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Nov. 1, 2012
TOPEKA State health officials have completed a six-month investigation of a syphilis outbreak in north central Kansas and believe the problem has been contained.
Investigators confirmed 26 cases of syphilis in either primary or secondary stages of the sexually transmitted disease.
Infected individuals from 22 of the 26 cases were living in Kansas. Four were confirmed out of state. All but one of the 22 infected Kansans were male.
Seventeen of the Kansas cases were in Geary, McPherson, Ottawa, Pottawatomie, Riley and Saline counties. The other five cases were in counties north of those, but officials declined to identify them because it might help publicly identify the victims.
“We deal with clusters periodically, but this was the largest one we’ve had in a very long time,” said Jennifer VandeVelde, who runs the Kansas Infertility Prevention Project at the Kansas Department of Health and Environment.
“What’s interesting is that they’re usually in Kansas City, Wichita or Topeka – urban areas with lots of people and lots of disease,” VandeVelde said. “But this one was in an area that’s populated, certainly, but not what you’d call urban.”
Most of the 21 infected males were infected through sexual relations with other men, she said.
Syphilis is a highly contagious sexually transmitted disease that’s spread by person-to-person contact with bacterium in syphilis sores, typically during vaginal, anal, or oral sexual relations. It also can be transmitted from infected pregnant women to their fetuses, sometimes resulting in babies being born with the disease.
“Untreated syphilis can lead to some pretty significant long-term health consequences, including brain, cardiovascular and organ damage,” said Nikki Mayes, a spokesperson for the national Centers for Disease Control and Prevention.
Babies, she said, were especially vulnerable to the consequences.
“A pregnant woman who has syphilis and goes untreated can result in congenital syphilis, which can cause things like still births, deaths soon after birth, physical deformities and neurological complications.”
The lone female among the 26 cases, VandeVelde said, was pregnant and had first tested negative for syphilis. But she was retested at KDHE’s behest and found to be positive. Treatment spared her passing the infection to her baby.
“She’d had exposure after the test was conducted, so, but for this investigation, she very likely could have been infected when she gave birth,” VandeVelde said. “The bacteria that causes syphilis can cross the placental barrier and just go into the fetus and wreak havoc. Anything that you can think of happening to a fetus, syphilis can probably cause it.”
KDHE last year confirmed 58 cases of syphilis in 54 males and four females.
The latest investigation, VandeVelde said, began when a physician who screens all patients for syphilis had one who tested positive. The patient, she said, had not suspected the infection, displayed no symptoms, and had no prior history of having had a sexually transmitted disease.
Citing confidentiality concerns, VandeVelde declined to identify the physician who discovered the infection other than to say that he or she had “been around long enough to (see fit to) screen just about everybody.”
She also would not say where the physician was from or whether the patient was male or female.
Because syphilis is covered by the state’s mandatory reporting laws, the physician alerted KDHE.
VandeVelde’s office, in turn, arranged to have one of its 10 behavioral intervention specialists meet with the patient.
“We asked who they were having sex with, we asked about symptomology, we asked them about travel history,” VandeVelde said. “We asked who they knew who may be engaging in high-risk behaviors and may benefit from being tested.”
From there, she said, the investigation grew to eventually include having 395 people “tested for syphilis as a result of high-risk behaviors.”
Intervention specialists, VandeVelve said, met with each person they interviewed because “…what we’ve found is that if you try to call people, a lot of times they think it’s a joke or that you’re pretending. So we always go, show them identification and let them know there’s reason to believe they’ve been in contact with syphilis.”
The responses varied from those contacted, she said.
“Some were not surprised. They’d been through the process before and knew what to do. Some were completely shocked,” she said. “It was a big wake-up call for them. It really gave them a chance to look at how their behaviors were putting them at risk. And some were really, really angry.
The intervention specialists arranged for the interviewees to be tested, usually at one of the local health departments. Testing involved drawing a blood sample.
Most of those tested also were treated. Generally, treatment involves a penicillin G benzathine injection in each hip.
“It’s old-school penicillin,” VandeVelde said. “Treatment hasn’t changed in 20 or 30 years, but it’s highly effective.”
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