Rates of sexually transmitted diseases in California reached a record high last year, health authorities said Monday.
State officials are particularly concerned by a spike in stillbirths due to congenital syphilis.
More than 300,000 cases of chlamydia, gonorrhea and syphilis were reported in 2017, a 45 percent increase from five years ago, according to data released by the California Department of Public Health.
Chlamydia and gonorrhea are most common among people under 30, the report said, warning that rates of the diseases may be indicators of a struggling public health system.
A Billboard advertises free STD tests using a play on former former presidential candidate Bernie Sanders’s campaign slogan. Rates of STDs have shot up 45 percent in California (file)
Rates of chlamydia are highest among young women, while men account for the majority of syphilis and gonorrhea cases.
If left untreated, chlamydia and gonorrhea can lead to infertility, ectopic pregnancy and chronic pelvic pain. Syphilis can result in blindness, hearing loss and neurologic problems.
The figure that caused the greatest alarm for researchers and administrators was 30 stillbirths resulting from congenital syphilis statewide – the highest number reported since 1995, the CDPH said. Los Angeles County alone saw congenital syphilis cases jump from eight in 2013 to 47 last year.
‘For California to have a steady increase in congenital syphilis is shameful,’ said Dr Jeffrey Klausner, a professor of medicine at University of California, Los Angeles.
He pointed to nations such as Cuba, Thailand and Belarus that have nearly eliminated the life-threatening infection seen in infants.
‘We’ve known how to control syphilis since early 1900s. Seeing it come back like this is a sign of failure of the public health safety net,’ Klausner said.
Klausner placed much of the blame for the overall STD spike on what he called the ‘decimation’ of public health infrastructure since the 2008 financial crisis.
Funding slashed a decade ago hasn’t been restored, leading to continued closing of clinics and collapse of education programs about risks and treatment options.
Dr Heidi Bauer, chief of the state health department’s STD Control Branch, agreed that budget issues are part of the problem.
She estimated that about $20 million in state and federal money is allocated yearly to fighting STDs – a small number in a state with nearly 40 million residents.
Bauer also suggested the rise in STDs may be a symptom of more general problems in areas such as the economically hard-hit San Joaquin Valley where people are struggling with poverty, substance abuse, mental health issues and homelessness.
She also partially blamed the funneling of patients away from public health services toward primary care physicians under the Affordable Care Act.
California is hardly alone in its uphill battle against STDs.
In spite of increased public awareness and sexual health campaigns,rates of STDs have been climbing across the US for the past three years.
In fact, California is not the state worst plagued by STDs. In 2017, the number of cases of chlamydia per 100,000 people in Texas was double the rate seen in California.
Rates of the STD in Texas – while they remain high – have somewhat leveled off in recent years, whereas they increased by 16 percent between 2016 and 2017 in California.
Other states, including Illinois, Oklahoma, Alabama and New York all also continue to see high numbers of chlamydia, gonorrhea and syphilis.
States struggling to control the spread of the infections may also be facing public health care challenges and disparities in access to information, care and treatment.
‘For sexual health, primary care wasn’t the most effective method,’ Dr Bauer said.
Someone who depended on public clinics for STD screening and treatment may not want to discuss it with their doctor, or may not have a doctor at all, she said.
A microscope image shows the chlamydia trachomatis bacteria, which has infected scores of Californians, magnified 200 times (file image)
The health department is spearheading a ‘multi-pronged’ effort to educate the public about the risks and get the word out to medical providers about the latest advances in screening and treatment, Bauer said.
Officials are also increasing efforts to follow up on cases, especially those involving pregnant women with syphilis, she said.
Experts agreed that sex education in schools and programs in the community should raise awareness and that there is a need to have public discussions about the often stigmatized conditions.
To that end, the California Health Department has introduced or partnered with several campaigns to promote new takes on outdated sexual education.
In September, several schools in the Los Angeles Unified School District introduced a new curriculum called Puberty: The Wonder Years, which is intended to introduce students as young as nine to sexual education.
The newly-minted Center for Health Equity aims to address disparities – like the far higher rates of STDs among black Californians and in poorer districts – in public health measures and access to care in the state.
But the new figures suggest there is much more to be done to combat the spread of STDs in California – and the US, more broadly.
‘While there are advocates and champions for cancer, nobody is out there saying, ‘I have gonorrhea and these are the best ways to treat it.’ There’s no one out there being a champion for these conditions,’ said Klausner.
The health department’s director, Dr. Karen Smith, urged sexually active people to use condoms and get tested regularly. Many STDs can be cured with antibiotics if attacked quickly.
Rates for chlamydia, gonorrhea, and syphilis have been rising nationally for several years.
More than two million new cases of all three infections were reported in the United States in 2016 – the most ever, according to the Centers for Disease Control and Prevention. CDC numbers for 2017 won’t be available until later this year.