April 6, 2011
New report shows some STDs surged in 2010 in Minnesota
Chlamydia and syphilis cases reach new highs, gonorrhea cases drop
A new report from the Minnesota Department of Health (MDH) shows that the number of reportable sexually transmitted diseases (STDs) in Minnesota climbed to a new high of 17,760 in 2010, alarming health officials. Reportable STDs in Minnesota include chlamydia, gonorrhea and syphilis. There were 16,912 cases reported in 2009.
"Chlamydia reached a record level of 15,294 cases this past year," said Peter Carr, manager of the STD and HIV Section at MDH. "Not only does this total represent a 6 percent increase from the previous year, it’s the highest number of cases ever recorded in Minnesota in a single year since we began tracking chlamydia back in 1986."
MDH data show that chlamydia occurs statewide with nearly one in three cases occurring in the Greater Minnesota areas. About 70 percent of cases occurred in teens and young adults ages 15 to 24.
"The biggest concerns we have with chlamydia are that it affects our younger age groups, often goes unnoticed and it can lead to serious and costly reproductive health consequences if not treated," said Carr.
Untreated chlamydia can lead to infertility in some women and, in rarer cases, even among men. An infected woman can pass the infection to her newborn child, causing premature delivery, infant pneumonia and serious eye infections leading to blindness. About three of four females and one of two males will show no symptoms once infected. The best way to detect unsuspected cases is through routine testing.
All sexually active women age 25 and under and women over 25 with risk factors such as a new sexual partner should be screened each year for chlamydia, according to guidelines from the Centers for Disease Control and Prevention (CDC). Some clinics have incorporated these screening guidelines within their electronic patient records so clinicians are automatically alerted when its time to provide the screenings to their patients.
The MDH report also showed that the number of syphilis cases rose to a 30-year high of 347 cases (all stages) in 2010, a 62 percent increase compared to the previous year.
"Untreated syphilis is also a serious concern since it can lead to blindness, mental illness, dementia and death," said Carr. "Testing and diagnosing the disease in its early stages is critical as that is when the disease is most infectious."
For syphilis, MDH data show that 221 early syphilis cases were reported in 2010 compared to 117 cases in 2009. New infections continued to be centered within the Twin Cities metropolitan area. The percentage of those co-infected with syphilis and HIV rose from 45.3 percent in 2009 to 48.6 percent in 2010. There is a two- to five-fold increased risk of getting and spreading HIV infection when syphilis is present.
Among the early syphilis cases, 94 percent (207 cases) were males with a vast majority of these cases (89 percent) occurring among men who have sex with men (MSM). Sixty-six percent of the cases among MSM were among whites, but a disproportionate number of cases (23 percent) were among African-Americans. Nearly 57 percent of the cases among MSM were also infected with HIV.
CDC recommends that health providers provide annual syphilis screenings to their MSM patients. For those at highest risk with multiple partners, especially if they are HIV positive, CDC recommends testing as often as every three months.
Gonorrhea remains the second most commonly reported STD in Minnesota with 2,119 cases reported in 2010 representing nearly a 9 percent decrease compared to 2009. Nearly two-thirds of all gonorrhea cases occur among the 15 to 24 year old age group. A positive trend is showing that gonorrhea has decreased by 36 percent over the last 5 years in the state.
"Although the drop in gonorrhea cases may be a positive sign that screening, partner follow-up and treatment strategies are making an impact, we are still seeing gonorrhea affecting certain communities and geographical areas at higher rates," said Carr.
MDH data show that about 77 percent of the gonorrhea cases occur within the 7 county metropolitan area with most of the cases involving 15 to 24 year olds. African-Americans are experiencing the highest rates of gonorrhea infection.
Health officials emphasize that it is important to remain diligent in identifying and treating gonorrhea cases. Untreated gonorrhea can lead to infertility in both men and women. Gonorrhea can spread to organs and joints and these conditions can be life threatening. Gonorrhea can be passed to newborns during childbirth causing blindness if the infant is not treated.
"Overall, the report shows that we need to give STDs our full attention in order to reverse some of these trends," said Carr. "On April 12, the Minnesota Chlamydia Partnership that we belong to is launching a new and first-ever statewide action plan for reducing and preventing chlamydia in our state."
To address the rising number of syphilis cases, health officials noted that a syphilis awareness campaign will be launched this summer to reach MSM in order to prevent syphilis from spreading and to provide opportunities for testing.
The MDH Partner Services Program provides follow-up services to people with HIV, syphilis, and those referred from clinics with untreated chlamydia and gonorrhea and their sexual partners who may need examination and treatment. The program also provides follow-up services to patients referred from clinics who have untreated chlamydia and gonorrhea. Partner referral cards are available to clinics from the MDH to help clients notify their partners anonymously.
Health providers are responsible for making reasonable attempts to assure treatment of the sex partners of their STD infected patients. A new approach called expedited partner therapy (EPT) allows physicians in Minnesota to dispense prescriptions or medications through their patients who have tested positive for chlamydia or gonorrhea to treat their sexual partners who are uninsured, unwilling or unable to get to a clinic.
Health officials noted that people can prevent getting or spreading STDs by delaying the start of sexual activity, limiting the number of sexual partners, getting tested, knowing their STD status, practicing safer sex at all times, and by not sharing needles for drug use, piercing or tattooing. Getting tested for STDs each year is very important for sexually active persons - even without symptoms. And, if infected, it is important for partners to be examined and tested.
To help create awareness about STDs in Minnesota, MDH has made online educational resources available on behalf of National STD Awareness Month (April). In addition, MDH will continue to support chlamydia and gonorrhea screening clinics serving areas with the highest rates of infection.
The complete STD Surveillance Report – 2010, STD fact sheets, and information about National STD Awareness Month (April) can be found on the MDH website at: www.health.state.mn.us/std.
To learn more about expedited partner therapy for chlamydia and gonorrhea in Minnesota, visit the MDH website at: www.health.state.mn.us/ept.
The new CDC treatment guidelines for STDs are available online at: www.cdc.gov/STD/treatment/default.htm.
For confidential information about the prevention, testing locations and treatment of STDs, call the Minnesota Family Planning & STD Hotline, toll free, at 1-800-78-FACTS (voice or TTY), 651-645-9360 (Metro area), or visit their website at sexualhealthmn.org/.
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Strategy for Reducing and Preventing Chlamydia in Minnesota Presentation
9 – 11 a.m., April 12, at Snelling Office Park, 1645 Energy Park Drive, St. Paul, MN. The Minnesota Chlamydia Partnership (MCP) will present the new and first-ever action plan for reducing and preventing chlamydia in Minnesota. The event is free and there is no pre-registration required but seating is limited to the first 140 persons who attend. To view the presentation online from your own computer, follow the instructions on the MCP website: www.health.state.mn.us/mcp.
STD and HIV Section