Sexually Transmitted Disease Surveillance 1993

Division of STD/HIV Prevention 

December 1994

U.S. Department of Health and Human Services 
Public Health Service 
Centers for Disease Control and Prevention 
National Center for Prevention Services 
Division of STD/HIV Prevention 
Surveillance and Information Systems Branch 
Atlanta, Georgia 30333

                         Copyright Information 

All material contained in this report is in the public domain and may be
used and reprinted without special permission; citation to source,
however, is appreciated.

                           Suggested Citation

Division of STD/HIV Prevention. Sexually Transmitted Disease
Surveillance, 1993.  U.S. Department of Health and Human Services, Public
Health Service.  Atlanta: Centers for Disease Control and Prevention,
December 1994.

Copies can be obtained from Information Services, National Center for
Prevention Services, Centers for Disease Control and Prevention, 1600
Clifton Road, Mailstop E-06, Atlanta, Georgia 30333.

                                 
                                 Syphilis

     --   Between 1992 and 1993, the incidence of primary and secondary
          (P&S) syphilis in the United States declined from 13.3 to 10.4
          cases per 100,000 population (Figure_18 and Table_1).

     --   In 1993, P&S syphilis rates were below the Healthy People 2000
          (HP 2000) national objective of 10 cases per 100,000 population
          in 36 states (Figure_19 and Table_22).

     --   In 1993, 2,006 (64%) of 3,116 counties in the United States
          reported no cases of P&S syphilis. Of 1,110 counties reporting at
          least one case of P&S syphilis, 649 (58%) counties reported rates
          of 10 cases or less per 100,000 population (Figure_20). The
          rates of P&S syphilis were above the HP 2000 objective in 461
          counties. These counties accounted for 81% of all reported P&S
          syphilis cases.

     --   In 1993, the rates of P&S syphilis declined in all regions of the
          U.S., indicating the epidemic of syphilis that began in the
          mid-1980's has subsided.  However, the rate of 18.8 cases per
          100,000 population in the South remained well above the HP 2000
          objective (Figure_21).

     --   The overall rate of P&S syphilis in large cities (>200,000
          population) declined from 24.5 cases per 100,000 population in
          1992 to 17.8 in 1993 (Figure_22 and Table_27).  However,
          rates exceeded the HP 2000 objective in 36 (56%) of 64 of the
          large cities in the United States and outlying areas for which
          data were available (Table_26).

     --   Since 1990, the rates of P&S syphilis have declined for all
          racial and ethnic groups (Figure_24 and Table_21B). 
          However, the 1993 rate for non-Hispanic blacks of 76.5 cases per
          100,000 population was more than 60 times greater than the rate
          for non-Hispanic whites (Figure_24 and Table_21B). 

     --   Between 1992 and 1993, the overall rate of congenital syphilis
          decreased from 94.7 to 79.0 cases per 100,000 live births
          (Figure_27, Table_34).  During this period, rates
          increased in nine states (Alabama, Louisiana, Michigan,
          Mississippi, Missouri, New Jersey, Ohio, South Carolina, and
          Tennessee) reporting more than 10 cases in 1993 (Table_35).

     --   In 1993, fourteen states (Florida, Georgia, Illinois, Louisiana,
          Michigan, Mississippi, Missouri, New Jersey, New York, North
          Carolina, Pennsylvania, South Carolina, Tennessee, and Texas) had
          rates that exceeded the HP 2000 objective of 50 cases per 100,000
          live births (Table_35).

     --   Additional information on syphilis and congenital syphilis can be
          found in the Special Focus Profiles section.


Figure_17. Syphilis - Reported cases by stage of illness: United
               States, 1941-1993    
Figure_18. Primary and secondary syphilis - Reported rates: United
               States, 1970-1993 and the year 2000 objective    
Figure_19. Primary and secondary syphilis - Rates by state: United
               States, 1993
Figure_20. Primary and secondary syphilis - Counties with rates above
               and counties with rates below the year 2000 objective:
               United States, 1993   
Figure_21. Primary and secondary syphilis - Rates by region: United
               States, 1981-1993 and the year 2000 objective   
Figure_22. Primary and secondary syphilis - Rates in U.S. cities of
               >200,000 population, 1981-1993 and the year 2000 objective
Figure_23. Primary and secondary syphilis - Rates by gender: United
               States, 1981-1993 and the year 2000 objective    
Figure_24. Primary and secondary syphilis - Rates by race and
               ethnicity: United States, 1981-1993 and the year 2000
               objective    
Figure_25. Primary and secondary syphilis - Age- and gender-specific
               rates: United States: 1993    
Figure_26. Congenital syphilis - Reported cases in infants <1 year of
               age and rates of primary and secondary syphilis among women:
               United States, 1970-1993    
Figure_27. Congenital syphilis - Rates in infants <1 year of age:
               United States, 1981-1993   

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