U.S. Gonorrhea Rate Drops to Record Low; Increases Seen in Number of Chlamydia, Syphilis Cases, CDC Report Says

Gonorrhea prevalence in the United States dropped nearly 5% between 2002 and 2003, falling to a record low of 116.2 cases of the sexually transmitted disease per 100,000 people, according to CDC's "2003 STD Surveillance Report," which was released Monday, the AP/Macon Telegraph reports. The national gonorrhea rate has dropped rapidly since 1975, when CDC began a nationwide program to control the spread of the disease. Between 1975 and 1997, gonorrhea prevalence in the country declined 74%, and the only increase since 1975 occurred in 1998. The decline can be attributed to an increased number of screening and treatment programs at clinics nationwide in the 1980s and 1990s, according to Dr. David Martin, director of the Louisiana STD Research Center and professor of infectious disease at Louisiana State University Medical School. However, current gonorrhea prevalence likely will not decrease any further unless more screening programs outside of the clinic setting -- such as in prisons, schools and drug treatment facilities -- are implemented, Martin said. Despite the overall decline in gonorrhea prevalence, a higher percentage of gonorrhea strains were resistant to traditional antibiotic treatments in 2003 than in the previous year; about 4.1% of samples of the disease collected in 2003 showed resistance to common antibiotics, compared with 2.2% in 2002. In addition, black people in the United States are more than 20 times as likely to have gonorrhea than white people, according to the study. Dr. Ronald Valdiserri, deputy director of CDC's National Center for HIV, STD and TB Prevention, said that the racial disparity may be the result of unequal access to health care facilities (Yee, AP/Macon Telegraph, 11/29).

Chlamydia, Syphilis
The number of chlamydia cases in the United States increased about 5% between 2002 and 2003, but the rise in the number of cases most likely is due to improved screening and diagnostics and not a resurgence of the disease, according to the CDC study, Reuters reports. In 2002, 834,555 cases of chlamydia were reported in the United States, compared with 877,478 cases in 2003. However, CDC estimates that about two million other U.S. residents -- mostly women -- have cases of chlamydia that have not been diagnosed or reported. CDC recommends annual chlamydia screenings for women ages 26 and older who have multiple sex partners and all sexually active women under age 26. CDC on Monday also announced that the number of syphilis cases in the United States increased between 2002 and 2003. In 2002, 6,862 cases of primary and secondary syphilis infections were reported, compared with 7,177 cases in 2003. In addition, CDC estimates that about 60% of syphilis cases in the United States occur among men who have unprotected sex with men. The increase in the number of syphilis cases among MSM is of "particular concern" to officials because as many as 70% of MSM who recently have been diagnosed with syphilis also are HIV-positive, according to Reuters (Simao, Reuters, 11/29).

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