Reported neurologic, ocular, and otic manifestations among syphilis cases — 16 states, 2019

Details

• Alternative Title:
  Sex Transm Dis
• Personal Author:
  Jackson, David A. ; McDonald, Robert ; Quilter, Laura A. S. ; Weinstock, Hillard ; Torrone, Elizabeth A.
• Description:
  Background:
  
  Syphilis can cause neurologic, ocular, or otic manifestations, possibly resulting in permanent disability or death. In 2018, CDC began collecting syphilis clinical manifestation data via the National Notifiable Diseases Surveillance System (NNDSS). We present the first reported U.S. syphilis neurologic, ocular, and otic manifestation prevalence estimates.
  
  Methods:
  
  We reviewed 2019 NNDSS data to identify jurisdictions reporting ≥70% of syphilis cases ≥15 years old with clinical manifestation data (considered “complete reporting”). Among these jurisdictions, we determined reported neurologic, ocular, and otic manifestation prevalence, stratified by demographic, behavioral, and clinical characteristics.
  
  Results:
  
  Among 41,187 syphilis cases in 16 jurisdictions with complete reporting, clinical manifestations were infrequently reported overall: neurologic (n=445, 1.1%), ocular (n=461, 1.1%), otic (n=166, 0.4%), any (n=807, 2.0%). Reported clinical manifestation prevalence was highest among cases ≥65 years old (neurologic: 5.1%; ocular: 3.5%; otic: 1.2%) and those reporting injection drug use (neurologic: 2.8%; ocular: 3.4%; otic: 1.6%). Although reported neurologic and ocular manifestation prevalence was slightly higher among HIV-infected vs. HIV-negative persons, approximately 40% of cases with manifestations were HIV-negative. Reported otic manifestation prevalence was similar regardless of HIV status. When stratifying by HIV status and syphilis stage, reported prevalence was highest among HIV-infected persons with unknown duration/late syphilis (neurologic: 3.0%; ocular: 2.3%; otic: 0.7%).
  
  Conclusions:
  
  Reported neurologic, ocular, and otic manifestation prevalence was low among syphilis cases, but these data are likely an underestimate given potential underreporting. Reported clinical manifestation frequency, including among HIV-negative persons, emphasizes the importance of evaluating all syphilis cases for signs/symptoms of neurosyphilis, ocular syphilis, and otosyphilis.
  
  
• Subjects:
  Eye Infections, Bacterial HIV Infections Humans Neurosyphilis Prevalence Syphilis
• Keywords:
  Ocular Syphilis Otosyphilis Surveillance
• Source:
  Sex Transm Dis.
• Pubmed ID:
  35819903
• Pubmed Central ID:
  PMC9481702
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:2aa3feb6246ff1675433cb40133c5d940848539d719afb6a9bfb075dbc04b0761d3405ae7b6c633601b49a2a2c7b018a3ce2392a679df5ab53a23bb3574d22b9
• Download URL:
  https://stacks.cdc.gov/view/cdc/121276/cdc_121276_DS1.pdf
• File Type:
  [PDF - 417.70 KB ]