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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.

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

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.

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

Data Archive: Previous STD Annual Reports

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