In 2000 and 2001, the national rate of reported primary and secondary syphilis cases in the United States reached the lowest since reporting began in 1941. In 2009, the rate of gonorrhea cases reached a historic low.
Now this progress has unraveled. Sexually transmitted infections - syphilis, gonorrhea and a third illness, chlamydia - hit an all-time high in the United States last year. This is a surge of illness that did not have to happen and must be addressed.
The latest depressing news about sexually transmitted diseases, or STDs, which can have severe impact on health, comes in the annual surveillance report for 2018 by the Centers for Disease Control and Prevention, published Oct. 8. Syphilis cases in the primary and secondary stages, the most infectious, increased 14 percent to 35,000, the highest number since 1991. Gonorrhea increased 5 percent to more than 580,000 cases, again the highest reported since 1991. Chlamydia increased 3 percent, to more than 1.7 million cases, the most ever reported to the CDC.
Half of these are among young people, ages 15 to 24 years old. The infections can lead to serious complications, including infertility, and they can facilitate transmission of HIV. Although gonorrhea resistant to multiple antibiotics has not yet become a major factor in the United States, the problem has been growing around the world and may well limit treatment options in the future.
Syphilis is a genital disease caused by the bacterium Treponema pallidum that if untreated in pregnant women can lead to infection of the fetus and may result in stillbirth or infant death. The latest report says there was a surge in infant deaths from syphilis, from 77 in 2017 to 94 last year, and a 40 percent increase in cases when the disease was passed from a mother to her baby during pregnancy, to 1,306 cases, the most since 1995.
This should not be happening. Tools exist to fight these diseases, including prevention education, testing and antibiotic treatment. But the rise in cases suggests that people who are vulnerable are not being reached. Drug use, poverty, unstable housing and decreased condom use among vulnerable groups, including young people and gay and bisexual men, are all factors, according to the CDC.
But Gail Bolan, director of the CDC division of STD prevention, notes in the foreword to the report that the "resurgence of syphilis, and particularly congenital syphilis, is not an arbitrary event, but rather a symptom of a deteriorating public health infrastructure and lack of access to health care." Many state, county and local public health departments have been stretched thin due to the opioid epidemic and other demands. On the federal level, inflation-adjusted spending has been slipping; the House has wisely approved a $10 million uptick, and the Senate ought to follow suit.
When it comes to fighting sexually transmitted diseases, there are no excuses. This is a battle that can and should be won.
-- The Washington Post