STD Surveillance 2001 Adapted from CDC by Jill Gallin, CPNP Assistant Professor of Clinical Nursing

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

0

10

20

30

40

50

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)

0

60

120

180

240

300

1984 86 88 90 92 94 96 98 2000

Chlamydia — Rates by state: United States and outlying areas, 2001

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.

Rate per 100,000population

<=150150.1-300>300

VT 104.8 NH 111.9 MA 163.8 RI 277.8 CT 226.6 NJ 193.9 DE 356.4 MD 295.3

Guam 278.4

Puerto Rico 72.2 Virgin Is. 120.6

(n= 7)(n= 29)(n= 17)

326.6

437.7

279.6272.3

301.0 307.8

235.4

413.4

332.7

156.3

352.0 250.9

194.7

225.0219.7

399.2

104.9

312.8

169.2

414.6

249.3

212.7

187.3241.8

343.8

244.5

274.6

165.4

331.7

303.7

217.9

231.0

382.1

241.2

273.5

334.5

134.5

259.1

231.3

129.7

303.6

169.9

Chlamydia — Rates by region: United States, 1984–2001


WestMidwestNortheastSouth

0

70

140

210

280

350

1984 86 88 90 92 94 96 98 2000

Chlamydia — Rates by sex: United States, 1984–2001


MenWomen

0

90

180

270

360

450

1984 86 88 90 92 94 96 98 2000

Chlamydia — Age- and sex-specific rates: United States, 2001

Men Rate (per 100,000 population) Women

Age3,000 2,400 1,800 1,200 600 0 0 600 1,200 1,800 2,400 3,000

Total 65+55-6445-5440-4435-3930-3425-2920-2415-1910-14 9.9


Age3,000 2,400 1,800 1,200 600 0 0 600 1,200 1,800 2,400 3,000

Total 65+55-6445-5440-4435-3930-3425-2920-2415-1910-14

375.9


Age3,000 2,400 1,800 1,200 600 0 0 600 1,200 1,800 2,400 3,000

Total 65+55-6445-5440-4435-3930-3425-2920-2415-1910-14

604.9


Age3,000 2,400 1,800 1,200 600 0 0 600 1,200 1,800 2,400 3,000

Total 65+55-6445-5440-4435-3930-3425-2920-2415-1910-14

284.7


Age3,000 2,400 1,800 1,200 600 0 0 600 1,200 1,800 2,400 3,000

Total 65+55-6445-5440-4435-3930-3425-2920-2415-1910-14

140.4


Age3,000 2,400 1,800 1,200 600 0 0 600 1,200 1,800 2,400 3,000

Total 65+55-6445-5440-4435-3930-3425-2920-2415-1910-14

70.3


Age3,000 2,400 1,800 1,200 600 0 0 600 1,200 1,800 2,400 3,000

Total 65+55-6445-5440-4435-3930-3425-2920-2415-1910-14

37.1


Age3,000 2,400 1,800 1,200 600 0 0 600 1,200 1,800 2,400 3,000

Total 65+55-6445-5440-4435-3930-3425-2920-2415-1910-14

15.9


Age3,000 2,400 1,800 1,200 600 0 0 600 1,200 1,800 2,400 3,000

Total 65+55-6445-5440-4435-3930-3425-2920-2415-1910-14

5.5


Age3,000 2,400 1,800 1,200 600 0 0 600 1,200 1,800 2,400 3,000

Total 65+55-6445-5440-4435-3930-3425-2920-2415-1910-14

2.2


Age3,000 2,400 1,800 1,200 600 0 0 600 1,200 1,800 2,400 3,000

Total 65+55-6445-5440-4435-3930-3425-2920-2415-1910-14

