As Snohomish County sees spike in syphilis, new clinic gets funds

This story is another in a series of updates based on the latest data, programs and policies of the Snohomish County Health Department.

EVERETT — The new Snohomish County Health Department received $975,000 in the two-year state budget for a pilot project to bring back some services for sexually transmitted infections.

A clinic will be housed again in the building at 3020 Rucker Ave., after about a 14-year hiatus.

“It’s really exciting, and it will help us to be able to respond more quickly,” said Dennis Worsham, director for the health department.

Given the sharp rise in rates of syphilis, that timeliness is especially important. Dr. James Lewis, health officer for the department, added that an advantage to such a clinic in public health is the ability to provide testing, treatment and case management in one appointment. That could also include anonymous notification to other at-risk people in one appointment. The notification still relies on the patient’s consent.

The department could offer some of these expanded services as soon as this summer, for many sexually transmitted infections. The goal of the clinic is to provide free services regardless of insurance status.

In Snohomish County, the case rate of “primary and secondary syphilis” — the earlier stages of the disease — grew from 5.6 per 100,000 people in 2019 to 11.1 in 2022. With the rise overall in syphilis, Snohomish County saw a small number of cases of congenital syphilis in 2021 and 2022, after zero cases from 2015 to 2020. The county cannot release the exact count because of privacy issues.

Congenital syphilis is the illness of a fetus or baby born to women with untreated syphilis, which can lead to miscarriage, stillbirth, premature birth, low birth weight or death soon after birth. Congenital syphilis can also cause deformed bones, severe anemia, neurologic complications and more.

“It’s a big concern to get one case, because it’s a preventable disease,” Worsham said. “We’ve got to do what we can now to help interrupt that transmission.”

Statewide, rates of congenital syphilis cases jumped from 20 per 100,000 births in 2019 to 63 in 2021.

For that reason, the Snohomish County Health Department issued an advisory to health care providers, to urge routine testing of sexually active women, particularly those who are pregnant. Those screenings should be covered by insurers because the U.S. Preventive Services Task Force has recommended them for people at increased risk of infection.

The money from the state will also help the department do a “landscape analysis” — to study sexually transmitted infection transmission and how to target appropriate services. That includes HIV pre-exposure treatment.

Services could include mobile clinics to increase access to testing and treatment. That can help lower barriers such as insurance status, confidentiality concerns, fear of stigma based on sexual identity or behaviors, and distrust of the medical system based on past discrimination, according to Worsham and Lewis.

Worsham emphasized the need to focus on disease prevention and treatment based on “high-risk behaviors,” no matter the person’s identity. According to state data, the highest case rates of syphilis by race/ethnicity were among “Black, non-Hispanic” people in 2021. Historically men who reported having sex with men made up the largest share of syphilis cases in the state. But in 2021, men who “report partners of the opposite sex” became the majority of all syphilis cases in the state, coinciding with the rapid rise in the number of cases among pregnant and “pregnancy-capable persons.”

“It’s important for us from a public health perspective,” Worsham said, “to know the disproportionality, and it helps us on the intervention and outreach side of the work that we need to do.”

But there are high-risk behaviors in all communities, he added: “It’s not about race, nor is it about gender identity or sexual orientation, it’s about a behavior.”

The health department urges people to get tested, communicate with partners about sexual history, use a condom and follow through with recommended treatments for sexually transmitted infections.

Joy Borkholder: 425-339-3430; joy.borkholder@heraldnet.com; Twitter: @jlbinvestigates.