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National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention

Division of STD Prevention

Sexually
Transmitted
Disease
Surveillance
2010
Division of STD Prevention
November 2011

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
Division of STD Prevention
Atlanta, Georgia 30333

and TB Prevention.Acknowledgments Publication of this report would not have been possible without the contributions of the state and territorial health departments. sexually transmitted disease control programs. STD. and the Epidemiology and Surveillance Branch of CDC’s National Center for HIV/AIDS. and public health laboratories. regional Infertility Prevention Projects. ii STD Surveillance 2010 . We also acknowledge the contributions of staff within the Division of STD Prevention. the Statistics and Data Management Branch. Viral Hepatitis.

Mosher WD.gov/std/stats/ STD Data on Wonder http://wonder.gov/std/program/pupestd. 2011 http://www. National health statistics reports.cdc. Atlanta: U. Sionean C. however.cdc. Copen C.cdc.cdc.cdc.cdc.gov/std. and sexual idenity in the United States: Data from the 2006-2008 National Survey of Family Growth.S. citation as to source is appreciated. Department of Health and Human Services.pdf Behavioral Surveillance Youth Risk Behavior Surveillance System: http://www.cdc.gov/std/Program/data-mgmt.gov/std/SyphSurvReco.Copyright Information All material contained in this report is in the public domain and may be used and reprinted without special permission. Sexual behavior.gov/std/stats.html STD Data Management & Information Technology http://www.htm STD Program Operation Guidelines http://www.cdc. MD: National Center for Health Statistics. Selected STD Surveillance and Prevention References and Web Sites STD Surveillance Reports 1993–2010 http://www. National Survey of Family Growth Chandra A.gov/std/healthcomm/fact_sheets.cdc. Sexually Transmitted Disease Surveillance 2010.gov/STD/treatment/ STD Program Evaluation Guidelines http://www.gov/std/program/GL-2001.gov/HealthyYouth/yrbs/index.htm STD Fact Sheets http://www. no36.gov/nchs/data/nhsr/nhsr036. sexual attraction.cdc.htm Recommendations for Public Health Surveillance of Syphilis in the United States http://www. 2011. Suggested Citation Centers for Disease Control and Prevention. Web Site The online version of this report is available at http://www.cdc. Hyattsville.htm.pdf STD Surveillance 2010 iii .htm STD Treatment Guidelines http://www.

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Institute of Medicine (US). Washington (DC): National Academy Press.and community-based interventions that are effective and can be implemented immediately. STD Surveillance 2010 v . strong leadership. there are existing individual. 43. The first hurdle will be to confront the reluctance of American society to openly confront issues surrounding sexuality and STDs.Foreword “STDs are hidden epidemics of enormous health and economic consequence in the United States.”1 1 Eng TR. all members of the community must do their part. and accept new responsibilities. That is why a multifaceted approach is necessary to both the individual and community levels. but it is negligible when compared with the likely return on the investment. To successfully prevent STDs. STDs are public health problems that lack easy solutions because they are rooted in human behavior and fundamental societal problems. A successful national initiative to confront and prevent STDs requires widespread public awareness and participation and bold national leadership from the highest levels. They are hidden because many Americans are reluctant to address sexual health issues in an open way and because of the biologic and social characteristics of these diseases. modify how they deliver services. All Americans have an interest in STD prevention because all communities are impacted by STDs and all individuals directly or indirectly pay for the costs of these diseases. The process of preventing STDs must be a collaborative one. In this process. Despite the barriers. editors. The hidden epidemic: confronting sexually transmitted diseases. organization. or sector can effectively do it alone. Butler WT. many stakeholders need to redefine their mission. there are many obstacles to effective prevention efforts. 1997. partnerships. Indeed. p. The additional investment required to effectively prevent STDs may be considerable. and adequate resources will be required. No one agency. refocus their efforts. innovative thinking.

S. Prior to the publication of Sexually Transmitted Disease Surveillance 2010. as well as information about Healthy People 2020 STD objectives and progress toward meeting these objectives. missing. and chancroid. incidence rates by these characteristics. are the data sources of many of the figures vi STD Surveillance 2010 . This annual publication is intended as a reference document for policy makers. which provide the case report data for chlamydia. and sex data. population. missing. or invalid data were redistributed on the basis of the state’s distribution of known age group. race/ethnicity. The figures and tables in this edition supersede those in earlier publications of these data. and STD surveillance case definitions. The accompanying text identifies major findings and trends for selected STDs. and TB Prevention Centers for Disease Control and Prevention 1600 Clifton Road. state. appear somewhat lower than in previous reports. The surveillance information in this report is based on the following sources of data: (1) notifiable disease reporting from state and local STD programs. health planners. race/ethnicity. gonorrhea. Any comments and suggestions that would improve future publications are appreciated and should be sent to Director. the Tables. and others who are concerned with the public health implications of these diseases. Sexually Transmitted Disease Surveillance 2010 consists of four sections: the National Profile. the values for unknown. Because of incomplete diagnosis and reporting. regional. the number of STD cases reported to the Centers for Disease Control and Prevention is less than the actual number of cases occurring in the U. the Special Focus Profiles. and the Appendix. or invalid values for age group. The counts presented in this report are summations of all valid data reported in reporting year 2010. For the states for which 50% or more of their data were valid for age group. The Tables section provides statistical information about STDs at county. The Special Focus Profiles section contains figures and text that describe STDs in selected populations that are a focus of national and state prevention efforts. and most of the statistical tables in this publication.Preface Sexually Transmitted Disease Surveillance 2010 presents statistics and trends for sexually transmitted diseases (STDs) in the United States through 2010. race/ethnicity. the STD Surveillance Network. syphilis. redistribution methodology is not applied to any of the data. and (3) other national surveys implemented by federal and private organizations. and sex. (2) projects that monitor STD prevalence in various settings. Beginning with the publication of Sexually Transmitted Disease Surveillance 2010. metropolitan statistical area. when the percentage of unknown. The Appendix includes information on how to interpret the STD surveillance data used to produce this report. particularly by race/ ethnicity for chlamydia and gonorrhea. race/ethnicity. Mailstop E-02 Atlanta. and national levels. Division of STD Prevention National Center for HIV/AIDS. researchers. and the Gonococcal Isolate Surveillance Project. Viral Hepatitis. Because missing data are excluded from calculations of rates by age group. Georgia 30333 The STD surveillance systems operated by state and local STD control programs. National summary data of case reports for other STDs are not available because they are not nationally notifiable diseases. the National Job Training Program. Government Performance and Results Act goals and progress toward meeting these goals. including regional Infertility Prevention Projects. the state’s incidence and population data were excluded from the tables that presented data stratified by one or more of these variables. STD. The National Profile section contains figures that provide an overview of STD morbidity in the United States. program managers. These systems are an integral part of program management at all levels of STD prevention and control in the United States. and sex. and sex exceeded 50% for any state.

Guide to Acronyms CDC Centers for Disease Control and Prevention CSF cerebrospinal fluid DSTDP Division of STD Prevention GISP Gonococcal Isolate Surveillance Project HEDIS Healthcare Effectiveness Data and Information Set HHS U. Department of Health and Human Services HMOs health maintenance organizations HIV human immunodeficiency virus HP2020 Healthy People 2020 HPV human papillomavirus HSV herpes simplex virus Infertility Prevention Project IPP MICs minimum inhibitory concentrations MPC mucopurulent cervicitis MSA metropolitan statistical area men who have sex with men MSM MSW men who have sex with women only nucleic acid amplification tests NAATs NDTI National Disease and Therapeutic Index NGU nongonococcal urethritis NHANES National Health and Nutrition Examination Survey NHDS National Hospital Discharge Survey NJTP National Job Training Program OMB Office of Management and Budget P&S primary and secondary PID pelvic inflammatory disease QRNG quinolone-resistant Neisseria gonorrhoeae RPR rapid plasma reagin SSuN STD surveillance network STD sexually transmitted disease VDRL Venereal Disease Research Laboratory STD Surveillance 2010 vii .S.

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..................33 Other Sexually Transmitted Diseases................................................ United States..............................................83 Tables National Summary........... xv Census Regions of the United States................................... 143 Table A3............... Healthy People 2020 (HP2020) Sexually Transmitted Diseases Objective Status...................... Selected STDs—Percentage of Unknown...............................................77 STDs in Persons Entering Corrections Facilities...................................... 145 STD Surveillance Case Definitions......................................................................................................................................................................................................................87 Chlamydia..................................................................................... 142 Table A2................................... 2010.................. Missing...........................................................x Figures in the Special Focus Profiles......................................................................................... Reported Cases of STDs by Reporting Source and Sex..................................53 STDs in Women and Infants....................................................................................................................89 Gonorrhea.....................................................................................................................................63 STDs in Racial and Ethnic Minorities...................................................................................................................................................................................................... 144 Table A4...........................................................................................................................vii Figures in the National Profile................................................................................................................................................... or Invalid Values for Selected Variables by State and by Nationally Notifiable STD...........................................xiii Tables in the National Profile..............7 Gonorrhea..............................................................................v Preface....................................................................................................................................................5 Chlamydia...................101 Syphilis..............................................................................133 Selected STDs........45 Special Focus Profiles................................................................................................. 2010............................................................69 STDs in Men Who Have Sex with Men.................................Contents Acknowledgments.............................. 2010...........134 Appendix Interpreting STD Surveillance Data...............................................................................................................................................................................................................................................................135 Table A1................................................................................................................................................................................................................................ Government Performance and Results Act (GPRA) Sexually Transmitted Diseases Goals and Measures....................................................................................................................................17 Syphilis..........................................................................................................................................................................................................1 National Profile................................ xix National Overview of Sexually Transmitted Diseases (STDs)................................................................................................................................155 STD Surveillance 2010 ix ..................................................................................................................vi Guide to Acronyms............................................................................................................................. ii Foreword..............................................................................................................................................................................146 Contributors........................................................................................................................................................55 STDs in Adolescents and Young Adults.................................................112 Chancroid.......