114.2


Age3,000 2,400 1,800 1,200 600 0 0 600 1,200 1,800 2,400 3,000

Total 65+55-6445-5440-4435-3930-3425-2920-2415-1910-14 139.8


Age3,000 2,400 1,800 1,200 600 0 0 600 1,200 1,800 2,400 3,000

Total 65+55-6445-5440-4435-3930-3425-2920-2415-1910-14

2,536.1


Age3,000 2,400 1,800 1,200 600 0 0 600 1,200 1,800 2,400 3,000

Total 65+55-6445-5440-4435-3930-3425-2920-2415-1910-14

2,447.0


Age3,000 2,400 1,800 1,200 600 0 0 600 1,200 1,800 2,400 3,000

Total 65+55-6445-5440-4435-3930-3425-2920-2415-1910-14

824.6


Age3,000 2,400 1,800 1,200 600 0 0 600 1,200 1,800 2,400 3,000

Total 65+55-6445-5440-4435-3930-3425-2920-2415-1910-14

301.9


Age3,000 2,400 1,800 1,200 600 0 0 600 1,200 1,800 2,400 3,000

Total 65+55-6445-5440-4435-3930-3425-2920-2415-1910-14

119.1


Age3,000 2,400 1,800 1,200 600 0 0 600 1,200 1,800 2,400 3,000

Total 65+55-6445-5440-4435-3930-3425-2920-2415-1910-14

51.4


Age3,000 2,400 1,800 1,200 600 0 0 600 1,200 1,800 2,400 3,000

Total 65+55-6445-5440-4435-3930-3425-2920-2415-1910-14

18.1


Age3,000 2,400 1,800 1,200 600 0 0 600 1,200 1,800 2,400 3,000

Total 65+55-6445-5440-4435-3930-3425-2920-2415-1910-14

5.1


Age3,000 2,400 1,800 1,200 600 0 0 600 1,200 1,800 2,400 3,000

Total 65+55-6445-5440-4435-3930-3425-2920-2415-1910-14

2.9


Age3,000 2,400 1,800 1,200 600 0 0 600 1,200 1,800 2,400 3,000

Total 65+55-6445-5440-4435-3930-3425-2920-2415-1910-14

436.3

Chlamydia — Trends in positivity among 15-44 year old women tested in family planning clinics by HHS regions, 1988–2001

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

IX

XVIII

VII

VI

V

IV

III

III

Region IRegion II

Region III

Region IV

Region V

Region VIRegion VII

Region VIII

Region IX

Region X 97 98 99 00 01

5.7 6.2 6.2 6.47.3

96 97 98 99 00 01

6.74.9 4.6 4.1 4.9 5.1

96 97 98 99 00 019594

7.46.0 5.3 5.6 6.0 6.3 6.0 5.5

97 98 99 00 01

8.910.1 9.5

8.6 8.5

97 98 99 00 01

5.6

7.5 7.2 7.1 6.6

96 97 98 99 00 01

8.4 8.9 9.78.7 8.8 8.5

96 97 98 99 00 01

4.9 4.7 5.4 5.3 5.5 5.4

96 97 98 99 00 0194 95

6.05.0 4.6 4.6 5.3 5.4 5.6 6.0

96 97 98 99 00 01

5.1 5.25.9 6.3 6.2 6.3

96 97 98 99 00 0194 95939291908988

13.0

10.0 9.58.0

6.75.0 4.7 4.1 3.9 3.9 4.6 4.9 5.3 5.3

Gonorrhea



Gonorrhea — Reported rates: United States, 1970–2001 and the Healthy People year 2010 objective

R ate (per 100,000 population)

G onorrhea2010 O bjective

0

100

200

300

400

500

1970 73 76 79 82 85 88 91 94 97 2000

Note: The Healthy People 2010 (HP2010) objective for gonorrhea is 19.0 cases per 100,000 population.

Gonorrhea — Rates by region: United States, 1981–2001 and the Healthy People year 2010 objective


