Syphilis is on the rise again throughout Nevada, and it’s particularly widespread in Clark County.
How bad is it? The county’s infection rate is now the highest per capita in the U.S.
In 2017, 24 per 100,000 people in Clark County became infected, which is two and a half times the national rate.
Dr. Joe Iser, chief health officer at the Southern Nevada Health District, attributes the spike to a number of factors, including so-called hookup apps.
“There are these apps [where] you can have anonymous sex -- men with men, men with women, swipe left, swipe right -- and you can meet someone and often times those sexual encounters don’t [include] the use of condoms,” he said.
To make matters worse, Las Vegas is a place where people from around the world come to have a good time.
“The old saying ‘What happens in Vegas, stays in Vegas' -- it’s actually kind of the opposite. What happens in Vegas is brought here by our tourists and by others who come here, and this is true for many infectious diseases,” he said.
In addition, Las Vegas has many illegal sex workers who are often not tested for diseases, unlike their legal counterparts in Nevada's brothels.
Iser said another factor is the drug treatment used to prevent the spread of HIV/AIDs. PrEP, or pre-exposure prophylaxis, is taken to help protect against the HIV virus.
“If you’re no longer afraid of getting HIV, which to most is the scariest of the sexually transmitted diseases, then you are more comfortable having sex without condoms," he said.
But the factor that concerns Iser the most has resulted in a dramatic spike in congenital syphilis: when a pregnant woman contracts the disease or when a woman contracts the disease and then becomes pregnant.
“We know that a lot of the infections are due to the fact that women will get pregnant and not see their doctor or may not see their doctor frequently enough,” he said.
Iser said women will become infected after their first prenatal visit and not know until they've given birth because they never return for more prenatal care.
He said the valley's homeless problem contributes to the lack of prenatal care.
The consequences to a baby born with syphilis can be dire, from intellectual impairment to physical deformities. There is also a significant chance of premature birth or even stillbirth, Iser said.
The spike in the number of cases of congenital syphilis is significant. He said in 2016 there were nine cases in Clark County. In 2017, there were 20 cases and in 2018, there were 24.
"That's pretty scary to us," he said.
The health district is now working to educate local obstetricians and gynecologists about the problem. It is also teaching family and general practitioners how to talk to patients about risky sexual behaviors.
But in the long term, Iser thinks more education for youth about the risks of unprotected sex and sexually transmitted diseases needs to be done.
“I think there should be a standardized, evidence-based program of sex education in at least middle school and high school,” he said.
Dr. Joe Iser, chief health officer, Southern Nevada Health District