Epidemiology of syphilis in Bulgaria, 1990-1998

There have been great political, social and economic changes in Bulgaria since 1990 with higher incidences of syphilis when compared with the previously controlled morbidity of syphilis. There has been a 7-fold increase in 1998 compared with 1990. The male/female ratio remained the same 1.2:1. A higher number of cases was reported in cities than in villages and small towns, 80.68% in 1990; 73.4% in 1998. The number of employed patients with syphilis has decreased during the years--from 75.5% in 1990 to 44% in 1998, with a corresponding increase in syphilis in the unemployed. The age group at highest risk is 20-24 years, 28.7% in 1991; 24% in 1998. The least affected group are those older than 55--the incidence being 6.34% in 1990; 2.6% in 1997 and 4% in 1998. The prevalence of the different stages of early infection remained the same. The incidence of congenital syphilis increased from 1 in 1990 and 1991 to 21 in 1996, 29 in 1997 and 35 in 1998.