Teen Girls' Chlamydia Drives STD Rate Up

Memphis Tops Cities, Miss. Tops States With Highest Chlamydia Rates

By Daniel J. DeNoon
WebMD Health News

Reviewed By Louise Chang, MD

Nov. 16, 2009 -- Teen girls and young women have the highest rates of chlamydia, the sexually transmitted disease that's exploding across the U.S.

More than 1.2 million cases have been officially reported, the largest number of cases for any of the diseases that must be reported to the CDC.

Because chlamydia infections usually don't cause symptoms until they result in pelvic inflammatory disease, many cases remain undetected and hence unreported. Sexually active girls and women under age 26 should be screened for chlamydia every year, but only 41.6% of eligible women enrolled in Medicaid or private health plans do so.

Chlamydia rates are three times higher in women than in men and eight times higher in African-Americans than in whites.

Left untreated, some 10% to 20% of chlamydia infections cause pelvic inflammatory disease. That can lead to long-lasting pelvic pain, ectopic pregnancy, and infertility. Every year, the CDC estimates, chlamydia and other STDs leave at least 24,000 U.S. women unable to bear children.

Girls ages 15 to 19 have the highest chlamydia rate: 3,276 cases per 100,000 females. The rate is only a little lower in women ages 20 to 24: 3,180 cases per 100,000 females.

Overall, chlamydia rates went up 9.2% from 2007 to 2008, the most recent year for which there is data. Some of the increase is due to increased screening, but the CDC suspects that much of the increase reflects a rising number of new infections.

Chlamydia rates ranged from state to state, with rates highest in Mississippi and Alaska (each with more than 700 cases per 100,000 population) and lowest in New Hampshire, West Virginia, Vermont, and Maine (each with under 200 cases per 100,000 population.

However, 57% of chlamydia cases are in cities. Here's the ranking, by chlamydia rate, of the 50 largest metropolitan areas in the U.S.:

Metropolitan Statistical Area	2008 Cases	2008 Rate per 100,000
Memphis, Tenn.-Miss.-Ark.	9,199	1,385.9
Virginia Beach-Norfolk-Newport News, Va.-N.C.	8,789	1,036.3
Birmingham-Hoover, Ala.	4,948	862.6
Detroit-Warren-Livonia, Mich.	18,826	824.1
Jacksonville, Fla.	5,392	810.8
Richmond, Va.	4,981	797.8
Baltimore-Towson, Md.	10,774	779.4
Austin-Round Rock, TX	5,933	760.4
Indianapolis, IN	6,352	736.9
Cincinnati-Middletown, OH-KY-IN	8,031	735.7
San Antonio, TX	7,206	709.7
Kansas City, MO-KS	7,115	703.7
St. Louis, MO-IL	10,166	702.3
Buffalo-Cheektowaga-Tonawanda, NY	4,076	697.6
New Orleans-Metairie-Kenner, LA	3,722	694.3
San Diego-Carlsbad-San Marcos, Calif.	10,257	692.7
Philadelphia-Camden-Wilmington, Pa.-NJ-DE-MD	20,708	687.8
Chicago-Naperville-Joliet, Ill.-Ind-Wis.	33,220	687.3
Oklahoma City, Okl.	4,119	681.3
Rochester, N..Y	3,594	680.9
Columbus, Ohio	6,027	678.5
Dallas-Fort Worth-Arlington, TX	20,125	658.5
Charlotte-Gastonia-Concord, NC-SC	5,469	649.6
Las Vegas-Paradise, NV	5,842	647.7
Denver-Aurora, CO	7,824	637.6
Houston-Baytown-Sugar Land, TX	17,287	615.4
U.S. MSA TOTAL	501,750	607.0
Orlando, FL	6,160	600.9
Cleveland-Elyria-Mentor, OH	6,487	595.9
Los Angeles-Long Beach-Santa Ana, CA	38,100	587.7
New York-Newark-Edison, NY-NJ-PA	56,829	584.9
Tampa-St. Petersburg-Clearwater, FL	8,099	579.4
Hartford-West Hartford-East Hartford, CT	3,474	569.4
Sacramento-Arden-Arcade-Roseville, CA	5,997	564.5
Atlanta-Sandy Springs-Marietta, GA	14,898	557.9
Louisville, Ky.-Ind.	3,504	554.3
Washington-Arlington-Alexandria, DC-VA-MD-WV	14,967	550.7
San Francisco-Oakland-Fremont, Calif.	11,514	544.5
Phoenix-Mesa-Scottsdale, Ariz.	10,725	518.3
Nashville-Davidson-Murfreesboro, Tenn.	3,916	507.5
Riverside-San Bernardino-Ontario, Calif.	10,009	490.9
Seattle-Tacoma-Bellevue, Wash.	7,975	481.2
San Jose-Sunnyvale-Santa Clara, Calif.	4,218	478.8
Miami-Fort Lauderdale-Miami Beach, Fla.	13,144	472.6
Minneapolis-St. Paul-Bloomington, Minn.-Wis.	7,037	436.5
Salt Lake City, Utah	2,254	417.0
Pittsburgh, Pa.	5,092	416.6
Portland-Vancouver-Beaverton, Ore.-Wash.	4,468	409.6
Providence-New Bedford-Fall River, R.I-.Mass.	3,327	402.3
Boston-Cambridge-Quincy, Mass.-N.H.	8,458	367.2
Milwaukee-Waukesha-West Allis, Wis.	1,116	141.3

Chlamydia isn't the only STD on the rise. Once on the verge of being eliminated from the U.S., syphilis is making a comeback. Syphilis rates are up 67% since 2004,and jumped 18% from 2007 to 2008. Driving the syphilis comeback are infections among men who have sex with other men, who make up 63% of cases, but heterosexual syphilis is on the rise, too.

The CDC reports the data in its "National Overview of Sexually Transmitted Diseases (STDs), 2008," released Nov. 16, 2009.

SOURCES: CDC: "National Overview of Sexually Transmitted Diseases (STDs) 2008," Nov. 16, 2009.

News release, CDC, Nov. 16, 2009.

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