Syphilis in Missouri: a continuing problem.

Syphilis has re-emerged as a significant public health problem in the United States and Missouri. Reported cases of primary and secondary (P&S) syphilis and congenital syphilis in Missouri have been increasing since the late 1980s, and a major outbreak of these diseases continues in the St. Louis area. The nature of syphilis combined with certain characteristics of those populations at highest risk of infection can make prevention and control difficult. Achieving success requires the cooperative efforts of practicing physicians and public health professionals.

An update on the epidemiology of AIDS in Missouri.

It has been 13 years since the initial report from the Centers for Disease Control and Prevention (CDC) describing the condition that came to be known as the acquired immunodeficiency syndrome (AIDS). Because of the public health significance of the AIDS epidemic, an elaborate national surveillance system, involving CDC along with state and local health departments, came to be established. The surveillance system now provides detailed information about the epidemiology of AIDS in this country. At the national level, through September 1993, 339,250 cases of AIDS have been reported to CDC; 204,390 of these individuals have died, for a case-fatality rate of 60.2%. Human immunodeficiency virus (HIV) infection/AIDS is now the leading cause of death in American men aged 25-44, and the fourth leading cause of death for women in this age group. The AIDS epidemic continues to disproportionately affect minorities. For blacks, the cumulative incidence rate is approximately 3.7 times that of whites; for Hispanics it is approximately 2.7 times that of whites. The majority of AIDS cases nationally are attributable to transmission of HIV among men who have sex with other men. However, the annual incidence of AIDS is currently rising faster among women than among men, and AIDS incidence is increasing more rapidly among persons who are reported to have acquired their infection through heterosexual contact than among persons in other exposure categories. Along with the increase in the number of cases in women, there has been a corresponding increase in the number of pre- or perinatally-acquired cases in children.(ABSTRACT TRUNCATED AT 250 WORDS)