Sexually Transmitted Disease Surveillance 1995

Division of STD Prevention

September 1996

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 
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,
1995. U.S. Department of Health and Human Services, Public Health Service.
Atlanta: Centers for Disease Control and Prevention, September 1996.

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

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                                Syphilis

Although the U.S. syphilis rate declined in 1995 to its lowest level in
many years, this disease remains an important problem in certain
geographical areas, particularly among African-Americans. Syphilis, a
genital ulcerative disease, facilitates the transmission of HIV infection,
and may be particularly important in contributing to HIV transmission in
those parts of the country, such as the South, where rates of both
infections are high. Untreated early syphilis during pregnancy results in
perinatal death in up to 40% of cases, and, if acquired in the previous
four years, may lead to infection of the fetus in over 70% of cases. For
syphilis, as for other STDs, differential reporting of cases from public
and private sectors may magnify the differences in reported rates by
race/ethnicity.

--  In 1995, 16,500 cases of primary and secondary (P&S) syphilis were
    reported to CDC. This is the fewest cases reported since 1960. Between
    1994 and 1995, the incidence of P&S syphilis in the United States
    declined from 7.9 to 6.3 cases per 100,000 population (Figure_18
    and Table_1).

--  In 1995, P&S syphilis rates were below the revised Healthy People 2000
    (HP2000) national objective of 4 cases per 100,000 population in 33
    states (Figure_19 and Table_22). Twelve states reported no or
    fewer than 5 cases of P&S syphilis in 1995.

--  In 1995, 2,144 (69%) of 3,116 counties in the United States reported no
    cases of P&S syphilis compared with 2,105 (68%) counties in 1994. Of
    972 counties reporting at least one case of P&S syphilis in 1995, 384
    (40%) counties reported rates of 4 cases or less per 100,000 population
    (Figure_20). Therefore, the rates of P&S syphilis were above the
    revised HP2000 objective (4.0 per 100,000) for 588 counties in 1995.
    These counties (19% of the total counties in the United States)
    accounted for 89% of all reported P&S syphilis cases.

--  In 1995, the rates of P&S syphilis continued to decline for all regions
    of the United States. However, the rates of 12.1 and 5.6 cases per
    100,000 population in the South and Midwest, respectively, were above
    the revised HP2000 objective (Figure_21 and Table_23).

--  The overall rate of P&S syphilis in large cities (>200,000 population)
    declined from 12.6 cases per 100,000 population in 1994 to 10.0 in 1995
    (Figure_22 and Table_27). However, rates exceeded the revised
    HP2000 objective in 38 (59%) of 64 large cities in the United States
    and outlying areas for which data were available (Table_26).

--  During the period 1992-1995, the rates of P&S syphilis have generally
    declined regardless of racial and ethnic group (Figure_24 and
    Table_21B). However, the 1995 rate for non-Hispanic blacks of 46.2
    cases per 100,000 population was nearly 60 times greater than the rate
    for non-Hispanic whites (Figure_24 and Table_21B).

--  Between 1994 and 1995, the overall rate of congenital syphilis
    decreased from 55.6 to 39.0 cases per 100,000 live births
    (Figure_27, Table_34). However, compared with 1994, increases
    were observed in 1995 for six (California, Florida, Georgia, Maryland,
    Mississippi, Oklahoma) of the 25 states reporting more than five cases
    (Table_35).

--  In 1995, 12 states (Arkansas, California, Florida, Georgia, Illinois,
    Louisiana, Mississippi, Missouri, New Jersey, New York, Pennsylvania,
    South Carolina) had congenital syphilis rates that exceeded the revised
    HP2000 objective of 40 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, 1941-1995
Figure_18.  Primary and secondary syphilis -- Reported rates: United
                States, 1970-1995 and the Healthy People year 2000
                objective
Figure_19.  Primary and secondary syphilis -- Rates by state: United
                States, 1995
Figure_20.  Primary and secondary syphilis -- Counties with rates above
                and counties with rates below the Healthy People year 2000
                objective: United States, 1995
Figure_21.  Primary and secondary syphilis -- Rates by region: United
                States, 1981-1995 and the Healthy People year 2000
                objective
Figure_22.  Primary and secondary syphilis -- Rates in U.S. cities of
                >200,000 population, 1981-1995 and the Healthy People year
                2000 objective
Figure_23.  Primary and secondary syphilis -- Rates by gender: United
                States, 1981-1995 and the Healthy People year 2000
                objective
Figure_24.  Primary and secondary syphilis -- Rates by race and
                ethnicity: United States, 1981-1995 and the Healthy People
                year 2000 objective 
Figure_25.  Primary and secondary syphilis -- Age- and gender-specific
                rates: United States, 1995
Figure_26.  Congenital syphilis -- Reported cases in infants <1 year of
                age and rates of primary and secondary syphilis among
                women: United States, 1970-1995
Figure_27.  Congenital syphilis -- Rates in infants <1 year of age:
                United States, 1981-1995 and the Healthy People year 2000
                objective

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