A total of 1,030,911 cases of chlamydia were reported to the US in 2006, from 976.445 of 2005, and the real number of infections is probably on the order of 2.8 million, estimated Mr . Johnson Douglas and colleagues, of the national center for the prevention of HIV/SIDA, viral hepatitis, STD, and TB. Although there was substantial progress by preventing, while diagnosing, and by treating certain diseases in prior years, the CDC estimates that roughly 19 million STDs occur every year. Present among almost half young adults, the investigators wrote in the annual update book. The national rate of reported cases of Chlamydia in 2006 was 347.8 in 100.000, compared with 329.4 in 100.000, translating into an increase of 5.6%.
"The increases in reported cases and rates likely reflect the continued expansion of screening efforts and increased use of more sensitive diagnostic tests," the CDC investigators noted. "However, the continued increases may also reflect an actual increase in infections."
There were also significant racial disparities in chlamydia infections, with African Americans having a rate more than eight times higher than that of whites (1,275 per 100,000 versus 153.1 per 100,000). About 46% of all chlamydia cases in 2006 were reported among African Americans.
Chlamydia occurrence was also higher by a factor of five among American Indians/Alaska Natives, at 797.3 per 100,000, and by a factor of three among Hispanics, at 477.0 per 100,000.
Because women are disproportionately affected by chlamydia, with untreated disease resulting in a high incidence of pelvic inflammatory disease, ectopic pregnancies, and infertility, CDC treatment guidelines recommend that women be retested for chlamydia approximately three months after treatment.
Among other major STDs, according to the CDC:
Gonorrhea
Rates of gonorrhea remained relatively stable, with only slight increases from 2005 to 2006. A total of 358,366 cases of gonorrhea were reported in 2006, making it the second most commonly reported infectious disease.
The highest rates of gonorrhea were in the southern United States, and there was also a 2.9% increase in the west from 2005 to 2006.
The reasons for the increase are unknown, said Dr. Johnson.
Also of concern to STD specialists is growing drug resistance, with 13.8% of all gonococcal isolates collected through the CDC's Gonococcal Isolate Surveillance Project in 2006 showing resistance to fluoroquinolones, compared with 9.4% in 2005 and 6.8% in 2004.
"Resistance to the fluoroquinolones has been highest among men who have sex with men," the investigators reported.
The CDC no longer recommends prescribing fluoroquinolones for men who have sex with men or for infections acquired in California, Hawaii, and other regions where fluoroquinolone resistance is widespread, leaving only cephalosporins as first-line agents in these areas, the investigators noted.
"Although 2006 data show no indication of cephalosporin resistance, increased monitoring for emerging resistance and accelerated research into new treatments are needed to continue the nation's progress in controlling this common sexually transmitted disease," they cautioned.
Syphilis
Although rates of primary and secondary syphilis reached a nadir in 2000, the rate has been creeping back up, and from 2005 to 2006 the rates for both primary and secondary increased from 2.9 per 100,000 to 3.3 per 100,000, translating into an absolute increase of 13.8%.
Most of the change came from increased syphilis infections among men, from 5.10 per 100,000 in 2005 to 5.7 per 100,000 in 2006, but there was also an increase among women, from 0.9 per 100,000 to 1.0 per 100,000 in 2006. The rate of congenital syphilis also increased slightly from 8.2 per 100,000 live births in 2005 to 8.5 per 100,000 in 2006.
"The reasons for these overall increases among females are not yet clear," the report's authors wrote.
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