Gonorrhea rate declines in the city

by Symptom Advice on December 21, 2010

After years of having the highest rates of gonorrhea in thecountry, St. Louis has dropped to 12th, according to annual federalstatistics released Monday.

The city continues to struggle with its chlamydia infectionrate, however, maintaining the second-highest rank for two years ina row.

Each year, the Centers for Disease Control and Preventionreleases data on the three sexually transmitted diseases —chlamydia, gonorrhea and syphilis — that physicians are required toreport. St. Louis has consistently ranked in the top five ingonorrhea and chlamydia infection rates over the last decade,reaching the top spot in both diseases three years ago and secondplace last year.

The latest numbers show that reported cases of gonorrhea in thecity dropped from 1,890 cases in 2008 to 1,296 cases in 2009. Thatnumber is 55 percent lower than just four years ago, when therewere 2,828 cases, according to the St. Louis Department ofHealth.

“To have that cut in half in just a few years is justwonderful,” said Pamela Rice Walker, the interim director of thecity Health Department. “Some is just due to improved medications,but if that was the only thing happening, then our ranking wouldnot have changed.”

The drop also reflects a nationwide improvement in the gonorrhearate, which is at the lowest level since the CDC began tracking thedisease in 1941. Cases are declining among all racial and ethnicgroups and are down 17 percent overall since 2006.

Walker attributes the city’s drop in rank to education effortswith students and parents in St. Louis schools, identifying andtreating those who are infected earlier, and the opening two yearsago of a youth drop-in center, the SPOT, which provides free STDtesting.

“We are getting young people into places like the SPOT andgetting them tested,” Walker said. “Schools are letting us in.We’ve been in every public school from middle school on up. … Allthose things are helping raise awareness.”

Most importantly, she said, parents are talking to theirchildren about the risks of sexual activity.

“STDs are symptomatic of larger issues. they are symptoms ofself-esteem issues, hopelessness, poverty and not having a plan forthe future,” Walker said. “We need to talk to kids about theirplans for future and what they want to do with their lives, and howsexual activity can interfere with that. … It’s the mostimportant key to get this under control.”

Untreated gonorrhea and chlamydia can cause pelvic inflammatorydisease in women, which can result in infertility. Some studiessuggest that people with STDs are also at increased risk forHIV.

Paula Gianino, the director of Planned Parenthood in the St.Louis region, said the agency began a campaign three years ago toinform teenagers and young adults that testing and treatment iseasy, needle-free and affordable. “Many medications are just aone-pill treatment,” she said.

The number of syphilis cases in the city also dropped from 58 in2008 to 39 in 2009, but despite the improvements, the number ofchlamydia cases has remained about the same — 4,264 in 2008 and4,390 in 2009.

Nationwide, chlamydia diagnoses also continue to climb. Butfederal and local health officials say the increase is likely todue to increased screening for the infection, which often has nosymptoms.

“I am concerned that we rank as high as we do, but for us, it’simportant to look at the fact that young people are actuallygetting tested,” said Lawrence Lewis, coordinator at the SPOT,which has tested about 2,500 people ages 13-24 for STDs sinceopening two years ago. “They are actually taking opportunity tocare for their own health, which is something most people should beexcited about.”

The CDC reported that acknowledging that STD rates are higheramong teens, young adults and minority groups is key to acommunity’s prevention and treatment strategy. For example, morethan two-thirds of the gonorrhea and chlamydia cases in St. Louisare diagnosed in people ages 15-24.

At the SPOT, 4169 Laclede Avenue, young people can take part ingroup and individual counseling to stop risky behavior. SPOT is anacronym for Supporting Positive Opportunities with Teens.

The city Health Department also encourages doctors at federallyfunded health centers and emergency rooms to get permission fromat-risk patients to test for STDs.

In August, Missouri joined Illinois and at least 23 other statesin legalizing “expedited partner therapy,” which allows doctors toprescribe antibiotics for the sexual partners of their patientstesting positive for gonorrhea and chlamydia.

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