National Gonorrhea Rates Level Off; Number of Drug-Resistant Cases Increases
The rate of gonorrhea infection has leveled off in the United States, but infection rates are rising in many cities hardest hit by the disease, according to CDC officials, the AP/South Florida Sun-Sentinel reports. Statistics released by the CDC at the National STD Prevention Conference in San Diego indicate that the national gonorrhea rate in 2000 was 131.6 cases per 100,000 people, a drop from the 1999 rate of 132 cases per 100,000 people. The gonorrhea infection rate "stabilized" in 2000 after rising 9% from 1997 to 1999 (McClam, AP/South Florida Sun-Sentinel, 3/5). However, the prevalence of gonorrhea rose in 2000 in 13 of the 20 cities with the highest infection rates, and gonorrhea infections increased by more than 20% in five cities that already had high rates, including Kansas City, Mo., Buffalo, N.Y., Jacksonville, Fla., Birmingham, Ala., and Detroit, Mich. Gonorrhea infection rates declined by more than 20% in Atlanta, Washington, D.C., and Chicago, and health officials said that the disparities between the two groups of cities could be due to "huge gaps" in testing and treatment for sexually transmitted diseases. The CDC called for more research to determine which prevention methods are successful in the cities with lower gonorrhea prevalence rates (AP/Las Vegas Sun, 3/5). Researchers are interested in preventing increases in STD rates, as bacterial STDs such as gonorrhea serve as biological cofactors that facilitate HIV transmission (Kaiser Daily HIV/AIDS Report, 2/13).
Richmond, Va., had the highest rate of gonorrhea among U.S. cities. The city's infection rate of 923.6 cases per 100,000 residents is approximately seven times the national average. George Jones, health promotions coordinator for the Richmond Department of Public Health, said that health officials and the public need to overcome the "taboo" that surrounds gonorrhea and other STDs. "There are a lot of authorities who don't want to talk about it. ... People have to stop turning their heads and pretending the problem is not here," he said. Rochester, N.Y., had the second-highest gonorrhea rate in the country in 2000, and Baltimore dropped from having the highest infection rate in 1999 to having the third-highest infection rate in 2000 (Smith, Richmond Times-Dispatch, 3/6). However, health officials in several of the cities with high gonorrhea prevalence rates said that new data suggest that infections are falling. Nancy Bennett, deputy health director for Monroe County, N.Y., said that the number of Rochester's gonorrhea cases fell from 2,142 in 2000 to 1,900 in 2001, a year for which CDC statistics are not yet available (Leingang, Rochester Democrat & Chronicle, 3/6). Officials in Kansas City, Mo., which had the eighth-highest gonorrhea rate for 2000, said that the city's data indicate infections "dropped sharply" in 2001 (Bavley, Kansas City Star, 3/6).
Syphilis Continues to Decline
The CDC also noted that syphilis infections in the United States have continued to drop (Askari, Detroit Free Press, 3/6). Syphilis infection rates fell in 15 of the 20 cities that had the highest rates in 1999 (Rubin, USA Today, 3/6). Detroit was ranked as the city with the most new syphilis cases in 2001, according to preliminary data (Detroit Free Press, 3/6). Syphilis infection rates have been declining nationally since the late 1980s, and federal funding for syphilis prevention will total $38 million this year (Goldsmith, Newark Star-Ledger, 3/6).
Antibiotic-Resistant Gonorrhea Rising on the West Coast
Drug-resistant strains of gonorrhea are on the rise in California and other parts of the West Coast, forcing health officials to reconsider current treatment recommendations, the Los Angeles Times reports (Ornstein, Los Angeles Times, 3/5). Cipro and other fluoroquinolone antibiotics have been "top-line" treatments for gonorrhea since the 1980s, when the disease became resistant to tetracycline (Chase, Wall Street Journal, 3/5). However, health officials have noted a recent increase in the number of gonorrhea infections that are resistant to fluoroquinolone antibiotics. Fluoroquinolone-resistant gonorrhea accounted for 4% of gonorrhea cases studied in Southern California in the last six months of 2001 (Los Angeles Times, 3/5). On the West Coast, the proportion of gonorrhea cases that are resistant to Cipro has increased from 0.1% in 1998 to 0.4% in 2000, and Cipro-resistant gonorrhea has been reported in Seattle, San Francisco, San Diego and Orange County (Wall Street Journal, 3/5). Drug-resistant gonorrhea is most common in homosexual and bisexual men and people who have had sexual partners from Asia, where the resistance is more widespread. Doctors and health officials are concerned that the rise of drug-resistant gonorrhea will decrease the number of treatment options available for the disease. To fight drug resistance, health officials in San Francisco and San Diego have advised physicians to avoid treating gonorrhea with Cipro and other fluoroquinolones, suggesting instead that they use cephalosporins, a class of antibiotics proven to treat the disease without producing drug resistance. During the conference this week, officials from California will discuss whether to rewrite treatment recommendations for all doctors in the state (Los Angeles Times, 3/5).
HealthCast of STD Speeches
Conference plenary sessions, featuring George Strait, Jr., health care journalist and former chief medical correspondent for ABC News, and Newsday health and medical reporter Laurie Garrett, will be available on kaisernetwork.org's HealthCast Web site on Friday, March 8, by 12 p.m. ET.