Reported syphilis cases in Kansas City jumped by 71 percent last year and included nine cases of congenital syphilis in which the mother passed the disease on to her newborn child.
The spike has set off alarm bells at the Kansas City Health Department, which could see cuts in or reallocations of health levy funds that support the city's safety net system in next year’s municipal budget.
“With the general increases of sexually transmitted diseases across the city, which is mirroring what’s happening across the country, we really should be concerned with sexually transmitted diseases,” says Tiffany Wilkinson, manager of the health department’s Communicable Disease Prevention Division.
The Centers for Disease Control and Prevention reported that sexually transmitted diseases, or STDs, increased nationwide by more than 200,000 to a record of nearly 2.3 million in 2017, the last year for which figures are available. And cases of syphilis, a highly treatable but potentially deadly disease, almost doubled between 2012 and 2017.
In Kansas City, the number of reported cases of primary and secondary syphilis leapt from 121 in 2017 to 207 last year.
“The thing that’s been kind of alarming to us is that it (syphilis) has shifted in the population itself, so we’re starting to see more women with the disease,” Wilkinson says. “And that comes with the possibility that the woman can pass it on to her unborn child.”
Of the nine reported cases of congenital syphilis in Kansas City last year, one resulted in a stillbirth.
Up to 40 percent of babies born to women with untreated syphilis may be stillborn or die from the infection as a newborn, according to the health department.
Even babies without symptoms of the disease can develop serious problems in short order, including cataracts, deafness or seizures, according to the CDC.
Why the big jump in cases in Kansas City? Wilkinson offered a couple of possible reasons:
- More cases tied to methamphetamine use in which people are using the drug and then having unprotected sex or trading drugs for sex and money
- Women having sex with men who had sex with other men
The CDC recently cited drug use as a major risk factor for syphilis, saying that the risky sexual behaviors associated with it may be behind the jump in syphilis cases in the heterosexual population.
Someone with syphilis or other sexually transmitted infections such as gonorrhea or chlamydia has a higher chance of becoming HIV-infected if he or she is exposed to the HIV virus.
That, Wilkinson says, could portend an increase in HIV infections in the future.
“We’re already seeing some that are co-infected, meaning that they’re having infections of both right at the same time,” Wilkinson says. “So it’s something that really has spiraling consequences down the road and we just want to make sure that we're identifying those cases early, getting them properly treated and preventing any basic medical consequences from that.”
Dr. Dana Hawkinson, an infectious disease physician at The University of Kansas Health System, says lack of education about STDs also has played a part in their rise.
“People just may not be using protection such as condoms,” he says.
“There are several factors that all play into this and there’s not one right answer,” Hawkinson says. “It’s a conglomeration of quite a few factors that are all coming together to show an increase in the rates of these otherwise preventable and treatable diseases.”
Hawkinson recommends that people who engage in risky sexual activities get tested frequently for infections such as HIV, syphilis, gonorrhea and chlamydia, either through their physicians or their local health departments.
The Kansas City Health Department’s Sexual Health Clinic tests for STDs free of charge and provides treatment if needed, also free of charge.
The increase in syphilis cases comes as the city is in the process of formulating the budget for the fiscal year beginning May 1.
Kansas City Councilman Quinton Lucas, who sits on the committee that oversees the health department, says that the city needs to reconsider how it allocates health levy funds.
The health levy, drawn from property taxes, generates about $50 million a year to support the city’s safety net system and the city-run ambulance service.
“We continue to have issues with trying to ensure the health levy dollars are actually going to public health uses,” says Lucas, who is running for mayor. “In recent years we’ve seen a few more diversions into broader public safety areas. I think it’s accurate to say that we’re not dedicating our full health levy funds to good public health uses. And I think what we’re seeing now is some of the repercussions of that.”
Lucas says that while he’s a big supporter of public safety, there are other funding sources for it, including the general fund and public safety sales taxes.
“Whereas the health levy – I mean nobody’s going to be voting on whether we want more treatment for syphilis tomorrow, because I don’t know if the public necessarily understands the threat that we have from a number of sexually transmitted diseases and the long-term impact on our community,” Lucas says.
“Therefore, I think it’s important that where we already have dedicated funds that we make sure we’re preserving them. And so what I would do, very simply, is make sure that dollars that are allocated to public health uses are allocated exclusively to public health uses.”
Dan Margolies is a senior reporter and editor at KCUR. You can reach him on Twitter @DanMargolies.