After being cooped up at home for a year-plus due to the pandemic, people’s ability to live at least semi-freely again has contributed to a spike in sexually transmitted diseases (STDs) that were already on the rise, sexual health experts say. On Monday, at a medical conference on STDs, David Harvey, executive director of the National Coalition of STD Directors, called the spike “out of control,” according to the Associated Press.
Experts said a rise in syphilis is particularly concerning, as a 26% increase was reported last year with a total of 171,074 cases, according to preliminary data from the Centers for Disease Control and Prevention (CDC). For context, a total of 101,590 were reported in 2017. Cases of congenital syphilis, which occurs in babies delivered by people with the disease, were up to nearly 2,700 last year compared to 941 in 2017.
There are numerous types of STIs that may or may not show symptoms. Infections with symptoms can be easily detected and cured. However, STIs without symptoms might be difficult to even diagnose, as these infections can potentially exist without exhibiting any symptoms at all.
Health Shots spoke to Dr Shalini Vijay, Senior Consultant Obstetrician and Gynaecologist, Motherhood Hospitals, Lullanagar to find out about the types of STIs that cause hardly any symptoms and are therefore hard to recognize.
“The prevalence of sexually active high school students getting tested for an STI in the past year is relatively low, despite national guidelines,” says a coauthor of the study, Nicole Liddon, PhD, a senior health scientist at the Centers for Disease Control and Prevention (CDC). These findings are important, as they provide the first national estimates of annual STI testing among a representative sample of U.S. high school students, she adds.
Early prenatal care and STD testing are essential with each pregnancy to safeguard mothers and their babies from the dangers of syphilis. CDC recommends syphilis testing for all pregnant women the first time they see a healthcare provider about their pregnancy. Women who are vulnerable for acquiring or who live in high-prevalence areas should be tested again early in the third trimester and at delivery.
“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.”
The national rise in congenital syphilis parallels increases in syphilis among women of reproductive age. From 2017 to 2018, syphilis cases increased 36 percent among women of childbearing age. Addressing rising syphilis incidence is critical to prevent congenital syphilis. Women can protect themselves by practicing safer sex, being tested for syphilis by a health care provider, and if infected, seeking treatment immediately and asking her partner to get tested and treated to avoid reinfection.
CDC released its 2019 STD Surveillance Report showing that STD rates in the U.S. reached all-time highs for the sixth consecutive year. Even more concerning, the report found that a growing number of babies in the U.S. are dying as a result of syphilis passed from mother to child during pregnancy (congenital syphilis) – all because women are not receiving simple, CDC-recommended testing and treatment.
Congenital syphilis is entirely preventable, but according to CDC’s report, cases of congenital syphilis nearly quadrupled between 2015 and 2019. In 2019:
• More than three-fourths (77%) of all cases were due to gaps in testing and treatment during the mother’s prenatal care – either when a mother was tested and diagnosed with syphilis but did not receive treatment, or when the mother did not receive a timely syphilis diagnosis during her pregnancy.
• Nearly two-thirds (65%) of all babies born with congenital syphilis were Black or Hispanic, highlighting the stark disparities in testing and treatment.
This is entirely unacceptable given the dire ramifications of congenital syphilis. As we observe Black Maternal Health Week, we are calling for action to address this crisis and its disparate impact. Forty percent of babies born to women with untreated syphilis may be stillborn or die from infection as a newborn. Those that survive can suffer severe, life-long health consequences, including deformed bones, blindness, or deafness.
“Every single case of syphilis in a newborn baby is a heartbreaking symptom of our nation’s chronically underfunded public health system,” said NCSD Executive Director David Harvey. “Congenital syphilis is 100% preventable, and the failure to protect newborns from this disease reflects our failure to invest in public health and to care for our most vulnerable members of society. We can and must do better.”
Pennsylvania state health officials are reporting increased amounts of sexually transmitted infections, in particular syphilis, prompting officials to encourage the public to take steps to decrease their risk.
Pregnant women should be screened at first and third trimester because of the sharp increase in the number of babies born with the disease in the United States. Nationally, cases of congenital syphilis increased by 185 percent between 2014 and 2018. In 2019, five congenital syphilis cases were reported in the state of Pennsylvania, following seven cases reported in 2018. These reported cases of congenital syphilis in the state represented the highest number of cases in more than 25 years.Early syphilis in Pennsylvania is currently at the highest rate in more than 20 years. Over the last five years, early syphilis reported in women of child-bearing age (women aged 15 to 44) increased 114 percent, from 78 cases in 2015 to 167 cases in 2019.
