Wednesday, November 14, 2007

2006 Chlamydia Rates In Utah Mirror National Rise Reported By The Centers For Disease Control

Chlamydia cases in Utah mirror a national climb that has public health officials concerned. Full stories published in the Salt Lake Tribune and the Deseret Morning News.

More than 1 million cases of chlamydia were reported in the United States last year — the most ever reported for a sexually transmitted disease, federal health officials said Tuesday November 13th, 2007 during release of an annual report by the Centers for Disease Control and Prevention on chlamydia, syphilis and gonorrhea. "A new U.S. record," said Dr. John M. Douglas Jr. of the Centers for Disease Control and Prevention (CDC).

The CDC released their findings in the form of a report entitled "Trends In Reportable Sexually Transmitted Diseases In the United States, 2006". Click HERE to view the HTML version, or click HERE to view the seven-page PDF version.


There were 1,030,911 cases of chlamydia in the United States in 2006, an average of 349 cases per 100,000 people. This is an increase of 5.6 percent from the 329 per 100,000 rate in 2005. Already in 2007, Utah has recorded 4,660 cases. In 2006, the state's rate was 197 cases per 100,000, only 46th in the nation, but a climb from a rate of 182 the year before. Tim Lane, manager of the Utah Department of Health STD Control Program, said Utah health officials have received reports of about 300 more cases so far this year than at the same time last year.

Most public health officials believe the larger number is not a pure increase in cases, but rather a reflection that more people are being tested for chlamydia, which in as many as 75 percent of cases has no symptoms but can do long-term, serious harm, including causing infertility. CDC and other health officials say all sexually active women should be screened each year for chlamydia. Besides sexual transmission, it also can be passed by a mother to her baby during childbirth. Detected early, it's easily treated.

Gonorrhea is a different story. In 2004, the nation's gonorrhea rate fell to 113.5 cases per 100,000 people, the lowest level since the government started tracking cases in 1941. But since then, health officials have seen two consecutive years of increases. The 2006 rate, about 121 per 100,000, still represents a 5.5 percent increase from 2005. Although Utah's gonorrhea rate is below one-third that of the country as a whole, the number of cases in the Beehive State also has climbed, from 603 cases in 2004 to 727 in 2005 and 888 cases in 2006, a rate of 36.0 per 100,000 people, 43rd in the nation. So far this year, the Utah Department of Health has received reports of 685 cases, nearly half of them in teens and young adults, 15-24, and an increasing number of cases are caused by a "superbug" version resistant to common antibiotics.

Health officials don't know exactly how many superbug cases there were among the more than 358,000 gonorrhea cases reported nationally in 2006. But a surveillance project of 28 cities found that 14 percent were resistant to ciprofloxacin and other medicines in the fluoroquinolones class of antibiotics.

Syphilis, a potentially deadly disease that first shows up as genital sores, has become relatively rare in the United States. About 9,800 cases of the most contagious forms of syphilis were reported in 2006, up from about 8,700 in 2005. The rate rose from 2.9 cases per 100,000 people to 3.3, a 14 percent increase. For congenital syphilis, in which babies get syphilis from their mothers, the rate rose only slightly from the previous year to 8.5 cases per 100,000 live births. Utah had 21 cases of primary or secondary syphilis last year and 45 latent cases, a rate of 0.9 per 100,000 people, 40th in the nation.

However, the Deseret Morning News failed to address a significant anomaly altogether, and the Tribune only briefly brushed the issue. And the issue - a significant racial disparity in the incidence of STDs. While Utah is over 90 percent white, the disparities are still noticeable. Blacks, who constitute only 0.9 percent of Utah's population, have an exponentially greater incidence of STDs than whites, and significantly higher than other races. Gays comprise a grossly disproportionate percentage of syphilis cases, responsible for 65 percent of syphilis cases nationwide despite comprising only 3 percent of the population. Fortunately, the CDC report addresses this problem at length; here is the pertinent excerpt:


Racial Disparities Persist Across All Reportable STDs


Racial and ethnic minorities continue to be disproportionately affected by sexually transmitted diseases in the United States. These disparities may be, in part, because racial and ethnic minorities are more likely to seek care in public health clinics that report STDs more completely than private providers. However, this reporting bias does not fully explain these differences. Other contributing factors include limited access to quality health care, poverty, and higher prevalence of disease in these populations.

Data in CDC’s
2006 STD Surveillance Report show higher rates of all STDs among minority racial and ethnic populations when compared to whites, with the exception of Asians/Pacific Islanders.

Chlamydia

In 2006, the rate of chlamydia among African Americans was more than eight times higher than the rate among whites (1275.0 vs. 153.1 per 100,000 population), with approximately 46 percent of all chlamydia cases reported among African Americans. Additionally, the rates among American Indians/Alaska Natives (797.3 per 100,000) and Hispanics (477.0 per 100,000), were five times and three times higher than whites, respectively. In 2006, chlamydia rates increased for all racial/ethnic groups, except for Asians/Pacific Islanders.

Gonorrhea

Racial disparities in gonorrhea rates are even greater and racial gaps in diagnosis of gonorrhea are more pronounced than any other disease. The gonorrhea rate among African Americans was 18 times greater than that for whites in 2006 (658.4 per 100,000 vs. 36.5 per 100,000). From 2005 to 2006, the gonorrhea rate among African Americans increased by 6.3 percent—the first increase since 1998. In 2006, African Americans accounted for 69 percent of reported cases of gonorrhea.

In that same year, American Indians/Alaska Natives had the second-highest gonorrhea rate (138.3 per 100,000), followed by Hispanics (77.4), whites (36.5), and Asians/Pacific Islanders (21.1). In 2006, there were increases in gonorrhea rates among all racial and ethnic groups, except Asians/Pacific Islanders.

Syphilis

Although racial gaps in syphilis rates are narrowing, disparities remain, with rates in 2006 approximately six times higher among blacks than among whites. This represents a substantial decline from 1999, when the rate among blacks was 29 times greater than among whites. It is important to note that this narrowing reflects both declining disease rates among African Americans as well as significant increases among white males in recent years.

Despite some progress, African Americans continue to remain disproportionately affected by syphilis with a rate of 11.3 cases per 100,000 population in 2006. This is more than three times the rate for Hispanics, who have the second highest rate (3.6 cases per 100,000) as well as American Indians/Alaska Natives (3.3 cases per 100,000).

In 2006, the P&S syphilis rate among blacks increased for the third consecutive year, following more than a decade of declines. Between 2005 and 2006, the rate among blacks increased 16.5 percent (from 9.7 to 11.3), with the largest increase among black males (15.5 to 18.3, an increase of 18.1 percent).

In 2006, the rate of P&S syphilis in black females was 16 times higher than in white females. In that same year, 43.2 percent of all reported P&S syphilis cases occurred among African Americans, while whites accounted for 38.4 percent. Syphilis rates increased for all races and ethnicities in 2006.


So, despite comprising only 12% of the national population, blacks accounted for 46% of the chlamydia cases, 69% of the gonorrhea cases, and 43% of the syphilis cases in 2006. Maybe blacks ought to obsess just a little bit less with "racism", huh?

Some are trying, though. On June 5-6, 2007 in Atlanta, GA, a wide variety of experts met with CDC policymakers to exchange information and brainstorm solutions to the racial disparities in STDs within the black community. The results are documented in a 48-page PDF report entitled "Consultation to Address STD Disparities in African American Communities".

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