Pandemic doesn’t stop ‘stunning’ rise in gonorrhea, syphilis cases

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Sexually transmitted disease rates continued to climb even during the pandemic, the CDC reported.In 2020, there were 677,769 cases of gonorrhea reported to the CDC, up from 616,392 in 2019.Cases of congenital syphilis, or syphilis among newborns, increased 235% from 2016 to 2020.In Georgia reported cases of primary and secondary syphilis in women more than doubled.Nationwide, women 15-44 reported a 156% increase in primary and secondary syphilis cases

In Georgia, reported cases of primary and secondary syphilis in women more than double from 2016-2020

Sexually transmitted diseases appeared to take a break at the beginning of the coronavirus pandemic. By the end of the year, however, the number of reported cases of gonorrhea, syphilis and congenital syphilis were higher than in 2019, which set a record.

The latest report from the Atlanta-based Centers for Disease Control and Prevention found chlamydia cases, which usually account for the largest portion of STDs, decreased, however. There were 1.6 million cases reported in 2020, down 1.2% from 2016.

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“The COVID-19 pandemic put enormous pressure on an already strained public health infrastructure,” said Jonathan Mermin, M.D., M.P.H., director of CDC’s National Center for HIV, Viral Hepatitis, STD and TB Prevention. “There were moments in 2020 when it felt like the world was standing still, but STDs weren’t. The unrelenting momentum of the STD epidemic continued even as STD prevention services were disrupted.”

The CDC report found that, at the end of 2020:

  • Reported cases of gonorrhea and primary and secondary syphilis were up 10% and 7%, respectively, compared to 2019.
  • Syphilis among newborns (congenital syphilis) also increased, with reported cases up nearly 15% from 2019, and 235% from 2016. Early data indicate primary and secondary syphilis and congenital syphilis cases continued to increase in 2021. as well.
  • Reported cases of chlamydia declined 13% from 2019.

Even in the face of a pandemic, the CDC reported, 2.4 million cases of STDs were reported in the U.S. in 2020, including 133,945 cases of all stages of syphilis — up 52% from 2016 — and 677,769 reports of gonorrhea — up 45% from 2016.

These were “stunning” increases, Hilary Reno, an associate professor at the Washington University School of Medicine and medical director of the St. Louis County Sexual Health Clinic, told the New York Times. “I can’t tell you how many primary-care physicians have called me recently and said, ‘I just saw my first-ever case of syphilis this year.’”

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Rates rise more for women

Although rates have usually been highest in gay and bisexual men, followed by straight men, their numbers have risen more slowly than have those for women. In Georgia, for example, reported cases of primary and secondary syphilis more than doubled, climbing from 113 in 2016 to 257 in 2020.

Among heterosexual women, cases increased 30% from 2018 to 2019 and 21% from 2019 to 2020, “jumps that experts attribute in part to the increasing prevalence of opioid and methamphetamine abuse, which makes risky sexual behavior — transactional sex, condomless sex — more likely among all genders,” the Times reported.

The most common missed opportunity to lower those numbers happened when mothers did not receive prenatal care or syphilis testing (41%). These numbers are likely fueled by a more than 156% increase in primary and secondary syphilis among women 15-44 years.

When comparing U.S. regions, Southern women reported the most cases (3,450), followed by those in the West (2,689), Midwest (1,134) and Northeast (628).

These increases have contributed to the surge in congenital syphilis, which the report found has increased dramatically in the past five years. In 2020, for example, there were 149 stillbirths and infant deaths, reflecting a 210% increase since 2016.

Early 2021 data indicate P&S syphilis and congenital syphilis continued to increase, with congenital syphilis cases already surpassing 2020 counts.

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