High rate of chlamydia cases places Hawaii sixth in nation

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Hawaii is the sixth-ranking state in chlamydia rates while the nation reported the most-ever cases of the sexually transmitted disease - more than 1 million cases - last year, said the U.S. Centers for Disease Control.

State and national health officials say the higher number and rate is largely a result of better and more intensive screening.

More bad news: Gonorrhea rates are jumping again after hitting a record low, and an increasing number of cases are caused by a "superbug" version resistant to common antibiotics - a problem most noticeable in California and Hawaii, officials said.

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ATLANTA » More than 1 million cases of chlamydia were reported in the United States last year -- the most ever reported for a sexually transmitted disease, federal health officials said yesterday.

"A new U.S. record," said Dr. John M. Douglas Jr. of the Centers for Disease Control and Prevention.

More bad news: Gonorrhea rates are jumping again after hitting a record low, and an increasing number of cases are caused by a "superbug" version resistant to common antibiotics, federal officials said yesterday.

Syphilis is rising, too. The rate of congenital syphilis -- which can deform or kill babies -- rose for the first time in 15 years.

While gonorrhea and syphilis rates appear to relatively low in Hawaii, chlamydia rates remain high -- 435.1 cases per 100,000 population -- and the state ranks sixth in 2006, compared to fifth in 2005, said Roy Ohye, the state program coordinator tracking sexually transmitted diseases.

States with higher rankings for chlamydia were Alaska, Mississippi, South Carolina, New Mexico and Alabama .

Ohye said he thinks Hawaii's ranking is due to the high level of reporting by medical laboratories and of screening for sexually transmitted diseases in the state.

Many community health centers in Hawaii offer free screening for chlamydia to qualified women.

"Proportionately, we do screen a lot of women, compared to other states," Ohye said.

Ohye said chlamydia, if untreated, can cause pelvic inflammatory diseases in women and lead to infertility or give rise to newborns with serious medical problems, including eye infections and pneumonia.

He said chlamydia is usually transmitted by unprotected sex or oral genital sex.

Ohye said the rates of chlamydia are highest in younger age groups including ages 20-24 and 15-19, indicating a lack of caution.

"The fact that positivity rates are highest in the younger age groups means they're not using condoms," he said.

Ohye said chlamydia can be treated effectively with antibiotics but can go undetected without proper medical screening.

He said chlamydia symptoms are not as severe as gonorrhea in men and many women do not display the symptoms of having chlamydia.

Chlamydia is the most common sexually transmitted disease reported to the CDC. Nearly 1,031,000 cases were reported last year, up from 976,000 the year before.

The count broke the single-year record for reported cases of a sexually transmitted disease, which was 1,013,436 cases of gonorrhea, set in 1978.

In 2004, the nation's gonorrhea rate fell to 112.4 cases per 100,000 people, the lowest level since the government started tracking cases in 1941.

But since then, health officials have seen two consecutive years of increases. The 2006 rate -- about 121 per 100,000 -- represents a 5.5 percent increase from 2005.

Health officials don't know exactly how many superbug cases there were among the more than 358,000 gonorrhea cases reported in 2006. But a surveillance project of 28 cities found that 14 percent were resistant to ciprofloxacin and other medicines in the fluoroquinolones class of antibiotics.

Similar samples found that 9 percent were resistant to those antibiotics in 2005, and 7 percent were resistant in 2004. The appearance of the superbug has been previously reported, and the CDC is April advised doctors to stop using those drugs against gonorrhea.

Other doctors are worried. The superbug gonorrhea has been on the rise not only in California and Hawaii, where the problem has been most noticeable, but also in the South and parts of the Midwest.

"Suddenly we're starting to see the spread," Ghanem said.

Syphilis, a potentially deadly disease that first shows up as genital sores, has become relatively rare in the United States. About 9,800 cases of the most contagious forms or syphilis were reported in 2006, up from about 8,700 in 2005.

Chlamydia cases

Number of reported chlamydia cases in Hawaii, 2002-2006

	Female	Male
2002:	3,465	1,065
2003:	4,117	1,366
2004:	4,019	1,288
2005:	4,103	1,404
2006:	4,183	1,390

Source: State Health Department