Gonorrhea rates rising in western states since 2000

NEW YORK (Reuters Health) - Cases of gonorrhea, a common sexually transmitted disease infection, increased substantially in eight western states between 2000 and 2005, public health officials report in Friday's Morbidity and Mortality Weekly Report, a publication of the U.S. Centers for Disease Control and Prevention.

In contrast, infection rates have declined or remained stable in the rest of the United States.

Dr. M. Javanbakht, from the STD Program at the Los Angeles County Department of Public Health, and associates focused their investigation on states reporting increases of 25 percent or more between 2000 and 2005 or at least 500 cases in 2005.

All of these states were in the west, including Alaska, California, Hawaii, Nevada, New Mexico, Oregon, Utah and Washington.

According to case report data from the National Electronic Telecommunications System for Surveillance, the incidence of gonorrhea in these eight states rose by 52 percent, with Utah leading the way at 195.1 percent. Only New Mexico, Oregon and Washington reported rates between 25 percent and 50 percent.

In the remaining US states, the overall incidence declined by 15.3 percent.

No groups were spared; increases were documented for both sexes, all specified age groups, and in all specified racial and ethnic populations. The authors note that the increase among blacks was less than that among whites and Hispanics.

Investigators at the CDC in Atlanta think that the increases may be partially attributed to increased testing and use of new, more sensitive tests.

However, they say, "changes in testing procedures and screening practices do not account for all of the observed increase."

For example, similar increases were documented among groups less likely to be affected by screening and test practices -- such as men with gonorrhea causing symptoms -- a group that tends to seek medical care spontaneously -- and women tested at family planning clinics.

The CDC advises public health departments "to review their gonorrhea control programs" and "STD program officials should remain vigilant for early signs of increases and consider improved surveillance for gonorrhea."

Gonorrhea infection often produces no symptoms; symptoms that do occur include vaginal or penile discharge and pain during urination. The STD can lead to a variety of serious conditions including pelvic inflammatory disease and infertility. The infection may also fuel the transmission of HIV, the virus that causes AIDS.

SOURCE: Morbidity and Mortality Weekly Report, March 16, 2007.