Some STDs Increased Again In 2008
A new report from the Minnesota Department of Health (MDH) shows that the number of reportable sexually transmitted diseases (STDs) in Minnesota climbed to a new high of 17,650 in 2008, reflecting the continued seriousness of the problem. Reportable STDs in Minnesota include chlamydia, gonorrhea and syphilis. There were 17,057 cases reported in 2007 and 16,428 cases in 2006.
"Chlamydia was Minnesota's number one reported infectious disease this past year with 14,350 cases," said Peter Carr, director of the STD and HIV Section at MDH. "This represents a 7 percent increase compared to the previous year, a trend of annual increases we have seen for some time now."
Health officials noted that chlamydia cases have more than doubled over the last 13 years. The greatest increases for chlamydia geographically have been in Greater Minnesota and in the Twin Cities suburbs with a little over 11 percent increase in each area compared to last year. Nearly 70 percent of all cases occurred in teens and young adults aged 15 to 24.
"What surprised us with the 2008 chlamydia data was the sudden and large increase in cases among males," said Carr. "We saw a 13 percent increase among 15 to 24 year old males compared to the 2007 report. We will be following up with certain clinics to investigate the causes of this increase."
Untreated chlamydia can lead to infertility in some women and, in rarer cases, even among men. An infected woman can pass the infection to her newborn causing premature delivery, infant pneumonia and serious eye infections leading to blindness. About 3 out of 4 females and 1 out of 2 males will show no symptoms once infected. Routine testing, even in the absence of symptoms, is the only way to detect these cases.
To help find those cases without symptoms, the Centers for Disease Control and Prevention (CDC) has developed guidelines for health care providers that call for annual screenings of all sexually active women aged 25 and under and for women over 25 that have risk factors such as a new sexual partner. Electronic patient records at clinics that incorporate these screening guidelines are effective in reminding clinicians about the screening.
Gonorrhea remained the second most commonly reported STD in Minnesota with 3,036 cases reported in 2008. While this is a 12 percent decrease compared to 2007, MDH data continues to show large disparities in gonorrhea rates by race, ethnicity and geography. In 2008, nearly 80 percent of the gonorrhea cases occurred in the Twin cities and suburban areas, and with African Americans having a rate 40 times higher than that of whites.
"With gonorrhea cases, the Twin Cities and suburban areas saw a drop in the number of cases and Greater Minnesota saw a 14 percent increase," said Carr. "Statewide, about 6 out of 10 cases occurred among those between the ages of 15 and 24."
Untreated gonorrhea can also lead to infertility in both men and women. Gonorrhea can spread to organs and joints and these conditions can be life threatening. Gonorrhea can be passed to newborns during childbirth causing blindness if the infant is not treated.
"We also saw an increase in the number of early syphilis cases reported in 2008," said Carr. "Early syphilis—infection of less than one year—is the most infectious stage of the disease and a great concern to us, particularly with a 40 percent increase in 2008."
Regarding syphilis, MDH data show that 163 early syphilis cases were reported in 2008 compared to 114 cases in 2007. Of the 163 early syphilis cases, 97 percent (158 cases) were males with a vast majority of cases occurring among men who have sex with men (MSM). New infections continued to be centered within the Twin Cities metropolitan area. Seventy-four percent (121 cases) were among whites, 18 percent (30 cases) were among African Americans and 4 percent (7 cases) were among Latinos.
"Syphilis is a very serious disease if left untreated," said Carr. Untreated syphilis can lead to blindness, mental illness, dementia and death. There is a 2 to 5 fold increased risk of getting HIV infection when syphilis is present.
Health officials noted that it is important for health providers to provide more syphilis screenings to their at-risk clients. CDC recommends that MSM patients be tested at least annually. For those at highest risk with multiple partners, especially if they are HIV positive, they recommend testing as often as every three months.
"Of course, avoiding sexual contact is the best way to prevent getting an STD. For those who are sexually active, limiting sexual partners, e.g., monogamous relationships and correctly using a latex condom will greatly reduce the risk of getting an STD," said Carr. "Getting tested for STDs each year is equally important for sexually active singles - even without symptoms."
Health officials noted that it's very important that sexual partners of those infected with an STD be notified about the need to be tested and treated. Untreated partners remain reservoirs for spreading the disease and can re-infect the initial patient.
Health providers are responsible to make reasonable attempts to assure treatment of the sex partners of their STD infected patients. When partners are unable or unwilling to get to a clinic, expedited partner therapy (EPT) allows physicians to dispense prescriptions for partners through their patients who have tested positive for chlamydia or gonorrhea.
In addition, the MDH Partner Services Program provides follow-up for people with HIV, syphilis, and those with untreated chlamydia and gonorrhea and their sexual partners who may need examination and treatment. They also provide follow-up to chlamydia and gonorrhea infected patients referred from clinics who have not been treated. Partner referral cards are available to clinics from the MDH to help clients notify their partners anonymously.
To help create awareness about STDs in Minnesota, the Minnesota Department of Health will launch a statewide STD public service campaign during National STD Awareness Month (April). The department will continue to support chlamydia and gonorrhea screening clinics serving areas with the highest rates of infection.