Syphilis may not be the most talked-about sexually transmitted disease (STD), but it remains a prevalent health issue in San Antonio. Metropolitan Health District reported a decline in syphilis cases since 2013, but the number of syphilis cases in San Antonio are still three times higher than the rest of Texas, and more than seven times the national average.
“For the first time this year, we have actually seen the changing direction in STDs here in San Antonio,” said Dr. Anil T. Mangla, the assistant director of Metro Health’s Communicable Diseases Division, during a press conference on Tuesday. “The key is making sure that people are tested, they are identified, and then treated. The decrease is good news, but we still have a lot of work to do.”
Since 2012, Metro Health has collaborated with nonprofits and hospitals throughout Bexar County to reduce syphilis in adults and prevent the number of congenital cases. A disease without symptoms in the early stages, syphilis can damage essential organs like the heart, lungs and brain.
Congenital cases occur when pregnant women with syphilis transmit the disease to the baby in utero. If the baby is born before the cure is administered, they are more likely to be stillborn or to develop life-long health issues.
Staff members credited Metro Health Director Dr. Thomas Schlenker with making the identification, community education, and treatment of syphilis a priority in San Antonio.
“I moved here from Wisconsin, where congenital syphilis is a rare disease. We might have had one in the entire state the year that I moved there, so when I saw an average of 10 here every year in San Antonio, I was just shocked,” Schlenker said.
“Over the past three years, probably the biggest thing has been getting the local medical community to be aware that there was this terrible epidemic going on, they just didn’t know,” Schlenker added. “The goal has to be zero; there’s just no reason in the United States today that this is happening – we have to work until we get to zero.”
Metro Health found the biggest numbers of untreated STDs and congenital cases in lower-income areas of San Antonio and jails, where residents are less likely to have insurance or doctors.
Health officials noted that the number of primary and secondary syphilis cases in Bexar County dropped by 24% from 2013 to 2014, and the number of congenital cases in Bexar dropped by 70% between 2013 to 2014. Click here to download Tuesday’s statistical presentation on STDs in Bexar County.
The local health community hopes to completely eradicate syphilis cases through initiatives and recent legislation like SB 1128, which requires every Texas doctor to test pregnant women three times throughout their pregnancy, so any required treatment can be administered at least 30 days before their delivery date. The law also applies to women in jail who are often unable to get screening services during incarceration. Texas Gov. Greg Abbott signed the bill last week, and the law is expected to take effect by Sept. 1.
“We know that women can be exposed to the disease in between trimesters,” said Dr. K. Ashok Kumar, the immediate past president of Bexar County Medical Society. “The screening is very important, and getting the community and physicians involved is needed to grow.
“We need to go to the people who are being affected by these diseases, regardless of your economic place in the community, every man and woman should be tested,” Kumar added.
Metro Health has already prevented 34 congenital cases through an aggressive case management system, which tracks and tests women throughout their pregnancy. Metro recently acquired a new mobile unit, which is slated to open in mid-to-late August, and will serve as an extension of their clinical operations
“We are definitely excited to get this, it’s going to make the outreach so much easier to facilitate and provide a private, confidential space,” said Gisel Prado, the senior management analyst for Metro Health. “We’ll also providing treatment for chlamydia and gonorrhea in the field, which is something we are not doing. That’s going to be really important to the community, because they are so common.”
Metro Health will offer free testing services for National HIV Day at the Walgreens at Medical Center on June 25-26 from 4-7 p.m. and June 27 from 11 a.m.-3 p.m.
For those individuals interested in finding upcoming events or scheduling testing services, call Metro Health Outreach at 210-207-8839.
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Bringing tests to people at-risk where they are, using a mobile van is a great method – combine it with treatment based on suspicion and it’s even more worthwhile. Congratulations to Metro Health – congenital syphilis is preventable. From someone who was part of a similar effort more than 25 years ago—
“Decline Shows Chester Repelled Syphilis Outbreak
By Terence Samuel, Inquirer Staff Writer
POSTED: July 19, 1990
Health officials say the syphilis epidemic that tore through Chester last year, though not conquered, has been severely checked. They expect the number of new cases reported in the city to be far fewer this year.
In the first six months this year, the number declined 71 percent compared with the same period last year, from 269 syphilis cases to 77, according to the state Department of Health.
“The numbers are down considerably,” said Rob Hagarty, a public health adviser at the state health center in Chester.
In 1989, Chester residents accounted for 435 of the 502 new cases of syphilis in Delaware County. In 1988, the county totaled 61 cases. The outbreak so alarmed health officials that the state lauched a special effort to confine it. Clinic hours were expanded, more staff was hired, and a special outreach and education program that included a mobile testing unit was created.
And in April 1989, the state spent more than $10,057 on staff and equipment for a special two-week clinic in Chester.
It seems to have worked, they said.
Hagarty said he thought the increase in staff – from one full-time to three – and the heightened public awareness about the disease has arrested the spread of syphilis in Chester.
But more than that, he said, what helped were an additional five health centers in Chester where people can get tested for syphilis.
“There is increased access to clinical care, so it’s easier to get treatment,” Hagarty said.
Ed Powers, director of the state’s Sexually Transmitted Diseases Program, said the anti-syphilis effort in Chester last year was being studied as a model response for communities faced with severe outbreaks of syphilis among
drug users.
State epidemiolgists last year blamed the Chester epidemic on the high rate of drug abuse in the city. That, along with prostitution and the extensive practice among drug-abusers of trading sex for drugs, caused the rapid rate of infection, they said.
Despite the recent success with the infection rate, drug abuse poses a constant threat, Powers said.
“The concern is still there that in a drug-using community, . . . an increase could happen again,” he said. “So we’re going to stay in there.”
Perhaps there should be more access to clinics, and more clinics overall in Texas.