Sexually transmitted infections occur at a high rate in Bristol Bay. Now, for the first time in years, several cases of syphilis have been confirmed.
Bristol Bay has the unfortunate distinction of having the highest rate of chlamydia, not only in the state of Alaska, but in the United States, according to Dr. Catherine Hyndman, a physician with the Bristol Bay Area Health Corporation. In 2016, the rate of chlamydia in Bristol Bay was more than double the rate in the rest of the country.
But chlamydia is not the only sexually transmitted health threat on the rise in the bay. The region is now seeing an outbreak of syphilis.
“We haven’t seen syphilis in our area for many, many years,” said Hyndman. “But here in the last couple of months, we’ve had several confirmed cases of syphilis.”
This is a part of a growing national trend. Cases of syphilis in the United States have increased by 76 percent since 2013. In Alaska, 57 cases of syphilis were reported to the State of Alaska Epidemiology during 2017 and the beginning of 2018.
Syphilis is spread primarily through sexual contact, although a mother can also pass the infection to her infant at birth. The infection is treatable with antibiotics, and long-term damage can be minimized by early identification.
“It can start off as a painless ulcer,” said Hyndman. “And then it goes away. And then, some days to weeks later, you can break out in a rash all over your body, and once again that rash goes away on its own, but the dangerous thing is that particular bacteria can get into your brain and cause neurosyphilis, so it can stay with you forever and cause loss of memory and hallucinations and the like.”
Health care providers can test for sexually transmitted infections. In Dillingham, people can go to the Kanakanak Hospital or the Public Health Center, and in other communities the health clinic can provide assistance.
“They can just walk in and say, ‘You know, I’d like to be tested for sexually transmitted infections, and they will normally be given a cup to pee in,” Hyndman explained. “The pee test tests for gonorrhea and chlamydia. And they will be offered a blood test. The blood test tests for syphilis, also HIV, which can be sexually transmitted certainly, and for hepatitis C, which while it is not as easily sexually transmitted, is transmitted by sharing needles and doing injectable drugs.”
While the cause of the spike in syphilis in Bristol Bay is not known, Hyndman has a theory.
She said, “I suspect people have gotten a little complacent about using barrier methods, like condoms, to help prevent the spread of sexually transmitted diseases.”
Hyndman emphasized that drinking alcohol can increase people’s risk of contracting a STI by lowering inhibitions.
“If you do drink, it’s important to be really careful about where you drink because often times I wind up seeing people who have had sex with people they had no intention of having sex with because alcohol clouded their judgement.”
The Centers for Disease Control recommends regular syphilis testing for all persons living with HIV, men who have sex with men, and people whose partners have tested positive for syphilis. The CDC also recommends that all pregnant women be tested for syphilis at their first prenatal visit. To lower the chance of contracting syphilis, the CDC recommends using a latex condom during sex, but warns that this may not be completely effective because syphilis sores can occur in areas not covered by a condom.
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