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QX{'XgOm|a~ÐlxĚ~1Qeh82pST2;>H^4( 21  k=C Chart MSGraph.Chart.80*Microsoft Graph Chart0E Chart MSGraph.Chart.80*Microsoft Graph Chart0F Chart MSGraph.Chart.80*Microsoft Graph Chart/ 00DTimes New Romanl7|7 0 0DArial Narrowanl7|7 0 0" DWingdingsowanl7|7 0 00DTimesngsowanl7|7 0 0  ` .  @n?" dd@  @@``    o(  !)T          F&4&%!&(#  @  A DDQ   q  EI "   7 %%  b !"#$&'!   _"$ҕU@![3v8x $"$Ǫ;goS  $"$_r2/$WN <AA 3333fff@889g4KdKd7 0pp<4!d!d 0DX8 <4KdKd 0DFlO ʚ;Sk8ʚ;<4dddd@ 0g4:d:d7 0.p p 0___PPT10 ~___PPT9`z{D204? %O<Minnesota Department of Health *Last updated: 4/16/04]MBackground Information$CDC-recommended antibiotic treatments for gonorrhea: Ceftriaxone Single dose therapy, administered by injection Relatively expensive Cefixime Single dose therapy, administered orally Production discontinued in 2002; No longer available Ciprofloxacin, Ofloxacin, Levofloxacin (Quinolones) Single dose therapy, administered orally Spread of quinolone-resistant N. gonorrhoeae (QRNG) threatens the efficacy of fluoroquinolones as the frontline treatment for gonorrhea 5 D ^45 D ^4 G\8Prevalence of Quinolone-Resistant N. Gonorrhoeae (QRNG)$9#ZPrevalence of QRNG in Minnesota , 1999 - 2006*.$ $$  4Prevalence of QRNG by Mode of Transmission in Minnesota, 2002 - 2006  GE$ $E  B-Characteristics of 2006 QNRG cases (n = 19) 0."$BAll cases were male. 68% of the cases were White 32% of cases were 24 years old or younger and 37% of cases were among 25-29 years olds (Mean age  29, Median age  27) 17 of 19 cases (89%) were among gay/bisexual males 6% of cases among gay/bisexual males are also infected with HIV VKKKKKK"@What s Being Done in Minnesota? !!$"The MDH continues to test gonorrhea isolates from Room 111 and Red Door Clinic for Quinolone resistance In 2005 and 2006, through a project funded by APHL and CDC, the MDH conducted surveillance for QRNG among women tested at Red Door Clinic and Room 111; Room 111 continues to submit isolates for women Healthcare providers are encouraged to obtain travel histories of patients and to be alert for treatment failures. Gonorrhea infections acquired in areas with high QRNG prevalence and among MSM should receive non-quinolone therapy Clinicians and laboratories are asked to report suspected treatment failures and resistant gonococcal isolates to the MDH The MDH Partner Services Program follows up on all cases with quinolone resistant gonorrhea and their sex partners to ensure proper treatment#K# G^vEarly Syphilis Among Gay/Bisexual Men Minnesota, 2001-2006*<$ $-$  -Number of Early Syphilis Cases and Percent MSM, by Age, Minnesota, 2006>I    $   03Characteristics of Early Syphilis Cases Among Gay/Bisexual Men Minnesota, 2006*R" /"  / Gay and Bisexual men account for 89% of cases among men 78% of cases among MSM are White, and 55% are between the ages of 25 and 39 (mean age = 34) 76% of cases live in Hennepin County, and 65% in the City of Minneapolis 40% of cases are also infected with HIV Among cases interviewed by the MDH Partner Services Program: Internet was the most common venue for meeting partners (44%) Most reported having anonymous sex (61%), and of these 38% reported no condom use 14% of cases reported use of methamphetamine drugs 8AA\AAMAA(AA=AAA =@What s Being Done in Minnesota? !!