WASHINGTON — Rates for four common sexually transmitted diseases continue to rise in Washington, and across the United States, according to new state and federal reports. However, while several Southwest Washington counties have higher-than average STD rates, Pacific County generally does not.
Tracking limits harm
In Washington, medical providers must report new cases of chlamydia, gonorrhea, syphilis and herpes to the state Department of Health (DOH). The federal Centers for Disease Control (CDC) collects data from state health authorities, and publishes its findings each fall. This information helps researchers spot outbreaks and identify regions and groups that might benefit from outreach and prevention efforts. This year, for example, researchers noticed that rates for these diseases are generally increasing faster in the western states.
An absence of symptoms, lack of access to affordable healthcare and the stigma associated with STDs can all prevent infected people from getting treatment, and lead to the spread of the diseases. Scientists say it’s important to track these diseases and get sufferers into treatment, because the conditions can have serious, and widespread health impacts. Without treatment, the diseases can lead to internal scarring, ectopic pregnancies, and greater risk of contracting HIV. Additionally, some STDs can be transmitted during pregnancy or delivery, putting affected babies at risk for serious consequences like pneumonia and blindness.
Unlike some STDs, Chlamydia is fairly easy to treat with antibiotics. Nonetheless, it has held its spot as the most common STD in the country since 1994, according to CDC. The disease is particularly common among young women, partly because many infected females have no symptoms. In Washington, chlamydia is most common among 20 to 24-year-old women.
Between 2000 and 2016, the national chlamydia infection rate increased 98 percent, from 251 cases per 100,000 people, to 497 cases. According to CDC, rates of the disease increased the most in the western U.S. during the last three years.
With a 2016 rate of 432 per 100,000, Washington has an overall lower-than average rate compared to other states. However, researchers are still concerned because the rate rising fast — nationwide, it increased by almost six percent in the last year alone.
Pacific County’s rate actually dropped, from 270 in 2015 to 212 in 2016. With the exception of Wahkiakum County, where the numbers of cases were too small to count for statistical purposes, Chlamydia rates are generally much higher elsewhere in Southwest Washington.
The nationwide increase in cases might not be as bad as it sounds. According to CDC, it’s partly due to improved tests, and new policies that have led to more young women getting tested. However, this doesn’t explain why rates among men also increased. Researchers believe this may be an indication that even when women are diagnosed, their infected male partners are not getting diagnosed or treated.
For a while, it appeared that efforts to curb the spread of the second-most common STD in the U.S., were working. In 2009, the country hit an all-time low of about 98 cases per 100,000 people. Since then, however, the rate has climbed steadily. In 2016, the national rate was almost 146. Over the last four years, the biggest spike in cases was in the west, where rates increased by 97 percent.
Researchers say rates are growing largely because the disease is becoming increasingly resistant to treatment. In the past, it could be cured with a course of oral antibiotics, but the most commonly-prescribed antibiotic has lost its efficacy. Now, the CDC recommends treating it with two different antibiotics, one of which must be injected.
In Washington, the rate increased from about 103 to 114 in 2016. While the number of cases increased in most Southwest Washington counties, Wahkiakum had only one case of the disease in 2016 (up from none in 2015), and Pacific dropped, from six cases in 2015 to three cases in 2016.
The U.S. is currently experiencing the highest rate of syphilis cases since 1993. In 2000 and 2001, the national rate was 2.1 per 100,000 — the lowest since reporting began in 1941. By last year, it had climbed to 8.7; a 314 percent increase.
For much of the last 16 years, the increase was by far the greatest among gay, bisexual and other men who have sex with men. However, starting in 2013, women began contracting syphilis at higher rates than men.
Washington’s syphilis rates are below average, but climbing. The statewide rate rose from 6.5 to 7.9, an increase of about 21 percent.
In 2015, 25 counties had at least one case. By 2016, 28 counties were affected. Wahkiakum and Pacific counties had no 2015 cases, but in 2016, Wahkiakum had one, and Pacific had two.
Researchers are especially concerned about the rise in infected women, because it may be leading to a rise in infants born with congenital syphilis, a condition that can cause severe disability. Historically, Washington has recorded no more than about one case of congenital syphilis per year. However, in 2015 there were three cases, and in 2016, five.
The CDC does not collect nationwide data on this virus, but experts there say it is among the most common STDs, and that most people who have it are never diagnosed.
Some studies have shown that nationwide, rates have remained fairly stable. But in Washington, where DOH does collect data on new cases, the picture is somewhat more nuanced. At the state level, there were a little over 2,500 new cases diagnosed in both 2015 and 2016, for a rate of about 35 to 36 infected people per 100,000. However, local rates fluctuated significantly. In Pacific County, the number of new cases went from three to six. In Southwest Washington, rates also increased in Cowlitz, Clark and Lewis counties. Cowlitz County had the second-highest rate in the state, with about 52.5 cases per 100,000.
The state Department of Health works with local authorities, like Pacific County’s Health and Human Services Department, to detect new cases and investigate outbreaks. Such early detection and treatment efforts are the best way to stop the steady climb in STD rates, DOH experts say.
Health and Human Services offers STD screening to people who seek birth control through its family planning clinics in Long Beach and South Bend.
For more information about STDs and local testing options, visit tinyurl.com/Pacific-County-STDs.