W estM idw estN ortheastSouth2010 O bjective

0

120

240

360

480

600

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


M aleFem ale2010 O bjective

0

120

240

360

480

600

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


W hiteB lackH ispan icAsian/Pac Is lAm Ind /AK N at2010 O bjective

0

500

1,000

1,500

2,000

2,500

1981 83 85 87 89 91 93 95 97 99 2001

Gonorrhea — Age- and sex-specific rates: United States, 2001

M en R ate (per 100,000 population) W om en

Age750 600 450 300 150 0 0 150 300 450 600 750

Tota l 65+

55-64

45-5440-4435-39

30-3425-2920-2415-19

10-148.2


Age750 600 450 300 150 0 0 150 300 450 600 750

Tota l 65+

55-64

45-5440-4435-39

30-3425-2920-2415-19

10-14307.5


Age750 600 450 300 150 0 0 150 300 450 600 750

Tota l 65+

55-64

45-5440-4435-39

30-3425-2920-2415-19

10-14

563.6


Age750 600 450 300 150 0 0 150 300 450 600 750

Tota l 65+

55-64

45-5440-4435-39

30-3425-2920-2415-19

10-14

328.4


Age750 600 450 300 150 0 0 150 300 450 600 750

Tota l 65+

55-64

45-5440-4435-39

30-3425-2920-2415-19

10-14

203.9


Age750 600 450 300 150 0 0 150 300 450 600 750

Tota l 65+

55-64

45-5440-4435-39

30-3425-2920-2415-19

10-14

134.3


Age750 600 450 300 150 0 0 150 300 450 600 750

Tota l 65+

55-64

45-5440-4435-39

30-3425-2920-2415-19

10-14

90.5


Age750 600 450 300 150 0 0 150 300 450 600 750

Tota l 65+

55-64

45-5440-4435-39

30-3425-2920-2415-19

10-14

46.8


Age750 600 450 300 150 0 0 150 300 450 600 750

Tota l 65+

55-64

45-5440-4435-39

30-3425-2920-2415-19

10-14

17.2


Age750 600 450 300 150 0 0 150 300 450 600 750

Tota l 65+

55-64

45-5440-4435-39

30-3425-2920-2415-19

10-14

4.5


Age750 600 450 300 150 0 0 150 300 450 600 750

Tota l 65+

55-64

45-5440-4435-39

30-3425-2920-2415-19

10-14

128.6


Age750 600 450 300 150 0 0 150 300 450 600 750

Tota l 65+

55-64

45-5440-4435-39

30-3425-2920-2415-19

10-14 51.8


Age750 600 450 300 150 0 0 150 300 450 600 750

Tota l 65+

55-64

45-5440-4435-39

30-3425-2920-2415-19

10-14703.2


Age750 600 450 300 150 0 0 150 300 450 600 750

Tota l 65+

55-64

45-5440-4435-39

30-3425-2920-2415-19

10-14

664.1


Age750 600 450 300 150 0 0 150 300 450 600 750

Tota l 65+

55-64

45-5440-4435-39

30-3425-2920-2415-19

10-14

249.4


Age750 600 450 300 150 0 0 150 300 450 600 750

Tota l 65+

55-64

45-5440-4435-39

30-3425-2920-2415-19

10-14

112.7


Age750 600 450 300 150 0 0 150 300 450 600 750

Tota l 65+

55-64

45-5440-4435-39

30-3425-2920-2415-19

10-14

57.8


Age750 600 450 300 150 0 0 150 300 450 600 750

Tota l 65+

55-64

45-5440-4435-39

30-3425-2920-2415-19

10-14

31.2


Age750 600 450 300 150 0 0 150 300 450 600 750

Tota l 65+

55-64

45-5440-4435-39

30-3425-2920-2415-19

10-14

9.4


Age750 600 450 300 150 0 0 150 300 450 600 750

Tota l 65+

55-64

45-5440-4435-39

30-3425-2920-2415-19

10-14

2.0


Age750 600 450 300 150 0 0 150 300 450 600 750

Tota l 65+

55-64

45-5440-4435-39

30-3425-2920-2415-19

10-14

0.9


Age750 600 450 300 150 0 0 150 300 450 600 750

Tota l 65+

55-64

45-5440-4435-39

30-3425-2920-2415-19

10-14

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

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.

S usceptib le

P P N G

TR N G

P P N G /TR N G

P enR

TetR

C M R N G

79.1%

1.5%

5.2%

0.5%2.9%

4.4%

6.4%

Gonococcal Isolate Surveillance Project (GISP) — Percent of Neisseria gonorrhoeae isolates with resistance or intermediate

resistance to ciprofloxacin, 1990–2001

Note: Resistant isolates have ciprofloxacin MICs >1 g/mL. Isolates with intermediate resistance have ciprofloxacin MICs of 0.125 - 0.5 g/mL. Susceptibility to ciprofloxacin was first measured in GISP in 1990.

