Experts See Hope of Eradicating Syphilis in U.S.

New cases of syphilis in the United States fell during 1996 to their lowest rate in 40 years, a decline that health officials said could make it possible to eliminate the sexually transmitted disease from this country in the near future.

About 73% of U.S. counties reported no new cases of syphilis during 1996, according to provisional 1996 figures collected by the federal Centers for Disease Control and Prevention. Half of the 11,624 cases reported last year occurred in just 37 counties in the country. New cases were heavily concentrated in a few dozen cities and counties, primarily in the South.

“We are now sitting . . . with a historic opportunity to move to eliminate transmission of this disease within the United States,” said Judith N. Wasserheit, director of the Division of Sexually Transmitted Disease Prevention at the CDC.

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Syphilis has been curable with penicillin since 1947. The infection is caused by a bacterium, Treponema pallidum, that can damage tissue in many organs, producing a wide range of problems. The initial symptoms--a painless sore, followed by a rash--often go unnoticed and disappear without treatment, but the bacteria can persist in the body for many years. Untreated, the infection can invade all parts of the body, causing pain and eventually death.

Health officials said syphilis rates tend to fluctuate, often in apparent relation to changes in sexual behavior or drug use. The recent steep decline in cases followed a nationwide epidemic of the disease that began in the late 1980s and by 1990 had boosted the rate of new infections to 20.3 cases per 100,000 people. Last year’s rate was 4.4 cases per 100,000, close to the historic low of 3.9 cases per 100,000 that occurred in 1956 and 1957.

The recent decline is partly because of the cyclical nature of the disease and partly because of more aggressive treatment efforts by state and local health officials after the 1980s epidemic, said Michael St. Louis of the CDC.