STDs Continue to Rise in the U.S.

Combined cases of syphilis, gonorrhea and chlamydia reached an all-time high in the United States in 2018, according to the annual Sexually Transmitted Disease Surveillance Report released by the CDC.

Sexually transmitted diseases (STDs) can have severe health consequences for not only adults, but for newborns.

From 2017 to 2018, a 22% increase of reported 77 to 94 newborn deaths related to congenital syphilis occurred, according to the annual report.

The new report shows that from 2017 to 2018, there were increases in the three most commonly reported STDs:

• There were more than 115,000 syphilis cases, which includes cases of both primary and secondary stages. The number of primary and secondary stages increased 14% more to 35,000 cases. Among newborns, syphilis cases increased 40% to more than 1,300 cases.
• Gonorrhea increased 5% to more than 580,000 cases–the highest number reported since 1991.
• Chlamydia increased 3% to more than 1.7 million cases–the most ever reported to CDC.

“STDs can come at a high cost for babies and other vulnerable populations,” Jonathan Mermin, MD, MPH, director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, said in the report.

“Curbing STDs will improve the overall health of the nation and prevent infertility, HIV and infant deaths.”

Antibiotics can cure syphilis, gonorrhea, and chlamydia.

However, left untreated, STDs can be transmitted to others and produce adverse health outcomes such as infertility, ectopic pregnancy and increased HIV risk, according to the report.

Congenital syphilis-syphilis passed from a mother to her baby during pregnancy-can lead to miscarriage, stillbirth, newborn death and severe lifelong physical and neurological problems.

The 40% increase in congenital syphilis cases continues a dangerous trend seen in recent years, the report says. Although most states reported at least one case of congenital syphilis, states like Texas, California, Florida, Arizona, and Louisiana accounted for 70% of cases in the U.S.

Prevention

Early prenatal care and STD testing are essential with each pregnancy to safeguard mothers and their babies from the dangers of syphilis.

CDC recommends syphilis testing for all pregnant women the first time they see a healthcare provider about their pregnancy. Women who are vulnerable for acquiring or who live in high-prevalence areas should be tested again early in the third trimester and at delivery, the report says.

“There are tools available to prevent every case of congenital syphilis,” says Gail Bolan, M.D., director of CDC’s Division of STD Prevention, in the report. “Testing is simple and can help women to protect their babies from syphilis–a preventable disease that can have irreversible consequences.”

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Other findings from the report include:

• The national rise in congenital syphilis increases in syphilis among women of reproductive age.
• From 2017 to 2018, syphilis cases increased 36% among women of childbearing age.
• Addressing rising syphilis incidence is critical to prevent congenital syphilis.
• Women can protect themselves by practicing safer sex, being tested for syphilis by a health care provider and if infected, seeking treatment immediately and asking her partner to get tested and treated to avoid reinfection.
• Multiple factors drive the continued increase in STDs.
Data suggests these multiple factors contributing to the increase are:
• Drug use, poverty, stigma and unstable housing, which can reduce access to STD prevention and care.
• Decreased condom use among vulnerable groups, including young people and gay and bisexual men.
• Cuts to STD programs at the state and local level. In recent years, more than half of local programs have experienced budget cuts, resulting in clinic closures, reduced screening, staff loss, reduced patient follow-up and linkage to care services.

CDC continues to work on multiple fronts to address the nation’s STD epidemic.

For example, CDC provides resources to state and local health departments for STD prevention and surveillance.

CDC’s current funding program for health departments, Strengthening STD Prevention and Control for Health Departments, supports several high-priority strategies and activities, including eliminating congenital syphilis. As part this program, CDC supports health departments in conducting disease investigations, responding to public health outbreaks, providing training for health care providers, community engagement and partnerships and other efforts.

HHS, which includes CDC, is developing a Sexually Transmitted Infections (STI) Federal Action Plan to address and reverse the nation’s STD epidemic.
The plan is being developed by partners across the federal government, with input from a wide array of stakeholders. It will be released in 2020.

However, urgent action from all types of stakeholders is needed to help control the increases in STDs, the report says.

It’s encouraged healthcare providers should make STD screening and timely treatment a standard part of medical care; this work can start with taking a complete sexual history.

In addition, state and local health departments should strengthen the local public health infrastructure needed to prevent and control STDs, and ensure resources are directed to the most vulnerable populations.

For more information from CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, visit www.cdc.gov/nchhstp/newsroom/.