December 8, 1998 BALTIMORE (AP) - Baltimore has by far the country's highest rate of syphilis, at more than 30 times the national average, and the city blames the rise of crack and the trading of drugs for sex.
Baltimore also topped the nation in gonorrhea, with a rate nine times the national average.
The Centers for Disease Control and Prevention on Monday ranked the 20 cities with the highest rates of the two sexually transmitted diseases last year.
Overall, the CDC said, both diseases have been reduced to all-time lows in the United States. Syphilis has nearly been eradicated in all but a few cities.
``Our hope is to show that, on one hand, we have made tremendous progress as a nation, but there still is a substantial job that remains to be done,'' said Dr. Helene Gayle, director of the CDC's center for the prevention of sexually transmitted diseases.
Health officials in Baltimore said the spread of gonorrhea doesn't appear to be driven by drugs. Not so for syphilis.
``Once it takes off, it's like a conflagration,'' Dr. Peter L. Beilenson, the city health commissioner.
New Orleans and New York are among other cities that saw syphilis cases rise this decade as they were infiltrated by crack, but their rates have since fallen as health officials fought the problem.
Beilenson said crack came later to Baltimore, about 1995, and that explains the current high numbers.
Gonorrhea infected 991 of every 100,000 people in Baltimore, the CDC said. The nationwide rate is 123 infections per 100,000 people. The No. 2 city on the list, Washington, had 839 infections per 100,000 people.
And though syphilis infects just three people per 100,000 nationwide, the rate was 99 per 100,000 in Baltimore. That's more than twice the rate in the No. 2 city on the list, Memphis, Tenn., at 40 cases per 100,000 people.
Besides Baltimore, 14 cities appeared on both lists: Washington; St. Louis; Atlanta; Detroit; Richmond, Va.; Newark, N.J.; Norfolk, Va.; New Orleans; Memphis, Tenn.; Oklahoma City; Birmingham, Ala.; Chicago; Nashville; and Milwaukee.
Maryland had the highest infection rate among the 50 states, with 17.6 cases per 100,000.
Baltimore's syphilis rate is expected to be lower this year. The city health department projects no more than 500 cases by the end of the year, down from 667 in 1997. The projected drop would be the first since 1994.
``Obviously, we're too high for comfort, but I'm confident we're headed in the right direction,'' Beilenson said.
Beilenson attributed the expected drop to the restoration of the city's depleted staff of health workers, who detect and treat syphilis and trace patients' sexual partners.
Doctors from Johns Hopkins Hospital have been helping staff the city's sexually transmitted disease clinics. City health officials have also tried to educate doctors on how to test for syphilis.
Since about 25 percent of all people infected with syphilis pass through the city's jail, doctors at the Baltimore City Detention center now test all inmates for the disease, Beilenson said.
The disease is easily cured at its early stages with a single shot of penicillin, but if left unchecked it can cause organ damage, insanity and death.
Copyright 1998 The Associated Press. All rights reserved.
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