Syphilis in Ohio: Tale of two cities

Introduction: Nationwide, syphilis rates have increased since 2000. Two Ohio counties with high early syphilis morbidity include Franklin County (Columbus) and Hamilton (Cincinnati)County. These metropolitan areas are located about a hundred miles apart. We sought to discover whether or not the demographics and risk factor profiles of reported cases were similar in the two counties. Methods: Using 2011 data provided by the Ohio Department of Health, we conducted a county-by-county comparison of case demographics and disease intervention specialist (DIS)-collected risk factor profiles. Results: In Franklin County, 149 cases of early syphilis were reported: 131 (87.9%) were male and 18 (12.1%) were female. In Hamilton County, 242 cases were reported: 129 (53.3%) were male and 113 (46.7%) were female. In Franklin County, of the 119 males who described their partners to DIS, 93 (78%) reported exclusively male partners (5 reported both male and female partners). In Hamilton County, of 101 males, 35 (34.7%) reported exclusively male partners (5 reported both male and female partners). In Franklin County only 20 (16.8%) males reported exclusively female partners, while in Hamilton County, 61 (60.4%) males reported exclusively female partners. Conclusions: Even though Franklin and Hamilton Counties are only a hundred miles apart, the 2011 early syphilis morbidity in Franklin County involved men who have sex with men almost exclusively, while the morbidity in Hamilton County involved self-identified heterosexual men in almost two-thirds. These findings underscore the continuing importance of “shoe-leather” epidemiology made possible by the work of CDC-funded disease intervention specialists.