State ranks eighth in U.S. with chlamydia infections


POSTED: Friday, December 18, 2009

Hawaii continues to rank among the 10 states with the highest rates of chlamydia, a sexually transmitted disease that is common among adolescents and can lead to infertility.

“;We've been in the top 10 over 12 years,”; said Sonia Blackiston, Planned Parenthood of Hawaii health educator. “;It's appalling.”;

The state went from sixth place in 2006 to ninth in 2007 and to eighth last year with 5,982 cases—466 per 100,000 population, including men and women, said Peter Whiticar, chief of the Health Department's STD/AIDS Prevention Branch.

“;But our rate is going up,”; he said, noting it has climbed from 420 cases per 100,000 population in 2004. The drop in ranking simply means “;other states are getting more infections more quickly than we are,”; Whiticar said.

The U.S. Centers for Disease Control and Prevention said more than 1.5 million cases of chlamydia and gonorrhea were reported last year.

Adolescent girls, 15 to 19 years old, had the largest number of cases compared with any other age group, CDC said in its 2008 Sexually Transmitted Disease Report.





        Chlamydia is known as a “;silent”; disease because about three-fourth of infected women and about half of infected men have no symptoms. If symptoms do occur, they usually appear within one to three weeks after exposure.

In women the bacteria initially infect the cervix and the urethra. Women might have an abnormal vaginal discharge or a burning sensation when urinating. When the infection spreads from the cervix to the fallopian tubes, some women have lower abdominal pain, low back pain, nausea, fever, pain during intercourse or bleeding between menstrual periods. Chlamydial infection of the cervix can spread to the rectum.


Men with signs or symptoms might have a discharge from their penis or a burning sensation when urinating. Men might also have burning and itching around the opening of the penis.


Source: Centers for Disease Control




“;Gonorrhea is important but is in pretty good control in Hawaii,”; Whiticar said. Syphilis also is a serious disease but “;is not a young people's disease,”; he said.

However, chlamydia is a major risk for young people and should be discussed openly, he said. “;We talk a lot about flu and other things going around. Very large numbers of young people have chlamydia, but it is very difficult to talk about that.”;

Parents and young people should know the disease can cause irreversible damage and result in infertility if it is untreated, he said.

Blackiston said, “;We do know there is high prevalence among teenagers.”; Those who are sexually active are not protecting themselves, she said, noting Hawaii teens had the lowest rate for condom use in the nation in a Youth Risk Behavior Study two years ago.

“;The most common symptom of chlamydia is no symptom,”; Blackiston stressed. “;People can unknowingly carry chlamydia and pass it on to other people.”;

Chlamydia is thought to be a woman's disease because testing usually is done on women, but men also are affected. They are more symptomatic than women so they can be treated rather than tested, Whiticar said.

Chlamydia can be prevented by reducing a person's number of sexual partners, practicing abstinence and using condoms—“;clearly an area that could be strengthened in Hawaii,”; Whiticar said.

Testing, screening and treating a positive person can reduce the disease in the population, and Hawaii is the nation's leading state for screening of young women, he said. “;But when you screen more women, you potentially find more infections. We want to make sure we are treating infections properly.”;

Partners also should be treated to reduce chances of reinfecting people, Whiticar emphasized, describing problems of identifying them and getting them to seek health services.

Blackiston said more broad-based health education is needed for young people. “;It needs to be a community effort—not just a Planned Parenthood educator coming in for a 45-minute session once in a high school. It needs to come from parents, the media, community and government.”;

Schools have limited time and funding, and some are so focused on math and reading that many students are not getting basic health education, she said. “;Health needs to be more of a core curriculum because if you don't have health, math and reading don't matter.”;

Sexually active adolescents should be tested every six to 12 months and condoms used correctly to reduce risk, she said.

Confidential screening for sexually transmitted diseases also is available at the Health Department's Diamond Head Health Center, 3627 Kilauea Ave.