Tuesday , November 14, 2017 - 5:15 AM
OGDEN — Cases of chlamydia and gonorrhea have steadily risen for at least three years nationwide, and Weber County reflects that trend. In 2016, these sexually transmitted diseases ranked as Weber-Morgan Health Department’s top two confirmed diseases.
But these diseases often go undetected because most people don’t show any symptoms. And left untreated over the long term, chlamydia and gonorrhea can cause genital scarring, infertility and chronic pelvic pain. Pregnant women run the risk of premature births or miscarriage — or passing the infection to their newborns at birth.
Since the highest incidence of these diseases occurs in people ages 15-24, Jeralyn Perkins takes her job as a health educator with Weber-Morgan’s Teen Health program quite seriously. But confining discussions only to STDs (also called STIs) would do her students a disservice, Perkins believes.
“As educators, there’s a lot we can do to empower youth to have successful futures. STIs don’t mean the end of a successful future, but they definitely can affect it. But there’s so much more,” Perkins said. “Are we really helping them think critically about all the consequences? Are they prepared to handle how being sexually active affects all their relationships? What if they’re expecting commitment and their partner doesn’t reciprocate?”
Over the past decade, Perkins said they’ve worked to establish context and consistency across the school districts in Morgan, Weber and Ogden, using the Health Department’s federally supported curriculum.
“It covers healthy relationships very well, which is a huge part of sexual health for teenagers,” Perkins said. That includes instruction about rape, date rape, consent — and common misconceptions teens pick up from mass media. And an entire day is spent on STDs, Perkins added.
Cause for concern?
These infections get passed from partner to partner by fluids exchanged during anal, oral and vaginal intercourse.
In September, the Centers for Disease Control & Prevention described STDs as a substantial health challenge facing the U.S. According to the CDC, an estimated 20 million new STIs occur each year, accounting for almost $16 billion in costs. And these figures do not include the many cases that go undiagnosed.
In 2016, there were 1,598,354 chlamydia cases reported nationwide (for a rate of 497 per 100,000 people) — a 4.7 percent rate increase since 2015. And 468,514 gonorrhea cases were reported (for a rate of 146) — an 18.5 percent rate increase over the prior year.
The Weber-Morgan Health Department’s 2016 Annual Report logged 871 confirmed chlamydia cases and 212 confirmed gonorrhea cases — outpacing Hepatitis C and influenza, and ranking first and second on the area’s list of top 10 confirmed diseases.
The CDC posted 2015 county-by-county nationwide data and Weber and Davis led the charts in Northern Utah:
• Box Elder — 95 cases of chlamydia for a rate of 184.4; two cases of gonorrhea for a rate of 3.9.
• Cache County — 250 cases of chlamydia for a rate of 211.3; 15 cases of gonorrhea for a rate of 12.7.
• Davis County — 890 cases of chlamydia for a rate of 269.9; 92 cases of gonorrhea for a rate of 27.9.
• Morgan County — seven cases of chlamydia for a rate of 66; one case of gonorrhea for a rate of 9.4.
• Weber County — 790 cases of chlamydia for a rate of 329.5; 146 cases of gonorrhea for a rate of 60.7.
Amy Carter, a registered nurse and epidemiologist for the Weber-Morgan Health Department, helps spread the word that people need to get screened and tested for STDs. But that gets tricky due to the stigma associated with sexual activity and related infections.
“We try to get education and awareness out to the community and also to our clinicians and providers. We let them know about screenings depending on age and risky behavior,” Carter said. “Most of these diseases don’t have symptoms, so people don’t realize they could be infected, so it’s always one of our priorities.”
Carter referred to the ABCs of safe sexual conduct: A stands for abstinence (not always an option); B for being faithful or monogamous when both partners are uninfected; and C for correct and consistent condom use when A and B don’t work.
Haley Hamblin, also a registered nurse and Weber-Morgan’s STD program manager, said people can pick up free condoms at the Health Department.
“The patient just needs to come to the nursing window and ask for an envelope,” Hamblin said. Each envelope contains six condoms and an individual can get one envelope per week. “They’re welcome to ask for condoms, but if they ask for an envelope, we’ll know what they’re talking about.”
Routine testing a must
The CDC recommends that all sexually active and/or pregnant women younger than 25 get tested annually for chlamydia and gonorrhea, as should older women who have new or multiple sex partners — or a sex partner known to be infected. Pregnant women should also get retested during their third trimester to confirm they’re infection-free. And men who have sex with other men are encouraged to get tested every three to six months.
At the Weber-Morgan Health Department, a urine or urethral swab test that detects chlamydia, gonorrhea and syphilis costs $35, Carter said. And caught early, treatment is easy.
Chlamydia requires a one-time dose of oral antibiotics, unless someone is allergic to the medication. In those cases, a week’s worth of an alternate medication does the trick. For gonorrhea, the Weber-Morgan Health Department prescribes an oral antibiotic along with an injection.
But in some cases, that ease of treatment can be a double-edged sword. “If they have no symptoms or complications, and they get this easy treatment, they might not recognize the full significance of what these infections can do,” Carter said.
According to the CDC, untreated chlamydia can spread to a woman’s uterus and fallopian tubes, possibly causing pelvic inflammatory disease (PID) which can be painful and can cause permanent damage. Gonorrhea can also cause PID in women, along with scar tissue that can block the fallopian tubes.
Newborns who contract the infection at the time of delivery can develop conjunctivitis, serious eye infections or pneumonia.
In men, chlamydia can sometimes spread to the tube that carries sperm from the testicles, causing pain and fever. And in rare cases, it can cause infertility. There is also the outside chance gonorrhea can spread to a man’s blood and joints and be life-threatening. For both genders, these infections boost the chances of getting HIV.
Equal opportunity infections
Traysa Smith, a certified physician’s assistant for the Ogden Clinic Women’s Center in South Ogden, said she sees clients who run the gamut from self-pay to Medicaid, Medicare and otherwise insured.
“More common than not, my patients are asymptomatic, and we find an STI as part of their routine screening,” especially in the teens to 30 population, Smith said. “It’s part of their routine annual exam.”
And then there are those who specifically request screening because they have a concern or a known exposure, Smith said. Less consistent use of condoms could be a significant factor in why these infections are on the rise, Smith added.
“Every couple of years I notice a definite upswing in the numbers, and I’m not sure why that happens. ... People might not be aware their partner has another partner,” Smith said, adding that sometimes people lack accurate information or have a belief system that prevents them from using protection.
“It’s definitely a public health issue,” Smith said, adding that open communication — between partners and with medical care providers — is key to halting the spread of STDs. “I try to create a positive environment so people feel comfortable talking about their sexual health, their level of risk and whether they should get tested.”
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