$The MDH is continuing awareness campaigns (e.g., Health Notices, press releases) Encouraging physicians to screen gay/bisexual men at least annually and to ask about sex partners The MDH Partner Services Program continues to follow up on cases and sex partners The MDH has implemented innovative prevention strategies (e.g., internet banners, partnering with venues) In 2004, the MDH implemented the Syphilis Elimination Project to: Provide funding to community based programs to intensify outreach activities among high risk communities (e.g., gay/bisexual communities) Create an outbreak response plan to better respond to new outbreaks Assist health care providers to better serve patients at risk for syphilis Z6>@(Chlamydia Rates in Minnesota, 1996-2006 ))$%Between 1996 and 2006 the incidence rate of chlamydia infection more than doubled from 115 to 263 per 100,000 persons. In 2006, the rate increased by 5% The rate almost tripled among men (54 to 152) and more than doubled among women (175 to 372) Rates more than tripled among 25-29 year olds (214 to 723) and tripled among 30-39 year olds (56 to 163) Among 15-19 year olds, rates increased by1.6 times (640 to 1032) and among 20-24 year olds rates increased by 2.7 times (567 to 1549) In this time period, rates more than doubled among Whites, Hispanics, and Asian/Pacific Islanders. The chlamydia rates among Blacks and American Indians increased by 61% and 67%, respectively Across geographic areas, greatest increase was seen in Greater Minnesota where the rates almost tripled between 1996 and 2006 &A&,,  76What s Behind the Increase?$Improved diagnostic tools with increased sensitivity Improved screening practices by clinicians Improved case reporting among providers Addition of active surveillance component to MDH STD surveillance system Increase of disease in the population <PudAFPAF/!?#6789:;<=>?@ABCE=  ` 33ff̙` 3f3f` ___>?" dU@"?lFU@u<f `#@u " dd`    n?" dd@   @@``PV     @ ` `'p@`@` %x{(  x !x Z|v Ԕ8c?"0  X Click to edit Master title style!!  & "x N} ?"0 `P  * Data Source: Minnesota STD Surveillance System STDs in Minnesota: Annual Review >  u     #x Ny ?"`@  V*     $x 0 "P  }9Click to edit Master text styles Second level Third level!  :  l x T޽h? ? 33ff̙ NikO  "|k(  | !|  f ԔԔ8c8c?"  X Click to edit Master title style!!   "|  f8 ԔԔ8c8c?"   [#Click to edit Master subtitle style$$  l | T޽h? ? 33ff̙& 0 h6(  h h N$x\x\ .  C r*   `//`` h N x\x\ 3 .  ~*   `//``d h c $ ?  8 h NCx\x\ 9 g  RClick to edit Master text styles Second level Third level Fourth level Fifth level!    S   h Tx\x\ r   r*   `//`` h T x\x\ r3   t*   `//``H h 0ηo~ ? ̙3380___PPT10.G`q` d(  d d Nx\x\ .   p*    `//`` d Nx\x\ 3 . C z*   `//``  d Tx\x\ r   p*    `//`` d Tx\x\ r3   r*    `//``H d 0ηo~ ? ̙3380___PPT10.GEs6 0(    N]CԔԔ8c8c?P  lEMERGING TRENDS: Fluoroquinolone- Resistant Gonorrhea Syphilis Among MSM Continuing Increase of Chlamydia ^Z--(Z$$&    L  /  N C ?"0 `P W STDs in Minnesota: Annual Review XX  X  f  N޽h ? ̙337 91@(  <  NCԔԔ8c8c?  FPrevalence of Fluoroquinolone-Resistant Gonorrhea in Minnesota .G>( $&    *  /  N4C ?"0 `P W STDs in Minnesota: Annual Review XX  X  f  N޽h ? ̙33Q 8 s(  ~  s *!x0   ~  s *p$x`0  /  N ?"0 `P W STDs in Minnesota: Annual Review XX  X  f  N޽h ? X( 9 4(  4r 4 S P!x0p    4 0@@P` 42000 2 4 0Ĝp 42001 2 4 0@Ȝ p  42003 2 4 0@p`  42002 2 4 0Μ@ 51990s 2  4 0ќ` c/ QRNG prevalent in Asia, >40% in some countries0 20  4 0՜ sHawaii discontinues use of fluoroquinolones following increase in QRNG prevalence from 1.4% in 1997 to 9.5% in 1999t 2t 4 0pٜ  > 2  4 6ܜz \California discontinues use of fluoroquinolones after reaching QRNG prevalence of 5% in 2001]] 4 6   p>Increases in QRNG reported in other U.S. states (e.g., MI, MA)??  