Prostitution Blamed : County Syphilis Cases Up 45% Over Last Year

The number of syphilis cases reported in Orange County during the first six months of 1986 is up 45% over the same period last year, and county and state health officials are blaming prostitution.

Health officials said the worst outbreak was early in the year and that the numbers had turned downward before the end of the six-month period, but they view the recurring problem as alarming. Among those endangered are pregnant women and infants.

“We have now pretty good evidence that after we have these peaks of symptoms, we end up having some births of infants with congenital syphilis,” said Dr. James R. Greenwood, the Orange County Health Care Agency’s director of public health.

Finding all those who suffer from the disease is difficult because officials frequently are dealing with “people who don’t get prenatal care, and obviously the husbands don’t tell their wives they get syphilis,” Greenwood said. “It’s a problem we’ve had off and on in Orange County.”

“We periodically have increases,” said Dr. L. Rex Ehling, the county’s public health officer. “Very frequently it will be seasonal, so the overall numbers don’t always come out higher at the end of the year.”

The increase in syphilis cases indicates that “we’re seeing them earlier, and that’s a good sign,” Ehling said. By detecting the disease early, treatment is easier, and fewer people are exposed, he said.

Although syphilis is easily treated with penicillin, undetected and untreated cases can result in long-term neurological damage and stillborn babies, officials said.

“People no longer die of primary and secondary syphilis, but it’s still a problem,” said Jim Dobbins of the sexually transmitted diseases unit of the state Department of Health Services.

Consequently, he said, health officials have stepped up efforts to persuade infected men to urge their wives, particularly if they are pregnant, to be tested and treated for syphilis.

For the first six months of 1986, Orange County reported 379 cases of syphilis contracted within the preceding 12 months. That represents a 45.2% increase over the 261 cases reported for the first six months of 1985, said Jim Hebert, research analyst with the state Department of Health Services.

Statewide Cases Increase

Statewide, cases reported during the same periods increased by 8.9%, from 4,109 in 1985 to 4,476 cases in 1986, according to state health statistics.

The number of syphilis cases in Los Angeles County increased from 1,641 in the first six months of 1985 to 1,820 this year, or 10.9%. San Diego County’s numbers rose from 142 cases to 167 cases, or 17.6%, for the first six months of this year.

“The outbreaks tend to occur in urban areas and also in some of the agricultural counties . . . ,” Hebert said. “It tends to be among the migrant farm workers. The migrant workers oftentimes don’t have stable sex partners, so they tend to resort to prostitutes.”

“The mainstream population is not greatly at risk,” Hebert said. “It tends to be isolated into populations . . . who have large number of sex partners.”

Orange County health officials have seen the pattern repeated about four times in recent years, Greenwood said.

Migrant Workers

“We seem to have these large groups of migrant workers, or Hispanic males,” he said, “that live 10 or 12 to an apartment, and apparently these door-to-door prostitutes will come into the apartments and have intercourse with six or seven people at one time.

“That earns them enough to pay for their heroin habit. If they are infected, you suddenly have seven or eight new cases. This has been the way it’s been transmitted in Orange County for a number of years.”

A great increase in reported cases, such as that which occurred early this year, may be “just the unfortunate infection of a prostitute or two,” Greenwood said. “They (prostitutes) have a number of contacts per day, so they have the potential of infecting a great number of people.”

Orange County health workers, working with state investigators, have stepped up efforts at local health clinics to find people suffering from the disease and determine their sex partners. Health officials at Orange County Jail seek the cooperation of infected prostitutes who are inmates in identifying sex partners.

“It’s tough in the sense you’re dealing with prostitutes and heroin addicts, (who are engaged in) illegal activities and many times with individuals in the county illegally,” Greenwood said. “But we’ve been reasonably successful. Our records have always been confidential. People come to us often times voluntarily.”