Syphilis infectious agent Treponema Pallidum (Graphic: Wikimedia)

LANSING — The Ingham County Health Department is raising concern over what it is terming an “alarming” increase in new syphilis cases reported since Jan. 1.

“We are alarmed,” said Renee Canady, deputy health officer of the Ingham County Health Department. But officials at the department, including Canady, stopped short of calling this uptick an “outbreak.”

Syphilis is a bacterial infection that causes three stages of disease. In the first stage, an infected person will develop a chancre, or ulcer, where the bacteria have entered the skin. The chancre is sometimes painful and sometimes not. It will eventually go away without treatment. The second stage includes a rash on the hands and feet, and this too will clear up without treatment. The final stage, which can occur years later, includes the bacteria attacking internal organs, including the heart, liver, kidneys and brain.

A simple blood test can determine if a person is infected with the bacteria. The bacteria can be treated with antibiotics.

In Ingham County, three cases of syphilis were identified in all of 2008. The county has confirmed three cases in the first six weeks of this year. Health officials are currently indicating that the reported cases are in HIV-positive men who have sex with men, but they worry that this could spread beyond that subpopulation. As a result, the health department is encouraging anyone who is sexually active to get tested for the disease.

Genesee County, where Flint is located, saw a massive outbreak of the disease in its heterosexual population last year. The outbreak topped off at 109 cases, including five cases in newborn children.

In Kent County, home to Grand Rapids, health officials are not “alarmed,” but they are concerned about a cluster of cases they have discovered. The county has identified four confirmed cases of syphilis in men who have sex with men HIV-positive populations since Jan. 1. Last year the county reported eight such cases.

“This cluster is related to three other cases in southwest Michigan,” said Bridie Kent, public information officer for the Kent County Health Department.

Health officials in both Kent and Ingham counties warned that anyone who is sexually active is potentially at risk for the infection, and they note that visible indications of infection may not always be present. For instance, an infected person could have a chancre in the throat, which may not be visible, but could spread the disease. Officials warned that while condoms do reduce the risk of syphilis transmission, if the chancre is not covered by the condom, transmission of the bacteria is still possible from what they call “skin-to-skin” contact.

Also of concern is the fact the cases are appearing in HIV-positive individuals.

“Genital sores (chancres) caused by syphilis make it easier to transmit and acquire HIV infection sexually. There is an estimated twofold to fivefold increased risk of acquiring HIV if exposed to that infection when syphilis is present,” Kent said.

Both counties have begun significant outreach to affected communities. Ingham County has contacted local health care providers.

“We have focused our most recent education efforts in the direction of areas likely to be frequented by the MSM (men who have sex with men) population because of the current trend, but again, sexually active individuals that are either unaware of a partner’s behavior or unsure of a partner’s infection status are vulnerable to infection,” Kent said. “Part of the Kent County Health Department’s ongoing outreach is to encourage anyone who may be at risk to get tested and ’show you know.’ It’s the gateway to treatment, prevention and support.”

Both Kent and Ingham counties offer free or low-cost screenings for sexually transmitted infections.