Primary and secondary syphilis--United States, 1998.

Rates of primary and secondary (P&S) syphilis have been declining in the United States since the last national epidemic in 1990. Syphilis causes substantial morbidity and mortality in the form of cardiac and neurologic disease, stillbirth and developmental disability from congenital syphilis, and by facilitating transmission of human immunodeficiency virus. Syphilis is both preventable and curable and has been successfully controlled in most developed countries. In the United States, declines in P&S syphilis have been followed by epidemics occurring approximately every 7-10 years. During 1960-1990, these cyclical epidemics resulted in progressively higher peaks in morbidity. To evaluate the epidemiology of syphilis in the United States, CDC analyzed notifiable disease surveillance data for 1998. This report summarizes the results of that analysis, which indicate that in 1998 P&S syphilis declined to the lowest rates ever reported in the United States and that syphilis transmission increasingly is concentrated in fewer geographic areas.