Though the number of syphilis and congenital syphilis cases in Bexar County has sharply declined in recent years, studies show a citywide increase in other sexually-transmitted diseases such as chlamydia and gonorrhea, said Metropolitan Health District officials Wednesday.
Pregnant women with syphilis who do not seek or are unable to afford medical attention can transmit the disease to the baby in utero. Though the disease is curable, if the baby is born before the treatment is administered they are more likely to be stillborn or to develop life-long health issues. Just four years ago, the number of syphilis and congenital syphilis cases in San Antonio was described as an “epidemic.”
“One case of congenital syphilis is one case too many, it’s a completely preventable disease,” said Dr. Vincent Nathan, Metro Health Interim Director. He credited local health officials and politicians for the drafting and passage of Senate Bill 1128, which requires pregnant women be tested for syphilis at their first prenatal visit and during the third trimester.
The legislation, combined with community outreach and education has “reduced the number of congenital syphilis cases in San Antonio by more than 60% in the past year,” Nathan said.
According to the Texas Department of State Health Services, syphilis screenings allowed Texas clinicians to identify 79 cases of congenital syphilis in 2012, allowing them to effectively treat individuals. The screenings also helped catch, treat and prevent cases of congenital Hepatitis B.
Though the number of congenital cases has decreased dramatically, “we want to get the number of congenital syphilis cases down to zero,” said Dr. Anil T. Mangla, the assistant director of Metro Health’s Communicable Diseases Division.
Chlamydia and Gonorrhea
The number of STDs in San Antonio showed a steady decrease for several years, and officials are unsure why rates for gonorrhea and chlamydia began to climb in 2014 .
Between 2014 and 2015, the number of chlamydia cases in Bexar County increased from 11,127 to 13,313. The number of gonorrhea cases rose from 3,127 to 3,937 in that same time frame.
Women are twice as likely to contract chlamydia than men, while African-American non-Hispanic men were 1.5 times as likely to get chlamydia than white individuals. Mangla said that 57% of those affected by chlamydia were in the 20-29 age group.
Gonorrhea, he said, has affected African American men more than any other group in Bexar County. Gonorrhea was highest amongst age groups 20-29 and 15-19.
“You can see how the high school education about STDs is very disappointing,” Mangla said. “You can also see why our (STD) rates in San Antonio are still much higher than the rest of the state and national rates, we’ve really got to work together to solve this.”
Metro Health officials have collaborated with the Center for Disease Control, Bexar County and various nonprofits to reduce stigma about STDs and facilitate open discussions between patients and their doctors. They have worked to create a dialogue through their social marketing campaigns, which tell individuals: “Don’t get tagged with syphilis,” or “Share the moment, not syphilis.” Health officials are also working to improve community awareness about effective medicine.
Metro Health will continue outreach through events citywide, while its new mobile unit van will act as an extension of the clinic and benefit hard-to-reach communities. The van will provide testing and treatment as well, for individuals diagnosed with STDs.
“It’s easy to say ‘have safe sex,’ but many of these women who have been identified with congenital cases are drug abusers, many are prostitutes, and they’re doing this to try to make a living to take care of their kids,” Mangla said. But Metro Health officials are optimistic that they can help connect individuals with quality healthcare.
In 2015, there were 10 cases of congenital syphilis in Bexar County, but only two of those women received any prenatal care. The numbers are decreasing, but Metro Health and its partners must collaborate to reach more individuals and families.
“(Syphilis) doesn’t just stop when the child is born,” Mangla said, adding that the disease often leads to lifelong physical, mental and developmental issues. “These are people in our community, and we want to make sure they are taken care of.”
Top Image: City and County health professionals were in attendance for the Metro Health report on STDS on Wednesday. Photo by Lea Thompson.