STD Surveillance 2001
Adapted from CDC
by Jill Gallin, CPNP
Assistant Professor of Clinical Nursing
The number of disease reported
does not equal the incidence
Factors affecting report data
• Reporting systems
– Laboratories
– Providers
– Information systems
• Increase or decrease in screening
• Sensitivity of diagnostic tests/ Ability to
diagnose disease
Chlamydia
Sexually Transmitted Disease
Surveillance 2001
Division of STD Prevention
Chlamydia — Number of states that require reporting of
Chlamydia trachomatis infections: United States, 1987–2001
No. of states
50
40
30
20
10
0
1987
88
89
90
91
92
93
94
95
96
97
98
99
2000
01
Chlamydia — Reported rates: United States, 1984–2001
Rate (per 100,000 population)
300
240
180
120
60
0
1984
86
88
90
92
94
96
98
2000
Chlamydia — Rates by state: United States and outlying areas, 2001
231.3
212.7
104.9
165.4
217.9
169.2
156.3
303.6
241.2
169.9
244.5
194.7
231.0
187.3
241.8
307.8
279.6
331.7
352.0 250.9
134.5
301.0
343.8
225.0
303.7
129.7 259.1
249.3
219.7
274.6
273.5
272.3
382.1
Guam 278.4
414.6
326.6
413.4
334.5
399.2
437.7
VT
NH
MA
RI
CT
NJ
DE
MD
312.8
235.4
Rate per 100,000
population
(n= 7)
<=150
150.1-300 (n= 29)
(n= 17)
>300
332.7
Puerto Rico 72.2
104.8
111.9
163.8
277.8
226.6
193.9
356.4
295.3
Virgin Is. 120.6
Note: The total rate of chlamydia for the United States and outlying areas
(including Guam, Puerto Rico and Virgin Islands) was 275.5 per 100,000
population.
Chlamydia — Rates by region: United States, 1984–2001
Rate (per 100,000 population)
350
280
210
140
West
Midwest
Northeast
South
70
0
1984
86
88
90
92
94
96
98
2000
Chlamydia — Rates by sex: United States, 1984–2001
Rate (per 100,000 population)
450
360
270
Men
Women
180
90
0
1984
86
88
90
92
94
96
98
2000
Chlamydia — Age- and sex-specific rates: United States, 2001
Men
3,000
Rate (per 100,000 population)
2,400
1,800
1,200
600
0
9.9
375.9
604.9
284.7
140.4
70.3
37.1
15.9
5.5
2.2
114.2
Age
10-14
15-19
20-24
25-29
30-34
35-39
40-44
45-54
55-64
65+
Total
Women
0
600
1,200
1,800
2,400
3,000
139.8
2,536.1
2,447.0
824.6
301.9
119.1
51.4
18.1
5.1
2.9
436.3
Chlamydia — Trends in positivity among 15-44 year old women
tested in family planning clinics by HHS regions, 1988–2001
Region VIII
Region V Region II
7.5 7.2 7.1
6.0
Region X
13.0
5.6 6.0
5.0 4.6 4.6 5.3 5.4
94 95 96 97 98 99 00 01
5.6
6.6
6.4
5.7 6.2 6.2
Region I
7.3
6.7
4.9 4.6
4.9 5.1
4.1
96 97 98 99 00 01
97 98 99 00 01
97 98 99 00 01
10.0 9.5
8.0
6.7
5.0 4.7
4.9 5.3 5.3
4.1 3.9 3.9 4.6
X
88 89 90 91 92 93 94 95 96 97 98 99 00 01
II
VIII
V
Region IX
5.1 5.2
VII
IX
I
Region III
7.4
III
6.0
5.3 5.6
6.0 6.3 6.0 5.5
94 95 96 97 98 99 00 01
VI
5.9 6.3 6.2 6.3
IV
96 97 98 99 00 01
Region IV
8.9
10.1 9.5
8.6 8.5
Region VI
Region VII
9.7
8.7 8.8 8.5
8.4 8.9
97 98 99 00 01
4.9 4.7 5.4 5.3 5.5 5.4
96 97 98 99 00 01
96 97 98 99 00 01
Note: Trends adjusted for changes in laboratory test method and associated
increases in test sensitivity. No data on laboratory test method available for
Region VII in 1995 and Regions IV and V in 1996.