“Sexually transmitted diseases are serious diseases that impact many Pennsylvanians each year,” Acting Secretary Beam said. “It is essential that all residents are aware of the risks and dangers associated with STDs. Many of these diseases can be easily diagnosed and treated, which is why we encourage all residents to talk to their doctor about getting tested so we can further prevent diseases and keep our residents healthy.”
While the eyes of the nation are on the coronavirus pandemic, another threat to public health has been steadily growing in the United States. We’ve been battling rising rates of sexually transmitted infections (STI) for the last several years. In fact, 2020 marks the fifth consecutive year of increasing rates of gonorrhea, chlamydia and syphilis in the U.S., due in part to significant funding cuts to more than 50% of the nation’s public health STI programs. And now the COVID-19 pandemic has placed an even greater burden on our strained public health system and supply chains, shifting focus from one major public health issue to another.
We can’t risk losing one critical resource that will be essential to ending the STI epidemic — the availability of free and confidential STI testing for adolescents. Prior to the pandemic, national public health efforts were scaling up to improve STI and HIV testing, and quickly link youth to prevention services. Rapid identification and treatment of STIs not only has public health benefits in terms of lowering transmission, but when left untreated, STIs increase the risk of infertility, severe pelvic infection, chronic pelvic pain, ectopic pregnancy and HIV transmission.
While accounting for 25% of the population, adolescents and young adults comprise over 50% of STIs in the U.S. each year. Black, Latinx, and LGBT youth face the greatest burden of infections and risk of complications. Fortunately, significant advances have been made over the last several decades to improve rates of STI and HIV testing among adolescents and young adults. The American Academy of Pediatrics now recommends HIV screening by the age of 16-18 years for all youth regardless of their sexual activity.
Compared with their cisgender peers, gender-diverse teens are more likely to report sexual behaviors that put them at risk for HIV and other sexual health concerns, including the use of drugs or alcohol prior to sex, MedPage Today reports.
Brianna S. McMichael, MSN, MPH, of Children’s Minnesota in Minneapolis, conducted a survey of 411 teenagers who came into two emergency departments in the Midwestern city. She presented findings from the study at the American Academy of Pediatrics virtual meeting.
The study recruited young people 12 to 18 years old and provided them with an iPad on which to complete a survey while their parents stepped out of the room. Young people who came to the emergency department for mental health reasons or who were considered at risk for suicide were excluded.
As Covid-19 has rampaged across the United States, government officials have struggled with the basic steps needed to contain the pandemic. Should everyone get tested, or just people with symptoms? Should public health officials require Americans to wear masks or not? What’s the best way to track the infection, particularly in marginalized communities?
For one set of public health experts, the heated debates over testing, wearing masks and contact tracing were eerily familiar — as odd as it might seem, these are similar to arguments that officials and academics working to eradicate sexually transmitted diseases have been having for decades as they’ve worked to bring down the rates of infections like HIV, syphilis, gonorrhea and chlamydia.
Rates of chlamydia and gonorrhea are increasing among women ages 18 to 30 in the United States, a recent study by Quest Diagnostics suggests.
The study, recently published in the American Journal of Preventive Medicine, analyzed more than 17 million laboratory samples taken between 2010 and 2017 from females ages 12 to 30. Researchers found that while there was a decline in cases of chlamydia and gonorrhea among adolescents ages 12 to 17, women of ages 25 to 30 experienced a 50% increase in positive test results. Women 18 to 24 had a 21% increase in positive test results over the period of the study.
The U.S. Centers for Disease Control and Prevention (CDC) recommends annual screenings for sexually transmitted diseases (STDs) among sexually active women under 25, said Harvey Kaufman, director of Quest’s Health Trends Research Program. For women 25 and older, the CDC recommends screenings only for those with specific risk factors, such as reporting that their sex partner may have a concurrent sex partner. Kaufman, a co-author of the study, said the findings suggest that sexual and contraceptive practices have changed since 2002, when the CDC guidelines were first published.
Kaufman pointed out that the CDC guidelines were largely influenced by a 1998 study published in the New England Journal of Medicine that found that the overall rate of chlamydia among female Army recruits was 9.2%. As a result, the authors of the study recommended a screening program for female recruits 25 and under.