............... Chlamydia—Rates by Sex........... United States.......... 22 Gonorrhea—Rates by Region. 14 Chlamydia—Median State-specific Positivity Rates Among Women Aged 15–24 Years Tested in Family Planning Clinics.................... 25 Gonorrhea—Rates by Race/Ethnicity... United States........................................ United States................. 12 Chlamydia—Cases by Reporting Source and Sex........ 26 Gonorrhea—Cases by Reporting Source and Sex.. Figure 21........... United States..... MSW........................................ Figure 16.................. 11 Chlamydia—Rates by Age and Sex... United States.... 2001–2010.......... United States.. Figure 8... United States......................... Infertility Prevention Project............. Figure 26........ 13 Chlamydia—Percentage of Reported Cases by Sex and Selected Reporting Sources.. Infertility Prevention Project............... 12 Chlamydia—Rates by Race/Ethnicity........ United States.... 10 Chlamydia—Rates by State..... 1990–2010........... Figure 23... United States.............. 1997–2010......................................................................................... 26 Gonorrhea—Percentage of Reported Cases by Sex and Selected Reporting Sources..S.... Figure 6....... United States.... 2010.......................... Figure 22............. National Health and Nutrition Examination Survey....... by U..................... 16 Gonorrhea—Rates................. Figure 25. 2010......................... United States... Figure 19............................ United States...... Figure 10...................................... Figure 9...... 2001–2010......... 23 Gonorrhea—Rates by County........................... Gonorrhea Figure 14. 2010........... 24 Gonorrhea—Rates by Age and Sex.... 1999–2002............................................................ 2001–2010.... United States and Outlying Areas.................... United States and Outlying Areas.... United States..................................... 11 Chlamydia—Rates by County... 15 Chlamydia—Percentage of Nucleic Acid Amplification Tests Used Among Women Aged 15–24 Years Tested in Family Planning Clinics.... Figure 12. 10 Chlamydia—Rates by Region................ Figure 7.......... Department of Health and Human Services (HHS) Region. United States....................................... 2006–2010........ by U............... 2010.............. Figure 24....................... 15 Chlamydia—Trends in Positivity Rates Among Women Aged 15–24 Years Tested in Family Planning Clinics......... 2001–2010... 14 Chlamydia—Positivity Among Women Aged 15–24 Years Tested in Family Planning Clinics. 2010............ 2001–2010............... 2010................... 2001–2010............... Figure 5................................................. 2010................................................S........ 24 Gonorrhea—Rates by Age Among Women Aged 15–44 Years..... 27 Gonorrhea—Positivity Among Women Aged 15–24 Years Tested in Family Planning Clinics..... Figure 18........ United States............. 2010...... 2006–2010.. 27 STD Surveillance Network (SSuN) —Proportion of MSM.... 2001–2010................... 2010... Figure 20................ 28 x STD Surveillance 2010 ............................... Department of Health and Human Services (HHS) Region............ 1941–2010........ 22 Gonorrhea—Rates by Sex.......... 2010............ Figure 3.. United States and Outlying Areas... Figure 4.Figures in the National Profile Chlamydia Figure 1................................ United States and Outlying Areas........ and Women Among Interviewed Gonorrhea Cases by Site............... 1990–2010.............................. Infertility Prevention Project..... Figure 13........................ 25 Gonorrhea—Rates by Age Among Men Aged 15–44 Years..... Figure 2.......... by State................. United States... Infertility Prevention Project.. 13 Chlamydia—Prevalence by Age Group and Race/Ethnicity.... Infertility Prevention Project....... 2001–2010...................... Figure 17........... Figure 11.................. 23 Gonorrhea—Rates by State......... United States............ United States.................................... 2010.... Figure 15................. by State.....................

............. and Selected Reporting Sources................................................... Primary and Secondary Syphilis—Rates by Age Among Men Aged 15–44 Years.......................................................................... Congenital Syphilis—Reported Cases Among Infants by Year of Birth and Rates of Primary and Secondary Syphilis Among Women............. Primary and Secondary Syphilis—Reported Cases by Stage. Gonococcal Isolate Surveillance Project (GISP)—Drugs Used to Treat Gonorrhea Among GISP Participants................................ Primary and Secondary Syphilis—Reported Cases by Sex............ United States and Outlying Areas........................ 29 Figure 29.. 1941–2010............ 2010..................................................................... 2010.................... 41 Figure 43................ 31 Syphilis Figure 34.... and Race/Ethnicity.......... 2006–2010.................................................................... Primary and Secondary Syphilis—Rates by Region.. 2006–2010....... United States........ United States............ 40 Figure 41......... 2001–2010......... Gonococcal Isolate Surveillance Project (GISP)—Penicillin.......................... 2001–2010............ United States................ United States. 1990–2010............ Primary and Secondary Syphilis—Reported Cases by Reporting Source and Sex..... 2010...................... 42 Figure 46.................................... Tetracycline............... 2001–2010... 2010............ Primary and Secondary Syphilis—Rates by Age and Sex............................. 41 Figure 44........ 37 Figure 35.......................................... United States................................. Gonococcal Isolate Surveillance Project (GISP)—Distribution of Minimum Inhibitory Concentrations (MICs) to Cefixime Among GISP Isolates........................................ Gonococcal Isolate Surveillance Project (GISP)—Location of Participating Sentinel Sites and Regional Laboratories.................. Sex................................. 2010................... 30 Figure 32.. 2010..................... Primary and Secondary Syphilis—Rates by Age Among Women Aged 15–44 Years............ United States.......... 2001–2010............. 29 Figure 30........................................................... 39 Figure 39............. 31 Figure 33... 28 Figure 28...... 2010....................... United States..... and Sexual Behavior... Sexual Behavior................................ 2001–2010.......................... Primary and Secondary Syphilis—Rates by State....... 38 Figure 38.. United States........... United States. 2006 and 2009–2010................ 1988–2010............................... Primary and Secondary Syphilis—Rates by Sex and Male-to-Female Rate Ratios....... 42 Figure 45.............. and Ciprofloxacin Resistance Among GISP Isolates... Primary and Secondary Syphilis—Percentage of Reported Cases by Sex...... 38 Figure 37................... United States.................. 2010........Figure 27................. United States................. Gonococcal Isolate Surveillance Project (GISP)—Distribution of Minimum Inhibitory Concentrations (MICs) to Ceftriaxone Among GISP Isolates....... Primary and Secondary Syphilis—Rates by County.... 37 Figure 36.. Syphilis—Reported Cases by Stage of Infection.... United States................................ United States...... 1990–2010.......... Gonococcal Isolate Surveillance Project (GISP)—Distribution of Minimum Inhibitory Concentrations (MICs) to Azithromycin Among GISP Isolates................. Gonococcal Isolate Surveillance Project (GISP)—Percentage of Neisseria gonorrhoeae Isolates with Resistance or Intermediate Resistance to Ciprofloxacin........... 30 Figure 31.............. 43 Figure 47........... 2001–2010..... Primary and Secondary Syphilis—Rates by Race/Ethnicity.................. 43 STD Surveillance 2010 xi .............. 40 Figure 42............... Sexual Behavior............... 39 Figure 40....

..... 48 Figure 51. 1976–1980...... 1988–1994.... United States.. 2003–2006....Other Sexually Transmitted Diseases Figure 48............. Chancroid—Reported Cases........ 49 Figure 53...... 1966–2010...... 1981–2010...... 48 Figure 52............. Human Papillomavirus—Prevalence of High-risk and Low-risk Types Among Females Aged 14–59 Years....... Herpes Simplex Virus Type 2—Seroprevalence in Non-Hispanic Whites and Non-Hispanic Blacks by Age Group..... United States............. 50 Figure 54....................................................... Sex of Partners............... STD Surveillance Network (SSuN) —Genital Warts—Prevalence Among Sexually Transmitted Disease (STD) Clinic Patients by Sex.......... 1966–2010.... Genital Warts—Initial Visits to Physicians’ Offices........... Genital Herpes—Initial Visits to Physicians’ Offices..... 47 Figure 50........... 2005–2008....... Trichomoniasis and Other Vaginal Infections—Women—Initial Visits to Physicians’ Offices.............. 47 Figure 49.................. 1999–2004........... United States........ 51 xii STD Surveillance 2010 .... and Site...... United States..... National Health and Nutrition Examination Survey.......... 2010... 1966–2010... National Health and Nutrition Examination Survey.

.. United States............... United States and Outlying Areas................................ 2010.. Figure U.................. 2010.......... by State of Residence....... Department of Health and Human Services (HHS) Region... 58 Chlamydia—Positivity Among Women Aged 15–24 Years Tested in Prenatal Clinics........ Figure T..... by U..... by State. Figure S. 65 Figure L............ Figure F..... Chlamydia—Women—Rates by State......... 2000–2009........................................ United States and Outlying Areas.................................. 73 Gonorrhea—Rate Ratios by Race/Ethnicity. 58 Gonorrhea—Women—Rates by State........Figures in the Special Focus Profiles STDs in Women and Infants Figure A.... 74 Primary and Secondary Syphilis—Rates by Race/Ethnicity and Sex.............. 61 Pelvic Inflammatory Disease—Initial Visits to Physicians’ Offices by Women Aged 15–44 Years................ United States.. United States...................... United States and Outlying Areas.... Chlamydia—Prevalence Among Women Aged 16–24 Years Entering the National Job Training Program............................. 2000–2009....... 2010...... 2001–2010......... Chlamydia—Trends in Positivity Among Women Aged 15–19 Years Tested in Family Planning Clinics........... 73 Gonorrhea—Rates by Race/Ethnicity and Sex....................... Infertility Prevention Project..... Infertility Prevention Project. by State of Residence.. 59 Primary and Secondary Syphilis—Women—Rates by State.... 75 Primary and Secondary Syphilis—Rates Among Males Aged 15–19 Years by Race/Ethnicity............................................................ Figure D... Gonorrhea—Prevalence Among Women Aged 16–24 Years Entering the National Job Training Program.......... 75 Primary and Secondary Syphilis—Rates Among Females Aged 15–19 Years by Race/ Ethnicity. Chlamydia—Prevalence Among Men Aged 16–24 Years Entering the National Job Training Program.. 2010.................... 59 Gonorrhea—Positivity Among Women Aged 15–24 Years Tested in Prenatal Clinics....... 62 STDs in Adolescents and Young Adults Figure J.. United States..... 66 Figure N......... Chlamydia—Rates by Race/Ethnicity and Sex.................. 2010................................ United States..... United States..................................... 2010.... 2010........................ 2006–2010..... United States.................................. Figure I................... Gonorrhea—Prevalence Among Men Aged 16–24 Years Entering the National Job Training Program... Figure R........ 2001–2010............ United States and Outlying Areas..... 66 Figure M.. United States and Outlying Areas....................................... United States and Outlying Areas. United States.. 2010................... 2010...... United States and Outlying Areas.. Figure C....... by State of Residence....... 60 Congenital Syphilis—Infants—Rates by Year of Birth and State.......................... 2010.......... 60 Pelvic Inflammatory Disease—Hospitalizations of Women Aged 15–44 Years..S................................. 76 STD Surveillance 2010 xiii ..... Figure H.......... 2010..... United States..... by State...... 2001–2010........................ United States.... Figure B............................................... 61 Ectopic Pregnancy—Hospitalizations of Women Aged 15–44 Years.. Figure P............. by State of Residence.......... United States and Outlying Areas.... Figure G....................................... 2010................................................................. United States and Outlying Areas......... Figure E.. 2010....... 74 Gonorrhea—Rate Ratios by Race/Ethnicity and Region...................... 2001–2010...... Infertility Prevention Project...... 2010.......... Figure Q............ 65 Figure K.......................................................................... United States and Outlying Areas...... 67 STDs in Racial and Ethnic Minorities Figure O...................................

