STD rates in the U.S. have increased for the fifth consecutive year, reaching an all-time record high, according to 2018 data from the CDC's Sexually Transmitted Disease Surveillance Report.
Approximately 2.5 million combined cases of chlamydia, gonorrhea, and syphilis were reported to the CDC last year, according to surveillance data. These were the most commonly reported sexually transmitted infections. The report noted approximately 1.8 million cases of chlamydia, 600,000 cases of gonorrhea, and 100,000 cases of syphilis.
The CDC said many cases of STDs go undiagnosed and unreported, so national surveillance data likely only represents a fraction of the U.S. STD epidemic.
CDC data also revealed a 40% increase in congenital syphilis – about 1,300 total cases – from 2017 to 2018. This serious illness is transmitted from a pregnant mother to her baby and may result in miscarriage, stillbirth, and even death. Affected babies may suffer lifelong physical and neurological problems, according to the CDC.
Potentially Serious Consequences
Syphilis is caused by a spiral-shaped bacteria known as Treponema pallidum, according to MedicineNet author Melissa Conrad Stöppler, MD. When untreated, the illness progresses through distinct clinical stages with characteristic signs and symptoms.
The first stage, primary syphilis, is marked by the formation of a painless ulcer known as a chancre, she said. Secondary syphilis may cause symptoms including fever, fatigue, enlarged lymph nodes, hair loss, weight loss, headache, and muscle aches.
"About 15% of infected and untreated people will go on to develop the third stage of syphilis, which can occur as much as 10 to 20 years after the initial infection," Dr. Stöppler said. This stage is associated with damage to organ systems and can even be fatal.
"Untreated syphilis in a pregnant woman results in death of the fetus in up to 40% of infected pregnant women (stillbirth or death shortly after birth), so all pregnant women should be tested for syphilis at their first prenatal visit," Dr. Stöppler said. The CDC says some women may need repeat testing.
Syphilis at any stage is treated with antibiotics, but treatment cannot reverse existing organ damage, according to Dr. Stöppler. Treatment with penicillin is safe for pregnant women, she adds.
Chlamydia and Gonorrhea Often Occur Together
Chlamydia is caused by the bacteria, Chlamydia trachomatis. Many people with chlamydia do not have any symptoms and may not be aware they have the infection. "It has been referred to as a 'silent' infection for this reason," Dr. Stöppler said. Chlamydia may cause permanent damage to the reproductive tract, so it is important to diagnose and treat it with antibiotics.
Gonorrhea is a bacterial infection caused by Neisseris gonorrhoeae. Dr. Stöppler said that approximately 50% to 70% of those who are infected with gonorrhea are also infected with chlamydia. Gonorrhea was once easily cured with antibiotics; however, drug resistant strains are becoming more prevalent. Gonorrhea can still be treated with other injectable or oral medications, she said.
Prevention Is Best
Condoms decrease the risk of certain infections, like chlamydia and gonorrhea, Dr. Stöppler said, but they do not fully protect against syphilis, genital herpes, genital warts, and AIDS: "There really is no such thing as 'safe' sex. The only truly effective way to prevent STDs is abstinence."