Gonorrhea cases decline for first time in decade, but syphilis continues to surge
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Key takeaways:
- Reported cases of chlamydia, syphilis and gonorrhea in the U.S. surpassed 2.5 million for the third time in 5 years.
- Gonorrhea cases declined for the first time in at least a decade, the CDC said.
Reported cases of gonorrhea in the United States declined for the first time in at least a decade in 2022 while cases of chlamydia remained stagnant and syphilis continued its years-long surge, data released by the CDC on Tuesday showed.
Once again, more than 2.5 million cases of chlamydia, gonorrhea and syphilis were reported in the U.S. in 2022. The nation has hovered around 2 million or more cases since at least 2015.
“The CDC’s latest STI data show that our nation is facing a rapidly deteriorating public health crisis with real lives at stake — especially with syphilis — and will continue to spiral out of control until the administration and Congress provide communities with the funding they need to provide the most basic screening, treatment and prevention services,” the National Coalition of STD Directors said in a statement.
Although gonorrhea cases declined in 2022 from the year before, cases of congenital syphilis increased significantly, as did cases of syphilis at all stages. The rise in syphilis has caused concern among public health experts.
“We cannot continue to use decades-old prevention strategies to address today’s STI epidemic,” Laura Bachman, MD, MPH, FIDSA, FACP, acting director of the CDC’s Division of STD Prevention, said in a press release. “People need testing and treatment to meet them where they are [because] we know treatment is not always received in traditional health care settings.”
Using data collected through the National Notifiable Diseases Surveillance System and other STI monitoring programs, including the STD Surveillance Network and the Gonococcal Isolate Surveillance Project, the CDC reported rates and trends for the three nationally notifiable STIs for the 5-year period from 2018 to 2022.
Overall, the number of cases of all three infections declined to 2.505 million in 2022 from 2.531 million in 2021, a 1% decrease. The number of infections also represents a 1.9% increase in cases since 2018.
For the first time in at least a decade, the number of gonorrhea infections declined, dropping by 8.7% to roughly 648,000 cases in 2022. Since 2018, however, the number of gonorrhea cases has increased by 11.1%.
Bachmann said the decline in gonorrhea cases is being examined closely and that 2023 data could reveal whether there has been a true decline or if changes in diagnoses and reporting caused the shift.
“This finding may be a cause for an even closer look at public health efforts and redoubled prevention strategies, including those that improve access to STI testing and treatment,” she said.
Chlamydia increased 0.3% to 1.649 million cases in 2022. Even with the small increase in 2022, the number of chlamydia cases in the U.S. since 2018 has actually declined by 6.2%.
The number of syphilis cases in all stages increased by 17% in 2022 to 203,500, and has increased by 78.9% since 2018.
The largest increase was in congenital syphilis — a 30.6% rise to 3,755 cases in 2022. Cases have increased by 183.4% since 2018, according to the new report. In November, the CDC noted that cases of congenital syphilis have risen 10-fold in the past decade.
“Within the STI epidemic, syphilis is one infection that stands alone,” Bachmann said. “We are calling on all partners, particularly health care providers, to understand who should be tested for syphilis in their community. ... Every case is one too many when we have the tools to prevent it.”
She said the CDC must continue to support enhancing and expanding the delivery of STI services, care, monitoring, research and training, which includes creating STI express clinics. She said and the agency must also finalize guidance on the use of doxycycline as postexposure prophylaxis to prevent STIs.
“There are no shortcuts, and we have to meet people where they are,” Bachmann said. “Some people face tremendous barriers to STI prevention and health services. So, the most important work we do is often outside the clinic, whether it be reaching out to communities with testing, interviewing patients to offer services to their partners or delivering treatment directly to someone.”
References:
- CDC. Sexually transmitted infections surveillance, 2022: CDC’s 2022 STI Surveillance report underscores that STIs must be a public health priority. https://www.cdc.gov/std/statistics/2022/default.htm. Updated Jan. 30, 2024. Accessed Jan. 30, 2024.
- Out-of-control STI epidemic continues to put lives at risk. https://www.ncsddc.org/out-of-control-sti-epidemic-continues-to-put-lives-at-risk/. Published Jan. 30, 2024. Accessed Jan. 30, 2024.
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CDC. Sexually transmitted infections surveillance, 2022: CDC’s 2022 STI Surveillance report underscores that STIs must be a public health priority. https://www.cdc.gov/std/statistics/2022/default.htm. Updated Jan. 30, 2024. Accessed Jan. 30, 2024.
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