Perspective

Reported US cases of three STDs reaches record two million

Jonathan Mermin

More than two million cases of chlamydia, gonorrhea and syphilis — the most ever — were reported in the United States in 2016, according to the CDC.

The epidemic includes a 36% increase in syphilis infection among women and a 22% increase in gonorrhea among men, the agency said.

Increases in STDs are a clear warning of a growing threat,” Jonathan H. Mermin, MD, MPH, director of the CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, said in a press release. “STDs are a persistent enemy, growing in number and outpacing our ability to respond.”

According to the 2016 Sexually Transmitted Disease Surveillance report, Chlamydia accounted for the most reported cases, at 1.6 million. It was followed by gonorrhea at 470,000 cases, then primary and secondary syphilis — the most infectious stages — at 28,000 cases.

All three diseases can be cured with antibiotics. However, if left untreated, they can lead to serious complications like infertility, potentially deadly ectopic pregnancy, stillbirth and increased risk for HIV transmission, according to the CDC.

The report showed that syphilis infection increased by almost 18% from 2015 to 2016, and most cases were in men, especially those who have sex with men (MSM). About half of MSM diagnosed with syphilis also have HIV.

The U.S. also saw a 28% increase in syphilis among newborns. Of more than 600 congenital syphilis cases reported in 2016, more than 40 resulted in death or severe complications. Routine syphilis screening and timely treatment in pregnant women can prevent congenital infection, the CDC added.

The 22% rise in gonorrhea among men was the largest for that disease. According to the CDC, a large proportion of new gonorrhea cases is occurring in MSM. The threat of gonorrhea is compounded by drug resistance, the agency added.

CDC officials said the agency is taking steps to curb the epidemic, which includes improving diagnosis and treatment of pregnant women with syphilis and quickly treating newborns in the 10 states with the greatest congenital syphilis burden.

The CDC also said it will help health departments rapidly test for drug-resistant gonorrhea, quickly find those who are infected and include STD prevention in HIV care.

Health departments, for their part, should aim to rapidly detect STD cases and treat them in areas with the highest disease burden, the CDC said. – by Joe Green

Reference:

CDC. 2016 Sexually Transmitted Disease Surveillance. www.cdc.gov/std/stats16/toc.htm. Accessed Sept. 26, 2017.

Disclosure: Mermin reports no relevant financial disclosures.

Jonathan Mermin

More than two million cases of chlamydia, gonorrhea and syphilis — the most ever — were reported in the United States in 2016, according to the CDC.

The epidemic includes a 36% increase in syphilis infection among women and a 22% increase in gonorrhea among men, the agency said.

Increases in STDs are a clear warning of a growing threat,” Jonathan H. Mermin, MD, MPH, director of the CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, said in a press release. “STDs are a persistent enemy, growing in number and outpacing our ability to respond.”

According to the 2016 Sexually Transmitted Disease Surveillance report, Chlamydia accounted for the most reported cases, at 1.6 million. It was followed by gonorrhea at 470,000 cases, then primary and secondary syphilis — the most infectious stages — at 28,000 cases.

All three diseases can be cured with antibiotics. However, if left untreated, they can lead to serious complications like infertility, potentially deadly ectopic pregnancy, stillbirth and increased risk for HIV transmission, according to the CDC.

The report showed that syphilis infection increased by almost 18% from 2015 to 2016, and most cases were in men, especially those who have sex with men (MSM). About half of MSM diagnosed with syphilis also have HIV.

The U.S. also saw a 28% increase in syphilis among newborns. Of more than 600 congenital syphilis cases reported in 2016, more than 40 resulted in death or severe complications. Routine syphilis screening and timely treatment in pregnant women can prevent congenital infection, the CDC added.

The 22% rise in gonorrhea among men was the largest for that disease. According to the CDC, a large proportion of new gonorrhea cases is occurring in MSM. The threat of gonorrhea is compounded by drug resistance, the agency added.

CDC officials said the agency is taking steps to curb the epidemic, which includes improving diagnosis and treatment of pregnant women with syphilis and quickly treating newborns in the 10 states with the greatest congenital syphilis burden.

The CDC also said it will help health departments rapidly test for drug-resistant gonorrhea, quickly find those who are infected and include STD prevention in HIV care.

Health departments, for their part, should aim to rapidly detect STD cases and treat them in areas with the highest disease burden, the CDC said. – by Joe Green

Reference:

CDC. 2016 Sexually Transmitted Disease Surveillance. www.cdc.gov/std/stats16/toc.htm. Accessed Sept. 26, 2017.

Disclosure: Mermin reports no relevant financial disclosures.

    Perspective
    Harold Wiesenfeld

    Harold Wiesenfeld

    The CDC report on the record high level of sexually transmitted diseases represents an ongoing, and perhaps an increasing, threat to public health. This should serve as a warning and an alarm to our country that we have much more to do in getting this epidemic under control.

    It is worrisome that syphilis incidence continues to rise. While it disproportionately affects MSM, we are now seeing a nationwide increase in syphilis in women, and as a result an increase in congenital syphilis. Congenital syphilis carries devastating consequences, yet it is nearly completely preventable.

    As a society, we need to destigmatize STDs because they are quite common, and physicians need to be vigilant and discuss STD risks and screenings with their patients. People need to feel comfortable and educated on receiving routine care and requesting STD screening, which includes screening for HIV.

    • Harold Wiesenfeld, MD
    • Director, gynecologic specialties and reproductive infectious disease Women’s Hospital of the University of Pittsburgh Medical Center

    Disclosures: Wiesenfeld reports no relevant financial disclosures.