SOURCE: Regional Infertility Prevention Program; Office of Population Affairs; Local and State STD
Control Programs; Centers for Disease Control and Prevention
Gonorrhea
Sexually Transmitted Disease
Surveillance 2001
Division of STD Prevention
Gonorrhea — Reported rates: United States, 1970–2001 and the
Healthy People year 2010 objective
Rate (per 100,000 population)
500
Gonorrhea
2010 Objective
400
300
200
100
0
1970
73
76
79
82
85
88
91
94
97
Note: The Healthy People 2010 (HP2010) objective for gonorrhea is 19.0 cases
per 100,000 population.
2000
Gonorrhea — Rates by region: United States, 1981–2001 and the
Healthy People year 2010 objective
Rate (per 100,000 population)
600
West
Midwest
Northeast
South
2010 Objective
480
360
240
120
0
1981
83
85
87
89
91
93
95
97
99
2001
Gonorrhea — Rates by sex: United States, 1981–2001 and the
Healthy People year 2010 objective
Rate (per 100,000 population)
600
Male
Female
2010 Objective
480
360
240
120
0
1981
83
85
87
89
91
93
95
97
99
2001
Gonorrhea — Rates by race and ethnicity: United States, 1981–2001
and the Healthy People year 2010 objective
Rate (per 100,000 population)
2,500
2,000
White
Black
Hispanic
Asian/Pac Isl
Am Ind/AK Nat
2010 Objective
1,500
1,000
500
0
1981
83
85
87
89
91
93
95
97
99
2001
Gonorrhea — Age- and sex-specific rates: United States, 2001
Men
750
Rate (per 100,000 population)
600
450
300
150
0
8.2
307.5
563.6
328.4
203.9
134.3
90.5
46.8
17.2
4.5
128.6
Age
10-14
15-19
20-24
25-29
30-34
35-39
40-44
45-54
55-64
65+
Total
0
Women
150
300
450
600
750
51.8
703.2
664.1
249.4
112.7
57.8
31.2
9.4
2.0
0.9
128.5
Gonococcal Isolate Surveillance Project (GISP) — Location of
participating clinics and regional laboratories: United States, 2001
Tripler AMC
Gonococcal Isolate Surveillance Project (GISP) — Penicillin and
tetracycline resistance among GISP isolates, 2001
79.1%
1.5%
5.2%
0.5%
2.9%
Susceptible
PPNG
4.4%
TRNG
6.4%
PenR
PPNG/TRNG
TetR
CMRNG
Note: PPNG=penicillinase-producing N. gonorrhoeae; TRNG=plasmid-mediated tetracycline
resistant N. gonorrhoeae; PPNG-TRNG=plasmid-mediated penicillin and tetracycline resistant
N. gonorrhoeae; PenR=chromosomally mediated penicillin resistant N. gonorrhoeae;
TetR=chromosomally mediated tetracycline resistant N. gonorrhoeae; CMRNG=chromosomally
mediated penicillin and tetracycline resistant N. gonorrhoeae.
Gonococcal Isolate Surveillance Project (GISP) — Percent of
Neisseria gonorrhoeae isolates with resistance or intermediate
resistance to ciprofloxacin, 1990–2001
Percent
3.0
2.4
Resistance
Intermediate resistance
1.8
1.2
0.6
0.0
1990
91
92
93
94
95
96
97
98
99
Note: Resistant isolates have ciprofloxacin MICs >1 mg/mL. Isolates with
intermediate resistance have ciprofloxacin MICs of 0.125 - 0.5 mg/mL.
Susceptibility to ciprofloxacin was first measured in GISP in 1990.
2000
01
Syphilis
Sexually Transmitted Disease
Surveillance 2001
Division of STD Prevention
Syphilis — Reported cases by stage of illness: United States,
1941–2001
Thousands of cases
600
P&S
Early Latent
Total Syphilis
480
360
240
120
0
1941
46
51
56
61
66
71
76
81
86
91
96
2001
Primary and secondary syphilis — Reported rates: United States,
1970–2001 and the Healthy People year 2010 objective
Rate (per 100,000 population)
25
P&S Syphilis
2010 Objective
20
15
10
5
0
1970
73
76
79
82
85
88
91
94
97
Note: The Healthy People 2010 (HP2010) objective for primary and secondary
syphilis is 0.2 case per 100,000 population.
2000
Primary and secondary syphilis — Rates by state: United States and
outlying areas, 2001
1.0
0.0
0.1
0.0
0.4
0.7
0.1
0.4
0.1
0.2
1.6
0.2
0.8
0.6
0.4
0.5
3.3
1.6
0.5
3.5
0.9
1.7
1.0
2.5
0.7
0.3
0.5
1.4
1.2
5.5
5.8
1.8
5.9
Guam 7.8
4.9
3.2
5.1
2.3
3.9
0.0
VT
NH
MA
RI
CT
NJ
DE
MD
4.3
3.0
Rate per 100,000
population
<=.2
.21-4
>4
1.0
Puerto Rico 6.4
0.5
0.1
0.7
0.9
0.4
1.6
1.8
5.0
Virgin Is. 0.0
Note: The total rate of primary and secondary syphilis for the United States
and outlying areas (including Guam, Puerto Rico and Virgin Islands) was 2.2
per 100,000 population. The Healthy People year 2010 objective is 0.2 per
100,000 population.