4 6p*  qCDC recommends non-quinolone therapy for infections acquired in HI, CA, and other areas with high QRNG prevalencerr 4 0@ p`  42004 2 4 6p j  k9Prevalence of QRNG in MN five times higher than in 2002 :: 4 0` p  42005 2 4 6   b0Prevalence of QRNG in MN continues to increase 11/ 4 N ?"0 `P W STDs in Minnesota: Annual Review XX  X   4 < pd 20062 4 < Wj r CDC recommends fluoroquinolones no longer be used as first-line treatment among men who have sex with men (MSM)ssSf 4 N޽h ? 33ff̙$ : $$/! &$(   x   c $!x   R|    #"."Pe\ttttP1   H1?  Z5.8%00++99   H 1?   Y32800++99   H(1?  X1900++99   H 1?  Z200600++99   H&1?   Z6.8%00++99   H.1?   Y36500++99   H61?   X2500++99   HdD1?   Z200500++99   HF1?5   Z8.5%00++99   HN1? 5   Y33000++99   HV1?5  X2800++99   Hd1?5   Z200400++99 +  Hf1? 5  W500++99 )  Hhn1?e  W400++99 '  Hd|1? e W000++99 %  B}1?  n# Resistant Isolates00++99   H|1?5  Z1.4%00++99   H01? 5  Y36300++99   H1?5  Z200300++99   H81?e Z1.5%00++99   H1? e Y26800++99   H@1?e Z200200++99   H1?e X0%00++99   HHĹ1? e [1,36500++99   H̹1?e _ 1999-2001  00++99   BHι1? iQRNG Prevalence00++99   B\ܹ1?  k# Isolates Tested00++99   B޹1? ^Year00++99ZB   s *Ԕ ?`B   01 ?ZB   s *1 ?ZB   s *1 ?`B _  01 ?`B f  0Ԕ ?`B h  01 ?  `B i  01 ?`B   01 ?ee`B   01 ?`B   01 ?`B   01 ?`B   01 ?5 5 `B   01 ?  `B   01 ?   !  <\p` B For 1999 to 2003 the isolates tested came only from the Gonococcal Isolate Surveillance Project (GISP). GISP is a sentinel surveillance system established by the CDC to monitor antimicrobial resistance in gonorrhea among males. The Red Door Clinic in Minneapolis is one of the participating clinics. For 2004 through 2006 the numbers include isolates from Room 111 in St. Paul and include both males and females. .:     ]  H   0޽h ? X(5 ; 44CTW4(  Tx T c $ƹ!xPP   s/| | T #"."PP\tttt| T H$1?` | Z0.8%00++99 T HH 1? `| Y25800++99 T HP 1?  | W200++99 T H1?`  | Y27%00++99 T H1? ` | X6300++99 T H!1?` | X1700++99 T H(1? `| Z200600++99 T H01?`   Z0.4%00++99 T H 91? `  Y27900++99 T HA1?   W100++99 T H,I1?`   Y30%00++99 T H P(     NCԔԔ8c8c?  6Syphilis Among Gay/Bisexual Men in Minnesota <. -.( $ 7  /  NC ?"0 `P W STDs in Minnesota: Annual Review XX  X  f  N޽h ? ̙33! `(    HA ? `x <  6tC h |Number of Early Syphilis Cases by Gender Minnesota, 2001-2006*?$ $&$ ?    <hCj    <C1?   Early Syphilis includes primary, secondary, and early latent stages of syphilis.2T 2 Q   QH  0޽h ? 3y___PPT10Y+D=' = @B +m" ? "" /a!(  r  S !x0   |  ` #"."Pe\tttt ^ H1?|  ]80 (89)00++99 \ H\1? |  ]90 (88)00++99 Z H1?|  Y10400++99 X H1?|  Z200600++99  H1? |  ^100 (92)  00++99  H1?  |  ^109 (94)  00++99  HP1? |  Y11600++99  H1? |  Z200500++99  Hp1?   ]34 (83)00++99   H@1?   ]41 (85)00++99   H1?   X4800++99   H01?   Z200400++99   H,1?  X9300++99   H1?  X8200++99  Hp1?_  X4900++99  B1? _ nEarly Syphilis Cases00++99  H1?   ]73 (87)00++99  H1?   ]84 (90)00++99  H\$1?   Z200300++99  H&1?  ]56 (80)00++99  Hd41?   ]70 (85)00++99  H=1?  Z200200++99  HD1?_ ^ 5 (18)  00++99  HlM1? _ ]27 (55)00++99  HT1?_ Z200100++99  B0^1?_ qMSM Cases (% of males)00++99  B_1? _ iMales Cases (%)00++99  Bm1?_ ^Year00++99ZB  s *Ԕ ?`B  01 ?ZB  s *1 ?_ZB  s *1 ?_`B   01 ?`B ! 0Ԕ ?__`B " 01 ?  `B # 01 ?`B $ 01 ?`B % 01 ?  `B & 01 ?_`B ' 01 ?_`B ( 01 ?  `B ) 01 ?  `B Y 01 ?| | n * <p1?`  Early Syphilis includes primary, secondary, and early latent stages of syphilis.&S 2 Q   QH  0޽h ? 