Syphilis, gonorrhea on the rise in Oregon

Highly contagious sexually transmitted diseases, syphilis and gonorrhea, reached alarming levels in Oregon last year, and men who have sex with other men are particularly at risk.

Early syphilis cases hit the highest numbers since 1989, according to a data summary from Oregon Health Authority. In addition, gonorrhea cases jumped 18 percent from 2012 to 2013.

"We haven't seen numbers like this since the late '80s, early 1990s," said Dr. Sean Schafer, a medical epidemiologist with OHA. "These are definitely alarming."

Oregon's syphilis rate, at 10 per 100,000 people, is almost twice that of the national numbers, 5.3 cases per 100,000.

And this year is looking like another bad year, Schafer said.

Two babies in 2014 so far have been born with congenital syphilis, meaning their mothers passed it on during pregnancy, and one of the babies died, Schafer said.

The total number of early syphilis hit 404 in 2013, from 312 in 2012.

Early syphilis infections -- typically less than a year old -- are the most contagious.

There are two stages of early syphilis: primary and secondary. In the primary stage, two or three weeks after exposure through sexual contact, the infected person could get a sore. This could go unnoticed if it's not associated with sex or if it's in an invisible area of the body, such as the throat or vagina, Schafer said.

Then the secondary stage is a rash that could develop anywhere on the body, which again, could be a missed symptom.

About six weeks later, the rash goes away then the person develops latent syphilis. That means the syphilis bacterium is still in the body but it's no longer infectious, Schafer said.

Those who are at high risk are gay men, Schafer said. Ninety-six percent of the cases reported in 2013 were men, and 77 percent of them reported having sex with other men.

More than half of all cases also were infected with HIV.

Some gay men who have HIV will choose sexual partners with the same HIV status to avoid using a condom, Schafer said. In doing so, they could unknowingly transmit syphilis or gonorrhea.

Additionally, gay men could be experiencing condom fatigue or complacency, Schafer said. This could be especially true in men who have well-controlled HIV; with the improved treatments, transmission risk also has gone down.

"The point that if you have HIV and you think you don't need to use condoms because your partner has HIV is a mistake," Schafer said.

Gay men and women younger than 24 should be tested for syphilis and gonorrhea every year, Schafer said.

Early syphilis cases have been rising since 2007, when the the number of cases was 26.

Out of the 1,741 gonorrhea cases in 2013, 77 percent were males.

Gonorrhea often shows no symptoms, though men are more likely to experience signs that include painful urination or discharge from the penis. Women could see vaginal discharge or heavy or irregular periods.

Gonorrhea also could lead to pelvic inflammatory disease or loss of fertility. And syphilis, if untreated, could lead to heart and neurological disease.

Gay men are at higher risk for gonorrhea, Schafer said, but heterosexual men and women are also at risk, especially if they use methamphetamine.

Both syphilis and gonorrhea are treatable. Syphilis is treated with shots of penicillin and gonorrhea is treated with antibiotics.

Measles, which is considered no longer in transmission in the U.S. due to high immunization rates, also is on the rise.

In 2013, six cases were reported in Oregon, a 14-year high. The state already is on track to beat that figure this year, with five cases reported so far.

RELATED: CDC: Measles cases in USA hit 20-year high

Even though more than 90 percent of Americans are protected against measles, it tends to find the 10 percent who aren't vaccinated, said Dr. Paul Cieslak, medical director of the Oregon Immunization Program.

Nonmedical exemptions for school vaccines have been rising for the last 15 years, Cieslak said, and at 6.4 percent, Oregon has the highest exemption rate in the country.

A new state statute that's been in effect since March requires parents to have a conversation with a doctor or watch a video about vaccines before opting out of school shots. That could improve vaccination rates among children whose parents are seeking answers to some questions before getting their children vaccinated, Cieslak said.

"I am hopeful that it will reassure some percentage of those parents," he said. "For parents who really don't want the vaccine, they still have that prerogative."

In much of the cases reported in Oregon, unvaccinated people caught measles overseas, in countries where protection is not as high. All five of the cases reported in Oregon so far have been in unvaccinated children, Cieslak said.

Last year, two clusters were reported in Marion County, both initiated by an unvaccinated person who traveled overseas.

"The diseases are still out there," Cieslak said. "If we let the vaccination rates fall further, we're going to see a heck of a lot more of it than we are now."

syoo@StatesmanJournal.com, (503) 399-6673 or follow at Twitter.com/syoo.