. Figure EE.................. Gonococcal Isolate Surveillance Project (GISP)—Percentage of Urethral Neisseria gonorrhoeae Isolates Obtained from MSM Attending STD Clinics......... STD Surveillance Network (SSuN)—Gonorrhea and Chlamydia— Proportion of MSM Testing Positive for Gonorrhea and Chlamydia..... 81 Figure Z... 85 Chlamydia—Positivity by Age Group and Sex.............. United States................ STD Surveillance Network (SSuN)—Proportion of MSM Aattending STD Clinics with Primary and Secondary Syphilis.............................. Gonococcal Isolate Surveillance Project (GISP)—Percentage of Urethral Neisseria gonorrhoeae Isolates Obtained From MSM Attending STD Clinics............ 2010........ 2010................................ 81 Figure AA. 85 Gonorrhea—Positivity by Age and Sex........ Figure DD................... 80 Figure X.. 86 Gonorrhea—Positivity by Age Group and Sex........................... 80 Figure Y................................... 76 STDs in Men Who Have Sex with Men Figure W................ 1990–2010. 2010................ Juvenile Corrections Facilities............................................. Juvenile Corrections Facilities.. 2010............................................................... Congenital Syphilis—Infants—Rates by Year of Birth and Mother’s Race/Ethnicity............. Adult Corrections Facilities............. 2010..................... Gonorrhea or Chlamydia by HIV Status.. Adult Corrections Facilities........... Figure CC......................Figure V....... 2001–2010....................................... by Site... 2010. Chlamydia—Positivity by Age and Sex...... 86 xiv STD Surveillance 2010 ........ 82 STDs in Persons Entering Corrections Facilities Figure BB........... 2007–2010.. STD Surveillance Network (SSuN)—Primary and Secondary Syphilis and HIV— Proportion of MSM with Primary and Secondary Syphilis Who Are Co-infected with HIV..... 2010...... by Site.........

2010.............................. 87 Chlamydia Table 2............. Cases of Sexually Transmitted Diseases Reported by State Health Departments and Rates per 100.. 2006–2010........ Ranked by Rates... United States...........1941–2010........................ United States... Chlamydia—Reported Cases and Rates per 100. United States and Outlying Areas.............. Table 16... United States.................. Chlamydia—Women 15–25 Years of Age....... and Sex........... 2006–2010.. United States and Outlying Areas..........................000 Population by Age Group and Sex. 2006–2010........... 90 Table 4.......... Ranked by Rates.... 103 Gonorrhea—Men—Reported Cases and Rates by State/Area and Region in Alphabetical Order......... 104 Gonorrhea—Reported Cases and Rates in Selected Metropolitan Statistical Areas (MSAs) in Alphabetical Order.... 2006–2010........ United States.... 2010.................... Age Group. Table 14. 2006–2010........ United States and Outlying Areas.......... 102 Gonorrhea—Women—Reported Cases and Rates by State/Area and Region in Alphabetical Order.. 97 Table 11A.... Chlamydia—Reported Cases and Rates in Selected Metropolitan Statistical Areas (MSAs) in Alphabetical Order.. 2006–2010...................... 105 Gonorrhea—Women—Reported Cases and Rates in Selected Metropolitan Statistical Areas (MSAs) in Alphabetical Order... 108 STD Surveillance 2010 xv ........... 99 Table 12.... 95 Table 9........ United States............................................... United States.................. 107 Gonorrhea—Counties and Independent Cities Ranked by Number of Reported Cases....... Chlamydia—Women—Reported Cases and Rates by State/Area and Region in Alphabetical Order...... United States.................... United States........ 2006–2010......... United States............. 101 Gonorrhea—Reported Cases and Rates by State/Area and Region in Alphabetical Order.................. Table 17.......... 2010..............Tables in the National Profile National Summary Table 1.......... Age Group.................................. Chlamydia—Reported Cases by Race/Ethnicity.. United States........... United States............................... United States.............. 89 Table 3. United States.....................000 Population................ Table 20......... 96 Table 10...... 98 Table 11B.000 Population by Race/Ethnicity..................... Chlamydia—Men—Reported Cases and Rates by State/Area and Region in Alphabetical Order..... Chlamydia—Men—Reported Cases and Rates in Selected Metropolitan Statistical Areas (MSAs) in Alphabetical Order.......................... 2006–2010....................... Table 15........................ 2006–2010..... United States.... Table 18.. Chlamydia—Women—Reported Cases and Rates in Selected Metropolitan Statistical Areas (MSAs) in Alphabetical Order...... 106 Gonorrhea—Men—Reported Cases and Rates in Selected Metropolitan Statistical Areas (MSAs) in Alphabetical Order............. 93 Table 7....................... United States and Outlying Areas..... United States and Outlying Areas............. 92 Table 6.................... Chlamydia—Rates per 100........ 2006–2010...... 2006–2010.... Table 19... 2010....... 2006–2010................................ Chlamydia—Reported Cases and Rates by State/Area and Region in Alphabetical Order................... Gonorrhea—Reported Cases and Rates by State............. 94 Table 8.. 2006–2010...... 91 Table 5....... 100 Gonorrhea Table 13.......... United States and Outlying Areas................... 2006–2010........ 2006–2010...... Chlamydia—Reported Cases and Rates by State............. Chlamydia—Counties and Independent Cities Ranked by Number of Reported Cases...................................... 2006–2010................... United States........................... and Sex.................

. and Sex................ United States....... 2009–2010............................... Age Group................ Gonorrhea—Reported Cases by Race/Ethnicity............................. 2006–2010........... Ranked by Rates........... United States...................... United States............ and Sex.................... 117 Table 29..... 122 Table 34.... 114 Table 26. 125 Table 36........ United States..... 2006–2010.......... Primary and Secondary Syphilis—Men—Reported Cases and Rates by State/Area and Region in Alphabetical Order............. 113 Table 25............... Primary and Secondary Syphilis—Reported Cases and Rates per 100.... 2006–2010... United States.... 2006–2010.... 127 Table 38........................ 124 Table 35B............. Primary and Secondary Syphilis—Women—Reported Cases and Rates in Selected Metropolitan Statistical Areas (MSAs) in Alphabetical Order................................. 121 Table 33.......... 2006–2010.......... United States.. Age Group............. 120 Table 32................................ 2006–2010..... United States............ United States..... 119 Table 31.......... 2006–2010... 116 Table 28.................Table 21........................ Primary and Secondary Syphilis—Women—Reported Cases and Rates by State/Area and Region in Alphabetical Order........ Primary and Secondary Syphilis—Reported Cases by Race/Ethnicity................................................. 2006–2010................. Primary and Secondary Syphilis—Reported Cases and Rates Among Men and Women and Male-To-Female Rate Ratios in the Counties and Independent Cities Ranked in the Top 30 for Cases in 2010......... 2006–2010............ Primary and Secondary Syphilis—Rates per 100................ 110 Table 22B...... 111 Syphilis Table 23.. and Sex........... 2006–2010. Primary and Secondary Syphilis—Reported Cases and Rates by State............ Primary and Secondary Syphilis—Reported Cases and Rates by State/Area and Region in Alphabetical Order.......... Gonorrhea—Rates per 100.... 128 xvi STD Surveillance 2010 . United States... 2006–2010...................................... and Sex.......... United States. United States and Outlying Areas..........000 Population by Age Group and Sex.... United States.... All Stages of Syphilis—Reported Cases and Rates by State/Area and Region in Alphabetical Order.... Early Latent Syphilis—Reported Cases and Rates in Selected Metropolitan Statistical Areas (MSAs) in Alphabetical Order................. Primary and Secondary Syphilis—Reported Cases and Rates in Selected Metropolitan Statistical Areas (MSAs) in Alphabetical Order........................... United States and Outlying Areas.. United States and Outlying Areas..... 2010........... 112 Table 24................... United States and Outlying Areas...... 115 Table 27................. United States............ 2010....... 109 Table 22A. 126 Table 37................ United States and Outlying Areas......000 Population by Race/Ethnicity....................... 118 Table 30............. Primary and Secondary Syphilis—Men—Reported Cases and Rates in Selected Metropolitan Statistical Areas (MSAs) in Alphabetical Order.......000 Population by Age Group and Sex.... 2006–2010................. All Stages of Syphilis—Reported Cases and Rates in Selected Metropolitan Statistical Areas (MSAs) in Alphabetical Order........................ 123 Table 35A.......... United States and Outlying Areas.... 2006–2010.... Late and Late Latent Syphilis—Reported Cases and Rates by State/Area and Region in Alphabetical Order....................... United States................... 2006–2010........000 Population by Race/Ethnicity................................................ United States........... Age Group.................. Gonorrhea—Reported Cases and Rates per 100........... 2006–2010.... 2006–2010..... Early Latent Syphilis—Reported Cases and Rates by State/Area and Region in Alphabetical Order.. 2006–2010......................... Primary and Secondary Syphilis—Counties and Independent Cities Ranked by Number of Reported Cases..................... Age Group..............................................................

. United States.............................. Selected STDs and Complications—Initial Visits To Physicians’ Offices............................................................. United States and Outlying Areas.... 144 Government Performance and Results Act (GPRA) Sexually Transmitted Diseases Goals and Measures.. Table 42........ National Disease and Therapeutic Index.. 2010.............................. Table 40............................................ 2006–2010................... Table 41...................... Late and Late Latent Syphilis—Reported Cases and Rates in Selected Metropolitan Statistical Areas (MSAs) in Alphabetical Order.......................Table 39... 2006–2010.......... Ranked by Rates......... Table A4...... United States........ Chancroid Table 43....... United States and Outlying Areas...................................... 2010..... Selected STDs—Percentage of Unknown...... United States....... 2006–2010.... Table A3.... 142 Reported Cases of STDs by Reporting Source and Sex: United States....... Table A2.... 129 Congenital Syphilis—Reported Cases and Rates in Infants by Year of Birth. by State........ 132 Chancroid—Reported Cases and Rates by State/Area in Alphabetical Order.... 2010.......... 130 Congenital Syphilis—Reported Cases and Rates in Infants by Year of Birth by State/Area and Region in Alphabetical Order... 1966–2010.................. 145 STD Surveillance 2010 xvii ........................ Missing................ or Invalid Values for Selected Variables by State and by Nationally Notifiable STD............... 2006–2010.................... United States... 131 Congenital Syphilis—Reported Cases and Rates in Infants by Year of Birth by Race/ Ethnicity of Mother.............. 143 Healthy People 2020 (HP2020) Sexually Transmitted Diseases Objective Status................... 133 Selected STDs Table 44.. 134 Interpreting STD Surveillance Data Table A1............