33ff̙   0(  r  S !x0    0 BA ?$x0  \  <a  Early Syphilis includes primary, secondary, and early latent stages of syphilis.SS   QH  0޽h ? 33ff̙80___PPT10.ae @ @P6(  Pr P S $xP0   P  HRR1 Ԕ8c?!xuE    P <1?P  Early Syphilis includes primary, secondary, and early latent stages of syphilis.:T 2  Q   RH P 0޽h ? 33ff̙E A PDg(  Dx D c $!x0   x D c $D$xP  / D N̗ ?"0 `P W STDs in Minnesota: Annual Review XX  X  f D N޽h ? 33ff̙JB pXl(  X X NCԔԔ8c8c? !Continuing Increase of Chlamydia ."!($ "  / X NC ?"0 `P W STDs in Minnesota: Annual Review XX  X  f X N޽h ? ̙33# [S h(  h h HA k?  k h 6C X GChlamydia in Minnesota Rate per 100,000 by Year of Diagnosis, 1996-2006 Hi$1 H  XB h 0Dp@  h <C 0  A115 per 100,000  h <C v0 A263 per 100,000 XB  h 0D `P H h 0޽h ? 3 C `p0(  px p c $ԝ!x0   x p c $$xP  f p N޽h ? 33ff̙ E p\(  \x \ c $!x0    \ c $$x @ <$D 0  "PpV \ 0 `  Since effects of the first three factors outlined above would have stabilized over time, the increase is most likely due to an actual increase of disease in the population..PlFKF \ 0|P XThe observed increase since 1996 is most likely due to combination of factors including:.YPlFKFX/ \ Nܫ ?"0 `P W STDs in Minnesota: Annual Review XX  X  f \ N޽h ? 33ff̙ 0  (   d  c $   u  3 rH x\x\9 g   Historically, rates have been similar among males and females. In 2001, the P&S rate among women increased, driven by an increase among Black women. The increase did not continue into 2002 and the female rate decreased to previous levels. In 2002 the P&S rate among men increased dramatically (3 fold) due to an increase among MSM. The rate continues to increase in 2003 (see Emerging Trend). H   0ηo~ ? ̙33 0 Pl4(  ld lc $    l3 r(ss9 g   fChlamydia is the most commonly reported bacterial STD. The chlamydia rate decreased between 1992-1996, then increased markedly in 1997. The rate increase from 1996-1997 occurred across demographic groups (gender, age, race/ethnicity) and could be due to one or more of the following: Increased sensitivity of diagnostic tests (switch from EIA to LCX or other DNA-amplification test) Increased screening Real increase in disease incidence The chlamydia rate increased by 21% between 2001-2002. Part of that increase (at least 1/3) was a result of active surveillance activities initiated in January 2002 that improved completeness of reporting. The gonorrhea rate generally decreased from 1992 through 1997 and increased from 1998 through 2002, with slight dips in 1993 and 2001. The gonorrhea rate increased by 13% between 2001-2002. At least 1/3 of that increase was due to the implementation of active surveillance. The primary & secondary syphilis rate has generally decreased over the past decade. However, in 2001 the rate increased from 0.3 to 0.7 per 100,000. The increase occurred primarily among heterosexual Black women and was associated with crack use. The number of cases among Black women decreased in 2002, but the overall P&S syphilis rate increased again (from 0.7 to 1.2 per 100,000) due to a large increase in cases among White men-who-have-sex-with-men (MSM). 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Gonorrhoeae (QRNG).Prevalence of QRNG in Minnesota, 1999 - 2006GPrevalence of QRNG by Mode of Transmission in Minnesota, 2002 - 2006 .Characteristics of 2006 QNRG cases (n = 19) !Whats Being Done in Minnesota? PowerPoint PresentationPowerPoint Presentation<Early Syphilis Among Gay/Bisexual Men Minnesota, 2001-2006INumber of Early Syphilis Cases and Percent MSM, by Age, Minnesota, 2006RCharacteristics of Early Syphilis Cases Among Gay/Bisexual Men Minnesota, 2006!Whats Being Done in Minnesota? PowerPoint PresentationPowerPoint Presentation)Chlamydia Rates in Minnesota, 1996-2006 Whats Behind the Increase?  