CDC Reports Sharp, Sustained Increase in STDs Over the Past 4 Years

A new analysis released by the US Centers for Disease Control and Prevention (CDC) reveals a steep and sustained increase in the number of sexually transmitted diseases (STDs) over the past few years.

Specifically, over 2.3 million cases of chlamydia, gonorrhea, and syphilis were diagnosed in 2017 in the United States, a number that is up by about 200,000 cases since the previous year and 31% higher than it was in 2013. The 2017 data marks the fourth consecutive year in which sharp increases in STD incidence have been reported.

At the CDC’s National STD Prevention Conference held this year in Washington, D.C., a representative from the CDC shared STD data collected over a 5-year period, comparing numbers reported 2013 with preliminary data from 2017.

A 76% increase in the number of primary and secondary cases of syphilis were reported in the analysis, going from 17,375 cases in 2013 to 30,644 cases in 2017. They add that the majority of these cases, or 70%, occurred among those who are gay, bisexual, or men who have sex with men. Over 1.7 million cases of chlamydia were diagnosed in 2017, according to the recent data; this disease remained the most common STD reported to the CDC. A little less than half of the reported cases, or 45%, were among females between the ages of 15 and 24.

A 67% overall increase in the number of gonorrhea diagnoses were reported, jumping from 333,004 cases to 555,608 cases, with the number of these diagnoses increasing two-fold in men since 2013. However, the speedy increase in cases reported in women is dually concerning, according to the CDC, as numbers have been on the rise for the third consecutive year.

Although the CDC recommends 2 antimicrobials to treat uncomplicated gonorrhea—250 mg of ceftriaxone intramuscular and 1 g of oral azithromycin—a recent report found that only 81% of patients infected with uncomplicated gonorrhea are receiving the recommended regimen. Treatment adherence is imperative, especially as the number of cases of drug-resistant gonorrhea also continues to grow.

“Our first-line drugs—combination cephalosporins and azithromycin—are still effective for gonorrhea, but we’re seeing an emergence of case reports of resistance to these drugs, which is of huge concern,” Christine Johnston, MD, MPH, FIDSA, an associate professor in the Division of Allergy & Infectious Diseases, University of Washington, Seattle, and medical director of the University of Washington STD Prevention Training Center, part of the CDC-funded National Network of STD Clinical Prevention Training Centers, said in a recent interview with Contagion^®.

She added that although she has not seen resistance to the combination therapy recommended by the CDC for gonorrhea in her practice, that does not mean that it won’t happen. “The main concern is that we are marching through classes of antibiotics for treatment,” she said. “Several drugs have been available, but gonorrhea has rapidly acquired resistance with use of these drugs.”

Although emerging resistance to ceftriaxone has not been seen since the dual therapy recommendation was implemented, the new analysis reports that emerging resistance to azithromycin has been on the rise in laboratory testing—resistance has increased from 1% in 2013 to 4% in 2017.

“We expect gonorrhea will eventually wear down our last highly effective antibiotic, and additional treatment options are urgently needed,” Gail Bolan, MD, director of the CDC’s Division of STD Prevention, said in a recent statement. “We can’t let our defenses down—we must continue reinforcing efforts to rapidly detect and prevent resistance as long as possible.”

In order to reverse these trends, the CDC has issued a call-to-action for health care providers to make screening for STDs and providing timely treatment a standard part of medical care.