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Census Regions of the United States West Midwest Northeast South West Midwest South Northeast Alaska Arizona California Colorado Hawaii Idaho Montana Nevada New Mexico Oregon Utah Washington Wyoming Illinois Indiana Iowa Kansas Michigan Minnesota Missouri Nebraska North Dakota Ohio South Dakota Wisconsin Alabama Arkansas Delaware District of Columbia Florida Georgia Kentucky Louisiana Maryland Mississippi North Carolina Oklahoma South Carolina Tennessee Texas Virginia West Virginia Connecticut Maine Massachusetts New Hampshire New Jersey New York Pennsylvania Rhode Island Vermont STD Surveillance 2010 xix .

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During 2006–2010.000 males). reflecting the large number of women screened for this disease (Tables 4 and 5). The continued increase in chlamydia case reports in 2010 most likely represents a continued increase in screening for this usually asymptomatic infection. Parents can better educate their children about STDs and sexual health. and openly discuss ways to protect their health with partners and providers. the District of Columbia. interested. gonorrhea.1% compared with the rate in 2009. the District of Columbia. In 2010. Among men entering the program in 2010 in 48 states.0% (range: 3. communities. and more complete STD Surveillance 2010 national reporting.0 cases per 100.307.893 cases of sexually transmitted Chlamydia trachomatis infection were reported to the Centers for Disease Control and Prevention (CDC) (Table 1). state. and Puerto Rico. the median state-specific chlamydia positivity was 7.000 population. the chlamydia rate in blacks was over eight times the rate in whites. Overview 1 . Puerto Rico. The median state-specific prevalence was 11. when public programs for screening and treatment of women were first established to avert pelvic inflammatory disease (PID) and related complications.2% to 21. Data from multiple sources on the prevalence of chlamydial infection in defined populations have been useful in monitoring disease burden and guiding chlamydia screening programs.2%) (Figure B).6 cases per 100. and Puerto Rico. Working together.8% to 12.2% (range: 1. Rates of reported chlamydial infections among women have been increasing annually since the late 1980s.4% (range: 5. the chlamydia rate in men increased 36. Health providers can assess their patients’ risks and talk to them about testing. and local public support for STD prevention. but it also may reflect a true increase in morbidity. the median state-specific chlamydia prevalence was 7.1 surveillance is a key component of all our efforts to prevent and control these diseases. Individuals can use condoms consistently and correctly. Rates also varied among different racial and ethnic minority populations.4%.7 cases per 100. This is the largest number of cases ever reported to CDC for any condition. the median state-specific chlamydia test positivity was 8. The Hidden Epidemic: Confronting Sexually Transmitted Diseases. an increase of 5. and the Virgin Islands. This case count corresponds to a rate of 426. men are increasingly being tested for chlamydial infection. with the increased availability of urine testing. Several observations for 2010 are worthy of note.2% (range: 2. and individuals can take action to prevent sexually transmitted diseases (STDs) and their related health burdens. and syphilis.5% increase in women during this period.7%) among women aged 15–24 years who were screened at selected family planning clinics in all 50 states. Puerto Rico. local community leaders can promote STD prevention education. The prevalence of infection was greater among economically disadvantaged women aged 16–24 years who entered the National Job Training Program (NJTP) in 2010 in 44 states. As noted in the Institute of Medicine report.3%) (Figure K). However. For example.000 females) was over two and a half times the rate among men (233.7% to 21. and the Virgin Islands (Figures 10 and 11). In 2010. Chlamydia In 2010. the overall rate of chlamydial infection in the United States among women (610. a total of 1. compared with a 19. committed public and private organizations.7%) (Figure L).National Overview of Sexually Transmitted Diseases (STDs). At selected prenatal clinics in 16 states. the District of Columbia. In addition to federal. This overview summarizes national surveillance data for 2010 on the three notifiable diseases for which there are federally funded control programs: chlamydia.8% to 13. 2010 All Americans should have the opportunity to make choices that lead to health and wellness. expanded use of more sensitive tests. in 2010.

In 2010. a total of 13. In 2010. the South had the highest gonorrhea rate among the four regions of the country (Table 14). and in 2000. the median facility-specific chlamydia positivity was 14.8% between 2009 and 2010. Although wide disparities exist in the rates of STDs among racial and ethnic groups. In 2010.5% (range: 4. the overall rate decreased for the first time in 10 years. In 2010. rates for black women aged 15–19 years were 38 times the rate for white women of the same age. Rates in the South and Midwest remained higher than rates in the Northeast and West. South.8 cases per 100. The low rate of syphilis and the concentration of most syphilis cases in a small number of geographic areas led to the development of the National Plan to Eliminate Syphilis from the United States. Since 2002. these disparities have decreased for syphilis over the past 10 years. however. In men. as in previous years. which was announced by the Surgeon General in 1999 and updated in 2006. the cephalosporins remain the only class of antibiotics recommended for the treatment of gonorrhea. syphilis rates increased 75% among black men aged 15–19 years and 134% among those aged 20–24 years. During 1997–2006.Among adolescent females entering selected juvenile corrections facilities.5%). it was the lowest since reporting began in 1941. The percentage of isolates with elevated mean inhibitory concentrations (MICs) to cefixime increased during 2009–2010.3%.7% during 1990–2000. In 2010. in men. Gonorrhea Following a 74% decline in the rate of reported gonorrhea during 1975–1996.0% to 26. rates increased 46% during 2006–2010 and 59% among those aged 20–24 years. the rates in women have been slightly higher than rates in men (Figure 15). the P&S syphilis rate among blacks was eight times the rate among whites.1 in men (Figure 15). gonorrhea rates in women were highest among those aged 15–24 years. After 14 years of decline.774 cases of P&S syphilis were reported to CDC. Antimicrobial resistance remains an important consideration in the treatment of gonorrhea. overall gonorrhea rates plateaued for 10 years. Continued monitoring of susceptibility patterns to these antibiotics is critical. In 2010. As with chlamydia. then increased each year from 2001 through 2009.341 cases of gonorrhea were reported in the United States. the gonorrhea rate in blacks was 18. These data showed a continuing high burden of disease in some adolescents and young adults in parts of the United States. and West. The rate decreased 21% in women but increased slightly. As with chlamydia. The 2010 rate among black men aged 15–19 years was 25 times the rate for white men of that age. Among black women aged 15–19 years. 2 the Gonococcal Isolate Surveillance Project (GISP). when the rate among blacks was 24 times higher than the rate among whites. In 2010. but decreased in the Midwest (Figure 16). With increased resistance to the fluoroquinolones now endemic in the United States.000 population (Figure 14.8%).5% (range: 0.5 cases per 100. Overview STD Surveillance 2010 . The number of cases increased from 2006–2008 but has since decreased with 377 cases reported in 2010. which corresponds to a rate of 100. a 15% decrease since 2008. they were highest among those aged 20–24 years (Figure 19). gonorrhea rates in men and women were similar. In 2010. 1. particularly among isolates from the West and from MSM. data on gonorrhea prevalence in defined populations were available from several sources in 2010. the gonorrhea rate in women was 106. During 2006–2010. and 8 in men who have sex with men (MSM). Syphilis The rate of primary and secondary (P&S) syphilis reported in the United States decreased during the 1990s. which is substantially lower than the disparity observed in 1999. 7 from the West. No isolates with decreased susceptibility to ceftriaxone were seen in 2010 in CDC’s sentinel surveillance system.2 The overall rate of P&S syphilis in the United States declined 89. the number of reported cases of congenital syphilis reached an historic low of 339 cases in 2005. it decreased during 2006–2009 to the lowest rate since national reporting began and then increased 2. In 2010. During 2009–2010 rates increased in the Northeast. Table 1). 9 isolates with decreased susceptibility to cefixime were reported.000 population compared with a rate of 94. a total of 309. the median facility-specific chlamydia positivity was 6.7 times the rate in whites. Among adolescent males entering selected juvenile corrections facilities.5% to 13.

4 While some decreases were observed this year. Atlanta: U. Washington (DC): National Academy Press. These findings highlight the importance of continually reassessing and refining surveillance. Weinstock HS. Am J Pub Health. syphilis rates remain disproportionately high among black men and women. Ann Intern Med. 2011. Swint EB. and control strategies to eliminate syphilis. 4 Heffelfinger JD. Berman SM. 1 Eng TR. Overview 3 .97(6):1076-1083. The hidden epidemic: confronting sexually transmitted diseases. prevention. especially among young MSM. the syphilis rates among all MSM have increased since 2001. p 43. 1997. The national plan to eliminate syphilis from the United States. Beltrami JF. STD Surveillance 2010 3 Su JR. Department of Health and Human Services. 2006. Butler WT.145-151.155 (3). Weinstock HS. Trends in primary and secondary syphilis among men who have sex with men in the United States. 2 Centers for Disease Control and Prevention. Primary and secondary syphilis among black and Hispanic men who have sex with men: case report data from 27 states.3. 2007.Although efforts to eliminate syphilis have focused on racial and ethnic minority populations.S. editors. Institute of Medicine (US). Zaidi AA.

.

NATIONAL PROFILE .

NATIONAL PROFILE .

STD Surveillance 2010 National Profile 5 . and chancroid) by age. syphilis.National Profile The National Profile section contains figures that show trends and the distribution of nationally reportable STDs (chlamydia. gonorrhea. sex. race/ethnicity. and location for the United States.

