STD's: the gift that keeps on giving

                                                      

In my years of working as a microbiologist, I spent quite a few of those years doing molecular and other testing for various sexually transmitted diseases (STD's), including chlamydia, gonorrhea, Herpes, and Human Papillomavirus (HPV). We used to joke that I was the STD Queen, although it's nothing I ever put on my resumé! I would have thought that increased awareness of the dangers of unprotected sex would result in a steady decline in the rates of STD's. Sadly, that isn't the case. Check out these statistics.

Chlamydia remains the most commonly reported infectious disease in the United States. In 2006, 1,030,911 cases were reported, up from 976,445 in 2005. Even so, most chlamydia cases go undiagnosed. The national rate of reported chlamydia in 2006 increased 5.6 percent from 2005. The increase could be due to better screening efforts and more sensitive tests, but could also reflect an actual increase in infections.

Gonorrhea is the second most commonly reported infectious disease in the United States, with 358,366 cases reported in 2006. Following a 74 percent decline in the rate of reported gonorrhea from 1975 through 1997, overall gonorrhea rates plateaued, then increased for the past two years. In 2006, the gonorrhea rate increased 5.5 percent since 2005, the second consecutive year in which the rate increased. Like chlamydia, gonorrhea is under-diagnosed, and about twice as many new infections are estimated to occur each year as are reported.

The rate of primary and secondary (P&S) syphilis — the most infectious stages of the disease — decreased throughout the 1990s, and in 2000 reached an all-time low. However, over the past six years, the syphilis rate in the United States has been increasing. Between 2005 and 2006, the national P&S syphilis rate increased 13.8 percent, and the number of cases increased from 8,724 to 9,756.

The overall increase in syphilis rates from 2005 to 2006 was due primarily to increases among males, with the rate increasing by 11.8 percent in that group. However, the rate among females increased for the second year in a row, by 11.1 percent, following a decade of declines. Additionally, the rate of congenital syphilis (transmission from mother to newborn) increased slightly in 2006. While it is too early to know if this increase among newborns is a trend, increases in congenital syphilis have historically followed increases among women.

Source: Trends in Reportable Sexually Transmitted Diseases in the United States, 2006: National Surveillance Data for Chlamydia, Gonorrhea, and Syphilis, www.cdc.gov

Human Papillomavirus (HPV) has been shown to be the leading cause of cervical cancer, and with Merck's development and FDA approval of a vaccine, it's our first chance to prevent cancer with a vaccine, a remarkable achievement. A recent study shows that HPV may also be among the leading causes of oral cancer in men, causing as many cancers as smoking and alcohol use. While further study is needed, Merck plans to ask for government permission to offer the vaccine to boys as well as girls and young women. This would aid in stopping the transmission of the virus to women, but this new study shows that it may also provide significant health benefits to males. While it's a personal choice, I encourage everyone to have their kids vaccinated. It does not in any way condone sexual activity at a young age, but it certainly could protect them as young adults.

While the vaccine is certainly encouraging, we're forgetting an important point here. Why, after the dangers of unprotected sex have been so widely publicized, are our rates still going up? Have we learned nothing? A key word in the CDC's statistics is "undiagnosed." That means there are a significant number of people out there sharing DNA that have no idea they have an infection. Doesn't anyone find that scary any more? And while things like chlamydia, gonorrhea, and syphilis can be cured with antibiotics, things like Herpes and HIV stay with you forever. It should be a sobering thought, and prevent the spread of these infections, but that's not what is happening.

This may seem like a bit of a delicate subject, but I'm speaking as a healthcare worker concerned about what I continue to see, year after year. We see kids in junior high coming up positive for these infections, and every time we see that, we say, "Awww, man!" While there are a host of social and personality issues that come into play in cases like that, my primary focus is to see people of all ages prevent the transmission of these preventable infections.

Just be careful out there, okay?

Tags: Chlamydia, gonorrhea, syphilis, HPV