Georgia epidemiology report, Vol. 24, no. 11 (Nov. 2008)

November 2008

volume 24 number 11

Sexually Transmitted Diseases (STDs) in Georgia

Georgia ranks among the top 10 states in the United States with high case rates for chlamydia, gonorrhea, and syphilis.

Approximately 65,000 new STD infections are reported in Georgia each year. Young people aged 15-24 years old are most affected.

HOW DO PEOPLE GET STDs? STDs can be transmitted during unprotected vaginal, anal, or oral sex. STDs can be passed on from mother to the baby in the womb or during delivery. Persons with STDs may be asymptomatic and may transmit their infection unknowingly to their sexual partner.

WHAT ARE SERIOUS HEALTH CONSEQUENCES OF STDs? The consequences of untreated STDS for women may include pelvic inflammatory disease (PID), ectopic pregnancy, and infertility. Complications among men are less common, but may include epididymitis and urethritis, which can cause pain, fever, and in rare cases, sterility.

WHO ARE AT RISK FOR STDs? The greater the number of sex partners a person has, the greater the risk of STD infection. Persons at increased risk for STDs include those who have unprotected sexual intercourse with multiple sex partners or who engage in high-risk behavior such as drug and alcohol abuse or trading sex for drugs. In recent years, increases in syphilis have been reported among men who have sex with men.

WHAT CAN BE DONE TO PREVENT THE SPREAD OF STDs? The surest way to avoid transmission of sexually transmitted diseases is to abstain from sexual contact or to be in a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected. Avoiding alcohol and drug use may also help prevent transmission because these activities may lead to risky sexual behavior.


WHAT STD PROGRAM SERVICES ARE AVAILABLE IN GEOR-

GIA?

Education and counseling of persons at risk on ways to adopt safer

sexual behavior



Effective diagnosis and treatment of infected persons

Identification of persons that have been exposed to an STD

WHO BENEFITS FROM STD PROGRAM SERVICES? Georgia communities benefit from the STD Program activities in
reducing the spread of STDs and the complications they cause.

Case rate/100,000

In 2007, 44,218 chlamydia cases, 18,380 gonorrhea cases, and 697 infectious syphilis cases (primary and secondary stages) were reported in Georgia.
The number of chlamydia cases increased 10%, primary and secondary stage syphilis increased 9%, gonorrhea cases decreased 11% from 2006 to 2007.

STSDTDCCaasseeRRaatetessppeerr110000,0,00000 GeGoerogrigai,a2, 0200303--22000077

500 450 400

4 14

394

376

472 431

350 300 250 200 15 0

205

18 4

220

17 7

19 6

10 0 50

6.9 7.0 7.6 6.7 7.4

0 2003 2004 20052006 2007

Year

Chlaammy di a Goonnoorrrhheeaa PPrimi maarryy&&Seeccoonnddaarry SSyypphhi illiiss

The highest STD case rates by age group for chlamydia and gonorrhea were in persons 15-24 years old, and for primary and secondary stage syphilis in persons 20-29 years old.
Among racial groups, African-Americans had the highest case rates for chlamydia, gonorrhea and syphilis.
Rates of reported chlamydia cases are very high and were almost 3 times higher in females (690 cases/100,000 population) than in males (240/100,000) in 2007, likely reflecting a greater number of women screened for this infection.

Three-fourths (77%) of all STD cases in Georgia were reported in the metropolitan Atlanta area in 2007.

The Georgia Epidemiology Report Via E-Mail To better serve our readers, we would like to know if you would prefer to receive the GER by e-mail as a readable PDF file.
If yes, please send your name and e-mail address to Gaepinfo@dhr.state.ga.us. | Please visit, http://health.state.ga.us/epi/manuals/ger.asp for all current and past pdf issues of the GER.

Chlamydia Case Rates per 100,000 by Health District, Georgia, 2007

1-2
2-0 1-1

3-1 3-2 3-3

3-4 3-5
R oc k da le

10-0

4-0

5-2

Case Rates: 100-399 400-699 >=700
6-0

7-0

5-1

9-1

8-2

8-1

9-2

S eminole Dec a tur

Number of Cases

Primary & Secondary Syphilis among MSM by Race

400

Georgia, 2003 - 2007

302
300

200

217 194
151

113 105

120

119

120

100

66

7

14

4

5

4

0

2003

2004

2005

2006

2007

Year

Black White Other

The number of men with cases of primary or secondary stage syphilis and HIV increased over 600% from 40 cases in 2003 to 285 cases in 2007.
Over the past 5 years, the number of infectious syphilis cases almost tripled among Black men who have sex with men (MSM).
Co-infection with HIV is rising among men with primary and secondary stage syphilis.

Division of Public Health http://health.state.ga.us
S. Elizabeth Ford, M.D., M.B.A., F.A.A.P. Acting Director, State Health Officer
Martha N. Okafor, Ph.D., Deputy Director Health Information, Policy, Strategy, & Accountability

John M. Horan, M.D., M.P.H. State Epidemiologist
Director, Epidemiology Section http://health.state.ga.us/epi
Cherie Drenzek, D.V.M., M.S. Director, Acute Disease Epi Section

Georgia Epidemiology Report Editorial Board
Carol A. Hoban, M.P.H., Ph.D. Editor Kathryn E. Arnold, M.D.
Cherie Drenzek, D.V.M., M.S. John M. Horan, M.D., M.P.H. S. Elizabeth Ford, M.D., M.B.A., F.A.A.P. Angela Alexander - Mailing List Jimmy Clanton, Jr. - Graphic Designer

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Georgia Department of Human Resources
Division of Public Health

Two Peachtree St., N.W. Atlanta, GA 30303-3186 Phone: (404) 657-2588
Fax: (404) 657-7517
Please send comments to: gaepinfo@dhr.state.ga.us