.

which assesses chlamydia screening coverage of sexually active young women who receive medical care through commercial or Medicaid managed care organizations.307. which are usually asymptomatic.2) (Table 3). In 2010. Chlamydia screening and reporting are likely to continue to expand in response to the Healthcare Effectiveness Data and Information Set (HEDIS) STD Surveillance 2010 annual measure.7 To better monitor trends in disease burden in defined populations during the expansion of chlamydia screening activities.000 population (Figure 1. in part. a total of 1. the lack of awareness among some health care providers and the limited resources available to support these screenings.8 Chlamydia—United States In 2010. Because of the large burden of disease and risks associated with infection. data on chlamydia positivity and prevalence among people screened in a variety of settings are used.7). chlamydial infection can facilitate the transmission of human immunodeficiency virus (HIV) infection.7 cases in Alaska (Figure 3. It is among the most prevalent of all STDs.Chlamydia Background C. women aged 16–20 years in commercial plans had a chlamydia screening coverage rate of 41. This case count corresponds to a rate of 426.1% compared with the rate of 405. pregnant women infected with chlamydia can pass the infection to their infants during delivery. National Profile: Chlamydia 7 . ectopic pregnancy. test positivity serves as a reasonable approximation of prevalence.3 In addition.2 As with other inflammatory STDs. potentially resulting in neonatal ophthalmia and pneumonia.893 chlamydial infections were reported to CDC in 50 states and the District of Columbia (Table 1). Data from a randomized controlled trial of chlamydia screening in a managed care setting suggested that screening programs can lead to as much as a 60% reduction in the incidence of PID. CDC recommends that all sexually active women younger than age 26 years receive an annual chlamydia screening.000 population in New Hampshire to 861.9 per 100. the rate of reported chlamydial infection increased from 160. and improvements in the information systems used for reporting.S. which is a major cause of infertility. Chlamydia by Region During 2001–2010. while those in Medicaid had a rate of 54.4 The increase in reported chlamydial infections during the last 20 years reflects the expansion of chlamydia screening activities. and since 1994.1 Chlamydial infections in women. and chronic pelvic pain. Based on estimates from national surveys conducted from 1999–2008. chlamydia prevalence is 6.0%. During 1990–2010.000 population. Studies also demonstrate the high prevalence of chlamydial infections in the general U. Table 1). trachomatis infection is the most commonly reported notifiable disease in the United States.9 cases per 100.4%.6 In 2009.3). can result in PID. chlamydia rates increased in all regions (Figure 2). In most instances. an increased emphasis on case reporting from providers and laboratories.8% among sexually active females aged 14–19 years. and the West (391.3% in 2000 to 41. population.2 to 426.6% in 2007 among sexually active females aged 16–25 years (or aged 16–26 years during 2000–2002) who were enrolled in commercial or Medicaid health plans in the United States during 2000–2007. the use of increasingly sensitive diagnostic tests. Table 2). Chlamydia by State In 2010. has comprised the largest proportion of all STDs reported to CDC (Table 1). which is an increase of 5. followed by the Midwest (418.0 cases per 100. However.5 The annual chlamydia screening rate increased from 25. chlamydia rates by state ranged from 185. rates were highest in the South (468.0 cases per 100.000 population). the Northeast (392.3 in 2009. many women who are at risk are still not being tested— reflecting.

7 cases per 100. the proportion of cases reported from non-STD clinic sites has continued to increase (Figure 7).4 cases per 100.000 females) was over two and a half times the rate among men (233.7% of chlamydia cases were reported from an STD clinic in 2010 and 26. The lower rates among men also suggest that many of the sex partners of women with chlamydia are not receiving a diagnosis of chlamydia or being reported as having chlamydia. Within these age ranges.Chlamydia by Metropolitan Statistical Area In 2010. In 2010.S.9 cases per 100.000 population.9 cases (Table 7).3 to 233.3%) of 3. non-institutionalized population aged 14–39 years that provides an important measure of chlamydia disease burden. were highest in those aged 20–24 years (1. The rate of chlamydia among blacks was more than eight times the rate among whites (1.8% from the 2009 rate (242.3 cases per 100.7 cases per 100. 762 (24. Chlamydia by County Counties in the United States with the highest chlamydia case rates per 100.700. Over time.378.8% increase over the 2009 rate of 614.7 to 138. Chlamydia by Race/Ethnicity In 2010.8 to 610.000).4% (from 171.000 females) and 20–24 years (3.917.000) was 4. although substantially lower than the rates among women. In contrast. aged 19 years (4.6 cases per 100.5 and 138.5% of chlamydia cases were reported through an STD clinic (Figure 8).000 population in the 50 most populous metropolitan statistical areas (MSAs) increased (Table 6). respectively). Chlamydia by Reporting Source Most chlamydia cases reported in 2010 were from venues outside of STD clinics (Table A2).000 females).187.0 cases per 100. the overall rate of reported chlamydial infection among women in all 50 states and the District of Columbia (610.3 times the rate among whites.000 population were located primarily in the Southeast and West.7 cases per 100.142 counties had rates higher than 400.9 cases per 100.5%. the 2010 rate of 638.9 Prevalence was higher among nonHispanic blacks than non-Hispanic whites in all age groups (Figure 9). chlamydial infection is increasingly being diagnosed in symptomatic and asymptomatic men. rates among blacks increased 26.7 cases per 100.2) increased 6. In 2010.705.000 females).000 females). the reported chlamydial infection rate among men increased 36. among men. chlamydia rates were highest among black men and women (Figure 6.6) (Table 8).7 times the rate among whites.167.6 cases per 100.0 cases per 100.000) was 2. with the advent of highly sensitive nucleic acid amplification tests (NAATs) that can be performed on urine. reported rates 8 were highest among women aged 18 years (4. Table 10).000 was a 3. among women.9% (from 919.167. only 9. The rate among American Indians/Alaska Natives (592. Chlamydia by Sex In 2010. including Alaska (Figure 4). the highest age-specific rates of reported chlamydia in 2010 were among those aged 15–19 years (3. civilian.3% (from 110.8 cases per 100.2% and was similar in males and females (2. Table 11B). However. the overall prevalence of chlamydial infection was 2.6 cases per 100.407.0% and 2.000 females) (Table 12).000 females) (Figure 5.000). 28. During 2006–2010.000 population. Among whites. Most cases among women were reported from private physicians/ health maintenance organizations (HMOs) (37. respectively). Fifty-four counties and independent cities reported 40% of all chlamydia cases in 2010 (Table 9). Among women. rates increased 25.5% increase among women during the same period (from 510. In 2010. During 2006–2010. The 2010 rate among men (259. Tables 4 and 5). Chlamydia Prevalence in the Population The National Health and Nutrition Examination Survey (NHANES) is a nationally representative survey of the U. The rate among Hispanics (369. likely reflecting a larger number of women screened for this infection (Figure 1.5%).5 cases per 100.8 to 1.2 cases per 100.000 males) compared with a 19.5% of chlamydia cases were reported by these MSAs.5 cases per 100. National Profile: Chlamydia STD Surveillance 2010 . Table 10). During 1999–2002. Age-specific rates among men.000 males).0% were reported from private physicians/HMOs. and aged 20 years (4. 57. Chlamydia by Age Among women. the chlamydia rate per 100.000 males) (Figure 5.

Prevention of pelvic inflammatory disease by screening for cervical chlamydial infection. Ann Intern Med. Am J Epidemiol. 6 Centers for Disease Control and Prevention. 1999. but this finding could be a reflection of screening recommendations. NAATs usage was 98% or higher in 2010. Racial differences also persist. MMWR Morb Mortal Wkly Rep. positivity increased through 2009 and then decreased in 2010. 7 National Committee for Quality Assurance.58(14):362-5. In 2010. the District of Columbia. Sexually transmitted diseases treatment guidelines. V. Department of Health and Human Services (HHS) in 1988 as a CDC-supported demonstration project. Screening criteria and practices vary by region and state. 2011. 10 Dicker LW. VII. Sex Transm Infect. Stamm WE. Mosure DJ.Prevalence Monitoring Chlamydia Summary Chlamydia screening and prevalence monitoring activities were initiated in Region X of the U. Puerto Rico. From epidemiological synergy to public health policy and practice: the contribution of other sexually transmitted diseases to sexual transmission of HIV infection. The reported number of chlamydia cases is higher among women. 2011. STD Surveillance 2010 1 2 Centers for Disease Control and Prevention. IV. Levine WC. See Definitions of HHS Regions in the Appendix for details. Mosure DJ. Impact of switching laboratory tests on reported trends in Chlamydia trachomatis infections. to the remaining HHS regions (I. Heidrich FE. and IX). 43-44. chlamydia screening services for women were expanded to three additional HHS regions (III. and the Virgin Islands was 8. Wasserheit JN.0% (range: 3. 1999 to 2002. Papp JR. 2000.60(1):18. and X). and VIII). II. 4 Centers for Disease Control and Prevention. IV. Chlamydia Among Special Populations More information on chlamydia screening programs for women of reproductive age and chlamydia among adolescents. In five HHS regions (I. 5 National Committee for Quality Assurance. racial/ethnic groups.34(21):1362-6.7%) (Figures 10 and 11). Washington (DC): National Committee for Quality Assurance. Erratum in: MMWR Recomm Rep. which may be attributable to an increase in reported tests in 2010 due to the implementation of an electronic data system. The remaining two regions (II and IX) used NAATs more than 93% of the time in 2010. In some regions. 1996.147(2):89-96.S. N Engl J Med. 2000–2007. p. NAATs were used nearly exclusively during 2006–2010. 2010. Andrilla H. 3 Fleming DT. Gonorrhea and chlamydia in the United States among persons 14 to 39 years of age. 2009. federally funded chlamydia screening supplements local. 2007. 2010.59(RR-12):1-110. In three other regions (III. Chlamydia screening among sexually active young female enrollees of health plans — United States. Levine WC.25:251-3. CDC Grand Rounds: Chlamydia prevention: challenges and strategies for reducing disease burden and sequelae. and VIII) and in 1995. 9 Datta SD. and both sexes. et al. V. MMWR Morb Mortal Wkly Rep. VI. Chlamydia positivity versus prevalence: what’s the difference? Sex Transm Dis. Chlamydia test positivity among women aged 15–24 years screened in family planning clinics increased in most HHS regions during 2006–2010 (Figure 12). especially those of younger age (15–19 and 20–24 years). Using more sensitive tests has been shown to affect positivity. McQuillan G. Sternberg M.and state-funded screening programs. Holmes KK. Berman SM. geographic areas. the median state-specific chlamydia test positivity among women aged 15–24 years who were tested during visits to selected family planning clinics in all 50 states. Johnson RE. trachomatis infections remain high among most age groups. VII. Scholes D. Washington (DC): National Committee for Quality Assurance. Black CM. The state of healthcare quality 2010.10 Use of NAATs in family planning clinics to screen women aged 15–24 years for chlamydia is increasingly widespread (Figure 13). 2009. In region IX. The positivity trend data in Figure 10 and Figure 12 are not adjusted for changes in laboratory test methods and associated increases in test sensitivity. and people in corrections facilities is presented in the Special Focus Profiles. Both test positivity and the number of reported cases of C. p. minority populations. rates among blacks continue to be substantially higher than rates among other racial/ethnic groups. HEDIS 2010: technical specifications. No. Stergachis A. VI. In 1993. National Profile: Chlamydia 9 . 8 Dicker LW.60(12):370-3.75:3-17. 89-92. Berman S. 1998.151(4):430-5.8% to 13.

