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Published on January 14, 2020

These 3 diseases have hit an all-time high in the U.S.

STD Rise

For the fifth year in a row, combined cases of gonorrhea, chlamydia and syphilis have risen in the United States, according to a Sexually Transmitted Disease Surveillance Report released by the CDC.

The report found that the combined rate of infections totaled 2.4 million in just the last year alone. The research also found the following sexually transmitted disease (STD) prevalence:

  • Chlamydia – 1.8 million reported cases, a 19 percent increase since 2014
  • Gonorrhea – 583,405 reported cases, a 63 percent increase since 2014
  • Primary and Secondary Syphilis – 35,063 reported cases, a 71 percent increase since 2014
  • Congenital Syphilis in Newborns – 1,306 reported cases, a 185 percent increase since 2014.

Healthcare professionals are aware of the trend and always on the lookout for STDs, according to gynecologist Nisha David, MD, at Cape Obstetrics in Falmouth.

“Every time anyone under the age of 25 comes into our office, we’re supposed to screen for gonorrhea and chlamydia,” she said. “If they come in for a UTI (urinary tract infection), we’re supposed to look for gonorrhea and chlamydia. If they come in for birth control, we’re supposed to screen for it. Even if they say they are not sexually active, we’re supposed to do it.”

The screening tool for those two diseases is a simple urine test. The test for syphilis is a blood test, so when Dr. David orders that screening, she also orders a whole panel of STD tests, including hepatitis B and C, HIV and sometimes herpes.

Even though syphilis is on the rise nationally, locally it is very rare in women and she has never seen a case of it in a newborn baby. But it is also very serious because it develops in stages and, if left untreated, can eventually be fatal. With primary syphilis, there is a painless genital lesion. It can also affect the anus or the mouth. If it goes unnoticed, it disappears and the syphilis moves into the secondary stage. Symptoms include a rash, swollen lymph glands, weight loss, muscle aches, fatigue and neurological symptoms.

Because of the serious damage STDs can cause to newborn babies (for instance, congenital syphilis can be fatal), every pregnant woman is screened as part of their baseline labs on their first visit. All newborn babies are also given eye ointment to prevent blindness, in case they were exposed to gonorrhea.

What to Watch For

Dr. David commonly sees patients with another type of STD.

“On the Cape we have a very high prevalence of hepatis C because we have a high incidence of patients with substance use disorder,” she said.

But, the most common sexually transmitted disease is still the human papillomavirus, or HPV, and Dr. David treats many patients with the disease.

“The research shows that 90 percent of women nationwide have been exposed to HPV at some point in their life,” she said.

The good news on HPV is that the numbers are expected to drop because the current generation is being vaccinated against it.

“My hope is that another generation from now, no one will have HPV,” Dr. David said. “And the vaccine is getting better and better. Every couple of years they add a couple of new strands of the virus that they cover. Initially it was the top couple most aggressive strands, but now it’s up to 9 strands.”

Dr. David also sees a lot of people who don’t realize that they have gonorrhea and chlamydia. Symptoms for both diseases include vaginal discharge, but they can also be asymptomatic. The conditions are often picked up on a patient’s prenatal or annual screening. Trichomoniasis is another STD with a symptom of discharge that people often don’t know they have.

STD patients are slipping through the cracks, in part, because of the change in birth control methods. When the pill was the most common form of birth control, women came in for an annual exam, which included STD screening.

“Nowadays there are more long-acting, reversible contraceptives like IUDs and Nexplanon that people can have for three to five years, so they don’t always come in for an annual exam, even though they should,” Dr. David said. “Nexplanon is a popular option for teenagers because they don’t have to remember to take a daily pill. It’s a plastic rod that is put in the arm that provides reliable birth control for three years.”

Another reason for the rising prevalence of STDs is that both partners need to be treated or reinfection will occur. In years past, doctors prescribed medication for both partners at one visit, but that is no longer allowed.

Ideally people should be tested before each new sexual partner. Or, at the very least, they should wear a condom, Dr. David said.

“I think there is plenty of education about this,” she said. “People just need to actually follow it. People know what they are supposed to do, but they don’t think that the partner they are about to sleep with has an STD.”

The CDC report found that cases of STDs tended to be highest among adolescents and young adults, but STDs can hit at any age, and they are surprisingly prevalent among seniors.

“A lot of the rising rates actually come from retirement communities,” Dr. David said. “They may not be using protection because they are no longer worried about pregnancy.”