WASHINGTON – Syphilis cases on the Eastern Shore rose sharply from 1996 to 1998, even as cases recorded for the entire state dropped for the first time in five years.
Reported syphilis cases on the Eastern Shore jumped from 11 in 1996 to 54 last year, the only region of the state to show a significant increase. Most of that increase was in Wicomico County, where reported cases jumped from two to 32.
Southern Maryland was the only other region with an increase, inching up from six syphilis cases to seven between 1996 and 1998 in the three-county region, according to the state Department of Health and Mental Hygiene.
The state rate fell by more than 25 percent during the same period, driven by a sharp drop in Baltimore City, where cases fell from 557 to 483. The statistics measure primary and secondary syphilis, the stages at which the disease is infectious.
Health officials blamed drug use for the Shore’s increase and said they have taken steps to reverse the trend.
“We began to be concerned with the rise in cases in Wicomico and along the Eastern Shore in 1997,” said Dave Akres, senior public health adviser with the state’s division of epidemiology and disease control.
He said the state is focusing efforts to fight the disease along the Eastern Shore. Those include better screening of inmates in detention centers, which often have high rates of syphilis among inmates, and more cooperation with the Centers for Disease Control and Prevention on programs to heighten community awareness and outreach.
Wicomico County has responded with more syphilis screenings, intensive partner tracking and treatment, and outreach services in high-risk neighborhoods, said Beebe Triplett, health services specialist in the Wicomico County Health Department.
“We go door to door in high-risk neighborhoods and educate them on syphilis,” she said. The county also offers free syphilis screening and treatment at a public health facility.
Officials linked the rise in syphilis on the Shore, and particularly in Wicomico, to an increase in drug use in the region.
“A big percentage of the syphilis cases here had involvement with crack cocaine use,” said Triplett. “Addicts tend to trade sex for drugs. Also being on drugs makes them lose judgment and indulge in high-risk behavior like not using condoms.”
There could also be a link to an influx of people from Baltimore, Triplett said. The city still had the country’s largest number of syphilis cases, despite last year’s big drop.
“Salisbury is a city where a lot of people go through partying,” Akres said.
Efforts to control the disease appear to be paying off. Triplett said preliminary data for the county this year shows a drop in syphilis cases, with only 10 reported so far this year.
“If this continues, we should see a definite improvement,” she said.
Akres added that the health department projects a 50 percent drop in syphilis cases along the Eastern Shore this year and a 30 to 40 percent drop in the entire state. A drop in the number of latent cases of syphilis across the state “makes us comfortable that the disease is under control,” said Akres.
That drop has already started. Statewide, total cases of syphilis fell from 888 in 1997 to 665 in 1998.
“They are going down dramatically, for the most part,” said John Crick, acting director for epidemiology and disease control in DHMH.
After Baltimore City, Prince George’s County had the most cases in the state in 1998 with 51 cases, down from 86 in 1997. The county still has the 24th highest number of syphilis cases in the nation.
But health officials said they are optimistic that the disease would be wiped out from the state in the next few years.
“We’re mopping up on an epidemic over the past two years,” Akres said. “Our idea is to clean it out.”