The U.S. gonorrhea rate fell to a record low in 2009, but the syphilis rate notched up again and the chlamydia rate reached a historic high, the federal government said in its annual report on sexually transmitted diseases.
The new Centers for Disease Control and Prevention (CDC) report also shows that the nation is nowhere near meeting the STD goals of Healthy People 2010, an ongoing national scorecard for good health that was last updated in 2000 by the Clinton administration.
For instance, Healthy People 2010 sought to have only a small fraction — 3 percent — of young men and women test positive for chlamydia at STD clinics. Instead, the 2009 data showed much higher chlamydia infection rates among clinic visitors — 16 percent for women and 24 percent for men.
Also, the 2009 gonorrhea rate of 99 cases per 100,000 persons was the lowest the government has seen since it started keeping records in 1941. But as welcome as this rate is, it still dwarfed the hoped-for 2010 rate of 19 cases of gonorrhea per 100,000 persons.
Gonorrhea is "still the second most commonly reported infection in the United States, so there's still a high burden of it," said Charlotte Kent, acting director of the CDC's Division of STD Prevention.
STDs are "hidden epidemics of enormous health and economic consequence in the United States," the CDC said in its report, Sexually Transmitted Disease Surveillance, 2009.
Many Americans are reluctant to address sexual health issues, and yet all of their communities are affected by STDs, the agency said, noting that the estimated 19 million new STD cases a year cost $16.4 billion a year in health costs.
In 2009, a record 1,244,180 cases of chlamydia were reported. This was a 2.8 percent increase over the 2008 rate and the largest number of cases for any condition ever reported. This is also less than half the estimated 2.8 million chlamydia cases that are believed to be out there, said Ms. Kent, an epidemiologist.
Chlamydia is a troublesome infection because it typically has no symptoms, so people do not seek treatment. In women, chlamydia can lead to pelvic inflammatory disease, which, if left untreated, can rapidly impair or destroy their ability to become pregnant.
"We estimate conservatively that about 24,000 women a year become infertile because of undiagnosed and untreated chlamydia and gonorrhea," Ms. Kent said.
Chlamydia can also impair men's reproductive organs, but a major concern of chlamydia in men is that they will infect their wives and girlfriends.
Black men have a far higher chlamydia rate — nearly 12 times — than white men do, and the rate of chlamydia in black women was nearly eight times higher than in white women, the CDC report said.
In 2009, the number of U.S. syphilis cases rose to 13,997, up almost 5 percent from 13,500 cases in 2008. The number of babies born with syphilis — which can result in retardation or death — was stable, with 427 cases reported in 2009.
The gonorrhea rate was a bright spot in the STD data, with cases falling to 301,174 from 336,742 cases in 2008.
However, gonorrhea is a "wily organism" that has become resistant to all but one class of drug, said Ms. Kent. The medical community is promoting gonorrhea prevention and searching for new methods of curing it. "But one of the best ways to insure that [antibiotic] resistant gonorrhea doesn't become a problem is for there to be very little of it" in the population, said Ms. Kent.
An advantage of the Obama administration's new health care law is it will open up STD testing and treatment to more people, added Ms. Kent. STD screenings will fall under qualified prevention services, so people will be able to get tested without a co-payment, she said.
The new CDC report does not include data on HIV/AIDS, which is covered separately. Other STDs, like herpes and human papillomavirus, are discussed in the new report, but these infections are not reportable and reliable data is sparse.
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