Fonts UsedDesign TemplateEmbedded OLE Servers Slide TitlesP 3;Editor Tracy Sides__fanderk1anderk1  !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~Root EntrydO)@i%vofPicturesCurrent User5SummaryInformation($PowerPoint Document(cDocumentSummaryInformation8ph.Chart.80*Microsoft Graph Chart/ 00DTimes New Roman67 0 0DArial Narrowan67 0 0" DWingdingsowan67 0 00DTimesngsowan67 0 0  ` .  @n?" dd@  @@``    o'  !)T '        F&4&%!&&#  @  A DDQ   q  EI "   7  ##  b !"$%!   _"$ҕU@![3v8x $"$Ǫ;goS  $"$_r2/$WN <AA 3333fff@889g4KdKd7 0pp<4!d!d 0\7 <4KdKd 0\FlO ʚ;Sk8ʚ;<4dddd@ 0g4:d:d7 0.p p 0___PPT10 ~___PPT9`z{\204? %O<Minnesota Department of Health *Last updated: 4/16/04]MBackground Information$CDC-recommended antibiotic treatments for gonorrhea: Ceftriaxone Single dose therapy, administered by injection Relatively expensive Cefixime Single dose therapy, administered orally Production discontinued in 2002; No longer available Ciprofloxacin, Ofloxacin, Levofloxacin (Quinolones) Single dose therapy, administered orally Spread of quinolone-resistant N. gonorrhoeae (QRNG) threatens the efficacy of fluoroquinolones as the frontline treatment for gonorrhea 5 D ^45 D ^4 G\8Prevalence of Quinolone-Resistant N. Gonorrhoeae (QRNG)$9#ZPrevalence of QRNG in Minnesota , 1999 - 2006*.$ $$  4Prevalence of QRNG by Mode of Transmission in Minnesota, 2002 - 2006  GE$ $E  B-Characteristics of 2006 QNRG cases (n = 19) 0."$BAll cases were male. 68% of the cases were White 32% of cases were 24 years old or younger and 37% of cases were among 25-29 years olds (Mean age  29, Median age  27) 17 of 19 cases (89%) were among gay/bisexual males 6% of cases among gay/bisexual males are also infected with HIV VKKKKKK"@What s Being Done in Minnesota? !!$"The MDH continues to test gonorrhea isolates from Room 111 and Red Door Clinic for Quinolone resistance In 2005 and 2006, through a project funded by APHL and CDC, the MDH conducted surveillance for QRNG among women tested at Red Door Clinic and Room 111; Room 111 continues to submit isolates for women Healthcare providers are encouraged to obtain travel histories of patients and to be alert for treatment failures. Gonorrhea infections acquired in areas with high QRNG prevalence and among MSM should receive non-quinolone therapy Clinicians and laboratories are asked to report suspected treatment failures and resistant gonococcal isolates to the MDH The MDH Partner Services Program follows up on all cases with quinolone resistant gonorrhea and their sex partners to ensure proper treatment#K# G^vEarly Syphilis Among Gay/Bisexual Men Minnesota, 2001-2006*<$ $-$  -Number of Early Syphilis Cases and Percent MSM, by Age, Minnesota, 2006>I    $   03Characteristics of Early Syphilis Cases Among Gay/Bisexual Men Minnesota, 2006*R" /"  / Gay and Bisexual men account for 89% of cases among men 78% of cases among MSM are White, and 55% are between the ages of 25 and 39 (mean age = 34) 76% of cases live in Hennepin County, and 65% in the City of Minneapolis 40% of cases are also infected with HIV Among cases interviewed by the MDH Partner Services Program: Internet was the most common venue for meeting partners (44%) Most reported having anonymous sex (61%), and of these 38% reported no condom use 14% of cases reported use of methamphetamine drugs 8AA\AAMAA(AA=AAA =@What s Being Done in Minnesota? !!