To the editors:

I commend Kitry Krause’s article (November 13) on the syphilis epidemic facing Chicago. As a veteran health care administrator who presently heads a prominent testing, treatment, and research center for sexually transmitted diseases (Howard Brown Health Center), I know too well the need to bring to the public’s eye the vicious cycle of sexually transmitted diseases (STDs) in America, and our public health system’s apparent inability to put into place effective preventative mechanisms to stop the cycle.

It is a startling reality that the number of syphilis cases reported last year was four times the number in 1988 and that 57 percent were among persons between the ages of 10 and 29. Even more unsettling is that syphilis, as reported in the article, is only one of many on a long list of diseases (including AIDS, chlamydia, gonorrhea, hepatitis, herpes, and more) that share the same or similar modes of transmission. And, as Jane Schwebke so aptly stated, “[STDs] travel together.” It cannot be stressed strongly or often enough that a person who is perceived at risk for contracting one condition should also be perceived at risk of contracting others.

Furthermore, the article appropriately reinforces the fact that anyone engaging in unprotected sexual intercourse is at risk of contracting one or more STDs. All populations wherein unprotected sexual activity is ongoing will eventually, if not already, be plagued by these conditions. Even in the age of AIDS, large numbers of people are still engaging in unprotected sexual activity and are at risk.

Krause does not, however, stress strongly enough how masterful syphilis is at concealing itself. Syphilis frequently has NO noticeable symptoms in the primary and secondary stages, as well as the latent stage. Far too many cases of syphilis go unnoticed, undiagnosed, and untreated until it is too late.

When will we, as individuals and as a society, lose our inhibitions and hesitations toward discussing and educating about the problems of STDs? Every year another 300,000 people are infected with hepatitis B and 5,000 die as a result of it. (Ironically, there is currently available a vaccine to prevent this deadly virus.) When will we learn that an ounce of prevention is worth more than a pound of cure?

And lastly, we need more health care centers and practitioners that are perceived by the patient as less of a threat than the disease itself. Howard Brown Health Center was established in 1974 to provide STD education, anonymous testing, and treatment in a friendly, compassionate manner and continues in this tradition today. In addition to providing anonymous HIV testing, we also have confidential testing and treatment programs for a variety of diseases transmitted in modes similar to HIV. Anyone who has been or is considering being tested for exposure to HIV should also consider these other testing programs. It is an investment in one’s personal health that can pay a very large dividend.

Eileen Durkin

Executive Director

Howard Brown Health Center