Annual Summary: 2003 Minnesota Sexually Transmitted Disease Statistics

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Overview of Statistics and Highlights:
The number of cases and rates (per 100,000 persons) for all reportable bacterial sexually transmitted diseases (STDs) for the years 1999 through 2003 are presented in Table 1 by year of diagnosis. Table 2 displays chlamydia, gonorrhea and primary/secondary syphilis case numbers and rates by residence, age, gender, and race/ethnicity for 2003. Chlamydia and gonorrhea case numbers and rates by county for 2003 are shown in Table 3.

Between 2002 and 2003 in Minnesota, the chlamydia rate increased by 6% and the gonorrhea rate increased by 5%. The resurgence of early syphilis primarily among gay/bisexual men that began in 2002 continued in 2003. Ninety-two cases of early syphilis (which includes primary, secondary, and early latent stages) were reported in Minnesota in 2003 compared to 82 cases in 2002 and 49 cases in 2001. Of the 92 early syphilis cases in 2003, 83 (90%) occurred among men. Seventy-one (86%) of the men reported having sex with other men (MSM). Almost half (42%) of the MSM diagnosed with early syphilis were co-infected with HIV. Similar trends have been observed in other parts of the country. MDH is collaborating with local physicians, clinics, and community-based organizations to stem the increase.

Between 2002 and 2003 in Minnesota, the primary/secondary syphilis rate decreased by 17% while the early latent syphilis rate increased by 80%. The increase in cases that were reported during the early latent stage (no symptoms present at diagnosis) rather than primary or secondary stage highlights the importance not only of building greater awareness of syphilis symptoms among those at risk, but also the importance of routine screening.

STD rates continue to be highest in the seven-county metropolitan area, particularly in the cities of Minneapolis and St. Paul. Adolescents and young adults aged 15-24 years have the highest rates of chlamydia and gonorrhea, whereas the highest rates of primary/secondary syphilis are among persons in older age groups. Gonorrhea rates are comparable for men and women. However, due to more frequent screening among women, the reported rate of chlamydial infection among women is more than twice the rate among men. Rates of STDs remain elevated among communities of color.

Sources and Limitations of Data:
In Minnesota, laboratory-confirmed infections of chlamydia, gonorrhea, syphilis, and chancroid are monitored by the MDH through a combined physician and laboratory-based surveillance system. State law (Minnesota Rule 4605.7040) requires both physicians and laboratories to report all cases of these four bacterial STDs directly to the MDH. Other common sexually transmitted conditions caused by viral pathogens, such as herpes simplex virus (HSV) and human papillomavirus (HPV), are not reported to the MDH. Factors that impact the completeness and accuracy of the available data on STDs include: level of screening, individual test-seeking behavior, accuracy of diagnostic tests, and compliance with case reporting. Thus, any changes in STD rates may be due to one of these factors or due to actual changes in STD occurrence.

Population counts used to calculate rates by residence, by gender, and by race/ethnicity were obtained from the U.S. Census Bureau. Population counts for 1999 were estimated by interpolation between the 1990 and 2000 Census data. Rates for 2000-2003 were calculated using each year’s case data and population counts from the 2000 Census. The 2000 Census data on race include the number of persons by race alone or in combination with one or more races. Thus, persons who identified themselves by more than one race are “over counted” in the denominators.

Table 1. Number of Cases and Rates (per 100,000 persons) of Chlamydia, Gonorrhea, Syphilis, and Chancroid
-- Minnesota, 1998 - 2003

 

1999

2000

2001

2002

2003

Disease

Cases

Rate

Cases

Rate

Cases

Rate

Cases

Rate

Cases
Rate

Chlamydia

7,459

153

8,147

166

8,369

170

10,118

206

10,714
218

Gonorrhea

2,830

58

3,189

65

2,708

55

3,051

62

3,202
65

All Stages of Syphilis

70

1.4

80

1.6

135

2.7

149

3.0

195
4.0

- Primary/Secondary Syphilis

10

0.2

16

0.3

33

0.7

59

1.2

47
1.0

- Early Latent Syphilis

9

0.2

18

0.4

16

0.3

23

0.5

45
0.9

- Late Latent Syphilis (1)

50

1.0

44

0.9

81

1.6

65

1.3

103
2.1

- Other Syphilis

0

0.0

0

0.0

3

0.1

1

0.02

0
0.00

- Congenital Syphilis (2)

1

1.5

2

3.0

2

3.0

1

1.5

0
0.0

Chancroid

1

0.02

0

0.0

0

0.0

0

0.0

0
0.0

NOTE: Data exclude cases diagnosed in federal or private correctional facilities.
(1) Late latent syphilis includes neurosyphilis
(2) Congenital syphilis rate per 100,000 live births