$The MDH is continuing awareness campaigns (e.g., Health Notices, press releases) Encouraging physicians to screen gay/bisexual men at least annually and to ask about sex partners The MDH Partner Services Program continues to follow up on cases and sex partners The MDH has implemented innovative prevention strategies (e.g., internet banners, partnering with venues) In 2004, the MDH implemented the Syphilis Elimination Project to: Provide funding to community based programs to intensify outreach activities among high risk communities (e.g., gay/bisexual communities) Create an outbreak response plan to better respond to new outbreaks Assist health care providers to better serve patients at risk for syphilis Z6>@(Chlamydia Rates in Minnesota, 1996-2006 ))$%Between 1996 and 2006 the incidence rate of chlamydia infection more than doubled from 115 to 263 per 100,000 persons. In 2006, the rate increased by 5% The rate almost tripled among men (54 to 152) and more than doubled among women (175 to 372) Rates more than tripled among 25-29 year olds (214 to 723) and tripled among 30-39 year olds (56 to 163) Among 15-19 year olds, rates increased by1.6 times (640 to 1032) and among 20-24 year olds rates increased by 2.7 times (567 to 1549) In this time period, rates more than doubled among Whites, Hispanics, and Asian/Pacific Islanders. The chlamydia rates among Blacks and American Indians increased by 61% and 67%, respectively Across geographic areas, greatest increase was seen in Greater Minnesota where the rates almost tripled between 1996 and 2006 &A&,,  76What s Behind the Increase?$Improved diagnostic tools with increased sensitivity Improved screening practices by clinicians Improved case reporting among providers Addition of active surveillance component to MDH STD surveillance system Increase of disease in the population <PudAFPAF/!?#6789:;<=>?@ABCEU  ` 33ff̙` 3f3f` ___>?" dU@"?lFU@u<f `#@u " dd`    n?" dd@         !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdghi@@``PV     @ ` `'p@`@`' 0 %x{(  x !x Zlu Ԕ8c?"0  X Click to edit Master title style!!  & "x N{ ?"0 `P  * Data Source: Minnesota STD Surveillance System STDs in Minnesota: Annual Review >  u     #x Nx ?"`@  V*     $x 0 "P  }9Click to edit Master text styles Second level Third level!  :  l x T޽h? ? 33ff̙ Nikg  `"|k(  | !|  f ԔԔ8c8c?"  X Click to edit Master title style!!   "|  f  ԔԔ8c8c?"   [#Click to edit Master subtitle style$$  l | T޽h? ? 33ff̙6  (    NԔԔ8c8c?P  lEMERGING TRENDS: Fluoroquinolone- Resistant Gonorrhea Syphilis Among MSM Continuing Increase of Chlamydia ^Z--(Z$$&    L  /  NH ?"0 `P W STDs in Minnesota: Annual Review XX  X  f  N޽h ? ̙337 910(  <  NԔԔ8c8c?  FPrevalence of Fluoroquinolone-Resistant Gonorrhea in Minnesota .G>( $&    *  /  N ?"0 `P W STDs in Minnesota: Annual Review XX  X  f  N޽h ? ̙33i 8 s(  ~  s *=!x0   ~  s *=$x`0  /  N^ ?"0 `P W STDs in Minnesota: Annual Review XX  X  f  N޽h ? X( 9 4(  4r 4 S d!x0p    4 0xf@@P` 42000 2 4 0|lp 42001 2 4 0h p  42003 2 4 0p@p`  42002 2 4 0dr@ 51990s 2  4 0w` c/ QRNG prevalent in Asia, >40% in some countries0 20  4 0 { sHawaii discontinues use of fluoroquinolones following increase in QRNG prevalence from 1.4% in 1997 to 9.5% in 1999t 2t 4 0~  > 2  4 6Ёz \California discontinues use of fluoroquinolones after reaching QRNG prevalence of 5% in 2001]] 4 6   p>Increases in QRNG reported in other U.S. states (e.g., MI, MA)??  