Figure 1.

Chlamydia—Rates by Sex, United States, 1990–2010

Rate (per 100,000 population)
750
Men
Women
Total

625
500
375
250
125
0

1990

1992

1994

1996

1998

2000

2002

2004

2006

2008

2010

Year
NOTE: As of January 2000, all 50 states and the District of Columbia have regulations that require the reporting of chlamydia cases.

Figure 2.

Chlamydia—Rates by Region, United States, 2001–2010

Rate (per 100,000 population)
500

400750
625
300
500
200

West
Midwest
Northeast
South

375

100
250
0
125
0

10

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

Year
1990

1992

1994

1996

1998

2000

National Profile: Chlamydia

2002

2004

2006

2008

2010

STD Surveillance 2010

Figure 3.

Chlamydia—Rates by State, United States and Outlying Areas, 2010

320
316

372

290

323
272

Guam
504

388
366
407

411

393

240

407

387

351
470 355

341

534

862
464

649

Puerto Rico
150

574

202
186
320
330
360
300
504
460
932

213 391
448

450
726

484

377

443

380

435

388

583

511

496

285

VT
NH
MA
RI
CT
NJ
DE
MD
DC

196

582
459

Rate per 100,000
population

<300.0

(n = 10)

300.1–400.0 (n = 18)
Virgin
Islands
555

403

>400.0

(n = 26)

NOTE: The total rate of chlamydia for the United States and outlying areas (Guam, Puerto Rico, and Virgin Islands) was 422.6 per 100,000 population.
For more information on chlamydia reporting, see Chlamydia Morbidity Reporting in the Appendix.

Figure 4.

Chlamydia—Rates by County, United States, 2010

Rate per 100,000
population

<300.0

(n = 1,962)

300.1–400.0 (n = 418)
>400.0

STD Surveillance 2010

National Profile: Chlamydia

(n = 762)

11

Figure 5.

Chlamydia—Rates by Age and Sex, United States, 2010

Men
3,700

Rate (per 100,000 population)
2,960

2,220

1,480

740

0

774.3
1,187.0

740

1,480

153.2
91.3
39.3
10.9
2.8
233.7

2,960

3,700
3,378.2

20–24

3,407.9
1,236.1

30–34

309.0

2,220

15–19

25–29

598.0

Figure 6.

Age 0

Women

530.9

35–39
40–44

220.1
94.7

45–54

32.8

55–64

9.3

65+

2.1

Total

610.6

Chlamydia—Rates by Race/Ethnicity, United States, 2001–2010

Rate (per 100,000 population)
1500

American Indians/Alaska Natives
Asians/Pacific Islanders
Blacks
Hispanics
Whites

1200

900

600

300

0

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

Year

12

National Profile: Chlamydia

STD Surveillance 2010

Men Non-STD Clinic. Women 400 300 200 100 0 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Year Figure 8. NOTE: These categories represent 72. STD Surveillance 2010 National Profile: Chlamydia 13 . Of all cases. 11. Chlamydia—Percentage of Reported Cases by Sex and Selected Reporting Sources.5% of cases with a known reporting source. 2001–2010 Cases (in thousands) 800 700 600 500 Non-STD Clinic. Men STD Clinic.6% had a missing or unknown reporting source. 2010 Percentage 40 Private Physician/HMO* 35 STD Clinic 30 Other HD* Clinic Family Planning Clinic 25 Emergency Room 20 15 10 5 0 Men Women * HMO = health maintenance organization. United States. Chlamydia—Cases by Reporting Source and Sex.Figure 7. HD = health department. United States. Women STD Clinic.

et al.Figure 9. Figure 10. 14 National Profile: Chlamydia STD Surveillance 2010 .147(2):89-96. United States. 2007. Berman S. Ann Intern Med. the District of Columbia. Johnson RE. SOURCE: Datta SD. reported chlamydia positivity data. % 10 8 6 4 2 0 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Year NOTE: As of 1997. Infertility Prevention Project. Chlamydia—Median State-specific Positivity Rates Among Women Aged 15–24 Years Tested in Family Planning Clinics. See Definition of HHS Regions in the Appendix for definitions. McQuillan G.S. and outlying areas. Department of Health and Human Services (HHS) regions. Chlamydia—Prevalence by Age Group and Race/Ethnicity. all 10 U. Sternberg M. 1999 to 2002. Gonorrhea and chlamydia in the United States among persons 14 to 39 years of age. % 16 Non-Hispanic Whites Non-Hispanic Blacks Mexican-Americans 12 8 4 0 14–19 20–29 30–39 Age NOTE: Error bars indicate 95% confidence interval. which represent all 50 states. 1999–2002 Prevalence. 1997–2010 Median State-Specific Positivity Rate. National Health and Nutrition Examination Survey. Papp JR.

5 6.8 7.6 9.5 7.5 8.7 Virgin Islands 12.0 06 07 08 09 10 Region II III VII 7.5 VT NH MA RI CT NJ DE MD DC 5.3 7. United States and Outlying Areas.3 6.0 (n = 11) NOTE: Includes states and outlying areas that reported chlamydia positivity data on at least 500 women aged 15–24 years screened during 2010.6 7.3 8.8 10.6 11.8 7.1 13. Department of Health and Human Services (HHS) Region.1 5.3 5.2 9.7 8.6 7.3 7.5 6.8 10.0 7. 2006–2010 5.8 7. by U.4 5.1 8.4 7.8 >10.9 8. Infertility Prevention Project.9 7.5 12.3 7.2 7.6 5.8 6. 2010 6.8 06 06 07 08 09 10 06 07 08 09 10 Region V Region I 07 08 09 10 Region X 6.0 8.4 9.6 9.9 6.0 Positivity.8 4.Figure 11.6 4.8 6.2 6.6 8. Chlamydia—Trends in Positivity Rates Among Women Aged 15–24 Years Tested in Family Planning Clinics.0 6.8 8.2 06 07 08 09 10 Region VI* 9.7 06 07 08 09 Region VII 10 10.2 6.0 <5.0 9.1 Guam 396 9.3 06 II I IV 5.6 8.3 7. STD Surveillance 2010 National Profile: Chlamydia 15 . % 11.6 7. Infertility Prevention Project.7 4.3 8.8 7.0 9.9 8.3 11.3 6.4 06 07 08 09 10 Region III Region VIII 6.4 6.6 7.8 Puerto Rico 7.5 06 07 08 09 X 10 V VIII Region IX IX 07 08 09 VI 10 5. NOTE: See Definition of HHS Regions in the Appendix for definitions.S.3 7.0–9.4 6.7 12.1 13.7 5.2 11.0 4.2 8.4 06 07 08 09 10 Region IV * 2009 percent positivity for Region VI previously published in the 2009 Surveillance report has been corrected. by State.5 7.6 7.6 8.7 12.9 (n = 37) 8.4 9. Figure 12.6 5.2 9.6 8.8 7.7 6.0 6.3 6.0 (n = 5) 5.8 4.7 8.3 3. Chlamydia—Positivity Among Women Aged 15–24 Years Tested in Family Planning Clinics.5 6.2 5.6 7.0 6.9 4.8 5.0 10.

S. 16 National Profile: Chlamydia STD Surveillance 2010 . Infertility Prevention Project.Figure 13. Department of Health and Human Services (HHS) Region. Percentage 100 80 60 40 20 0 06 07 Chlamydia—Percentage of Nucleic Acid Amplification Tests Used Among Women Aged 15–24 Years Tested in Family Planning Clinics. 2006–2010 08 Region I Percentage 100 80 60 40 20 0 06 07 08 Region V 09 09 10 Percentage 100 80 60 40 20 0 06 07 10 Percentage 100 80 60 40 20 0 06 07 Percentage 100 80 60 40 20 0 06 08 09 10 Region II 08 09 10 Region III 08 09 10 08 09 10 Region VI Percentage 100 80 60 40 20 0 06 07 Percentage 100 80 60 40 20 0 06 07 08 Region VII Percentage 100 80 60 40 20 0 06 07 08 09 10 09 10 Region IV 09 10 Percentage 100 80 60 40 20 0 06 07 08 Region VIII Percentage 07 08 Region IX 09 10 100 80 60 40 20 0 06 07 Region X NOTE: See Definition of HHS Regions in the Appendix for definitions. by U.

