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 -2 - 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. -3 - 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 - 4 -