Sexually Transmitted Disease Surveillance 1994

Division of STD Prevention

September 1995

U.S. Department of Health and Human Services
Public Health Service
Centers for Disease Control and Prevention 
National Center for HIV, STD, and TB Prevention (proposed)
Division of STD Prevention
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 Prevention. Sexually Transmitted Disease Surveillance,
1994. U.S. Department of Health and Human Services, Public Health Service.
Atlanta: Centers for Disease Control and Prevention, September 1995.

Copies can be obtained from Information Technology and Services Office,
National Center for HIV, STD, and TB Prevention (proposed), Centers for
Disease Control and Prevention, 1600 Clifton Road, Mailstop E-06, Atlanta,
Georgia 30333 or by telephone at (404) 639-1819.

Both the 1993 and 1994 reports are now available electronically on CDC
WONDER. For information about registering for CDC WONDER, please contact
CDC's Information Resource Management Office at (404) 332-4569.

                                Syphilis

 --  In 1994, 20,627 cases of primary and secondary (P&S) syphilis were
     reported to CDC. This is the fewest cases reported since 1977. Between
     1993 and 1994, the incidence of primary and secondary syphilis in the
     United States declined from 10.4 to 8.1 cases per 100,000 population
     (Figure_18 and Table_1).

 --  In 1994, P&S syphilis rates were below the Healthy People 2000
     (HP2000) national objective of 10 cases per 100,000 population in 38
     states (Figure_19 and Table_22). Ten states reported no or
     fewer than 5 cases of P&S syphilis in 1994.

 --  In 1994, 2,105 (68%) of 3,116 counties in the United States reported
     no cases of P&S syphilis compared with 2,006 (64%) counties in 1993.
     Of 1,011 counties reporting at least one case of P&S syphilis in 1994,
     615 (61%) counties reported rates of 10 cases or less per 100,000
     population (Figure_20). The rates of P&S syphilis were above the
     HP2000 objective for 396 counties in 1994 compared with 461 counties
     in 1993. These counties (13% of the total counties in the United
     States) accounted for 77% of all reported P&S syphilis cases.

 --  In 1994, the rates of P&S syphilis continued to decline for all
     regions of the United States. However, the rate of 15.3 cases per
     100,000 population in the South remained above the HP2000 objective
     (Figure_21).

 --  The overall rate of P&S syphilis in large cities (>200,000 population)
     declined from 17.8 cases per 100,000 population in 1993 to 12.7 in
     1994 (Figure_22 and Table_27). However, rates exceeded the
     HP2000 objective in 30 (47%) of 64 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 1994
     rate for non-Hispanic blacks of 59.5 cases per 100,000 population was
     60 times greater than the rate for non-Hispanic whites (Figure_24
     and Table_21B).

 --  Between 1993 and 1994, the overall rate of congenital syphilis
     decreased from 80.7 to 55.6 cases per 100,000 live births
     (Figure_27, Table_34). However, compared with 1993, increases
     were seen in 1994 in eight of the 28 states reporting more than five
     cases (Arkansas, Indiana, Iowa, Kentucky, New Jersey, Oklahoma, South
     Carolina, and Tennessee) (Table_35).

 --  In 1994, 11 states (Arkansas, Illinois, Louisiana, Mississippi,
     Missouri, New Jersey, New York, Pennsylvania, South Carolina,
     Tennessee, and Texas) had congenital syphilis rates that exceeded the
     HP2000 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, 1941-1994    
Figure_18. Primary and secondary syphilis - Reported rates: United
               States, 1970-1994 and the year 2000 objective    
Figure_19. Primary and secondary syphilis - Rates by state: United
               States, 1994
Figure_20. Primary and secondary syphilis - Counties with rates above
               and counties with rates below the year 2000 objective:
               United States, 1994   
Figure_21. Primary and secondary syphilis - Rates by region: United
               States, 1981-1994 and the year 2000 objective   
Figure_22. Primary and secondary syphilis - Rates in U.S. cities of
               >200,000 population, 1981-1994 and the year 2000 objective
Figure_23. Primary and secondary syphilis - Rates by gender: United
               States, 1981-1994 and the year 2000 objective    
Figure_24. Primary and secondary syphilis - Rates by race and
               ethnicity: United States, 1981-1994 and the year 2000
               objective    
Figure_25. Primary and secondary syphilis - Age- and gender-specific
               rates: United States: 1994    
Figure_26. Congenital syphilis - Reported cases in infants <1 year of
               age and rates of primary and secondary syphilis among women:
               United States, 1970-1994    
Figure_27. Congenital syphilis - Rates in infants <1 year of age:
               United States, 1981-1994   

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