Syphilis Outbreak Grows in L.A.; Less Cause for Worry in O.C.

The number of syphilis cases reported in an outbreak among gay men in Los Angeles County has doubled to 51 in the past two weeks, adding urgency to public health officials’ efforts to contain the spread.

Twenty-eight of the 51 infected people also have the human immunodeficiency virus, which causes AIDS--worrisome because syphilis sores facilitate transmission of HIV, said Peter Kerndt, director of the county’s sexually transmitted diseases program.

Five cases were discovered in the county jail in Los Angeles this week, Kerndt said, and at least two of the infected men reported having many recent sexual partners. Public health officials offered testing and treatment to more than 300 inmates who identified themselves as homosexual.

The department focused on the incarcerated men because “jail is a reservoir for communicable disease, and if you do not have adequate resources there, the disease will amplify and return to the community,” Kerndt said.

Kerndt said that the syphilis outbreak is “very significant” when one considers that none of the 120 syphilis cases reported in all of 1999 in Los Angeles County were among gay men.

“We haven’t seen [much] syphilis reported among men who have sex with men in the last seven or eight years,” he said.

He and others say the outbreak--centered primarily in Silver Lake, Hollywood, West Hollywood and Long Beach--is a strong indication that “safer sex” practices are on the decline among many gays.

“With the cases doubling in the last two weeks, that’s pretty much proof positive there are hundreds of cases” in the county, said Michael Weinstein, president of the AIDS Healthcare Foundation. “Now the task is to keep it from becoming thousands of cases.”

Public health officials in other big cities say they have seen signs of the same pattern--although none report outbreaks as large as that in Los Angeles.

Orange County officials noticed an increase in syphilis cases last year but said the area is not experiencing anything close to the situation in Los Angeles. “This is not anything like what is happening in Los Angeles County, but we are looking at what is happening here to see if we are getting increased transmission,” said Penny Weismuller, division manager for disease control in the Orange County Health Care Agency.

King County in Washington state had an outbreak among 32 gay men (and 47 people total) in 1997-1998. San Francisco had an outbreak among seven gay men who met through an Internet chat room last summer, and earlier this year that city saw another spike of 12 cases. Philadelphia, as well, has reported increased infection rates among gay men. One federal health official said the pattern may be emerging in New York City too.

“It may be only a matter of time before syphilis becomes endemic in these communities,” said Dr. Jeffery D. Klauser, who has tracked the disease in San Francisco and Seattle. “That would mean the prospects for syphilis elimination would be over.”

The U.S. Centers for Disease Control and Prevention aim to eradicate syphilis, which reached its lowest levels ever in this country in 1998.

Although there is no proof yet of connections among the outbreaks, officials are looking for links.

“The gay population is extremely mobile,” said Jack Spencer of the CDC. “When you see [syphilis] in one city, you see it in others. That is a concern we have.”

Los Angeles County public health officials are preparing a plan of attack in response to the local outbreak. The plan is to be presented Tuesday to the Board of Supervisors.

Meanwhile, the county and AIDS Healthcare Foundation are urging people at risk to be tested for free this weekend at mobile centers in West Hollywood, Hollywood, Silver Lake and Griffith Park. For more information, call the hotline: (800) 758-0880.