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U.S. Chlamydia Infections Hit All-Time High
Date:11/13/2007

Million-plus cases reported, as gonorrhea, syphilis rates rise for 2nd year in a row, CDC says

TUESDAY, Nov. 13 (HealthDay News) -- The number of Americans newly infected with a sexually transmitted disease (STD) continues to rise, federal health officials reported Tuesday, with one infection in particular -- chlamydia - hitting a record million-plus new cases annually.

Numbers from 2006 show that cases of chlamydia, as well as gonorrhea and syphilis, continued to increase in the United States for the second year in a row, according to a new report by the U.S. Centers for Disease Control and Prevention (CDC).

The 1,030,911 new cases in 2006 for chlamydia, which can cause pelvic inflammatory disease in women as well as infertility, mark "an all-time high" for the disease in the United States, said Dr. John M. Douglas Jr., director of the Division of Sexually Transmitted Disease Prevention at the CDC's National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention.

The CDC now estimates that there are 19 million new cases of STDs diagnosed in the United States each year. Almost half of these occur among people 15 to 24 years of age, and they cost the health care system an estimated at $14.7 billion annually.

"STDs pose a serious and ongoing threat to millions of Americans," said Douglas during a teleconference on Tuesday.

"Young women, racial and ethnic populations, and men who have sex with men are particularly hard-hit by these diseases," Douglas said. "STDs can have serious health consequences, particularly if they are undiagnosed and left untreated"

In women, chlamydia and gonorrhea can lead to pelvic inflammatory disease and infertility. Syphilis can cause neuralgic damage and fatal infections in babies, Douglas added. In addition, all three of these diseases increase the risk for transmitting and developing HIV, the virus that causes AIDS, he said.

"This is a hidden epidemic that most people are not aware of -- how many STDs are out there -- the risk that they run and the need for getting regular testing and treatment and having their partners treated," Dr. Stuart Berman, chief of the Epidemiology and Surveillance Branch in the Division of STD Prevention at CDC, said during the teleconference.

"We'd like to see these rates going down," Berman added. "That they are not going down says there should be greater awareness by the public and maybe a little more attention paid both by the public and their providers."

The data are included in the new CDC report: Trends in Reportable Sexually Transmitted Diseases in the United States, 2006.

Chlamydia is the most common reportable infectious disease in the United States, according to the report, with more than a million cases reported in 2006. In 2006, the national rate of reported chlamydia was 347.8 cases per 100,000 people. That's an increase of 5.6 percent from 2005, officials said.

Young women 15 to 19 had the highest chlamydia rate, Douglas said. "There are approximately [an estimated] 2 million new cases of chlamydia each year," he said. "The CDC recommends that all women under 26 be screened for chlamydia annually."

The increase appears to be due to more screening and the use of more sensitive tests. But the CDC doesn't rule out an actual increase in infections, Douglas noted.

Gonorrhea is the second most commonly reported infectious disease in the United States, with 358,366 cases reported in 2006, the report found. The rate for gonorrhea in 2006 was 120.9 cases per 100,000 people -- that's a 5.5 increase since 2005, and the second year in which a bump in new cases was seen, he said.

The highest rates of gonorrhea were observed in the South, Douglas said, but they also increased in the West. In addition, gonorrhea is becoming resistant to some antibiotics, he said. For that reason, the CDC no longer recommends drugs called fluoroquinolones for treating the disease, he said.

The increase in cases of gonorrhea is disheartening, because it comes after a 74 percent drop in reported cases between 1975 and 1997, the CDC noted.

Both gonorrhea and chlamydia are underreported and underdiagnosed, the experts said. "Approximately twice as many new infections are estimated to occur each year as are reported," according to the CDC.

Since reaching a record low in 2000, the rate of new syphilis cases has been on the rise. From 2005 to 2006, the rate of syphilis increased 13.8 percent, to 3.3 cases per 100,000 people. In 2006, there were 9,756 cases of syphilis reported, up from 8,724 in 2006, Douglas said.

The increase in the number of cases between 2005 and 2006 was largely driven by men who have sex with men, according to the CDC. "In 2006, 64 percent of cases were among men who have sex with men," Douglas said.

In addition, the rate of syphilis increased among women from 0.9 to 1.0 per 100,000. There was also a small increase in cases of syphilis transmitted from mothers to newborns, from 8.3 per 100,000 in 2005 to 8.5 per 100,000 in 2006, the CDC reported.

The racial disparity in who is most affected by STDs continues. Black Americans are more than eight times more likely to have chlamydia. In fact, 46 percent of all new cases are among blacks, Douglas said.

"The racial disparities in the diagnosis of gonorrhea are stark," Douglas said. Blacks are 18 times more likely to get gonorrhea compared with whites. The rate of gonorrhea increased 8.3 percent from 2005 to 2006, and blacks account for 69 percent of all new cases.

The rates of syphilis are also higher among blacks, who were six times more likely than whites to develop the disease. Between 2005 and 2006, the rate of syphilis among blacks increased 16.5 percent. The biggest increase was seen among black men, the CDC noted.

In 2006, the rate of syphilis among black women was 16 times higher than among white women. In 2006, 43.2 case of syphilis occurred among black Americans and 34.8 percent were among whites, Douglas noted.

One expert believes sex education programs, along with condom use, could go a long way to reducing the country's STD incidence.

"Most people will be stunned to learn that STDs affect nearly 20 million Americans each year," said Dr. David Katz, director of the Prevention Research Center at Yale University School of Medicine. "This is an entirely preventable plague," he added.

Consistent use of condoms would prevent almost all cases of STDs, along with HIV, as well as unintended pregnancies, Katz said. "Political correctness may place an emphasis on abstinence programs, but the scientific evidence is clear -- they don't work," he said.

And sex education programs do not promote sexual activity, Katz added. "They do prevent disease. I hope this report encourages us all to see the public health need and the moral imperative regarding STD control as one and the same. The more time we spend pretending there are alternatives, the more needless suffering there will be," he said.

More information

To see the full report, visit the U.S. Centers for Disease Control and Prevention.



SOURCES: Nov. 13, 2007, teleconference with John M. Douglas Jr., M.D., director, Division of Sexually Transmitted Disease Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention; Stuart Berman, M.D., chief, Epidemiology and Surveillance Branch in the Division of STD Prevention, both U.S. Centers for Disease Control and Prevention; David Katz, M.D., M.P.H., director, Prevention Research Center, Yale University School of Medicine, New Haven, Conn.


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