Cleveland and Cuyahoga County Syphilis Profile, 2015

Special Thanks to the Following for their Authorship on this Report:

Julia Kosco, MPH Candidate          Case Western Reserve University

Vino Sundaram, MPH                     Cleveland Department of Public Health

What is Syphilis?

Syphilis is a sexually transmitted disease. It has four stages: primary, secondary, early latent, and late latent. The primary and secondary stages are the biggest threat because they are extremely infectious. 

Syphilis is spread through direct contact with a sore during vaginal, anal, or oral sex. It is also spread from an infected mother to her unborn baby (congenital syphilis) .

High risk groups include: pregnant women, MSM (men who have sex with men), those with an HIV infection, and those with partners who have tested positive for syphilis. 

source: Society of Syphilitics (


Primary syphilis is characterized by a sore, which can be found in the vagina, anus, rectum, mouth, or on the lips. They are usually firm, round, and painless. 

Sores usually appear 2-10 weeks after initial exposure, and last 3-6 weeks. 

Secondary syphilis is characterized by skin rashes and/or sores in the mouth, vagina, or anus. It is rough, red, or reddish brown and does not itch. 

The rash appears when sores are healing, or several weeks after the last sore has disappeared. This can be anywhere from 6-12 weeks. It usually lasts 2-6 weeks. 

Early latent and late latent syphilis happens when all previous symptoms have disappeared. If treatment was never sought, syphilis can remain in the body for years without exhibiting symptoms. When it does appear, it causes difficulty coordinating muscle movements, paralysis, blindness, dementia, or damage to organs. 

Syphilis in Cuyahoga County

Cuyahoga County has been experiencing syphilis outbreaks since 2007. 2015 had the highest recorded numbers yet at 200 cases, seeing an increase of 11.1% since 2014. 2014 had already increased 89.4% since 2013. 

Those aged 25-29 had the highest amount of syphilis cases, making up 25%. The next highest age groups were those aged 20-24 and 25-29, each making up 14%. 

Primary and secondary stage syphilis are the most infectious stages, so it is important to monitor them. From 2014 to 2015, P&S cases dropped 19.4%. 

The majority of syphilis cases were among African Americans at 65%. Whites were the next highest at 29%. 

Males made up 94.5% of the cases compared to females. 

Syphilis in Cleveland

Out of the 200 reported syphilis cases in Cuyahoga County, 119 of them were in Cleveland. 

Those aged 25-29 had the highest amount of syphilis cases, making up 24.4%.  The next highest age groups were those aged 20-24 and 35-39, each making up 16.8%.

From 2006-2015, P&S cases dropped by 18.4%. 

The majority of cases were African American at 70.5%. Whites were the next highest at 23.5%. 

Males made up 95.7% of the cases compared to females. 

Syphilis by Municipality and Neighborhood 


Cleveland had the overwhelming majority of syphilis cases in 2014-2015 at 222, but surrounding municipalities including: Cleveland Heights (19), East Cleveland (22), Euclid (14), Garfield Heights (14), and Lakewood (19) also had high numbers. 


Glenville and Union-Miles had the highest amounts of syphilis cases in 2014-2015, with 29 and 18 cases respectively. The next highest were: Detroit-Shoreway (11), Edgewater (13), and Hough (11). 

Risk Factors for Syphilis

HIV co-infection was reported in 59% of county cases and 58.8% of Cleveland cases

Sex with known HIV positive partners was reported in 7% of county cases and 6.7% of Cleveland cases

MSM behaviors were reported in 61.9% of male county cases and 58.7% of male Cleveland cases

An STD history was reported in 48.5% of country cases and 46.2% of Cleveland cases

Sex with anonymous partners was reported in 41.5% of county cases and 43.6% of Cleveland cases

Using the Internet to find sexual partners was reported in 21.5% of county cases and 25.2% of Cleveland cases

Lack of condom use was very prevalent, whether being used for anal, oral, or vaginal sex