Gonorrhea and syphilis cases surged to a 30-year high in the US during the first year of the COVID-19 pandemic, the Centers for Disease Control and Prevention (CDC) has revealed.
There were 678,000 infections with gonorrhea — which leads to pain urinating and unpleasant discharges from the genitals — detected in 2020, the latest report showed, the highest number since 1990 and up ten percent from the previous year.
For syphilis — a condition that can trigger painful rashes — there were 144,000 cases spotted over the same period, also a record for the last three decades but up just three percent in 12 months.
Total cases of sexually transmitted diseases (STDs) hit 2.4 million in 2020, down six percent from the record 2.5 million in 2019. But CDC officials warned total infections were likely still rising, arguing a fall was only recorded because fewer tests were carried out in 2020 as resources were re-directed to fighting COVID-19.
People in black and American Indian groups had the highest rates of STDs in America, the report showed, while gay and bisexual men had the highest rates of chlamydia. Mississippi had the highest rate of STDs in the country.
Jonathan Merin, the CDC’s director for STD prevention, warned the ‘unrelenting momentum’ of the nation’s STD epidemic continued throughout the first year of the pandemic — even as people limited contacts for fear of catching COVID-19.
It has been suggested that cases of the diseases — spread by vaginal, anal or oral contact — rose because a lack of testing left many infected people unaware they had an STD, leading to them unwittingly passing it on. Rising rates of drug use were also thought to be behind the rise.
Total cases of STDs in the US had risen for the previous seven years in a row from 1.8million in 2014, also driven by rising levels of drug use alongside poverty and cuts to prevention programs in the country.
The CDC report found gonorrhea cases have now hit their highest level for 30 years in the US, but officials suggest cases are likely even higher. They say most went unreported, however, because of cuts to testing as resources were redirected to fighting the COVID-19 pandemic
The above graph shows rates of syphilis across the US since 1940. It reveals that total syphilis cases (grey line) have also now risen to their highest level in 30 years, despite disruption triggered by the COVID-19 pandemic
Total cases of STDs — chlamydia, gonorrhea and syphilis — have been trending upwards for the previous seven years in a row. Infections fell in 2020 with 2.4million recorded compared to the previous year, but CDC officials said it was likely that cases had in fact continued to rise but this was not detected due to a drop in testing
The above graph shows the rate of chlamydia cases across the US, the country’s most common STD. Infections fell 12 per cent compared to last year, but CDC officials said this was likely down to a drop in testing for the disease
The CDC’s annual report — called 2020 Sexually Transmitted Disease Surveillance — compiled data from national surveillance systems where each state submits the number of STDs it has detected.
It also used figures collected through surveillance programs including the STD Surveillance Network — which monitors gonorrhea — and the Gonococcal Isolate Surveillance Project — which monitors rates of antibiotic resistance in gonorrhea.
What is gonorrhea? What are its symptoms? Can it be treated?
Gonorrhea is the second most common sexually transmitted disease in the US.
It is a bacterial infection of the genital area, and is spread by having vaginal, oral or anal sex with someone who is also infected.
What are the symptoms?
Warning signs of the infection include:
- Pain or a burning sensation when urinating;
- Increased vaginal discharge;
- White, yellow or green discharge from the penis;
- Vaginal bleeding between periods;
- Painful or swollen testicles;
How is gonorrhea diagnosed?
Doctors test a urine sample to work out whether someone has the bacterial infection.
For those who have oral or anal sex, swabs may also need to be taken from the throat or rectum.
What are the treatment options?
Gonorrhea can easily be treated using antibiotics.
But the CDC warns that everyone must complete their course of this medication, because of the rise of antibiotic resistant strains.
Chlamydia was the most common STD in the US in 2020, with 1.5 million cases detected — or three-fifths of the national total.
Its cases had dipped 12 percent compared to the previous year, but CDC officials said this was likely down to a lack of testing. The report said: ‘The decline in reported chlamydia cases is likely due to decreased STD screening and under-diagnosis during the pandemic, rather than a reduction in new infections.’
Gonorrhea was the second most common STD in the US, followed by syphilis.
No cases of chancroid—a tropical STD that causes swelling around the genitals—were detected.
Congenital syphilis cases — when the bacteria is found in newborns — rose 14 percent in a year in 2020 to their highest level since 1994, after 2,100 cases were detected.
Leandro Mena, the director of the CDC’s division of STD prevention, said: ‘The COVID-19 pandemic increased awareness of a reality we’ve long known about STDs.’
‘Social and economic factors – such as poverty and health insurance status – create barriers, increase health risks, and often result in worse health outcomes for some people.
‘If we are to make lasting progress against STDs in this country, we have to understand the systems that create inequities and work with partners to change them. No one can be left behind.’
Breaking the CDC data down by ethnic group revealed black people had the highest rates of chlamydia (1,086 cases per 100,000 people), gonorrhea (662.4) and syphilis (34.1).
The second highest rates for all three STDs were recorded among American Indians (612.6, 339.6 and 26.9, respectively).
On the other end of the scale, people in the Asian and white ethnic groups had the lowest rates of all three STDs.
The CDC also released surveillance carried out across eight US states monitoring the proportion of gay and straight men and women that had chlamydia.
Of the 33,000 participants, it found gay men were most likely to have an STD overall followed by straight men and women. It did not consider other sexualities.
The report said: ‘While STDs are increasing across many groups, the 2020 STD data show that some racial and ethnic minority groups, gay and bisexual men, and our nation’s youth continue to experience higher rates of STDs.
‘This trend shows that longstanding factors, such as lack of access to regular medical care, discrimination, and stigma, continue to stand in the way of quality sexual healthcare for everyone who needs it.’
Breaking the data down by state revealed Mississippi had the highest rates of chlamydia, gonorrhea and syphilis across the country. Louisiana had the second-highest rates of chlamydia and gonorrhea.
Early in 2020 it appeared that COVID-19 control measures including self-isolation requirements and orders to stay home might reduce the spread of STDs in the country. But the opposite appears to be the case.
Experts suggest the rising rates may be down to a lack of testing which left many people unaware they were infected and, as a result, they spread the infection more.
It was also suggested that more people fell into poverty during the pandemic, which is known to be associated with a higher likelihood of catching an STD.
Researchers say testing capacity is now returning to pre-pandemic levels, offering hopes for curbing the spread of the disease.
The federal Government has also bumped up its funding for STD prevention, releasing its first five-year plan to combat the diseases and investing $200 million in building up public health capacity.
What is syphilis? What are its symptoms? How is it diagnosed? Can it be treated?
Syphilis is a sexually transmitted infection that can cause serious health problems without being treated, especially for pregnant women.
The bacteria are spread through direct contact with a sore triggered by the disease during vaginal, anal or oral sex. The disease can also be spread from a mother to her child during childbirth.
What are the symptoms?
Syphilis infections in the early stages trigger the following warning signs:
- Sores on the penis, vagina, anus or lips;
- Rashes around the mouth, vagina or anus which are rough and red;
- sore throat;
- Patchy hair loss;
- Muscle aches and fatigue.
How is syphilis diagnosed?
Infections with this STD are detected using a simple blood test. It is also possible to diagnose the infection by testing fluid that has leaked from a sore.
Can it be treated?
Syphilis infections can be treated using a course of antibiotics. But doctors warn this may not reverse any damage a long-term infection has caused.
In cases where syphilis is not treated early, it can spread to the brain and nervous system, the eye and the ear. This can result in hearing loss, dizziness and changes to the mental state such as trouble focusing.