Syphilis

The medical community has a new warning for HIV-positive gay and bisexual men. With syphilis rates in that population increasing dramatically, a study has found that, if left untreated, the sexually transmitted disease leads to mental confusion, blurred vision, difficulty walking or other serious neurological complications in about 1 in 50 HIV-positive men.

The fugitive disease finds refuge in forsaken places: On street corners where women sell themselves for the price of a crack hit. In neighborhoods with boarded-over homes and shells of businesses long gone. In forlorn mobile home parks off rural highways and seedy truck stops off interstates. Syphilis, a centuries-old human scourge, sustains itself these days on a noxious brew of poverty, racial inequality and hopelessness. There is no good medical reason for it to endure.

In the year 1500, not long after Christopher Columbus and his crews began returning from their voyages to the New World, an epidemic of syphilis erupted in Europe. Shortly thereafter, more epidemics flared and swept across the continent, raging with much the same impact as AIDS does today. Sixteenth-Century European physicians said it was a disease they had never seen before, and some maintained that it had been introduced by Columbus' men, who had become infected in the Americas.

Los Angeles County health officials declared an outbreak of syphilis among gay men Wednesday after discovering at least 23 new cases, most of them in the past six weeks. The outbreak appears to be clustered in Hollywood, West Hollywood and Silver Lake and has struck men between the ages of 25 and 50. The sudden spread is unusual in a county that normally sees only about 100 cases a year, mostly among heterosexual men and women. "This is different, and that's why we've jumped on it," said Dr.

Los Angeles County public health officials announced Wednesday that an outbreak of syphilis primarily among gay men appears to be subsiding. Dr. James Haughton, medical director of public health for Los Angeles County, said that despite increased surveillance and testing, just one new case of syphilis has been reported in the last six weeks. "We are hoping the outbreak has peaked and is waning now," he said.

In a move to slash health care costs, the California Medical Assn. Monday said it wants to eliminate state requirements for premarital blood tests to detect German measles and syphilis. Premarital testing has not been effective in detecting these diseases and is costing California residents and insurers $20 million a year, said Dr. Val W. Slayton, who co-authored the proposal to eliminate the testing, which was adopted by CMA delegates meeting here.

Responding to an outbreak of 52 syphilis cases among predominantly gay men with multiple sexual partners, the Los Angeles Board of Supervisors approved a $1.5-million emergency campaign Tuesday to combat the disease and promote safe sex. Health advocates fear that the syphilis outbreak signifies increasingly risky sexual behavior on the part of those who have contracted it, which could increase the spread of AIDS.

The county Board of Supervisors voted Tuesday to launch a comprehensive media campaign to promote safe sex and aggressive condom distribution in response to a syphilis outbreak among gay men. Supervisors also directed the county Department of Health Services to develop strategies for faster reporting of syphilis and other sexually transmitted maladies and to assess the role of public and commercial sex venues in contributing to the spread of disease.

The physician who was president of the Macon County, Ala., Medical Society in 1969 insisted Tuesday that Surgeon General-designate Henry W. Foster Jr. was present at a meeting in which a controversial syphilis study was discussed and said that Foster expressed no opposition to the research at the time. "I know he was there," Dr. Luther C. McRae Jr. said in an interview. "He just looked up at the ceiling, leaned back in his chair and kind of rolled his eyes.

The betrayal began long ago in an era when more people trusted government in a rustic byway far from the nation's urban centers. Doctors used a group of ailing black men as guinea pigs, telling them that their syphilis was merely "bad blood." The so-called Tuskegee experiment has since become a national symbol of science run amok, a metaphor in the African American community for sinister motives in medical research, a wound that has yet to heal. On Friday, the U.S.