A new report from the Centers for Disease Control and Prevention (CDC) has summarized national surveillance data for 2015 on the three notifiable sexually transmitted diseases (STDs) for which there are federally funded control programs: chlamydia, gonorrhea, and syphilis. STDs are a substantial health challenge for the United States. The CDC estimates that nearly 20 million new sexually transmitted infections occur every year in this country, accounting for approximately $16 billion in health care costs.
More than 1.5 million cases of Chlamydia trachomatis infection were reported to the CDC in 2015. This case count corresponds to a rate of 479 cases per 100,000 people––an increase of 5.9% compared with the rate in 2014. During 2014–2015, the rate of reported chlamydia cases among women increased 3.8%, and the rate among men increased 10.5%. Following three years of decreases in rates during 2011–2014, the rate among women ages 15 to 19 years increased 1.5% during 2014–2015.
In 2015, the overall rate of chlamydial infection in the United States among women (646 cases per 100,000 females), based on reported cases, was more than twice the rate among men (305 cases per 100,000 males), reflecting the larger number of women screened for this infection. During 2011–2015, the chlamydia rate in men increased 20% compared with a 0.3% increase in women during this period.
Rates of reported chlamydia varied among different racial and ethnic minority populations. In 2015, the rate of chlamydia among blacks was 5.9 times the rate among whites, and the rate among American Indians/Alaska Natives was 3.8 times the rate among whites.
In 2009, the national rate of reported gonorrhea cases reached an historic low of 98 cases per 100,000 people, the CDC found. However, during 2009–2012, the rate increased slightly each year to 107 cases per 100,000 people in 2012, and then increased again during 2013–2015. In 2015, a total of 395,216 gonorrhea cases were reported, corresponding to a rate of 124 cases per 100,000 people––an increase of 12.8% from 2014.
During 2014–2015, the rate of reported gonorrhea increased 18.3% among men and 6.8% among women. Gonorrhea rates among both men and women increased in every region of the U.S., with the largest increases in the West and the South.
In 2015, the rate of reported gonorrhea cases remained highest among blacks (425 cases per 100,000 people) and among American Indians/Alaska Natives (193 cases per 100,000 people). Rates of gonorrhea declined 4.0% among blacks during 2011–2015, but increased among all other racial and ethnic groups, including a 71.3% increase among American Indians/Alaska Natives.
Antimicrobial resistance remains an important consideration in the treatment of gonorrhea. With increased resistance to the fluoroquinolones and declining susceptibility to cefixime, dual therapy with ceftriaxone and azithromycin is now the only CDC-recommended treatment for gonorrhea. In 2015, the percentage of isolates with elevated minimum inhibitory concentrations (MICs) of cefixime and ceftriaxone remained low (0.5% and 0.3%, respectively). During 2013–2015, the percentage of isolates with reduced azithromycin susceptibility increased from 0.6% to 2.6%. Continued monitoring of susceptibility patterns to these antibiotics is critical.
In 2000 and 2001, the national rate of reported primary and secondary (P&S) syphilis cases was 2.1 cases per 100,000 people––the lowest rate since reporting began in 1941, according to the CDC’s report. However, the P&S syphilis rate has increased almost every year since 2001. In 2015, a total of 23,872 P&S syphilis cases were reported, and the national P&S syphilis rate increased to 7.5 cases per 100,000 people––a 19.0% rise from 2014.
During 2014–2015, the P&S syphilis rate increased among both men (18.1%) and women (27.3%), and rates increased among both sexes in every region of the country. Nationally, P&S syphilis rates increased in every five-year age group among those ages 15 to 64 years and in every racial and ethnic group except for American Indians/Alaska Natives during 2014–2015.
During 2000–2015, the rise in the P&S syphilis rate was primarily attributable to increased cases among men and, specifically, among men who have sex with men (MSM). In 2015, men accounted for more than 90% of all cases of P&S syphilis. Of those male cases for whom the gender of the sex partner was known, 81.7% were MSM. Reported cases of P&S syphilis continued to be characterized by a high rate of human immunodeficiency virus (HIV) coinfection, particularly among MSM, the CDC reported.
Source: CDC; October 18, 2016.