According to the Sexually Transmitted Disease Surveillance Report published on Tuesday, the count of combined cases of gonorrhea, chlamydia, and syphilis has increased in the fifth consecutive year. Health officials have raised alarm on the count of STD cases in the U.S.
“Combined they total 2.4 million infections that were diagnosed and reported just in last year alone,” said Elizabeth Torrone, a CDC epidemiologist who worked on the new report, adding that the combined number marks “the most cases” ever recorded since monitoring began in the United States.
The rise in STDs can result in serious public health consequences and concerns. “Yet not 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,” Dr. Gail Bolan, director of the CDC’s Division of STD Prevention, wrote in the new report’s foreword.
“That progress has since unraveled. The number of reported syphilis cases is climbing after being largely on the decline since 1941, and gonorrhea rates are now increasing.
“Many young women continue to have undiagnosed chlamydial infections, putting them at risk for infertility.”
Such cases are on peak among adolescents and young adults as per the newly reported cases. New CDC called federal, state, and local agencies to build up the strategies to reduce STD count and help to improve sexual, maternal, reproductive and infant health.
“STDs cause a significant burden to the health care system — both in terms of direct medical costs for treating STDs as well as the personal cost for people who have an STD,” Torrone said. “As the STD epidemic continues to grow in the United States, the direct medical costs and the quality of life lost will just increase as well.”
chlamydia, gonorrhea, syphilis, and chancroid are four STD nationwide noticeable to CDC.
States with the highest number of cases reported are Nevada for primary and secondary syphilis, Alaska for chlamydia and Mississippi for gonorrhea. District of Columbia is reported highest cases, for each of the three diseases.
“We’ve seen increases like the nation as a whole has seen increases. We’ve seen some recently bigger jumps and there’s a number of factors to which we attribute that,” said Michael Kharfen, senior deputy director of the HIV/AIDS, Hepatitis, STD and TB Administration at the DC Department of Health, who was not involved in the new CDC report.
“We have been very aggressive in making STD screening available in lots of different both clinical and community settings, particularly among young people, who have a disproportionate number,” he said.
In 2018, a total of about 1.8 million cases of chlamydia infection were reported to CDC and 583,405 cases of gonorrhea were reported, which was a second growing concern for the United States.
Congenital syphilis concerns are increasing since 2013, congenital syphilis is found in infants when the pregnant mother is suffering from syphilis, this is severe, disabling and often life-threatening infection.
“One of the things that really stands out in this new report is the new and updated data on congenital syphilis, which is one of the most tragic consequences of this growing epidemic,” Torrone said.
“Most concerning in that overall case count — there were 94 infant deaths related to congenital syphilis,” Torrone said.
“All of those cases could have been prevented if pregnant women had been treated appropriately and in a timely way prior to delivery,” she said. “We really need to make sure that all pregnant women are screened at their first prenatal care visit, treated appropriately and that their partners are treated so that we prevent reinfection.”
“With gonorrhea, in particular, we have a real threat with drug resistance,” said Dr. Mark Mulligan, chief of infectious diseases at NYU Langone Health in New York and director of the NYU Langone Vaccine Center, who was not involved in the new CDC report.
“For most gonorrhea, we’re down to a single drug and if we lose that it could potentially become untreatable,” he said. “One need is to develop new antimicrobials for resistant organisms like gonorrhea. Another need or another strategy to combat the much broader problem of antimicrobial resistance is using vaccines to try to prevent the infections and therefore reduce the impact of drug resistance.”
“In order for a case to be represented in the report, the infection actually needs to be diagnosed and reported,” CDC’s Torrone said.
“We know that there are many more infections that occur that just are not getting diagnosed and treated,” she said. “The intervention that we need is really to be able to increase access to routine screening as well as quality prevention.”
“I think it’s important to remember that part of the increase in cases is because we’re actually doing a good job getting people screened,” Torrone said, but the “steep and sustained increases” in cases are unlikely explained by just increased screening alone.
“Some of that increase in incidence may be due to change in sexual behaviors,” she said, such as decreases in people using condoms
“We have an STD crisis in the US because prevention programs were sold short for years,” David Harvey, executive director of the National Coalition of STD Directors, said in the statement.
“Our first line of defense is underfunded and overwhelmed, leaving Americans vulnerable to STD outbreaks, and that’s exactly what we’re seeing,” he said. “STDs have real health and human costs. Babies dying from preventable conditions, like congenital syphilis, is not an outcome we can accept. This is a heartbreaking symptom of our nation’s STD crisis. Without a radical shift in how we prioritize sexual health in the United States, we can only expect things to get worse.”
“We should also think about new frontiers in STI testing. It’s now possible to test people in their own home, with self-collection kits and provide them with counseling via telehealth,” he said. “We just need to move away from traditional clinical models and be a bit more creative with how we reach young people.”