Table 2. Number of Cases and Rates (per 100,000 persons) of Chlamydia, Gonorrhea, and Primary/Secondary Syphilis by Residence, Age, Gender, and Race/Ethnicity -- Minnesota, 2003
Chlamydia
Gonorrhea
Primary/Secondary Syphilis
Group
Cases
Rate
Cases
Rate
Cases
Rate
Residence         
Minneapolis
2,887
755
1,374
359
21
5.5
St. Paul
1,776
618
575
200
5
1.7
Suburban (1)
3,073
156
789
40
16
0.8
Greater Minnesota
2,978
131
464
20
5
0.2
Age
<10 yrs
11
2
0
0
0
0.0
10-14 yrs
159
42
55
15
0
0.0
15-19 yrs
3,469
927
783
209
2
0.5
20-24 yrs
4,040
1,253
1,035
321
4
1.2
25-29 yrs
1,656
518
538
168
2
0.6
30-34 yrs
732
207
326
92
10
2.8
35-44 yrs
522
63
347
42
22
2.7
45+ yrs
125
8
118
7
7
0.4
Gender
Male
2,848
117
1,418
58
43
1.8
Female
7,866
317
1,784
72
4
0.2
Race(2)/Ethnicity
White
4,703
105
995
22
34
0.8
Black
3,025
1,490
1,475
727
6
3.0
American Indian
376
464
84
104
2
2.5
Asian/PI
462
275
49
29
1
0.6
Other
259
291
72
81
1
1.1
Unknown (3)
1,889
--
527
--
3
--
Hispanic (4)
804
561
152
106
2
1.4
TOTAL
10,714
218
3,202
65
47
1.0

NOTE: Data exclude cases diagnosed in federal or private correctional facilities
(1) Suburban is defined as the seven-county metropolitan area (Anoka, Carver, Dakota, Hennepin, Ramsey, Scott, and Washington Counties, excluding the cities of Minneapolis and St. Paul.
(2) Race-specific case counts include persons by race alone. Denominators used to calculate rates include race alone or in combination.
(3) No comparable population data available to calculate rates.
(4) Persons of Hispanic origin may be of any race.

Table 3. Number of Cases and Rates (per 100,000 persons) of Chlamydia and Gonorrhea by County of Residence -- Minnesota, 2003
 
Chlamydia
Gonorrhea
Chlamydia
Gonorrhea
County
Cases
Rate
Cases
Rate
County
Cases
Rate
Cases
Rate
Aitkin
14
91
1
7
Marshall
7
69
1
10
Anoka
495
166
133
45
Martin
14
64
3
14
Becker
37
123
7
23
Meeker
15
66
3
13
Beltrami
99
250
14
35
Mille Lacs
13
58
2
9
Benton
34
99
5
15
Morrison
21
66
1
3
Big Stone
0
0
0
0
Mower
67
174
12
31
Blue Earth
154
275
41
73
Murray
8
87
0
0
Brown
12
45
2
7
Nicollet
15
50
2
7
Carlton
50
158
10
32
Nobles
26
125
4
19
Carver
43
61
11
16
Norman
1
13
0
0
Cass
37
136
5
18
Olmsted
274
220
67
54
Chippewa
16
122
3
23
Otter Tail
32
56
7
12
Chisago
55
134
3
7
Pennington
29
213
5
37
Clay
52
102
5
10
Pine
16
60
1
4
Clearwater
5
59
0
0
Pipestone
5
51
0
0
Cook
3
58
1
19
Polk
36
115
5
16
Cottonwood
8
66
2
16
Pope
5
44
1
9
Crow Wing
67
122
4
7
Ramsey
2,042
400
642
126
Dakota
621
174
130
37
Red Lake
3
70
0
0
Dodge
24
135
3
17
Redwood
13
77
0
0
Douglas
20
61
0
0
Renville
15
87
1
6
Faribault
11
68
1
6
Rice
73
129
9
16
Fillmore
23
109
1
5
Rock
5
51
0
0
Freeborn
28
86
2
6
Roseau
14
86
1
6
Goodhue
49
111
6
14
St. Louis
453
226
74
37
Grant
2
32
0
0
Scott
114
127
19
21
Hennepin
4,190
375
1,751
157
Sherburne
54
84
7
11
Houston
17
86
2
10
Sibley
11
72
1
7
Hubbard
11
60
0
0
Stearns
294
221
35
26
Isanti
34
109
9
29
Steele
52
154
14
42
Itasca
67
152
8
18
Stevens
8
80
0
0
Jackson
4
35
0
0
Swift
14
117
0
0
Kanabec
10
67
2
13
Todd
17
70
0
0
Kandiyohi
59
143
4
10
Traverse
1
24
0
0
Kittson
1
19
0
0
Wabasha
44
204
5
23
Koochiching
11
77
3
21
Wadena
10
73
0
0
Lac qui Parle
4
50
1
12
Waseca
28
143
4
20
Lake
6
54
2
18
Washington
231
115
52
26
Lake of the Woods
2
44
0
0
Watonwan
16
135
3
25
Le Sueur
23
90
3
12
Wilkin
3
42
0
0
Lincoln
1
16
1
16
Winona
45
90
16
32
Lyon
30
118
5
20
Wright
84
93
8
9
McLeod
36
103
11
32
Yellow Medicine
10
90
2
18
Mahnomen
11
212
3
58
 

Note: Data exclude cases diagnosed in federal or private correctional facilities

Data Archive: Previous STD Annual Reports

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Updated Monday, June 02, 2014 at 02:43PM