STDs Continue to Spread Nationwide

Congenital syphilis--passed from pregnant mother to infant--is also on the rise, as are newborn deaths from the disease.

Congenital syphilis--passed from pregnant mother to infant--is also on the rise, as are newborn deaths from the disease. Shutterstock

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Cases of gonorrhea, chlamydia and syphilis rose for the fifth consecutive year, according to federal data released this week.

Diagnoses of sexually transmitted diseases rose nationwide for the fifth consecutive year, with nearly 2.5 million cases of chlamydia, gonorrhea and syphilis, according to a report released this week by the Centers for Disease Control and Prevention.

Chlamydia was the most common STD in 2018, with 1.7 million cases, a 3 percent increase from the prior year and the most ever reported to the CDC, according to the annual Sexually Transmitted Disease Surveillance Report

There were also more than 580,000 cases of gonorrhea (a 5 percent increase from 2017) and 115,000 cases of syphilis, including more than 1,300 cases among newborns, a 40 percent spike. Newborn deaths stemming from congenital syphilis—passed from a pregnant mother to her infant—increased 22 percent, from 77 to 94 deaths.

Every state in the country reported at least one case of congenital syphilis, but five states—Arizona, California, Florida, Louisiana and Texas—accounted for 70 percent of cases nationwide. Those rising rates of infection parallel increased rates of syphilis among young women of reproductive age, who saw cases spike 36 percent from 2017 to 2018.

Congenital syphilis is of particular concern to epidemiologists, as the disease can lead to miscarriage, stillbirth, newborn death and severe, lifelong physical and neurological problems, according to the CDC.

“STDs can come at a high cost for babies and other vulnerable populations,” Jonathan Mermin, director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, said in a statement. “Curbing STDs will improve the overall health of the nation and prevent infertility, HIV, and infant deaths.”

The first step in combating that problem is intensifying outreach efforts to young women, including testing for syphilis at every pregnant woman’s first prenatal visit, wrote Gail Bolan, director of the Division of STD Prevention at the CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention.

“One clear solution is to intensify our efforts to find women with syphilis and swiftly connect them to care and immediate treatment,” she wrote this week. “Doing so keeps them healthy and, for those who become pregnant, it keeps their babies healthy, too.”

Texas had the highest per-capita rate of congenital syphilis, followed by Nevada, Louisiana and Arizona. Nevada had the highest per-capita rate of primary and secondary syphilis, the stages at which the disease is most contagious. Gonorrhea was most common in Mississippi, while Alaska had the highest per-capita rate of chlamydia. Each of those infections is treatable with antibiotics. But when left untreated, the spread of the diseases are likely to continue, bringing with them rising rates of infertility, ectopic pregnancy and increased risk of HIV, among other things.

The CDC cited numerous factors contributing to the increase, including decreased condom use among young people and gay and bisexual men, cuts to health programs at the state and local level and ongoing drug use, poverty and unstable housing, all of which can reduce access to preventative care and treatment for STDs.

The federal Department of Health and Human Services is preparing an action plan to “address and reverse” the spread of these diseases, but that document will not be released until next year. In the meantime, the CDC is urging state and local health departments to increase municipal efforts, including making sure that resources are funneled to each community’s most vulnerable population. 

“The resurgence of syphilis, and particularly congenital syphilis, is not an arbitrary event, but rather a symptom of a deteriorating public health infrastructure and lack of access to health care. It is exposing hidden, fragile populations in need that are not getting the health care and preventive services they deserve,” Bolan wrote in the report’s foreword. “This points to our need for public health and health care action for each of the cases in this report, as they represent real people, not just numbers.”

Kate Elizabeth Queram is a Staff Correspondent for Route Fifty and is based in Washington, D.C.

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