December 27, 2012

Maine officials acting amid a surge in gonorrhea

The 441 infections in 2012, many involving people in their 20s, is quadruple the number reported in 2008.

By Kelley Bouchard
Staff Writer

The annual incidence of gonorrhea in Maine has more than quadrupled since 2008, when the state had the nation's second-lowest infection rate, according to the Maine Center for Disease Control and Prevention.

The increase – from 98 cases five years ago to 441 through Dec. 14 of this year – has state health officials scrambling to launch a public education campaign targeting Mainers in their 20s, who account for more than half of all reported cases in 2012.

Officials also are urging health care providers to screen all sexually active Mainers who may have been lax in protecting themselves against venereal diseases, said Dr. Stephen Sears, the state epidemiologist.

"They ought to be testing for this routinely," Sears said Thursday. "The increased infection in Maine is concerning and it's mirroring a national trend."

Maine's infection rate is growing faster than national and regional rates, however, at a time when the bacterial disease is becoming resistant to some antibiotic treatments.

The U.S. Centers for Disease Control and Prevention updated its treatment guidelines in August, recommending several alternatives to oral cephalosporins that are proving ineffective in many cases, Sears said.

While antibiotic-resistant gonorrhea hasn't cropped up much in Maine, Sears said, health care providers are being advised to follow the new treatment guidelines because the U.S. population is increasingly mobile.

The Maine CDC will review this year's gonorrhea cases in the coming weeks to look for patterns and trends among various racial, gender and age groups, Sears said.

"We actually don't know all the reasons why we're seeing an increase," he said. "All of the messaging around safe sex in recent years may not be followed as much."

Maine's total of reported cases rose from 162 in 2010 to 272 in 2011, a 68 percent increase, pushing the infection rate from 12 cases to 20 cases per 100,000 population, according to the federal CDC.

So far this year, Maine's gonorrhea cases have spiked 62 percent, to 441 cases, and driven the infection rate to an estimated 33 cases per 100,000 population, based on Maine CDC figures. That's nearly five times the 2008 infection rate of seven cases per 100,000 population.

In comparison, gonorrhea cases reported nationally rose from 309,341 cases in 2010 to 321,849 cases in 2011, according to the federal CDC, up 4 percent.

The increase pushed the national infection rate up 4 percent, from 100 cases to 104 cases per 100,000 population.

However, the national infection rate has decreased 14 percent overall since 2008, when it was 121 cases per 100,000 population.

Just over 300,000 gonorrhea cases had been reported nationally through Dec. 17 this year, according to the federal CDC.

The agency estimates that more than 700,000 Americans get new gonorrhea infections each year, but less than half are reported to health officials.

Southern states, as in previous years, had the highest infection rates in 2011 (135 cases per 100,000 population), followed by the Midwest (111 cases), Northeast (86 cases) and West (62 cases).

However, the Northeast experienced the greatest increase in infection rates (11 percent) from 2010 to 2011, followed by the West (6.5 percent), the Midwest (2.7 percent) and the South (2.1 percent).

By 2011, Maine's gonorrhea infection rate of 20 cases per 100,000 population ranked 44th in the nation.

States with lower infection rates were Idaho, Utah, New Hampshire, Montana, Wyoming and Vermont, which reported only 48 cases last year and had an infection rate of just under eight cases per 100,000 population.

Of the 441 gonorrhea cases reported in Maine so far this year, 240 were among people in their 20s, according to the Maine CDC.

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