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STDs are on the rise nationally and in Tennessee, according to the 2018 Central for Disease Control’s Annual STD Surveillance Report, published earlier last week.
According to the report, which tallies the STD reports from 2014 to present, the rate of reported STDs has risen steadily each year. Reported cases of congenital syphilis have risen the most, with a frightening 185 percent national increase since 2014. Primary and secondary syphilis was second, with a 71 percent increase, followed by Gonorrhea at 63 percent and Chlamydia at 19 percent.
Below are breakdowns of each reported STD by national and state rates.
The report states that a total of 1,758,668 cases of Chlamydia trachomatis were reported nationally in 2018, making it the “most common notifiable condition in the United States.” At a rate of 539.9 per 100,000 people, the disease has risen 2.9 percent nationally since 2017.
Rates of the disease are consistently higher in adolescents and young adults: according to the 2018 report, almost two-thirds of all reported chlamydia cases were among 15 to 24 year-olds.
Females tend to be screened for chlamydia at a far higher rate than males, making it hard to compare the reported cases between the two, but the trend for females was a 1 percent increase from 2017 and a 11.8 percent increase from 2014, nationally.
Men are starting to catch up, however, which CDC researchers suspect is due to the increased number of men—”including gay, bisexual, and other men who have sex with men (MSM)”—being tested for chlamydial symptoms “due to increased availability of urine testing and extragenital screening, increased transmission among men, or both.”
Tennessee ranks number 17 in the nation for rates of chlamydial infections, with 38,212 reported cases across the state in 2018. 2018’s number, as compared to 2017’s 35,087 reported cases, shows a 9 percent increase, and a 21 percent increase since 2014.
Females have seen a 7.7 percent increase since 2017, and a 15 percent increase since 2014, with 25,151 cases reported in 2018.
Males saw only 13,057 reported cases in 2018, making it a 11.2 percent increase since 2017 and a 32 percent increase since 2014.
There were a total of 583,405 cases of gonorrhea reported nationally in 2018, making it the second most common notifiable condition in the U.S. Unlike the steady rise in reported cases of chlamydia, cases of gonorrhea jumped a dramatic 82.6 percent since its “historic low” in 2009. From 2017 to 2018, cases increased 5 percent.
Females’ national rates of reported gonorrhea cases only increased 3.6 percent from 2017 to 2018 and 45.2 percent since 2014, while male rates increased 6 percent from 2017 to 2018, and 78.7 percent since 2014.
The higher rates in men, according to the report, “suggests either increased transmission, increased case ascertainment (e.g., through increased extra-genital screening among MSM), or both. The concurrent increase in cases reported among women suggests parallel increases in heterosexual transmission, increased screening among women, or both.”
In Tennessee, where the state ranks number 11 among all states for reported gonorrhea cases, there were 14,627 reported cases in 2018. This number shows a 17.7 percent increase from 2017’s 12,426 reported cases and a 98 percent increase from 2014.
Female rates of reported gonorrhea rose 18 percent from 2017’s 5,667 cases to 2018’s 6,681 cases, and saw an overall rise of 90 percent since 2014.
Male rates of gonorrhea cases rose a similar 17 percent from 2017’s 6,758 cases to 2018’s 7,946, and saw a much greater overall increase of 104 percent since 2014.
There were a total of 115,045 cases of all stages of syphilis reported, and according to the report, 35,063 cases of primary and secondary syphilis (P&S)—the most infectious stages of the disease—reported. Syphilis has increased steadily every year since another historic low in 2000 and 2001, increasing 15 percent between 2017-2018.
Rates of P&S have increased dramatically among men since 2000, which CDC researchers mostly attribute to MSM. “Similar to past years, in 2018, MSM accounted for the majority (53.5 percent) of all reported cases of P&S syphilis,” according to the report. “Of these, 41.6 percent were known to be living with diagnosed HIV.”
Rates of P&S among females have been on the rise as well, increasing 30.4 percent since 2017 and 172.7 percent since 2014. CDC researchers suspect a “rapidly growing heterosexual epidemic.”
1,306 cases of congenital syphilis were reported nationally in 2018, showing a 39.7 percent increase from 2017, and a national rate of 33.1 per 100,000 live births. The number of syphillic still births also increased in 2018, from 2017’s 64 to 2018’s 78), and the number of congenital syphilis-related infant deaths rose from 2017’s 13 to 2018’s 16.
Tennessee ranks number 27 in the nation for P&S syphilis, and number 19 for congenital syphilis. For all types of syphilis, Tennessee has seen a 19 percent increase since 2017, with 1,725 cases in 2018 and only 1,452 cases in 2017. Overall, Tennessee has seen a 72.4 percent increase since 2014.
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