Chlamydia in Minnesota: What is the Problem?

Ruth Lynfield, MD Minnesota Department of Health

What is Chlamydia and Why Should You Care? •

Chlamydia is a sexually transmitted disease caused by a bacterium or germ

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It is the most commonly reported disease in the U.S. and in Minnesota

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Most people do not have symptoms, but untreated chlamydia infection can lead to a severe infection of the womb, ovaries and tubes (PID or pelvic inflammatory disease), and can result in infertility and other longterm problems like chronic pelvic pain

•

Complications in men can include epididymitis (infection of the tube that carries sperm from the testes)

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Chlamydia can be easily diagnosed with lab tests and easily treated with antibiotics

What about Gonorrhea? •

Gonorrhea is another sexually transmitted disease caused by another bacterium or germ

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Many people do not have symptoms, but untreated gonorrhea infection can lead to PID and can result in infertility and other long-term problems including chronic pelvic pain in women

•

Complications in men can include epididymitis

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Untreated gonorrhea can result in blood and joint infection

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Infection can be passed on to a baby as it is being born and cause blindness, blood or joint infection

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Gonorrhea can be easily diagnosed with lab tests and easily treated with antibiotics

What are the Symptoms of Chlamydia or Gonorrhea? • Many people don’t have symptoms initially but are at risk for complications from their infection • Symptoms can include burning when urinating, vaginal or penile discharge, anal itching, rectal pain, bleeding between periods, testicular swelling • People infected with chlamydia or gonorrhea can more easily become infected with HIV, if exposed and more easily spread HIV if infected

Sexually Transmitted Diseases in Minnesota

Sexually Transmitted Diseases in Minnesota Rate per 100,000 people by Year of Diagnosis, 1999-2009 Gonorrhea

P&S* Syphilis

300

10

275

9

250

8

225

7

200 175

6

150

5

125

4

100

3

75

2

50 25

1

0

0 1999

2000

* P&S = Primary and Secondary.

2001

2002

2003

2004 Year

2005

2006

2007

2008

2009

Rate of P&S Syphilis

Rate of Chlamydia and Gonorrhea

Chlamydia

Age-Specific Chlamydia Rates by Gender Minnesota, 2009

Rate per 100,000 persons .

2400 2100

Males

1800

Females

1500 1200 900 600 300 0

10-14

15-19

20-24

25-29

30-39

Age in Years

40-44

45-49

50+

Chlamydia Rates by Race/Ethnicity Minnesota, 1999-2009 2250

White

Black

2000

American Indian

Asian/PI

Hispanic*

Rate per 100,000 persons .

1750 1500

2009 rates compared with Whites: Black = 16x higher American Indian = 4x higher Asian/PI = 3x higher Hispanic = 5x higher

1250 1000 750 500 250 0 1999

2000

2001

2002

2003

2004 Year

* Persons of Hispanic ethnicity can be of any race.

2005

2006

2007

2008

2009

Chlamydia Infections by Residence at Diagnosis Minnesota, 2009 Total Number of Cases = 14,186 Unknown 4%

Minneapolis 20%

Greater MN 30% St. Paul 14%

Suburban 32% Suburban = Seven-county metro area including Anoka, Carver, Dakota, Hennepin (excluding Minneapolis), Ramsey (excluding St. Paul), Scott, and Washington counties. Greater MN = All other Minnesota counties outside the seven-county metro area.

Age-Specific Gonorrhea Rates by Gender Minnesota, 2009

Rate per 100,000 persons

400 350

Males

300

Females

250 200 150 100 50 0 10-14

15-19

20-24

25-29

30-39

Age in Years

40-44

45-49

50+

Gonorrhea Rates by Race/Ethnicity Minnesota, 1998-2009 1200

White American Indian Hispanic*

Rate per 100,000 persons .

1000

Black Asian/PI

800

2009 rates compared with Whites: Black = 36x higher American Indian = 5x higher Asian/PI = 0x higher Hispanic = 4x higher

600 400 200 0 1998

1999

2000

2001

2002

2003 Year

* Persons of Hispanic ethnicity can be of any race.

2004

2005

2006

2007

2008

2009

Gonorrhea Infections in Minnesota by Residence at Diagnosis, 2009 Total Number of Cases= 2,302 Unknown 4% Greater MN 19%

Suburban 28%

Minneapolis 31%

St. Paul 18%

Suburban = Seven-county metro area including Anoka, Carver, Dakota, Hennepin (excluding Minneapolis), Ramsey (excluding St. Paul), Scott, and Washington counties. Greater MN = All other Minnesota counties outside the seven-county metro area.

Chlamydia Disproportionately Impacts Youth MN Population in 2000

Chlamydia Cases in 2009

(n = 4,919,479)

(n = 14,186) 25-29 yrs 16%

25-34 yrs 14% 35+ yrs 50%

30-44 yrs 12%

15-24 yrs 14%

45+ yrs 2% 15-24 yrs 69%