HIV is the sexually transmitted disease (STD) most likely to kill a disability insurance, long-term care insurance (LTCI) or other personal protection insurance sale, but other STDs are still out there.
One of the STDs that may be making a comeback is syphilis.
Syphilis infects only about 3.5 out of every 100,000 U.S. adults ages 40 and older.
Seventy-five years ago, syphilis was about as much of a public health threat as HIV is today. The invention of penicillin, and efforts to persuade sexually active adults to wear condoms, helped turn the tide.
Syphilis became a rarity. In 2003, states reported an average of only about 2.5 syphilis cases per 100,000 adults of all ages, according to data from the U.S. Centers for Disease Control and Prevention (CDC).
Since then, however, something has been going wrong: The overall syphilis rate has increased to about 5.5 per 100,000 people. For adults ages 40 and older, the incidence rate has increased to 3.6 per 100,000 people in 2013, from about 1.9 per 100,000 10 years earlier.
The overall rate of incidence is about five times higher for men than for women.
At the state level, the incidence rate for adults ages 40 and older ranges from just 0.4 cases per 100,000 older adults in West Virginia to about 7.5 cases per 100,000 in California.
Some of the state-to-state variation may be partly the result of differences in public health screening and reporting programs, but the incidence rate for older adults has increased sharply in most states between 2003 and 2013.
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For now, at least, the odds that any given disability, LTCI or other medically underwritten client will have syphilis are low. But the increase between 2003 and 2013 could be a sign of troubling behavior shifts.
Any behaviors that help syphilis spread more rapidly could also give diseases like Zika and Ebola a boost, if either of those microbes take hold in the United States.
For a look at a list of the 10 states with the most dramatic increases in older adults’ syphilis incidence rates between 2003 and 2013, along with a chart showing the increases for all 50 states and the District of Columbia, read on.
Cases per 100,000, 2013: 1.51
Cases per 100,000, 2003: 0.55
Change, in percent, between 2003 and 2013: 64%
Image: WC/Derek Jensen
Cases per 100,000, 2013: 2.47
Cases per 100,000, 2003: 0.86
Change, in percent, between 2003 and 2013: 65%
Image: TS/Alex Mann
Cases per 100,000, 2013: 1.03
Cases per 100,000, 2003: 0.33
Change, in percent, between 2003 and 2013: 68%
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Cases per 100,000, 2013: 2.56
Cases per 100,000, 2003: 0.8
Change, in percent, between 2003 and 2013: 69%
Cases per 100,000, 2013: 2.69
Cases per 100,000, 2003: 0.78
Change, in percent, between 2003 and 2013: 71%