Erie County health officials are raising concerns about what they’re calling a syphilis outbreak in Buffalo. In only the first seven months of 2006, the number of confirmed cases of syphilis—22—has nearly doubled the 13 cases discovered in all of 2005. “We’re expecting to at least be in the mid 30s by the end of the year,” says Michael Chase, a public health educator with the Erie County Department of Health. What makes the outbreak truly remarkable is that 21 of the 22 cases have ocurred in the gay community.

There are several factors that have contributed to this outbreak, the most prominent of which is the rise in popularity of the club drug crystal meth. “The syphilis spike has come in the last six months or so,” says Bryan James Whitley, program coordinator at the Pride Center of Western New York, “just as meth use has become quite prevalent in the Western New York gay community.” Crystal meth heightens sexual arousal and dramatically lowers inhibitions, and is often linked with unprotected sex in multiple partner situations. Crystal meth isn’t the sole cause of the syphilis outbreak, though.

Syphilis can be very difficult to detect. In fact, it’s often called “the great imitator,” because so many of its signs and symptoms are similar to those of other diseases. Primary syphilis generally manifests itself as painless chancres. According to Chase, this can be a problem in some cases. “People who receive it in the anus or the mouth often don’t see it, and it’s painless so they don’t even know it’s there. The philosophy of most men is to wait and see what happens, and if it goes away, then it must be nothing.” And indeed if one waits a week or two, the chancres disappear.

A month or so later, the secondary stage sets in, which is usually marked by a rash on the palms of the hands or the bottom of the feet. This is a tricky symptom, too, and it’s often misdiagnosed by both doctors and dermatologists. One case that Chase received this year was a man being treated for ringworm because of the rash on the bottom of his feet. Like the primary stage, the secondary stage only lasts a week or two before disappearing completely.

If it isn’t treated in the secondary stage, the consequences can be dire. The tertiary, or late, stage of syphilis attacks your brain or internal organs, and in Chase’s words, “You’re done.” It commonly results in paralysis, numbness, gradual blindness and dementia. In other cases, it causes death. There’s no treatment for syphilis once it has reached the tertiary stage. “That’s why we need to get people screened, tested and treated if they’re positive,” says Chase.

Chase also attributes several other factors to the recent rise in syphilis cases across Western New York. “It’s obvious that people are having unprotected sex again,” he says. “The message has been out there since the AIDS crisis in the ’80s, and people are now becoming complacent about it.” He says that the older generation may be getting tired of the same old safe sex message, and the younger generation wasn’t around to recall the devastation during the AIDS crisis, “when people were dying and every weekend you were going to a funeral.”

The Internet is another problem. “The Internet introduced anonymous sex. So they may think, ‘It’s going to be anonymous, we don’t have to talk about STDs, we just hook up and that’s the end of it.’”

Bathhouses are an age-old problem, he says. Toronto, only an hour and a half away, has several such city licensed and regulated bathhouses, and mostly gay men and women can go there to meet people and have anonymous sex.

“People think it’s just about syphilis, but it really isn’t,” says Chase. “It’s about a whole risky way of life, kind of the tip of the iceberg. So, yes, let’s talk about syphilis, but then let’s talk about gonorrhea and chlamydia.”

Meanwhile, the Pride Center is already gearing up to combat the current syphilis outbreak. Working with Erie County health officials, the Pride Center now provides free STD testing every Thursday evening from 4 to 8pm, along with its existing HIV testing service. On that night, Erie County sends one of its staff to test for STDs, particularly syphilis. In its third week of testing, the Pride Center is already noticing a positive trend. “Within the first week, over 50 percent of the people who came in wanted STD testing, not just HIV testing,” says Whitley.

Despite the small successes, there are still many hurdles, including the explosion of crystal meth usage in the region. “If you’re using crystal meth, you’ve got to get checked out for STDs,” Whitley says. He thinks the safe sex message has slipped from education curricula and mainstream press in recent years. “There’s a new generation that’s coming out without the message in their heads of being so careful. They’re going out to clubs, they’re going into bars, they’re trying out new experiences, they’re trying out drugs, and they don’t have the proper training and the message isn’t there in front of them.”

Some STD Testing Resources:

Erie County Department of Health,

858-7687

Pride Center of WNY, 852-7743

Project REACH, 845-0172

Planned Parenthood, 1-800-230-7526

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