1-866-PUB-HLTH
(1-866-782-4584)
Georgia's Notifiable Disease Emergency Reporting Hotline Information for Healthcare Providers
What is 1-866-PUB-HLTH? 1-866-PUB-HLTH (1-866-782-4584) is Georgia's Notifiable Disease Emergency Reporting Hotline. It is available for use 24 hours a day, 7 days a week for time-sensitive communication among healthcare providers, Public Health, and emergency responders. 1-866-PUB-HLTH is for the reporting of immediately notifiable diseases, including those that could result from a bioterrorism event, and public health emergencies. It is one easy-to-remember number that is distributed to all local, state, and federal partners for use in public health emergencies.
Who should use 1-866-PUB-HLTH? Public Health Partners, including but not limited to: healthcare providers, laboratory personnel, public health professionals, coroners, medical examiners, pharmacists, veterinarians, local police/fire/EMS/911 operators, and federal agencies should use the number to report immediately notifiable diseases and public health emergencies. Private citizens should NOT use this number.
How does it work? 1-866-PUB-HLTH is housed at the Georgia Poison Center and staffed by Public Health Specialists who respond to calls according to protocols developed by Public Health. Calls are triaged according to immediacy and public health significance, and those that require immediate notification of Public Health are passed to the Health District Epidemiologist On Call for response. Callers can always request to speak with someone in public health immediately, 24 hours a day, 7 days a week, even when reporting a non-urgent public health issue.
When should I use 1-866-PUB-HLTH versus other methods of reporting? When you have a public health emergency or diagnose an immediately notifiable disease, including clusters of any illness and potential agents of bioterrorism. To report other notifiable diseases, you may: call your County or District Health Office, OR report cases electronically through the State Electronic Notifiable Disease Surveillance System (SendSS) at http://sendss. state.ga.us, OR complete a Notifiable Disease Report Form (#3095) and mail in an envelope marked CONFIDENTIAL to your County, District, or State Health Department.
If I report a case using 1-866-PUB-HLTH, should I also report using additional (redundant) mechanisms? No. There is no need to report a case through multiple channels.
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The Georgia Epidemiology Report Epidemiology Branch Two Peachtree St., NW Atlanta, GA 30303-3186

PRESORTED STANDARD U.S. POSTAGE
PAID ATLANTA, GA PERMIT NO. 4528

November 2008

Volume24Number11

Reported Cases of Selected Notifiable Diseases in Georgia, Profile* for August 2008

Selected Notifiable Diseases
Campylobacteriosis Chlamydia trachomatis Cryptosporidiosis E. coli O157:H7 Giardiasis Gonorrhea Haemophilus influenzae (invasive) Hepatitis A (acute) Hepatitis B (acute) Legionellosis Lyme Disease Meningococcal Disease (invasive) Mumps Pertussis Rubella Salmonellosis Shigellosis Syphilis - Primary Syphilis - Secondary Syphilis - Early Latent Syphilis - Other** Syphilis - Congenital Tuberculosis

Total Reported for August 2008
2008 84 275 26 9 72 203 7 6 12 4 6 0 0 2 0 315 59 9 52 36 74 0 41

Previous 3 Months Total Ending in August

2006 2007 2008

171

252

274

10532

11573

5656

83

85

61

16

17

26

199

189

222

5866

4973

2166

21

20

31

21

19

10

58

48

44

13

7

10

6

6

15

1

8

5

3

0

0

10

5

11

0

0

0

690

611

910

308

423

222

33

26

37

130

161

175

105

120

114

243

309

260

1

3

0

145

120

126

Previous 12 Months Total Ending in August

2006 2007 2008

558

669

720

38684

42800

36194

222

274

248

39

38

57

700

673

707

19475

18813

14114

116

123

148

78

67

48

188

168

154

37

43

42

8

9

24

15

25

22

5

0

2

30

23

21

0

0

0

1906

1861

2349

1000

1817

1377

138

101

125

477

561

668

403

435

446

1005

1139

1236

8

11

7

521

491

482

* The cumulative numbers in the above table reflect the date the disease was first diagnosed rather than the date the report was received at the state office, and therefore are subject to change over time due to late reporting. The 3 month delay in the disease profile for a given month is designed to minimize any changes that may occur. This method of summarizing data is expected to provide a better overall measure of disease trends and patterns in Georgia.
** Other syphilis includes latent (unknown duration), late latent, late with symptomatic manifestations, and neurosyphilis.
AIDS Profile Update

Report Period
Latest 12 Months

Disease

Total Cases Reported*

Classification <13yrs

>=13yrs Total

HIV, non-AIDS 18

3,154

3,172

Percent Female MSM

28

25

Risk Group Distribution %

IDU

MSM&IDU HS

Unknown Perinatal White

2

1

4

67

1

18

Race Distribution %

Black

Hispanic Other

77

4

1

10/07-9/08 AIDS

2

1,949

1,951

27

30

3

1

7

59

<1

18

76

5

1

Five Years Ago:**

HIV, non-AIDS -

-

-

-

-

-

-

-

-

-

-

-

-

-

10/03-9/04 AIDS

12

1,678

1,690

29

33

7

3

15

40

1

18

76

5

1

Cumulative: HIV, non-AIDS 219

12,812

13,031

31

28

6

2

10

53

2

21

75

4

1

07/81-9/08 AIDS

239

33,182

33,421

20

43

14

5

14

23

1

30

67

3

1

Yrs - Age at diagnosis in years

MSM - Men having sex with men

IDU - Injection drug users

HS - Heterosexual

* Case totals are accumulated by date of report to the Epidemiology Section ** Due to a change in the surveillance system, case counts may be artificially low during this time period

***HIV, non-AIDS was not collected until 12/31/2003

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