There were 2.6 cases of syphilis for every 100,000 people in 1998, a 19 percent decline from the rate of 3.2 a year earlier, the Centers for Disease Control and Prevention said Thursday.
"We have an unprecedented window of opportunity to eliminate syphilis in the United States because rates are at an all-time low and because the disease now is extremely concentrated geographically," said Dr. Judith Wasserheit, director of the CDC's sexually transmitted disease prevention division.
Half of the 6,993 cases reported in 1998 came from 28 counties, or less than 1 percent of all U.S. counties. About 80 percent of all counties reported no new cases.
Surgeon General David Satcher and CDC Director Jeffrey Koplan, joined Thursday night by other national and local public health officials in Nashville, Tenn., announced the CDC's new initiative to eliminate the sexually transmitted disease.
By 2005, the federal government hopes to reduce syphilis cases to a rate of 0.4 per 100,000.
"Syphilis is an entirely preventable disease and it is very easy to diagnosis and to treat," Wasserheit said. "No American should have to face this disease in the 21st century."
The plan, aimed at areas with a heavy burden of syphilis cases or a potential for re-emergence, calls for closer monitoring, more community involvement, quicker response to outbreaks and greater access to health care for those infected or exposed. Nashville, Indianapolis and Raleigh, N.C., are the three initial sites where the plan will be put into effect.
Syphilis is a bacterial infection that starts with painless sores and then a rash and can attack the heart and brain and cause dementia and death. It can be cured if treated early with antibiotics.
The syphilis rate has been declining in the United States since 1990, when it peaked at 50,578 cases, or 20.3 cases per 100,000.
The rate was higher among blacks -- 17.1 per 100,000 compared with 0.5 among whites. But the disparity has narrowed since the beginning of this decade, when rates among blacks were 64 times those of whites.
"Syphilis, like many other health problems, tends to persist in communities that are plagued by a number of social problems including poverty, lack of access to health care and racism," Wasserheit said.
The drop has been attributed, in part, to increased funding for treatment and safe-sex practices prompted by the outbreak of AIDS, such as using condoms and having fewer partners.