Syphilis among young women on the rise in Phila.

Cases of infectious syphilis among women in their key childbearing years rose dramatically in Philadelphia last year, prompting the city Health Department to issue new screening guidelines yesterday in an alert to health-care providers.

The numbers are still relatively small: 218 cases in 2009, including 23 among women ages 15 to 29, up from 150 cases in 2008, including five in that age group. But that's a 360 percent increase in young women, who can transmit the disease congenitally.

Congenital syphilis can cause mental retardation and physical deformities such as cleft palate. Four cases of congenital syphilis were reported in the city last year.

Cases of primary and secondary syphilis - the infectious stages - have been increasing around the country in recent years, particularly in big cities and the South.

Rates in Philadelphia have been high, although some other cities have reported rates several times as large. Last year's numbers for other cities are not yet available.

Men who have sex with men have accounted for the bulk of syphilis cases in the past, and they constituted 69 percent of the Philadelphia total last year. The Health Department repeated its recommendations that sexually active men in that category be screened for syphilis every three to four months.

It added a recommendation that females ages 15 to 40 who had more than one sexual partner in the past year be screened annually.

Women should take that advice seriously, said William R. Short, an infectious-disease doctor at Thomas Jefferson University Hospital, because of the large number of serious congenital abnormalities that could develop in their babies. They also should avoid unprotected sex, he said.