Syphilis cases reach 30-year high in King County

Syphilis, once the scourge of 19th-century bohemian life, is back big-time in King County — especially among men who have sex with men.

Symptoms may not be recognized by some doctors, public-health officials said, because the disease was essentially wiped out locally nearly 20 years ago and some doctors have never seen a case of it.

But rates have been increasing for several years now, both nationally and in Washington state.

In King County, 283 cases were reported in 2010 — an 82 percent increase over the previous year and a 30-year high.

Medical providers must step up testing of gay and bisexual patients, said Dr. Matthew Golden, director of the HIV/STD program for Public Health — Seattle & King County.

And "men who have sex with men need to ask their medical providers to test for syphilis," he said.

Syphilis, a bacterial infection curable with antibiotics, causes a wide range of symptoms that can be mistaken for other maladies.

Among them are ulcers on the genitals, anus or mouth. The ulcers most often are painless and can go unnoticed.

The second stage of the disease is a body rash that can include the palms of the hands and soles of the feet.

Then the disease goes "underground."

Those carrying it are potentially infectious for the first year or longer, and at risk for severe medical consequences, including loss of vision and hearing and stroke.

Many men are unaware that syphilis can be spread through oral sex, Golden said.

Health-department officials urge routine and complete STD testing for all men who have sex with men.

Some public-health officials believe that advances in treating AIDS, which in most cases have changed the disease from a death sentence to more of a chronic disease, may have lulled some people into unsafe sexual practices.

In particular, many HIV-positive men may choose to have sex with other HIV-positive men and not use condoms, Golden said.

"While this may decrease HIV transmission, it may promote the transmission of syphilis. I think that's a big part of what we're seeing," Golden said.

In King County, 90 percent of the cases were among men who have sex with men, and more than half of those cases were among HIV-positive gay and bisexual men, public-health officials said.

STD testing is available from primary-care providers, the Gay City Wellness Center, the King County STD Clinic and other public-health clinics.

Carol M. Ostrom: 206-464-2249 or costrom@seattletimes.com