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Syphilis Elimination

The North Carolina Syphilis Elimination Project (NCSEP) began in 1998, when 28 counties across the United States were identified as, together, reporting more than 50 percent of the nation's morbidity for infectious syphilis. Now called the North Carolina Syphilis Elimination Effort (NCSEE), the project includes six of the state's 100 counties: Durham, Forsyth, Guilford, Mecklenburg, Robeson and Wake.

The N.C. Syphilis Elimination Effort strives to reduce syphilis through community involvement, surveillance, prevention, rapid outbreak response, targeted testing, health promotion and education.

The Communicable Disease Branch of the N.C. Division of Public Health has created a Syphilis Epidemic Response Team (Syphilis-ERT) with the following six focus areas to fight syphilis on multiple fronts:

  • Active Surveillance/Provider Awareness;
  • North Carolina MSM (Men Who Have Sex With Men) Task Force;
  • Outreach Targeted Testing Efforts;
  • Public Service Announcements (PSAs);
  • Enhanced Data Analysis; and
  • Collaboration with National Partners.

Why Is It Important to Eliminate Syphilis in North Carolina?

Syphilis is a preventable and curable sexually transmitted disease (STD) with serious consequences if not treated. In addition to reducing the burden of this disease, eliminating syphilis would reduce health disparities and reduce the spread of HIV infection.

North Carolina reached one of its lowest rates of primary, secondary and early latent (PSEL) infection in 2003. However, rates have risen overall since then. North Carolina reported 509 early syphilis cases in 2008; 937 early cases in 2009; and 724 early syphilis cases in 2010. North Carolina counties that experienced high rates of syphilis in 2010 included Cumberland, Forsyth, Guilford, Mecklenburg, Wake and Wayne.

Syphilis affects certain populations more than others:

  • African Americans are disproportionately affected by syphilis. Seventy-nine percent of syphilis cases identified in 2010 were African American (of which 82 percent were male), although African Americans constituted only 22 percent of the state's population. Only 16 percent of new syphilis cases were white and 3 percent were within the Latino community that year, while whites made up 68 percent of the general population and Hispanics 7 percent.
  • Males accounted for 81 percent of the early syphilis cases reported in 2010, with the highest rates in 25- to 29-year-old males. Men who have sex with men (MSM) constitute an increasing proportion of the total number of cases.

Syphilis and HIV are closely linked:

  • Preliminary data show that in 2010, 42 percent of all males diagnosed with syphilis were already HIV-positive.
  • This growing syphilis epidemic may also lead to increases in new HIV infections in North Carolina.

North Carolina map showing the change in primary, secondary and early latent syphilis infections from 2009 to 2010 (PDF, 108KB)