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Cincinnati syphilis outbreak spreading north

Area counties team up to prevent spike in cases.

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By Joanne Huist Smith  and Lauren Pack, Staff Writers 10:40 PM Wednesday, January 11, 2012

Dramatic increases in the number of syphilis cases in Cincinnati are having a ripple effect in the region including Butler, Warren and Montgomery counties.

“We fear the problem is coming up Interstate 75 and we want to stop it,” Jim Gross, health commissioner for Public Health: Dayton and Montgomery County said.

“Their problem can quickly become our problem,” Gross said, “and it’s important to understand that communicable diseases don’t respect regional boundaries.”

Jen Keagy, program manager of STD prevention programs for the Ohio Department of Health, said Butler and Warren counties, which have had historically very low or no incidences of syphilis, also are finding cases that originated in Hamilton County.

In 2008, four syphilis cases were reported in Butler County; 11 in 2009 and 12 in 2010, according to the Ohio Department of Health. In 2011, unconfirmed reports from health officials indicate 17 syphilis cases reported in Butler County.

Montgomery County had more syphilis cases in the fourth quarter of 2011 than in all of 2010. Overall, the county investigated and reported 70 cases in 2011, compared to 25 the year before. Gross said case interviews and investigations by disease intervention specialists found a rising number of syphilis cases in Montgomery County originated in Cincinnati.

Middletown Health Commissioner Jackie Phillips said syphilis cases have increased in her city.

“I have seen more in the past year than I have seen here and I have been here 14 years,” Phillips said.

She said the budget cuts, which led to decreases in personnel, could be linked to the spike.

“Anytime you do not have people to investigate and educate, you are going to see a rise,” Phillips said. She added even if people can not afford condoms to practice safe sex, they are available without cost in many locations.

Agencies do not have the personnel to go into the community and let people know about the number of syphilis cases reported and educate about prevention, Phillips said.

Because of the proximity to Hamilton County, Butler County officials are on alert to the increase of syphilis cases in that neighboring county.

“Our level of awareness is up,” said Jenny Bailer, nursing director for the Butler County Health Department.

“People do move around along the corridor and they take their diseases with them,” Bailer said.

She said chlamydia and gonorrhea are “fairly common” in the area, but the county has not experienced the outbreak in syphilis that Hamilton County has.

Dayton and Montgomery County will take the lead on administering a $740,000 state grant to run Hamilton County’s HIV/STD program. Montgomery County applied for the grant after the Ohio Department of Health pulled funding from the city of Cincinnati’s Health Department, which had run the program for all of Hamilton County since 1981.

“We are extending a hand to our southern neighbor. By us helping Cincinnati, we are in fact helping ourselves,” Gross said. ‘We will not spend Montgomery County Human Services Levy dollars on Hamilton County STD programs. We made it extremely clear to the Ohio Department of Health and Hamilton County that we will not spend one penny of Montgomery County taxpayer dollars on Cincinnati.”

Montgomery County will keep up to 10 percent of the grant for its oversight of the program as a whole, acting as fiscal manager, along with mentoring and coaching Hamilton County Public Health, which is taking over local administration of the program including

Syphilis cases began spiking in Hamilton County in late 2008 and have remained high, according to state data. The disease has spread through all age groups from teens to 60-year-olds, predominately striking blacks, gay men and heterosexual women, Keagy said.

“It’s hard to say where it originated,” Keagy said. “It really is all over the place.”

Keagy said the Ohio Department of Health has provided Cincinnati with “a tremendous amount of technical support” since 2008, to try and reduce its incidences of syphilis, but the rate still soared to 126.1 per 100,000 residents in 2010. Dayton’s rate in the same time period was 16.9 per 100,000 residents.

“We are not taking sides in this debate going on between the Cincinnati Department of Health and the Ohio Department of Health. We are not interested in sticking our noses in any fights between those entities,” Gross said. “I look at what we are doing the same as what any neighboring community would do in a disaster situation. Who knows, the next cry for help may be from Montgomery County.”

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