing to pick up the cases.

We should think of syphilis with any patients, according to our state health department, who have 

(1) sores or symptoms of syphilis on the genitalia, palms or soles, or unusual rashes, 

(2) persons who feel they are at risk and ask for testing, 

(3) persons with any other sexually transmitted diseases, especially gonorrhea or chlamydia, 

(4) persons with two or more sex partners in the last six months, 

(5) persons with sexual contact with a prostitute or who exchange drugs for sex and 

(6) any persons using illicit drugs or having sex partners who do, 

(7) all pregnant women should be tested for syphilis early in their pregnancy. We need to get all pregnant women in our state to health units or physicians as early as possible in their pregnancy before damage to the baby occurs.

In summary, syphilis is not just a problem affecting someone else, it is a problem impacting our state in a major way, a true emergency and we must all do what we can to combat it. Besides all the public health measures mentioned above, I think we all need to pray for a greater respect for sexuality, abstinence and waiting till marriage to become sexually active. The Southern Baptist Convention has an active program, nation wide now where youth are pledging to save themselves till marriage. Many other Christian and Jewish youth are joining in the same campaign. Let's encourage them and as intelligent adults, support the pure logic of this choice as well as its' spiritual soundness. If we don't, the future in our state and society is certainly not very bright.