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Syphilis cases rising in Detroit, driven by young men in their 20s

Facing an alarming surge in syphilis cases, Detroit and state health authorities are launching a campaign alerting the public about the sexually transmitted disease that they say is making a comeback among a much younger crowd than in previous years.

One of the things we’re learning is that with adolescents and young adults — they’ve not seen it, not experienced it, and they’re not seeing the early signs and symptoms,” said Karen Krzanowski, manager of the sexually transmitted disease section of the Michigan Department of Community Health.



“Many times, these things are cyclical,” said Loretta Davis, president and CEO of the Detroit Institute for Population Health,. “There’s … prevention fatigue.”

On average, about 100 cases of primary- and secondary-stage syphilis are reported for Detroit each year, with the number of cases increasing. Last year, the city logged 123 cases. By May 31, 82 cases had been reported, Davis said.

Though the numbers seem small, it’s important to raise awareness, she said.

We’d rather overreact than under-react,” she said.

Syphilis is caused by a bacterium transmitted by direct contact with syphilis sores mainly found on the external genitals, anus or in the rectum. The sores can also be found inside the mouth, according to the U.S. Centers for Disease Control and Prevention’s (CDC) website on syphilis.

In early stages, the sores are firm, round and painless. In later stages, syphilis causes a rash, especially on the palms of hands and soles of feet. In its earliest stages, syphilis is treatable with antibiotics.

Untreated, late-stage syphilis symptoms can appear 10-30 years after infection and include paralysis, numbness, blindness, dementia and even death, according to the CDC.

Pregnant women with the disease can pass it to the fetuses they are carrying.

Health officials are working on a radio- and billboard-based public awareness campaign. They are also working with community groups to raise awareness about testing and treatment.

Health officials rolled out a similar campaign in 2008 after detecting a syphilis outbreak in Genesee County. Prior to that, the campaign was deployed in 2001-02 when Detroit experienced a similar uptick in cases.

In the Detroit outbreak, cases were reported among heterosexual men and women in their 30s and were reported from a handful of zip codes, Krzanowski said.

But this time around, the cases have been reported among black men in their 20s having sex with other men. Moreover, the cases have been reported throughout the city.

Epidemiologist Liz Shane said interviews have not narrowed the syphilis to a single person. In fact, about one-fourth of those who were infected said they met their sexual partners online — something that’s not surprising, given the age of those who are infected, she said.

Genital sores caused by syphilis increase the risk of HIV transmission by two to five times, according to the CDC. About half of the people infected with syphilis in Detroit this year were diagnosed with HIV as well, Shane said.

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