Percent

R esistance

Interm ediate resistance

0.0

0.6

1.2

1.8

2.4

3.0

1990 91 92 93 94 95 96 97 98 99 2000 01

Syphilis



Syphilis — Reported cases by stage of illness: United States, 1941–2001

Thousands of cases

P&SEarly LatentTotal Syphilis

0

120

240

360

480

600

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


P&S Syphilis2010 Objective

0

5

10

15

20

25

1970 73 76 79 82 85 88 91 94 97 2000

Note: The Healthy People 2010 (HP2010) objective for primary and secondary syphilis is 0.2 case per 100,000 population.

Primary and secondary syphilis — Rates by state: United States and outlying areas, 2001

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.

Rate per 100,000population

<=.2.21-4>4

VT 0.5 NH 0.1 MA 0.7 RI 0.9 CT 0.4 NJ 1.6 DE 1.8 MD 5.0

Guam 7.8

Puerto Rico 6.4 Virgin Is. 0.0

(n= 10)(n= 34)(n= 9)

3.2

0.0

3.5 1.8

1.6 0.5

3.0

5.1

1.0

0.1

3.3 2.5

0.2

0.9 1.2

3.9

0.1

4.3

0.7

4.9

0.5

0.0

0.6 0.4

1.0

1.6

5.5

0.0

0.7

1.7

0.4

0.8

5.9

0.1

5.8

2.3

0.5

1.4

1.0

0.3

0.4

0.2

Primary and secondary syphilis — Rates by region: United States, 1981–2001 and the Healthy People year 2010 objective


WestMidwestNortheastSouth2010 Objective

0

10

20

30

40

50

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


MaleFemale2010 Objective

0

5

10

15

20

25

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


WhiteBlackHispanicAsian/Pac IslAm Ind/AK Nat2010 Objective

0

30

60

90

120

150

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

0

1:1

2:1

3:1

4:1

5:1

1981 83 85 87 89 91 93 95 97 99 2001

Primary and secondary syphilis — Age- and sex-specific rates: United States, 2001


