Syphilis in Houston/Harris County, March 2004 Update1

In March, there were a total of 27 early syphilis cases reported (P&S and EL). There were 19 (70%) males and 8 (30%) females.

Ten (37%) of total early syphilis cases were reported among men who have sex with men (MSM).

Table 1. Early Syphilis by Stage: March 2004 January-March 2004 Syphilis Stage MSM City % (MSM/City) MSM City % (MSM/City) Primary 1 3 33% 6 11 55% Secondary 8 12 67% 27 42 64% Early Latent 1 12 8% 11 31 35% Total 10 27 37% 44 84 52%

Houston/Harris County Early Syphilis Cases, March 2004:

Table 2. Ethnic/Racial Distribution: Time Hispanic Black White Asian/Pac Isl Unk Total March 2004 6 (22%) 12 (44%) 8 (30%) 0 1 (4%) 27 Jan-Mar 2004 21 (25%) 29 (35%) 32 (38%) 1 (1%) 1 (1%) 84

Table 3. Age Distribution: Time 0-19 20-29 30-39 40-49 50+ Total March 2004 4 (15%) 9 (33%) 8 (30%) 6 (22%) 0 27 Jan-Mar 2004 6 (7%) 25 (30%) 22 (26%) 25 (30%) 6 (7%) 84

Table 4. HIV Status Among Interviewed Clients: Current HIV Status Time # Cases # Interviewed2 Positive Negative3 Unknown4 Not Tested March 2004 27 26 (96%) 7 (27%) 11 (42%) 2 (8%) 6 (23%) Jan-Mar 2004 84 82 (98%) 24 (29%) 35 (43%) 2 (2%) 21 (26%)

MSM Early Syphilis Cases, March 2004:

Table 5. MSM Ethnic/Racial Distribution: Time Hispanic Black White Total March 2004 5 (50%) 1 (10%) 4 (40%) 10 Jan-Mar 2004 14 (32%) 5 (11%) 25 (57%) 44

Table 6. MSM Age Distribution: Time 0-19 20-29 30-39 40-49 50+ Total March 2004 1 (10%) 3 (30%) 4 (40%) 2 (20%) 0 10 Jan-Mar 2004 3 (7%) 11 (25%) 10 (23%) 16 (36%) 4 (9%) 44

Table 7. MSM HIV Status Among Interviewed Clients: Current HIV Status Time # Cases # Interviewed2 Positive Negative3 Unknown4 Not Tested March 2004 10 10 (100%) 5 (50%) 3 (30%) 0 2 (20%) Jan-Mar 2004 44 44 (100%) 22 (50%) 14 (32%) 0 8 (18%)

11 Data as of May 3, 2004 from HDHHS STD*MIS 2 Cases not interviewed due to refusal, failure to locate, or other reasons 3 Based on current HIV status (result should be within 30 days from date of interview) 4 Indeterminate or unknown Page 1 of 5 JHung Table 8. Houston/Harris County Distribution of Syphilis Cases by Stage, 2004

Month P S P&S Syphilis EL < 1Yr Early syphilis Unknown Late Total Syphilis (infectious syphilis) (P&S and EL < 1 yr) Duration Latent % change % change Latent % change 710 720 2004 *2003 from 2003 730 2004 *2003 from 2003 740 745 2004 *2003 from 2003 January 7 15 22 17 29.4% 10 32 30 6.7% 28 25 85 79 7.6% February 1 15 16 22 -27.3% 9 25 30 -16.7% 35 18 78 87 -10.3% March 3 12 15 18 -16.7% 12 27 29 -6.9% 32 27 86 86 0.0% April May June July August September October November December Total 11 42 53 57 -7.0% 31 84 89 -5.6% 95 70 249 252 -1.2% *Compared to same time in 2003

Page 2 of 5 JHung Table 9. MSM Distribution of Syphilis Cases by Stage, 2004

Month P S P&S Syphilis EL < 1Yr Early syphilis Unknown Late Total Syphilis (infectious syphilis) (P&S and EL < 1 yr) Duration Latent % change % change Latent % change 710 720 2004 *2003 from 2003 730 2004 *2003 from 2003 740 745 2004 *2003 from 2003 January 5 9 14 14 0.0% 5 19 20 -5.0% 7 1 27 32 -15.6% February 0 10 10 17 -41.2% 5 15 20 -25.0% 11 3 29 37 -21.6% March 1 8 9 14 -35.7% 1 10 18 -44.4% 7 4 21 33 -36.4% April May June July August September October November December Total 6 27 33 45 -26.7% 11 44 58 -24.1% 25 8 77 102 -24.5% *Compared to same time in 2003

Page 3 of 5 JHung Figure 1 below illustrates the number of MSM early syphilis cases relative to defined monthly outbreak thresholds.

Fig 1. MSM Early Syphilis Cases by Stage

Primary Secondary Early Latent

24 22 20 18

s 16 e s

a 14 C

f 12 o

. 10 P&S and EL Outbreak o Thresholds 7 Cases N 8 6 4 P&S Outbreak 2 Thresholds 5 Cases 0 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar 03 03 03 03 03 03 03 03 03 03 03 03 04 04 04 Mon/Year

Page 4 of 5 JHung Figure 2 below illustrates the MSM and non-MSM P&S syphilis cases as a percentage of all P&S syphilis cases.

Figure 2. P&S Syphilis: MSM and Non-MSM

MSM P&S Non-MSM P&S

100%

80% t

n 60% e c r e P 40%

20%

0% Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar 03 03 03 03 03 03 03 03 03 03 03 03 04 04 04

Mon/Year

Page 5 of 5 JHung