JUST SAY GO....

Chlamydia just became the most commonly reported disease ever in the US—but there’s something worse

The US Centers for Disease Control and Prevention (CDC) just released its annual summary of sexually transmitted diseases (STDs) for 2012, and it contains a grim little datum: With 1.4 million reported cases, chlamydia broke the record (pdf) for the most instances not just of STDs but of any condition recorded by CDC. But because not every disease has to be reported, that just means that it continues to beat out illnesses like rabies and ebola.

So we shouldn’t freak out too much—at least not about chlamydia. While 1.4 million cases sounds like a lot, chlamydia is easily treated, and only saw a 0.7% increase between 2011 and 2012. Syphilis and gonorrhea, the two other notifiable STDs presented in the report, are much more worrisome. (HIV data are dealt with separately.)

The 11.1% rate increase in syphilis was solely among men, with a particular uptick for gay and bisexual men. This was also true in 2011, and worried public health officials since people with syphilis are also more vulnerable to HIV.

Gonorrhea is an even bigger worry. After dropping in the 90’s, plateauing, and then hitting an all-time low in 2009, reported rates of gonorrhea have begun to rise steadily again. To make matters worse, the disease is now often impossible to treat: In 2013, the CDC assigned it an “urgent threat” level for antibiotic resistance—the highest the organization has, indicating that crisis could be imminent. As many as 30% of gonorrhea infections (pdf) are resistant to at least one class of antibiotic, with at least 23% invulnerable to former go-to drug tetracycline, so the current recommendation is to treat with a combination of two. But with strains now emerging showing resistance to even the newest classes of antibiotics—rendering them virtually incurable— it’s not clear how long the recommended treatment will be effective.

What to do? Using a condom properly will almost always prevent all three infections, but only 60% of sexually active teens use condoms, and older people use them even less. We can only hope one of Bill Gates’ contenders for a better condom brings the goods, and soon.

Correction: A previous version of this post stated that 30% of gonorrhea infections are resistant to all available antibiotics. This statistic in fact refers to the percentage of gonorrhea infections that are resistant to at least one antibiotic.

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