McKinley County syphilis rate tops nation

By Natasha Kaye Johnson
Diné Bureau

GALLUP — Syphilis is on the rise again.

The sexually transmitted disease has made a recent comeback in the United States over the last six years, and even more so in McKinley County.

While the final figures for 2006 have not been calculated by the New Mexico Department of Health, the New Mexico state rate is estimated to be between 8.2 and 9.5 per 100,000. But the rate for Native Americans in McKinley County is greater than 100 per 100,000.

"That's a 10-fold increase," said Jonathan V. Iralu, MD, FACP, Navajo Area IHS chief clinical consultant for infectious diseases. "This has us concerned. It's quite frightening to us as public health officials."

If untreated, syphilis can eventually result in the destruction of the brain, spinal cord, skin, and heart. The disease, Iralu said, is curable with a single injection of penicillin during the early stages.

"It can be cured with a drug that's been around since World War II," he said.

The number of new cases of early syphilis rose from 42 cases in 2005 to 72 in 2006. The 72 percent increase is the highest the county has recorded.

After epidemiological analysis, hospital officials concluded that every individual contracted the disease while consuming alcohol.

"Its (consuming alcohol) 100% connected to catching syphilis," he said. "Getting drunk and picking up someone in McKinley County is extremely risky."

While cases are predominantly diagnosed in young heterosexual men and women aged 30 to 40 years old who abuse alcohol, there are high school students who have contracted the disease. The youngest case diagnosed in the county was a four-year old child who was sexually abused.

And although its extremely rare, two women in McKinley County contracted the disease while pregnant and passed it on to their child. The disease resulted in a stillborn and the other needing treatment.

The recent syphilis outbreaks aren't unique to the City of Gallup and McKinley county. Flagstaff and Tuba City have had a smaller outbreak that health officials have linked with the use of methamphetamines.

"There is a problem in the midwest tribes too," said Larry Foster, STD coordinator of the Navajo Social Hygiene STD Control Program.

Tribes in New York and the New England area, he said, also have a higher incidence of syphilis outbreak compared to the national average, but not as high as McKinley County.

The outbreaks have prompted the Centers for Disease Control to station a public nurse in the Gallup area to help coordinate syphilis care between IHS, tribal, and state program. The collaboration has been the start of "SOS" "Stamp Out Syphilis" where health educators focus on reaching out to individuals at detox and rehabilitation centers.

Foster, and other officials, with the Navajo Area Indian Health Service and Navajo Division of Health Social Hygiene Program have been doubling their efforts the past several years to prevent outbreaks through health education and outreach. Many times, health educators, go as far as trekking to arroyos and going to the bars to encourage people to get tested.

The Din Unity Project, a collaboration between the Navajo Nation and the CDC, has also focused on testing in jails and in border-town communities.

Health officials are concerned that the syphilis outbreak may lead to increased HIV transmission on the Navajo Nation. In 2006, 22 new cases of HIV were diagnosed on the Navajo Nation.

"It's easy to catch HIV if you have syphilis," said Iralu.

Syphilis cannot be self-diagnosed, but individuals can be easily tested at a local health facility within 15 minutes.