Health officials and workers are grappling with a resurgence of a sexually transmitted infection that was barely worth mentioning five years ago. Transmission of syphilis has spiked dramatically since 2014, rising from nine annual cases to a projected 48 by the end of 2017.
So far this year, 26 cases of syphilis have been confirmed throughout the state, with most in Yellowstone and Missoula counties, where 12 and four were found, respectively. The state Department of Public Health and Human Services says one to two new cases are reported each week. Jon Ebelt, public information officer for the department, says that roughly 35 percent of the cases involve men who have sex with men, but an increasing number are being reported among heterosexuals.
At Missoula's Open Aid Alliance, a nonprofit that provides STI testing, counseling and syringe exchange services, "care coach" Jessica Vanderzil says the spike could be caused by a number of different factors—possibly an outbreak that started among a centralized group and spread, or even just an increase in testing that has led to more positive results.
Syphilis is a treatable bacterial infection that can be cured with a simple course of antibiotics. If left untreated, the effects can be deadly. According to Vanderzil, the first stage of infection is marked by the appearance of a firm, painless sore called a "chancre" at the infection site. After several weeks, the second stage begins, causing a spotted rash, most commonly on the hands and feet. Like the chancre, the rash eventually clears up, leading to a symptom-free period that can last years.
The final stage of syphilis is the most dangerous. The infection begins to attack the body's organs, causing symptoms from blindness to organ failure. It can be lethal if left untreated, but is still curable during this tertiary stage.
Untreated syphilis is of particular concern to pregnant women, since it can be transmitted to infants. A DPHHS infographic indicates that as many as 40 percent of infants born to untreated, infected mothers can be stillborn, with the remainder risking blindness, brain damage and other significant complications.
Like HIV and hepatitis C, syphilis can be detected with a blood test. Results are obtainable in roughly ten minutes. However, the rapid syphilis test has a higher potential for false positives than rapid tests for other infections, according to Open Aid Alliance Director of Programs Stephanie Cole. That potential for error requires a second, confirmatory test involving a larger blood draw. If that test confirms syphilis, treatment usually begins with a simple course of penicillin or other antibiotics.
"The sooner you know you have one of these infections, the sooner you can get treated and cured," Cole says.