An uptick in a sexually transmitted disease in Northwest Indiana is keeping health professionals busy promoting safe sex, awareness and increased testing.
Teens are not using condoms to prevent sexually transmitted disease — a strange revelation in the wake of the HIV/AIDS healthcare crisis in the U.S. the last 30 years, officials said. Consequentially, syphilis cases among 15- to 25-year-olds in Lake and LaPorte counties are rising.
“I’m a pediatrician and I talk to a lot of adolescents and syphilis is a thing they know the least about,” said Roland Walker, Gary health Commissioner. “You will find adults — especially older adults — who know about syphilis. You find a lot of kids and young adults who have never heard about it.”
Northwest Indiana’s sexually active young adults are at high-risk for syphilis, in part, because of geography, officials say.
Neighboring Cook County, Ill., ranks No. 2 in incidents of the disease in the United States, according the Centers for Disease Control, while downstate Marion County ranks 45th in the U.S. for syphilis. Indiana health officials blame the spread of syphilis on unprotected casual, random and anonymous sex combined with a lack of information about the disease.
While traveling recently, Walker said he “saw a great billboard and it said ‘Syphilis is Serious.’ But how insightful is that to the target group? If they have never heard the word syphilis, is it reaching them?”
Many people will never know they are infected unless they are tested, he said.
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“Nobody is immune and the symptoms can vary and they can be hidden,” Walker said. “The most important thing you can do is to have regular (STD) screens. If (young people) are unwilling to discuss (STD) with their regular doctor, the screenings are always available at the Gary Health Department.”
Any person who has any form of unprotected sex can get syphilis, disease intervention specialist Velzie Fuller said.
Fuller is a state contractor posted at the Gary Health Department. She serves all cities and towns for District 1, covering Jasper, Lake, LaPorte, Newton, Porter, Pulaski and Starke counties. Two other specialists, employed through the city, are also stationed with her.
Fuller and Walker are emphatic that everyone who engages in unprotected sex is at risk.
“We have some (clients) who are bisexual, gay or lesbian,” Fuller said. “We have straight people. Anyone can catch syphilis.”
Fuller said she has had a case with a patient as young as 15 who contracted syphilis through casual sex.
“I find that dealing with the younger ones, they have a nonchalant attitude,” Fuller said.
“If you (a parent) are not talking to your 13- or 14-year-old about the risk then you have already missed the boat,” Walker said. “Parents have a hard time learning that. Parents say ‘my child is not into those things.’ The level of discussion (I have with young patients) almost invariably changes when the parent is out of the room.”
The youthful nonchalance doesn’t take into account medication shortages.
Walker and Fuller say teen pregnancies are important considerations in the discussion of STD including syphilis.
Fuller said she has also seen a few cases of congenital syphilis, where unborn babies caught it from their pregnant mother. Indiana law requires physicians to test all women for syphilis when they become pregnant and to retest those at high risk for infection in the last trimester.
“If we can catch it early enough, with the proper treatment, the baby will be OK,” Fuller said.
Fuller said she thinks the disease is being spread around Northwest Indiana as people travel around the region, meeting others for anonymous sexual encounters. They unknowingly come into contact with the disease and then don’t realize they have it.
Northwest Indiana’s location along make its citizens particularly vulnerable, if they tend to travel for sexual encounters, officials said.
“We have two major highways and a lot of drifters,” Fuller said. “A lot of people are careless when they are having sex. They may have casual, random and anonymous sex in Illinois and they come back here.”
That lack of awareness is helping the disease to spread in the U.S. The Center for Disease Control reported the national syphilis case rate increased 22.7 percent in women from 2013 to 2014.
Indiana cases of syphilis skyrocketed from 2014 to 2015 when 285 cases of primary and secondary syphilis and 220 cases of latent syphilis were reported, according to the CDC. In 2014 there were 168 cases of primary and secondary syphilis and 129 cases of early latent syphilis.
Lake County accounted for 35 of the state’s additional 116 cases of primary and secondary syphilis. Of those, 28 who contracted the disease were male; eight were ages 15 to 20 and eight were ages 20 to 24. LaPorte County had six cases total in 2015, but a demographic breakdown is not characterized due to the small number. By comparison, Jasper, Newton, Porter, Pulaski and Starke counties had less than five cases each in each of the last three years.
Fuller, in her job with the state for three years, said she has witnessed the spike in Lake County cases.
“There’s been a huge increase in 2016 over 2015 and most of the cases come out of Lake and LaPorte counties,” Fuller said. “We get a lot of people that use dating sites and a lot of that is anonymous sex — for gay or straight people,” said Fuller. “They are using these sites and getting STD — including syphilis.”
Fuller said the only obvious solution to STD is for people to stop having sex, but, “that’s not going to happen.
“A lot of people are not fully aware of the consequences of having sexually transmitted disease,” she said. “If we could just get more people to use condoms. They can come here (to the Gary Health Department) and get a package of free condoms. Everyone who comes in for testing gets a package. We give them at least six to 10 and they can come in everyday to get them — there’s no age limit.”
She said she gives away at least 100 packages a week — maybe more.
No one is exempt, Fuller repeated.
“STDs do not have a face and they can be asymptomatic and without being tested, you don’t know,” Fuller said. “I wish more people would just get tested.”
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Nancy Coltun Webster is a freelance reporter for the Post-Tribune.
Places for information:
Sexually transmitted disease testing is available at many clinics, hospitals and Planned Parenthood locations.
For more information, contact the Gary City Health Department, 1145 W. 5th Ave., Gary, Ind. 46402 or call 219-882-5565.