4 6p*  qCDC recommends non-quinolone therapy for infections acquired in HI, CA, and other areas with high QRNG prevalencerr 4 0@ p`  42004 2 4 6p j  k9Prevalence of QRNG in MN five times higher than in 2002 :: 4 0x` p  42005 2 4 6T   b0Prevalence of QRNG in MN continues to increase 11/ 4 N8 ?"0 `P W STDs in Minnesota: Annual Review XX  X   4 < pd 20062 4 < Wj r CDC recommends fluoroquinolones no longer be used as first-line treatment among men who have sex with men (MSM)ssSf 4 N޽h ? 33ff̙$ : $$/! &$(   x   c $!x   R|    #"."Pe\ttttP1   Hp1?  Z5.8%00++99   HL1?   Y32800++99   H1?  X1900++99   HȤ1?  Z200600++99   HѤ1?   Z6.8%00++99   H0̤1?   Y36500++99   Hڤ1?   X2500++99   Hd1?   Z200500++99   H1?5   Z8.5%00++99   H1? 5   Y33000++99   Hx1?5  X2800++99   H8 1?5   Z200400++99 +  H41? 5  W500++99 )  H1?e  W400++99 '  H @(     NԔԔ8c8c?  6Syphilis Among Gay/Bisexual Men in Minnesota <. -.( $ 7  /  Nܕ ?"0 `P W STDs in Minnesota: Annual Review XX  X  f  N޽h ? ̙33! P(    HA ? `x <  6  h |Number of Early Syphilis Cases by Gender Minnesota, 2001-2006*?$ $&$ ?    <4j    <L1?   Early Syphilis includes primary, secondary, and early latent stages of syphilis.2T 2 Q   QH  0޽h ? 3y___PPT10Y+D=' = @B +" ? ""/a!(  r  S 0M!x0   |  ` #"."Pe\tttt ^ H(V1?|  ]80 (89)00++99 \ H1? |  ]90 (88)00++99 Z H`c1?|  Y10400++99 X Hpe1?|  Z200600++99  Hm1? |  ^100 (92)  00++99  Hl{1?  |  ^109 (94)  00++99  HX}1? |  Y11600++99  Ht1? |  Z200500++99  HX1?   ]34 (83)00++99   HT1?   ]41 (85)00++99   H@1?   X4800++99   H$1?   Z200400++99   H 1?  X9300++99   H 1?  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Z200200++99  H1?_ ^ 5 (18)  00++99  H 1? _ ]27 (55)00++99  H1?_ Z200100++99  B1?_ qMSM Cases (% of males)00++99  B#1? _ iMales Cases (%)00++99  BT-1?_ ^Year00++99ZB  s *Ԕ ?`B  01 ?ZB  s *1 ?_ZB  s *1 ?_`B   01 ?`B ! 0Ԕ ?__`B " 01 ?  `B # 01 ?`B $ 01 ?`B % 01 ?  `B & 01 ?_`B ' 01 ?_`B ( 01 ?  `B ) 01 ?  `B Y 01 ?| | n * <01?`  Early Syphilis includes primary, secondary, and early latent stages of syphilis.&S 2 Q   QH  0޽h ? 33ff̙   (  r  S LS!x0    0 BA ?$x0  \  <Da  Early Syphilis includes primary, secondary, and early latent stages of syphilis.SS   QH  0޽h ? 33ff̙80___PPT10.ae @  P6(  Pr P S E$xP0   P  @FRR1 Ԕ8c?!xuE    P <G1?P  Early Syphilis includes primary, secondary, and early latent stages of syphilis.:T 2  Q   RH P 0޽h ? 33ff̙] A 0Dg(  Dx D c $Q!x0   x D c $-V@ZBP^$G"_5c ՜.+,D՜.+,p  (0 8@HP X <Emerging STD Trends in Minnesota 2006 - MN Dept of HealthOn-screen ShowMDHc" Times New Roman Arial Narrow WingdingsTimesNikMicrosoft Graph ChartPowerPoint PresentationPowerPoint PresentationBackground Information9Prevalence of Quinolone-Resistant N. Gonorrhoeae (QRNG).Prevalence of QRNG in Minnesota, 1999 - 2006GPrevalence of QRNG by Mode of Transmission in Minnesota, 2002 - 2006 .Characteristics of 2006 QNRG cases (n = 19) !Whats Being Done in Minnesota? PowerPoint PresentationPowerPoint Presentation<Early Syphilis Among Gay/Bisexual Men Minnesota, 2001-2006INumber of Early Syphilis Cases and Percent MSM, by Age, Minnesota, 2006RCharacteristics of Early Syphilis Cases Among Gay/Bisexual Men Minnesota, 2006!Whats Being Done in Minnesota? PowerPoint PresentationPowerPoint Presentation)Chlamydia Rates in Minnesota, 1996-2006 Whats Behind the Increase?  Fonts UsedDesign TemplateEmbedded OLE Servers Slide TitlesP 3;Editor Tracy Sides_canderk1anderk1