Age7.5 6.0 4.5 3.0 1.5 0.0 0.0 1.5 3.0 4.5 6.0 7.5

Total 65+55-6445-5440-4435-3930-3425-2920-2415-1910-140.0


Age7.5 6.0 4.5 3.0 1.5 0.0 0.0 1.5 3.0 4.5 6.0 7.5

Total 65+55-6445-5440-4435-3930-3425-2920-2415-1910-14

1.4


Age7.5 6.0 4.5 3.0 1.5 0.0 0.0 1.5 3.0 4.5 6.0 7.5

Total 65+55-6445-5440-4435-3930-3425-2920-2415-1910-14

5.0


Age7.5 6.0 4.5 3.0 1.5 0.0 0.0 1.5 3.0 4.5 6.0 7.5

Total 65+55-6445-5440-4435-3930-3425-2920-2415-1910-14

5.9


Age7.5 6.0 4.5 3.0 1.5 0.0 0.0 1.5 3.0 4.5 6.0 7.5

Total 65+55-6445-5440-4435-3930-3425-2920-2415-1910-14

6.4


Age7.5 6.0 4.5 3.0 1.5 0.0 0.0 1.5 3.0 4.5 6.0 7.5

Total 65+55-6445-5440-4435-3930-3425-2920-2415-1910-14

7.2


Age7.5 6.0 4.5 3.0 1.5 0.0 0.0 1.5 3.0 4.5 6.0 7.5

Total 65+55-6445-5440-4435-3930-3425-2920-2415-1910-14

5.3


Age7.5 6.0 4.5 3.0 1.5 0.0 0.0 1.5 3.0 4.5 6.0 7.5

Total 65+55-6445-5440-4435-3930-3425-2920-2415-1910-14

3.4


Age7.5 6.0 4.5 3.0 1.5 0.0 0.0 1.5 3.0 4.5 6.0 7.5

Total 65+55-6445-5440-4435-3930-3425-2920-2415-1910-14

1.4


Age7.5 6.0 4.5 3.0 1.5 0.0 0.0 1.5 3.0 4.5 6.0 7.5

Total 65+55-6445-5440-4435-3930-3425-2920-2415-1910-14

0.4


Age7.5 6.0 4.5 3.0 1.5 0.0 0.0 1.5 3.0 4.5 6.0 7.5

Total 65+55-6445-5440-4435-3930-3425-2920-2415-1910-14

3.0


Age7.5 6.0 4.5 3.0 1.5 0.0 0.0 1.5 3.0 4.5 6.0 7.5

Total 65+55-6445-5440-4435-3930-3425-2920-2415-1910-14 0.2


Age7.5 6.0 4.5 3.0 1.5 0.0 0.0 1.5 3.0 4.5 6.0 7.5

Total 65+55-6445-5440-4435-3930-3425-2920-2415-1910-14

2.5


Age7.5 6.0 4.5 3.0 1.5 0.0 0.0 1.5 3.0 4.5 6.0 7.5

Total 65+55-6445-5440-4435-3930-3425-2920-2415-1910-14

3.8


Age7.5 6.0 4.5 3.0 1.5 0.0 0.0 1.5 3.0 4.5 6.0 7.5

Total 65+55-6445-5440-4435-3930-3425-2920-2415-1910-14

3.1


Age7.5 6.0 4.5 3.0 1.5 0.0 0.0 1.5 3.0 4.5 6.0 7.5

Total 65+55-6445-5440-4435-3930-3425-2920-2415-1910-14

3.0


Age7.5 6.0 4.5 3.0 1.5 0.0 0.0 1.5 3.0 4.5 6.0 7.5

Total 65+55-6445-5440-4435-3930-3425-2920-2415-1910-14

2.9


Age7.5 6.0 4.5 3.0 1.5 0.0 0.0 1.5 3.0 4.5 6.0 7.5

Total 65+55-6445-5440-4435-3930-3425-2920-2415-1910-14

2.0


Age7.5 6.0 4.5 3.0 1.5 0.0 0.0 1.5 3.0 4.5 6.0 7.5

Total 65+55-6445-5440-4435-3930-3425-2920-2415-1910-14

0.9


Age7.5 6.0 4.5 3.0 1.5 0.0 0.0 1.5 3.0 4.5 6.0 7.5

Total 65+55-6445-5440-4435-3930-3425-2920-2415-1910-14

0.2


Age7.5 6.0 4.5 3.0 1.5 0.0 0.0 1.5 3.0 4.5 6.0 7.5

Total 65+55-6445-5440-4435-3930-3425-2920-2415-1910-14

0.0


Age7.5 6.0 4.5 3.0 1.5 0.0 0.0 1.5 3.0 4.5 6.0 7.5

Total 65+55-6445-5440-4435-3930-3425-2920-2415-1910-14

1.4

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)

Cong. Syphilis2010 Objective

0

25

50

75

100

125

1981 83 85 87 89 91 93 95 97 99 2001

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.

Other Sexually Transmitted Diseases



Chancroid — Reported cases: United States, 1981–2001

Cases (in thousands)

0

1

2

3

4

5

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)

0

50

100

150

200

250

1966 69 72 75 78 81 84 87 90 93 96 99

SOURCE: National Disease and Therapeutic Index (IMS America, Ltd.)

Genital herpes simplex virus type 2 infections — Percent seroprevalence according to age in NHANES* II (1976-1980) and

NHANES III (1988-1994)

Percent

NHANES IINHANES III

0

8

16

24

32

40

Age Group

12-19 20-29 30-39 40-49 50-59 60-69 70+

Note: Bars indicate 95% confidence intervals.

*National Health and Nutrition Examination Survey

Genital warts — Initial visits to physicians’ offices: United States, 1966–2001


0

80

160

240

320

400

1966 69 72 75 78 81 84 87 90 93 96 99


Nonspecific urethritis — Initial visits to physicians’ offices by men:United States, 1966–2001


0

80

160

240

320

400

1966 69 72 75 78 81 84 87 90 93 96 99


Trichomonal and other vaginal infections — Initial visits to physicians’ offices: United States, 1966–2001


TrichomonalOther Vaginitis

0

900

1,800

2,700

3,600

4,500

1966 69 72 75 78 81 84 87 90 93 96 99


Documents

STD Surveillance 2001 Adapted from CDC by Jill Gallin, CPNP Assistant Professor of Clinical Nursing