NEW YORK (Reuters Health) - The Internet is a major player in the increase in early syphilis infections among San Francisco's population of men who have sex with men (MSM), health officials report.

According to an article in the December 19th Morbidity and Mortality Weekly Report, an outbreak in the summer of 1999 of early syphilis infections among MSM who met their sex partners on the Internet "presaged a rapidly expanding syphilis epidemic in San Francisco."

By 2002, San Francisco had the highest rates of primary and secondary syphilis of any metropolitan area in the country. Between 1998 and 2002, the number of early syphilis cases jumped from 41 to 495. At the same time, officials noted a spike in the proportion of cases that were among MSM, from 22% in 1998 to 88% in 2002.

A closer look at data on 415 MSM who were diagnosed with early syphilis in 2002 revealed that Internet chat rooms and sex partner sites were the most common venues for meeting partners - more common than bars, bathhouses, and sex clubs.

Among 151 MSM interviewed for partner management, nearly 45% reported meeting sex partners online, and roughly one-fifth of those men had no other locating information besides an e-mail address for online partners.

"As the association between syphilis among MSM and the use of the Internet as a means for meeting sex partners grows, health departments must adopt new strategies for partner notification," warn officials from the Centers for Disease Control and Prevention (CDC) and the San Francisco Department of Public Health.

They have evidence that Internet-based partner notification can be an effective tool for finding and treating early syphilis infections.

"Local health departments in other cities that have had large increases in early syphilis cases among MSM should consider using the Internet for partner notification and management," the authors of the report write.

The San Francisco Department of Public Health has developed interim online partner notification guidelines that address "concerns about protecting confidentiality and ensuring that messages are not discarded as junk e-mail, two common barriers to online partner notification."

Mor Mortal Wkly Rep CDC Surveill Summ 2003;52:1229-1231.

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