A new report from the Centers for Disease Control and Prevention (CDC) shows that new cases of the three most common nationally-reported sexually transmitted diseases (STDs), chlamydia, gonorrhea, and syphilis, have risen to record highs in the U.S. Notably, new cases for all three infections have been setting records since 2013. Data on other STDs (also called sexually transmitted infections, STIs), such as HPV and herpes, are also included in the annual report.
According to the report, 2.4 million new syphilis, gonorrhea and chlamydia infections were documented in 2018. This number represents100,000 more cases than were recorded in 2017. Because chlamydia, gonorrhea and syphilis infections can have no noticeable signs and symptoms, many cases go undiagnosed and are not reported to health authorities. As a result, the figures documented in the recent CDC report may not reflect the true burden of disease.
The latest data show that between 2017 and 2018:
- The rate of newly diagnosed cases of primary and secondary syphilis, the two most infectious stages of the disease, rose by 14%, to more than 35,000 cases. The majority of these cases continue to occur in men who have sex with men (MSM).
- Cases of gonorrhea increased 5%, to a total of more than 580,000 new diagnoses.
- New chlamydia cases increased by 3% to more than 1.7 million cases, representing the highest number of chlamydia cases ever reported to CDC.
The CDC has attributed the increase in new STD cases in part to drug use, poverty, stigma, and unstable housing, which can all reduce access to preventive care and treatment. Another factor contributing to the rise of STDs overall is decreased use of condoms among vulnerable groups, including young people and men who have sex with men. Cuts in funding for STD programs at the state and local level have also created challenges in prevention and treatment of these infections.
Antibiotics can cure all three of these STDs. But without treatment, syphilis can cause lifelong health problems or even lead to death. Untreated chlamydia and gonorrhea can cause pelvic inflammatory disease and can lead to infertility in women. Importantly, the presence STDs such as syphilis and gonorrhea can increase the risk of getting HIV.
The youngest patients
Among the most concerning statistics reported by the CDC is the sharp increase in infants born with syphilis (congenital syphilis). Mothers with undiagnosed and untreated syphilis can pass the infection to their babies during pregnancy. The number of newborns with syphilis increased by 40% from 2017 to 2018, resulting in over 1,300 confirmed cases.
An infected newborn may not have noticeable signs or symptoms of the disease at birth. Left untreated, congenital syphilis can cause complications later in life, such as cataracts, deafness, developmental delays, seizures, and even death. Ninety-four of the 1,306 infants born with syphilis died of causes related to their infection in 2018, a 22% increase from 2017.
Although most states reported at least one case of syphilis in a newborn during this period, five states – Texas, California, Florida, Arizona, and Louisiana – accounted for 70% of cases in the U.S.
"There are tools available to prevent every case of congenital syphilis," said Gail Bolan, M.D., director of CDC's Division of STD Prevention. "Testing is simple and can help women to protect their babies from syphilis – a preventable disease that can have irreversible consequences."
Getting and staying healthy
Anyone who is sexually active can get an STD, but taking steps to protect yourself can significantly reduce the chance of infection. Such steps include limiting the number of sex partners and using condoms consistently and correctly. Talking openly with sex partners about STDs and asking healthcare practitioners about getting tested—and completing treatment right away for you and your partner if positive—are also important ways to help prevent re-infection and spread of STDs.
Many people who have an STD don't know it—they don't have any or noticeable signs and symptoms, so the CDC recommends routine testing for the following groups:
- All pregnant women should get blood tests for syphilis, HIV, and hepatitis B early in pregnancy (first trimester or first prenatal health exam). Women at high risk for chlamydia and gonorrhea should also get tested for those diseases. Retesting for STDs in the third trimester is recommended for pregnant women who continue to be at risk of infection.
- All adults and teens from ages 13 to 64 should be tested at least once for HIV. Anyone with risk factors for HIV (e.g., men who have sex with men, injection drug users) should get tested for HIV at least once a year.
- All sexually active women younger than age 25 should get gonorrhea and chlamydia tests every year. Women 25 years old and older with risk factors such as new or multiple sex partners, or a sex partner with an STD, should also get annual gonorrhea and chlamydia tests.
- All men who have sex with men should be tested at least once a year for syphilis, chlamydia, and gonorrhea, while those who have multiple or anonymous partners should get tests every three to six months.
"STDs can come at a high cost for babies and other vulnerable populations," said Jonathan Mermin, M.D., M.P.H., director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. "Curbing STDs will improve the overall health of the nation and prevent infertility, HIV, and infant deaths."