According to a US Centers for Disease Control and Prevention (CDC) annual report on the national trends of three notifiable sexually transmitted diseases
(STDs): chlamydia, gonorrhea, and syphilis; the rate of reported infections continues to rise, and as before, it is likely the official data represents only
a small part of the true national picture. Not only are many cases of these diseases undiagnosed and unreported, but the figures do not cover other highly
prevalent infections, such as human papillomavirus and genital herpes.
Despite the enormous progress recent years have seen in the prevention, diagnosis and treatment of some STDs, the CDC estimates that around 19 million new infections occur in America every year, nearly 50 per cent of them in young people aged 15 to 24, causing nearly 15 billion dollars in direct medical costs in 2006, in addition to the untold physical and psychological damage, for which there is no price tag.
The 2006 figures for Chlamydia, the most commonly reported infectious disease in the US, show:
- Over 1.03 million reported cases of infection, up from 0.98 million in 2005.
- The national rate of reported infections rose by 5.6 per cent to 347.8 cases per 100,000 population.
- An estimated 40 per cent of cases are undiagnosed.
- An estimated 2.8 million infected women go untreated.
Chlamydia is easily cured with antibiotics, but three quarters of women have no symptoms, so it goes undiagnosed and untreated. However, it can lead to serious health problems for women, such as pelvic inflammatory disease (PID), ectopic pregnancy, and infertility. As many as 40 per cent of women with untreated chlamydia develop PID, 20 per cent of whom go on to become infertile.
Chlamydia does not usually affect men, but when it does, it causes epididymitis (a painful infection in the testicles) and urethritis (resulting in pain while urinating), which can result in sterility.
The CDC recommends annual chlamydia screening for all women under age 26 who are sexually active, plus older women with risk factors such as new or multiple sex partners.
The figures for Gonorrhea, the second most commonly reported infectious disease in the US, show:
- Over 358 thousand cases reported in 2006.
- From 1975 to 1997 there was a 74 per cent decline followed by a plateau, but then it started rising again two years ago.
- in 2006 the rate of reported infections rose by 5.5 per cent to 120.9 cases per 100,000 of the population compared with 2005.
- This was the second consecutive year of increase.
- Like chlamydia, most cases are undiagnosed and unreported.
- There are estimated to be twice as many unreported as reported new infections every year.
Research suggests that people who have gonorrhea are between three and five times more likely to become infected with HIV when exposed to the virus.
Drug resistance is a growing concern in the treatment and prevention of gonorrhea, said the CDC report.
The figures for Syphilis show:
- Reported cases have risen for the sixth consecutive year.
- The 1990s saw a decline in rates of primary and secondary (P&S) syphilis, the most infectious stages of the disease.
- There was an all time low in 2000, but the rates have been climbing year on year since.
- Between 2005 and 2006 the rates of P&S syphilis went up by 13.8 per cent, from from 2.9 to 3.3 cases per 100,000 population.
- The number of reported cases went up from 8,724 in 2005 to 9,756 in 2006.
- The overall rate of increase in the last year was mostly in males.
- The rate of transmission to newborns from their mothers during childbirth went up from 8.2 per 100,000 live births in 2005 to 8.5 in 2006.
The CDC report suggests that the 54 rise in syphilis among men reported in the last five years (from 3.7 per 100,000 in 2002 to 5.7 in 2006) is likely to be due to increased transmission among men who have sex with men, according to several research studies.
There has been a slight rise in the figures for women too but the CDC report said it is not clear what the reasons might be and will investigate this further.
An area for concern in all three types of STDs is the considerable racial disparities that exist among the figures. Racial and ethnic minorities appear to be more severely affected by reported STDs in the US. The CDC said one reason could be because these groups are more likely to be attending public health clinics that report STDs more fully than private clinics, and other reasons could be disproportionate access to health care, poverty, and higher actual rates of disease.
"Trends in Reportable Sexually Transmitted Diseases in the United States, 2006: National Surveillance Data for Chlamydia, Gonorrhea, and Syphilis."
US Centers for Disease Control and Prevention, issued 13 November 2007.
Click here to acess report online.
Written by: Catharine Paddock