STD Rates Continue to Skyrocket in the United States

Marcia Frellick

September 26, 2017

New cases of the three most common sexually transmitted diseases (STDs) in the United States have hit a record high, according to this year's Sexually Transmitted Disease Surveillance Report , released today by the Centers for Disease Control and Prevention (CDC).

In 2016, there were just more than 2 million new diagnoses for the three notifiable STDs for which there are federally funded control programs. Chlamydia diagnoses made up the majority of those, with 1,598,354 new cases (497.3 cases per 100,000 population), which was a 4.7% increase over 2015. Gonorrhea diagnoses followed, with 468,514 diagnoses, and primary and secondary syphilis, the most infectious stages of the disease, at 27,814 cases.

"STDs are a persistent enemy, growing in number, and outpacing our ability to respond," Jonathan Mermin, MD, MPH, director of CDC's National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, said in a CDC news release.

Sharp increases in syphilis and gonorrhea show the two diseases are hitting new populations.

Syphilis rates were up nearly 17.6% from 2015 to 2016, rising to 8.7 cases per 100,000 population. Whereas most (nearly 90%) of the cases occurred among men, especially men who have sex with men (MSM), the largest increases were seen among women and infants. Specifically there was a 35.7% jump in syphilis rates in women and a 27.6% increase in congenital syphilis in that year, which represents "a tragic systems failure," said Gail Bolan, MD, director of the CDC's Division of STD Prevention.

In 2016, 628 cases of congenital syphilis were reported, resulting in 40 deaths and severe complications. In 2015, there were 492 cases reported.

"All it takes is a simple STD test and antibiotic treatment to prevent this enormous heartache and help ensure a healthy start for the next generation of Americans," Dr Bolan said.

In 2016, the rate of gonorrhea infections was 145.8 cases per 100,000, which was an overall increase of 18.5% over 2015. The largest increase was seen among men (a 22.2% rise), and the report authors note that research suggests a large proportion of these are found in MSM. Among women, there was a 13.8% increase during the same period.

Growth in the disease is particularly troubling because antibiotic resistance is growing to the last recommended treatment for gonorrhea, according to the report.

These increases represent a dramatic change in the landscape for STDs. "[N]ot that long ago, gonorrhea rates were at historic lows, syphilis was close to elimination, and we were able to point to advances in STD prevention, such as better chlamydia diagnostic tests and more screening, contributing to increases in detection and treatment of chlamydial infections," Dr Bolan writes in the foreword to the report. "That progress has since unraveled."

The report calls for state and local health departments to reprioritize rapid detection and treatment for people living in areas hardest hit by STDs and for providers to make STD screening and timely treatment a regular part of care, especially for pregnant women and MSM.

The CDC estimates that there are 20 million new notifiable and nonnotifiable STD cases every year in the United States, and half of these occur in people 15 to 24 years old.

All three of the most common STDs can be cured with antibiotics, but if not treated, the resulting health effects can include infertility, ectopic pregnancy, stillbirth, and higher risk for HIV transmission.

The authors have disclosed no relevant financial relationships.

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