5 The threat of cephalosporin resistance highlights the need for continued surveillance of N. This is the lowest rate since recording of gonorrhea rates began.8 per 100. and decreased 6. The combination of persistently high gonorrhea morbidity in some populations and threat of cephalosporin-resistant gonorrhea reinforces the need to better understand the epidemiology of gonorrhea. followed by the Midwest (108. The rate increased slightly in 2010 to 100.000 population.1 Although an individual’s sexual behavior can increase the risk of acquiring gonorrhea. and South (2. as in previous years.341 cases reported in the United States (Figure 14 and Table 1). epidemiologic and biologic studies provide strong evidence that gonococcal infections facilitate the transmission of HIV infection. such as tubal infertility. In addition. and chronic pelvic pain.3 For these reasons. gonorrhea rates decreased further to 98. and West (58. like those resulting from C. plus the District of Columbia.1%). PID can lead to serious outcomes in women. gonorrhea rates decreased in the Midwest (Figure 16). Gonorrhea—United States In 2010.2 cases per 100.8% since 2009.000 population ranged by state from 7.341 cases of gonorrhea were reported in the United States. the number of gonorrhea cases reported to CDC is affected by many factors in addition to the actual occurrence of the infection within the population. Gonorrhea by Region In 2010. such as poverty. the reporting of gonorrhea cases to STD Surveillance 2010 CDC is incomplete.9 in Mississippi (Figure 17.4%).. Northeast (77. During 2009–2010. Infections due to Neisseria gonorrhoeae. gonorrhea rates per 100. reported an increase in gonorrhea rates (Table 14). The increase in gonorrhea rates during 2009–2010 was observed among men and women (Figure 15) and among all racial/ethnic groups (Figure 22).Gonorrhea Background Gonorrhea is the second most commonly reported notifiable disease in the United States. Table 14).4).5). National Profile: Gonorrhea 17 .2 During 1975–1997. the national gonorrhea rate declined 74% after implementation of the national gonorrhea control program in the mid-1970s (Figure 14). Although gonorrhea case reporting is useful for monitoring disease trends. 59% (30/51) of states.8% overall during 2006–2010. gonorrhoeae infections and broader use of nucleic acid amplification tests [NAATs] at non-genital anatomic sites). Changes in the burden of gonorrhea may be masked by changes in screening practices (e.5% in the Midwest (Figure 16. yielding a rate of 100. Most recently. rates increased in the Northeast. may contribute to the burden of gonorrhea in a community. and West.g. ectopic pregnancy. are a major cause of PID in the United States. Gonorrhea by State In 2010. the rate decreased 15. South. trachomatis. During 2009–2010. West (11. rates increased in the Northeast (15.7) (Table 14). fluoroquinolone resistance emerged and resulted in the availability of only a single class of antibiotics that meet CDC’s efficacy standards— the cephalosporins. the use of diagnostic tests with different test performance.4.8 cases per 100. and changes in reporting practices. During 2009–2010. a total of 309. As with other STDs.3 in Wyoming to 209. After the decline halted for several years.000 population) among the four regions of the United States.000 population (Table 1). social determinants of health.1 cases in 2009. gonorrhoeae antibiotic susceptibility. the South had the highest gonorrhea rate (134. with 309. Table 13). supplemental data on gonorrhea prevalence in persons screened in a variety of settings are useful in assessing the burden of disease in selected populations. Neisseria gonorrhoeae has progressively developed resistance to each of the antibiotics used for treatment of gonorrhea. The rate increased 2. however. screening for chlamydia with tests that also detect N.5%).

8) and American Indian/Alaska Native women (133.5%). Among blacks. gonorrhea rates increased among American Indians/Alaska Natives (21. women (145. Among whites aged 15–29 years. gonorrhea rates among women and men increased in the Northeast.408 counties (44.8%) in the United States had a rate less than or equal to 19 cases per 100.3%) (Figure 22).000 population). 18 Among men and women. and 65 years and greater (7. The total gonorrhea rate among women in these MSAs in 2010 (113. rates were higher among men than women. Gonorrhea by Race/Ethnicity and Sex Gonorrhea rates were higher in women than men among whites.0). 61. The rate among blacks was 18.1%) (Table 21).7) (Tables 18 and 19).7).000 population (Figure 18). Ten counties in Alaska had rates greater than 100 cases per 100. Gonorrhea rates were highest among black men (433.0) (Figure 19. During 2009–2010.Gonorrhea by Metropolitan Statistical Area The overall gonorrhea rate in the 50 most populous MSAs was 113.9 cases per 100. National Profile: Gonorrhea STD Surveillance 2010 .1 per 100. men had higher rates than women among those aged 30 years and older. Figure P).000 population in 2010 (Table 17). and Asian/Pacific Islanders. the rate was highest among those aged 20–24 years (421.1 to 100 per 100.5) and American Indian/Alaska Native men (77.6) was similar to rates among men (113. the gonorrhea rate was 106. Among blacks. gonorrhea rates were highest among adolescents and young adults.000 population among men (Tables 15 and 16). In 2010. Most counties with more than 100 cases per 100. and decreased in the Midwest (Tables 15 and 16). aged 15–39 years. Gonorrhea by Sex Before 1996. In 2010.1 per 100.2 times those of whites (Figure 22.6 times those of whites. Hispanics (11. the highest rates were observed among women aged 15–19 years (570.000 population among women and 94. whites (9. In 2010. 50% of reported gonorrhea cases occurred in just 63 counties or independent cities (Table 20).000 population were located in the South. Gonorrhea rates among American Indians/Alaska Natives (105. and West.000 population in 1. During 2009–2010. Table 21).7 times the rate among whites (23. Rates ranged from 19. In 2010.6%). rates were similar among women and men. Among American Indians/ Alaska Natives. Decreases were observed among those aged 35–39 years (1.2%) and more than 100 cases per 100. gonorrhea rates remained highest among blacks (432.2% of gonorrhea cases were reported by these MSAs (Table 17). Gonorrhea by County In 2010. women had higher rates than men. Hispanics.1) in the South had the highest gonorrhea rates.9) and 20–24 years (560.8% for women) (Figures 20 and 21).9) were 2.9%).2) and men (121. Asian/Pacific Islanders (13. gonorrhea rates increased among most age groups. Among men. The largest increases were observed among those aged 20–24 years (4. Rates have been higher among women since 2002.7) were 4.5%).9%).6) and black women (430. During 1997–2001. Hispanics. aged 25 years and older. Gonorrhea by Region and Sex During 2009–2010.5 cases per 100.5 cases per 100. South. More information on gonorrhea rates among racial/ ethnicity groups can be found in the Special Focus Profiles.000 population) (Figure 22). Hispanics. and rates among Hispanics (49. and blacks (0. representing a 4. rates were higher among women than men.1%).9%) and 30–34 years (3. gonorrhea rates were higher among men than women (Figure 15). 1. the largest increases were among those aged 20–24 years (6. Gonorrhea by Age In 2010. In 2010.4% rate increase from 2009 (109.0%). and American Indians/Alaska Natives in 2010 (Figure Q).000 population.1). Gonorrhea by Race/Ethnicity In 2010.2% for men and 3.107 counties (35.000 population in 627 counties (19. and Asians/Pacific Islanders aged 15–24 years. 55–64 years (1.2%). rates were higher among women than men (Table 22B).

28.1%) (Figure 26).5 µg/ml) were seen in 2010. Susceptibility testing for an additional oral cephalosporin. the median state-specific gonorrhea test positivity among women aged 15–24 years screened in selected family planning clinics in 47 states.06 µg/ml and 0. Across all SSuN jurisdictions in 2010. family planning clinics (10. was started in 2009. STD clinics were the most common reporting source (30. and emergency rooms (5.6% of gonorrhea cases were reported by STD clinics.2% of gonorrhea cases were estimated to be among MSM. susceptibility testing for this oral cephalosporin antibiotic was restarted in 2009. Other common reporting sources for males were private physicians/HMOs (22. Positivity data from gonorrhea tests are primarily available from family planning clinics. gonorrhoeae in the United States. STD Surveillance 2010 National Profile: Gonorrhea 19 .7% among women.5% of gonorrhea cases were reported by STD clinics (Table A2). Interpreting STD Surveillance Data. The proportion of isolates with MICs of 0. and women varied substantially across collaborating sites (Figure 25). 1987.0%). was established to monitor trends in antimicrobial susceptibilities of strains of N.5 µg/ml). cefpodoxime.0% to 4. had the highest proportion of estimated MSM cases (83%). and 46.Gonorrhea by Reporting Source The number of gonorrhea cases reported by STD clinics declined during 2001–2010 (Figure 23).0%) were the most common reporting source. followed by STD clinics (13. Cincinnati. Among men. gov/std/GISP. In 2010. 1997. More information about 2010 GISP data can be found at http://www. The locations and years of these isolates were San Diego. Prevalence Monitoring In 2010.10 Data are collected from selected STD clinics at 25–30 GISP sentinel sites and from 4–5 regional laboratories (Figure 27). private physicians or HMOs (29. In 2010.9%. the burden of disease represented by MSM. Susceptibility to Ceftriaxone Susceptibility testing for ceftriaxone began in 1987. SSuN collaborators interviewed 3.8%). other health department clinics (9. With the renewed availability of cefixime. Screening criteria and practices vary by state and over time.125 µg/ml did not change.6%). San Francisco County. and Philadelphia. 1992 and 1993. During 2009–2010. Gonococcal Isolate Surveillance Project Antimicrobial resistance remains an important consideration in the treatment of gonorrhea.25 µg/ml increased slightly from 0% in 2009 to 0. Additional information about SSuN methodology can be found in the STD Surveillance Network section of the Appendix.4–9 In 1986. Figure 28 displays the distribution of minimum inhibitory concentrations (MICs) to ceftriaxone among GISP isolates during 2006–2010. while the lowest proportion of morbidity estimated to be attributed to MSM was found in Jefferson County (Birmingham).6%) (Figure 24). the District of Columbia. This is a decrease from 2009. the proportion of isolates with MICs of 0. Puerto Rico. MSW. Based on these enhanced interviews.6%).4%) (Figure 24). 21. other health department clinics (8.446 gonorrhea cases representing 5% of total morbidity across participating jurisdictions. and family planning clinics (4.8% (range: 0. In 2010.3%). Information on the GISP antimicrobial susceptibility criteria used can be found in the Gonococcal Isolate Surveillance Project section of the Appendix. a national sentinel surveillance system.cdc. among women.8% among MSW. emergency rooms (5. and the Virgin Islands was 0. GISP has reported four isolates with decreased susceptibility to ceftriaxone (MIC of 0.0%). Alabama at 2.6%) (Figure 24). Interpreting STD Surveillance Data. This project provides more complete estimates of case characteristics often missing on routine case reports—such as gender of sex partners—which is essential for better targeting of gonorrhea control efforts. No isolates with decreased susceptibility to ceftriaxone (MIC ≥ 0. 23. when 22. the Gonococcal Isolate Surveillance Project (GISP).05% (n = 3) in 2010. STD Surveillance Network The STD Surveillance Network (SSuN) is a network of 12 states and independently funded cities collecting enhanced information on a representative sample of gonorrhea cases reported to the state or city health department from all reporting sources.

