03/04/11 — County still high on list for syphilis

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County still high on list for syphilis

By Phyllis Moore
Published in News on March 4, 2011 1:46 PM

The syphilis epidemic in Wayne County is not waning -- the county ranks second in the state for rates of primary and secondary cases -- sending officials scrambling to reverse the trend.

The N.C. Department of Health and Human Services, communicable disease branch, recently announced Wayne is No. 2 in the state, with a rate of 29, behind Forsyth County, whose rate was 35.6 and ahead of Hyde County, with 19.3.

In 2008, Wayne County was ranked first, with a rate of 13.2, so while its position dropped, the numbers still more than doubled in one year, said James Roosen, health director.

"Currently our chlamydia rate is 32 percent higher than the state average, and for gonorrhea, it's 82 percent higher," according to the 2009 data, he said. "We've had over a hundred cases of syphilis over the last two years compared to three cases in 2003 and three cases in 2004.

"It's gone from rare to an outbreak. We have seen an increase statewide until 2009-2010, then a decrease."

Certain populations might be more at risk, officials said. But the bottom line is the need to determine why the numbers are increasing and what to do about it.

Holly Watkins, director, policy communications with the Communicable Disease Branch, said Roosen's concern was correctly placed.

"In 2003-04, you were almost at zero level," she said of the county's ranking. "It did increase through 2008-2009 to be the real spike. But statewide for 2010, we have seen an increase in syphilis cases. It looks like the numbers were primary or secondary syphilis. ... I think the message that's really important to get out there is, if you're sexually active you need to be vigilant. It's important to get tested for STDs."

One of the biggest misperceptions out there is that physicians automatically check for STDs during regular office visits.

"A lot of people don't realize that a private doctor's office, just because they're getting their blood drawn, doesn't mean that they're getting an HIV or syphilis test," said Leigh Cutler, public health regional supervisor with DHHS Division of Public Health. "They can't assume it's getting done."

The local Health Depart-ment has made strides toward publicizing the need for testing and treatment, both through the media and expanding efforts beyond the free and confidential testing in the STD clinic. In recent years, it has also participated in the statewide program, "Get Real, Get Tested," canvassing at-risk neighborhoods and offering free testing.

"We're just trying to control disease in Wayne County," Roosen said. "One of the big deals with syphilis, it's only affecting 50 to 60 people over the last year. The rate is extremely low but when you compare us with other counties, the rate is very high.

"If you look at all the STDs, it was well over 1,000 people that had some form of an STD so that's one out of about 115 people that were affected last year with some form of STD. Hopefully they were treated and are OK now."

The concern, though, centers around those not getting tested or who are unaware they are at risk.

Education is key, Ms. Cutler said -- not only about the diseases, but where to obtain care.

"All the effort that has been put out there, whether it was the billboards or previous things in the paper, just the word of mouth, (health) providers here educating people," she said. "Sometimes we assume people know that the Health Department is here and what they do, just let people know what the services are here, offered at a very minimal cost."

Ms. Watkins noted that there are a variety of ways to get the message out, recognizing that there are still many who have never even heard of some of the STDs.

"This is the type of testing that should be routinized (during regular doctor visits)," she said. "It should be a normal part of the routine."

"Isn't it interesting, years ago, when you went in for your marriage license, you had to be tested for syphilis?" said Carolyn King, health education supervisor with the Health Department.

That is no longer required, but would be a better alternative than what is currently out there, Roosen said.

"Testing now is voluntary unless you go through our prenatal clinic or are in prison or jail," he said. "And if they do find an HIV case in jail, it can get very expensive for taxpayers."

It's also important to remember that HIV and STDs are "transmissable diseases," ones often passed along unknowingly, Ms. Watkins said. That makes it extremely important for those at risk, such as pregnant women, to get tested to prevent passing it along to an unborn child.

And then there is the stigma attached to going to the Health Department for testing, Mrs. Padgett said.

"They need to realize people could be coming in here for meetings, flu shots, different reasons," she said. "Everything's confidential."

"It would be nice if we could have more community-based organizations help with this," said Josa Raynor-Vaughn, communicable disease program manager.

Some have already joined the effort, Roosen said, including Wayne Memorial Hospital and the WATCH mobile van that canvasses the county.

"WATCH is testing through their mobile clinic, I think they're testing about 30 to 40 people every month," Roosen said.

While the epidemic aspect of the disease remains, it seems that the "outbreak" aspect has decreased, he pointed out.

"That means they may be treating it, taking better precautions," he said. "There's just better numbers out there so people understand better how to protect themselves."

"One of the messages that I really want to get out -- the ERs, the jail, young people, old people, it's really easy to sit back and say, 'That's not me' and not worry about it," Ms. Watkins said. "If you're sexually active, it's really important to come in and get tested. It's free, it's confidential, it's really important to come in and check your status."

The STD clinic at the Health Department is open Monday through Thursday, 7:30 a.m. until noon and 1-6 p.m. by appointment only, but walk-ins are seen, schedule permitting. For an appointment, call 731-1005.