(n= 10)
(n= 34)
(n= 9)
Primary and secondary syphilis — Rates by region: United States,
1981–2001 and the Healthy People year 2010 objective
Rate (per 100,000 population)
50
West
Midwest
Northeast
South
2010 Objective
40
30
20
10
0
1981
83
85
87
89
91
93
95
97
99
2001
Primary and secondary syphilis — Rates by sex: United States,
1981–2001 and the Healthy People year 2010 objective
Rate (per 100,000 population)
25
Male
Female
2010 Objective
20
15
10
5
0
1981
83
85
87
89
91
93
95
97
99
2001
Primary and secondary syphilis — Rates by race and ethnicity:
United States, 1981–2001 and the Healthy People year 2010
objective
Rate (per 100,000 population)
150
White
Black
Hispanic
Asian/Pac Isl
Am Ind/AK Nat
2010 Objective
120
90
60
30
0
1981
83
85
87
89
91
93
95
97
99
2001
Primary and secondary syphilis — Male to female rate ratios:
United States, 1981–2001
Male-Female rate ratio
5:1
4:1
3:1
2:1
1:1
0
1981
83
85
87
89
91
93
95
97
99
2001
Primary and secondary syphilis — Age- and sex-specific rates:
United States, 2001
Men
Rate (per 100,000 population)
7.5
6.0
4.5
3.0
1.5
0.0
0.0
1.4
5.0
5.9
6.4
7.2
5.3
3.4
1.4
0.4
3.0
Age
10-14
15-19
20-24
25-29
30-34
35-39
40-44
45-54
55-64
65+
Total
0.0
Women
1.5
3.0
4.5
0.2
2.5
3.8
3.1
3.0
2.9
2.0
0.9
0.2
0.0
1.4
6.0
7.5
Congenital syphilis — Rates for infants <1 year of age: United States,
1981–2001 and the Healthy People year 2010 objective
Rate (per 100,000 live births)
125
Cong. Syphilis
2010 Objective
100
75
50
25
0
1981
83
85
87
89
91
93
95
97
Note: The Healthy People 2010 (HP2010) objective for primary and secondary
syphilis is 0.2 case per 100,000 population. The surveillance case definition
for congenital syphilis changed in 1988.
99
2001
Other Sexually Transmitted
Diseases
Sexually Transmitted Disease
Surveillance 2001
Division of STD Prevention
Chancroid — Reported cases: United States, 1981–2001
Cases (in thousands)
5
4
3
2
1
0
1981
83
85
87
89
91
93
95
97
99
2001
Genital herpes — Initial visits to physicians’ offices: United States,
1966–2001
Visits (in thousands)
250
200
150
100
50
0
1966
69
72
75
78
81
84
87
SOURCE: National Disease and Therapeutic Index (IMS America, Ltd.)
90
93
96
99
Genital herpes simplex virus type 2 infections — Percent
seroprevalence according to age in NHANES* II (1976-1980) and
NHANES III (1988-1994)
Percent
40
32
24
16
NHANES II
NHANES III
8
0
12-19
20-29
30-39
40-49
Age Group
Note: Bars indicate 95% confidence intervals.
*National Health and Nutrition Examination Survey
50-59
60-69
70+
Genital warts — Initial visits to physicians’ offices: United States,
1966–2001
Visits (in thousands)
400
320
240
160
80
0
1966
69
72
75
78
81
84
87
SOURCE: National Disease and Therapeutic Index (IMS America, Ltd.)
90
93
96
99
Nonspecific urethritis — Initial visits to physicians’ offices by men:
United States, 1966–2001
Visits (in thousands)
400
320
240
160
80
0
1966
69
72
75
78
81
84
87
SOURCE: National Disease and Therapeutic Index (IMS America, Ltd.)
90
93
96
99
Trichomonal and other vaginal infections — Initial visits to
physicians’ offices: United States, 1966–2001
Visits (in thousands)
4,500
Trichomonal
Other Vaginitis
3,600
2,700
1,800
900
0
1966
69
72
75
78
81
84
87
SOURCE: National Disease and Therapeutic Index (IMS America, Ltd.)
90
93
96
99