Gonorrhea in AlaskaGonorrhea in Alaska

Region X Gonorrhea Control Region X Gonorrhea Control MeetingMeeting

Seattle, WASeattle, WAJuly 20, 2008July 20, 2008

Alaska STD ProgramAlaska STD ProgramSection of EpidemiologySection of Epidemiology

Division of Public Health, DHSSDivision of Public Health, DHSS

Gonorrhea long term trends – National and Alaska from Gonorrhea long term trends – National and Alaska from 1970s – late 1990s:1970s – late 1990s:

Nationally, the gonorrhea case Nationally, the gonorrhea case rate declined by 74% from 1975 – rate declined by 74% from 1975 – 1997.1997.

Alaska’s gonorrhea case rate Alaska’s gonorrhea case rate peaked in 1978 (1,310 cases per peaked in 1978 (1,310 cases per 100,000 persons) and decreased 100,000 persons) and decreased by 96% from that point to 1999 by 96% from that point to 1999 (49 cases per 100,000 persons).(49 cases per 100,000 persons).

Gonorrhea Infection Rates – Alaska and US, Gonorrhea Infection Rates – Alaska and US, 1998 - 20081998 - 2008

020406080

100120140160180

Cas

es p

er 1

00,0

00 P

erso

ns

AK case rate 53 49 58 72 100 88 88 91 94 86 85

US case rate 132 132 132 129 125 116 114 116 121 119 n/a

'98 '99 '00 '01 '02 '03 '04 '05 '06 '07 '08

Gonorrhea case rates by region – Alaska,Gonorrhea case rates by region – Alaska,2003-20082003-2008

0255075

100125150175200225250275300325350375400425450475

Anch/Mat-Su

Gulf Coast Interior Northern Southeast Southwest

Region

Case

s per

100

,000

per

sons

2003 2004 2005 2006 2007 2008

Regional data

Gonorrhea case rates by Region – Alaska,Gonorrhea case rates by Region – Alaska,20082008

267

373

73

12

1175

Regional data

Summary of 2008 GC DataSummary of 2008 GC Data

Total of 578 GC case reports; rate=85 cases per 100,000Total of 578 GC case reports; rate=85 cases per 100,000

Highest GC Infection rates among:Highest GC Infection rates among:– Individuals aged 15-24Individuals aged 15-24– Alaska Native/American IndiansAlaska Native/American Indians– Blacks/African AmericansBlacks/African Americans

Increases among:Increases among:– Alaska Native/American IndiansAlaska Native/American Indians– Asian/Pacific Islander malesAsian/Pacific Islander males

Decreases among:Decreases among:– Blacks/African Americans (40% among males)Blacks/African Americans (40% among males)– WhitesWhites– Asian/Pacific Islander femalesAsian/Pacific Islander females

GC cases by geographical region -- Alaska, GC cases by geographical region -- Alaska, Jan-Jun, 2003-2009Jan-Jun, 2003-2009

025

5075

100125

150175

200225

250

Anch/Mat-Su

Gulf Coast Interior Northern Southeast Southwest

Region

Num

ber o

f cas

e rep

orts

2003 2004 2005 2006 2007 2008 2009

Regional data

Proportion of Alaskan population v proportion Proportion of Alaskan population v proportion of GC case reports by Regionof GC case reports by Region

Borough and Census Area Estimate -- Alaska, J uly 1, 2008

Southwest

6%

I nterior

15%

Northern

3%Southeast

10%

Gulf Coast

11%

Anch/ Mat

Su

55%

Proportion of GC Infection by Region -- Alaska, J an-Jun,

2009

Southwest

29%

I nterior

5%

Northern

8%

Southeast

2%

Gulf Coast

3%

Anch/ Mat

Su

53%

Regional data

Half-year GonorrheaCases Among Males by Age Group -- Alaska, 2007 - 2009

0

10

20

30

40

5010

-14

15-1

9

20-2

4

25-2

9

30-3

4

35-3

9

40-4

4

45-4

9

50-5

4

55-5

9

60-6

4

Age (Years)

Num

ber

of G

C c

ases

2007

2008

2009

Age x Sex

Half-year Gonorrhea Cases Among Females by Age Group -- Alaska, 2007 - 2009

0102030405060708090

10-1

4

15-1

9

20-2

4

25-2

9

30-3

4

35-3

9

40-4

4

45-4

9

50-5

4

55-5

9

60-6

4

Age (Years)

Num

ber

of G

C C

ases

200720082009

Age x Sex

Gonorrhea cases by race and sex – Alaska, Jan-Jun 2007 - 2009

5203550658095110125140155170

Race and Sex

Num

ber

of G

C c

ases 2007 2008 2009

Program activitiesProgram activities

Partner Services as an inter-agency team in Partner Services as an inter-agency team in Anchorage and throughout AlaskaAnchorage and throughout Alaska (GC is priority over CT for interviewing activity)(GC is priority over CT for interviewing activity)

STD data dissemination to professionals and publicSTD data dissemination to professionals and public– Yearly bulletins to providersYearly bulletins to providers– Outbreak alerts to providers (*GC Outbreak pending)Outbreak alerts to providers (*GC Outbreak pending)– Agency alerts on changes in testing levels/positivity Agency alerts on changes in testing levels/positivity

ratesrates– STD data reports/analysis on requestSTD data reports/analysis on request

Capacity Building among Health Care ProfessionalsCapacity Building among Health Care Professionals– Annual STD Clinical UpdatesAnnual STD Clinical Updates– FSTDI offered twice yearly (since 2003)FSTDI offered twice yearly (since 2003)– Technical Assistance on Clinical and Partner Service Technical Assistance on Clinical and Partner Service

issuesissues– Prompt feedback on appropriate GC treatment Prompt feedback on appropriate GC treatment

regimensregimens

A few more things…A few more things…

Playful financing to increase DIS teamPlayful financing to increase DIS team Increase Field-based testing and treatment Increase Field-based testing and treatment

for quick dispositionsfor quick dispositions Encourage/support Section of Nursing to Encourage/support Section of Nursing to

hire Health Program Associates as STD DIShire Health Program Associates as STD DIS