Two million and counting – that’s the latest figure of reported cases of chlamydia, gonorrhea and syphilis in the United States, according to the Centers for Disease Control and Prevention (CDC).
These sexually transmitted diseases (STDs), some of which were once on a downward trend, are now resurging in records numbers and this has public health experts like me alarmed.
What are they?
Chlamydia, gonorrhea and syphilis are all bacterial infections. Chlamydia is the most common, reportable bacterial STD in the U.S. Gonorrhea is also widespread. Both can cause infections of the genitals, rectum and throat in men and women.
Syphilis is somewhat different from chlamydia and gonorrhea. It tends to cause ulcers or sores when people get infected, as well as a whole body rash that may involve the palms of the hand and soles of the feet.
All three STDs are curable with antibiotics but, if left undiagnosed and untreated, they can cause serious complications. Unfortunately, gonorrhea has developed resistance to a lot of the antibiotics that we’ve used to treat it. If this trend continues, we could find ourselves with a drug-resistant gonorrhea that we may not be able to treat and that would be worse case scenario.
What are the potential complications?
In women, one of the worries with chlamydia and gonorrhea is that they can travel from the cervix into the upper reproductive tract and cause pelvic inflammatory disease (PID). This is an infection of the uterus, fallopian tubes and ovaries. PID is very worrisome because if it isn’t diagnosed and treated early, it can result in long-term complications such as ectopic pregnancy, infertility and chronic pelvic pain.
One important thing to remember is that a large number of chlamydia and gonorrhea infections are completely asymptomatic, so people don’t even know that they’re infected. This is especially true in women and in patients who are infected in the throat or the rectum. Although patients may not have any symptoms, the damage can still be occurring and the infection can still be spread to sex partners.
Syphilis can cause serious complications as well. It can cause meningitis. It can also infect the eyes and result in blindness. Sometimes, it can affect hearing and people could experience ringing in the ears and hearing loss. The other big problem with syphilis is that when it occurs in women who are pregnant, it can infect the baby. This can result in something known as congenital syphilis. Babies can be stillborn. If they’re born alive, they can have very debilitating and long-standing problems associated with the syphilis infection.
How can you protect yourself?
- Always use barrier protection such as condoms.
- Limit the number of sexual partners.
- Avoid risky behavior, including having unprotected sex and sex while using recreational drugs or alcohol.
- Know your status and get screened on a regular basis. If your partner is negative and you’re negative, infection isn’t going to happen.
- Talk to your provider about your sexual health.
What are the screening guidelines?
- If you’re a sexually active woman under age 25 or an older woman with risk factors such as new or multiple sex partners, request annual chlamydia and gonorrhea tests.
- At-risk pregnant women should be tested for chlamydia and gonorrhea early in pregnancy. Repeat testing as needed.
- All pregnant women should be tested for syphilis.
Gay and bisexual men
- If you’re a man who has sex with men, you should be screened for chlamydia, gonorrhea and syphilis at least once a year and every three to six months if you have multiple sex partners.
As healthcare providers, we need to destigmatize STDs and incorporate screening and treatment into regular patient care. We need a coordinated approach to appropriately screen, diagnose and treat infected patients and their sex partners in order to ultimately break the cycle of STD transmission.
Dr. Jose A. Bazan is an infectious disease physician and assistant professor of clinical internal medicine at The Ohio State University Wexner Medical Center and medical director of the sexual health clinic at Columbus Public Health.