5 µg/ml (0.5% were from the West and 82. then in the Western states. tetracycline. 9 (0.6% by 2009.8 Figure 29 displays the distribution of MICs to cefixime among GISP isolates in 2006. 37. Since 1999.0–4.1% to 0. first in Hawaii and the Pacific Islands. During 2009–2010. and was restarted in 2009.9% of isolates from men who have sex exclusively with women were identified as QRNG. In 2010.2%). 23.2%).5 µg/ ml). and 8 (0.2% of isolates collected from GISP sites were resistant to penicillin.9% had MICs to cefpodoxime less than or equal to 0.9% had MICs of 0. and 1. 76.6%). 27.0 µg/ml to azithromycin decreased from 0.125 µg/ml.9%) isolates with decreased susceptibility to cefixime were from MSM. 58.2% during 2008–2009. 2009. Los Angeles.0 µg/ml.9% in 2006 and then decreased to 20. then among MSM. In 2010. Honolulu in 1989. and increased to 0.1%) isolates had MICs of 16. and San Francisco) and 2 were from the Midwest (Chicago and Cleveland). ciprofloxacin. Other Antimicrobial Susceptibility Testing Overall in 2010. The proportion of GISP isolates with MICs of ≥ 2. There were 70 (1.25 µg/ml (0. increases were observed in the proportion of isolates with MICs of 0.4 The proportion of GISP isolates identified as QRNG peaked in 2007 at 14. Of 5. fluoroquinolone-resistant Neisseria gonorrhoeae (QRNG) prevalence steadily increased.4% were from MSM.2%) isolates had MICs to azithromycin of 8. Quinolone-resistant Neisseria gonorrhoeae by Sex of Sex Partner The prevalence of QRNG in isolates from MSM peaked at 38. The percentage of isolates with elevated MICs (> 0. GISP has reported five spectinomycin-resistant isolates—from St. Louis in 1988. Of these 17 isolates. San Francisco in 1989.0 µg/ml). Susceptibility to Cefpodoxime GISP began monitoring cefpodoxime susceptibility in 2009. Since 2000. All isolates were susceptible to spectinomycin in 2010.250–0. Portland.03–0. Figure 30 displays the distribution of MICs to azithromycin among GISP isolates during 2006–2010. Nine isolates with decreased susceptibility to cefixime were reported in 2010—seven were from the West (Honolulu. particularly among isolates from the West and men who have sex with men (MSM).5 µg/ml. In 2010.693 GISP isolates tested for cefpodoxime susceptibility in 2010. and 2010.25 µg/ml) to cefixime increased during 2006–2010. 20 Susceptibility to Ciprofloxacin Resistance to ciprofloxacin (a fluoroquinolone antimicrobial) was first identified at GISP sites in 1991.5% in 2010. Long Beach in 1990. was discontinued in 2007. The proportion decreased to 9.125 µg/ml (1. or some combination of those antibiotics (Figure 32). 0. eight (88.5% in 2007 to 0.9% had MICs of 0. National Profile: Gonorrhea STD Surveillance 2010 .Susceptibility to Cefixime Susceptibility to Spectinomycin Susceptibility testing for cefixime began in 1992. Susceptibility to Azithromycin GISP began monitoring azithromycin susceptibility in 1992.11.12 and eventually among all populations in all regions of the United States.2%) isolates with decreased susceptibility to cefpodoxime (MICs of 1.015 µg/ml.7% to 1. and 0. and West Palm Beach in 1994.1% by 2009.0 µg/ml.8% (Figure 31).5% in 2010.9% of isolates from MSM and 7. GISP has reported 20 isolates with decreased susceptibility to cefixime (MICs of 0.4% to 1. and increased to 12.

During 2010.2%). 3 American Social Health Association. JAMA. Kaufman JS. Harvey AB.RR-12).60:873-7. decreased during 2006–2009. 2004. 2003. MMWR Morb Mortal Wkly Rep. similar to the proportion in 2009 (96. 5 Centers for Disease Control and Prevention. Knapp JS. Conner SM. Zhou L. Wang SA. The proportion treated with cefixime decreased from 13. and revised recommendations for gonorrhea treatment. Whittington WL. 4 Centers for Disease Control and Prevention.Gonorrhea Among Special Populations Antimicrobial Treatments Given for Gonorrhea The antimicrobial agents given to GISP patients for gonorrhea therapy are shown in Figure 33.75(1):3-17. 96. or levofloxacin) and 1. Gesink DC. 1990. Sexually transmitted diseases in America: how many cases and at what cost? Menlo Park (CA): Kaiser Family Foundation. 2011. In 2010. Increases in fluoroquinolone-resistant Neisseria gonorrhoeae among men who have sex with men — United States.2% in 2008 to 7. Zenilman J. 12 Centers for Disease Control and Prevention.6% were also treated with doxycycline.8% in 2010. Are neighborhood sociocultural factors influencing the spatial pattern of gonorrhea in North Carolina? Ann Epidemiol 2011. 23.9% in 2009 to 46. Ballard RC. MMWR Morb Mortal Wkly Rep.1% were also treated with another antibiotic. 7 2 Sullivan AB. and 1. MMWR Morb Mortal Wkly Rep. 1988 to 2003: the spread of fluoroquinolone resistance.4% in 2010. 2010. MSM. MMWR Morb Mortal Wkly Rep. Cephalosporin susceptibility among Neisseria gonorrhoeae isolates — United States.51:1041-4. Neisseria gonorrhoeae with reduced susceptibility to azithromycin — San Diego County.59(No. ofloxacin. 2004.56:332-6.13:196204. 2011. 75. Among patients treated with a cephalosporin.5% of GISP patients were treated with fluoroquinolones (ciprofloxacin.3% were also treated with azithromycin. among adolescents and young adults.000 population for 10 years during 1996– 2006. 2007. National Profile: Gonorrhea 21 . Wasserheit JN. 1 Fleming DT.7% were treated with azithromycin monotherapy. and some racial/ethnic groups. Gonorrhea Summary The national gonorrhea rate fluctuated at about 115 cases per 100. and increased slightly in 2010. the proportion treated with ceftriaxone 125 mg decreased from 53. High rates persist in some geographic areas.1% did not receive a second antibiotic. 2010. The GISP continues to monitor for the emergence of decreased susceptibility and resistance to cephalosporins and azithromycin. Zaidi AA.60:579-81. et al. 1999. et al. 10 Schwarcz S. More information about gonorrhea in racial/ethnic groups. 0. 2009. Antimicrobial resistance for Neisseria gonorrhoeae in the United States. Sexually transmitted diseases treatment guidelines. From epidemiological synergy to public health policy and practice: the contribution of other sexually transmitted diseases to sexual transmission of HIV infection. 11 Centers for Disease Control and Prevention. Sex Transm Infect. Increases in fluoroquinolone-resistant Neisseria gonorrhoeae — Hawaii and California.Fitch M. Update to CDC’s sexually transmitted diseases treatment guidelines. 2002.147:81-9.53:335-8. Dowell D. 2000–2010. Knapp JS. Schnell D. women of reproductive age. Ann Intern Med.9% in 2010. National surveillance of antimicrobial resistance in Neisseria gonorrhoeae.264:1413-7. 21:245-252. 1998. Brown P. 2001. Thompson S. MMWR Morb Mortal Wkly Rep. adolescents.6% in 2009 to 37. 6 STD Surveillance 2010 Centers for Disease Control and Prevention. 2007. et al. Hook EW 3rd. California. Gonococcal Resistance: Are Cephalosporins Next? Curr Infect Dis Rep. The proportion treated with ceftriaxone 250 mg increased from 21. 2006: fluoroquinolones no longer recommended for treatment of gonococcal infections. 0. 8 Centers for Disease Control and Prevention. 9 Kirkcaldy RD. and other populations at higher risk can be found in the Special Focus Profiles.5% of GISP patients were treated with cephalosporins. 2011. MMWR Recomm Rep.

1990–2010 Rate (per 100.000 population) 400 Men Women Total 300 200 100 0 1990 1992 1994 1996 1998 2000 2002 2004 2006 2008 2010 Year 22 National Profile: Gonorrhea STD Surveillance 2010 . 1941–2010 Rate (per 100. United States.000 population) 500 400 300 200 100 0 1941 1946 1951 1956 1961 1966 1971 1976 1981 1986 1991 1996 2001 2006 Year Figure 15. Gonorrhea—Rates. United States.Figure 14. Gonorrhea—Rates by Sex.

5 9.1 73.9 101.3 58.7 27.000 population.7 136.9 122.5 Guam 54.1–100.5 28.6 per 100.3 11.4 71. 2001–2010 Rate (per 100.0 10. STD Surveillance 2010 National Profile: Gonorrhea 23 . Puerto Rico.4 7.6 66.2 40.6 165.2 59.3 108.8 93.5 Rate per 100. 2010 43.1 168.1 9.000 population <19.5 61.1 350. Gonorrhea—Rates by State.0 209.0 (n = 8) 19. United States and Outlying Areas.0 57.3 VT NH MA RI CT NJ DE MD DC 12.9 118.4 37.7 161.0 (n = 23) >100.1 142.Figure 16.7 113.0 (n = 23) NOTE: The total rate of gonorrhea for the United States and outlying areas (Guam.2 119. and Virgin Islands) was 99.8 Virgin Islands 137.9 150.9 100.2 90.9 128. United States. Gonorrhea—Rates by Region.6 93.3 55.3 65.4 114.7 102.5 182.1 49.4 Puerto Rico 7.5 31.3 198.9 31.4 174.000 population) 300 West Midwest Northeast South 250 200 150 100 50 0 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Year Figure 17.6 73.5 11.1 130.0 67.

000 population) 600 450 300 150 0 253.5 Total National Profile: Gonorrhea 106.0 (n = 1.408) 19.1 11.5 600 560.2 40–44 34.1 107.0 24 (n = 627) 48.1–100.4 Age 0 15–19 150 Women 300 64.2 23.3 30–34 146. United States.Figure 18.0 55–64 1.9 65+ 0.1 45–54 750 226. 2010 Rate per 100.3 450 570.9 20–24 421.0 2.000 population <19. 2010 Men 750 Rate (per 100.107) >100.0 Figure 19.5 35–39 85.7 25–29 241. Gonorrhea—Rates by County.0 (n = 1.8 9.5 STD Surveillance 2010 . Gonorrhea—Rates by Age and Sex. United States.4 94.

Gonorrhea—Rates by Age Among Men Aged 15–44 Years. 2001–2010 Rate (per 100. United States. United States.000 population) 750 600 Age Group 15–19 20–24 25–29 30–34 35–39 40–44 2007 2009 450 300 150 0 2001 2002 2003 2004 2005 2006 2008 2010 Year STD Surveillance 2010 National Profile: Gonorrhea 25 . Gonorrhea—Rates by Age Among Women Aged 15–44 Years. 2001–2010 Rate (per 100.Figure 20.000 population) 1000 Age Group 30–34 35–39 40–44 15–19 20–24 25–29 800 600 400 200 0 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Year Figure 21.

Women 160 120 80 40 0 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Year 26 National Profile: Gonorrhea STD Surveillance 2010 . United States. Men Non-STD Clinic. 2001–2010 Rate (per 100. 2001–2010 Cases (in thousands) 200 Non-STD Clinic.Figure 22. Women STD Clinic. 2002 2003 2004 2005 Year 2006 2007 2008 2009 2010 Gonorrhea—Cases by Reporting Source and Sex. Gonorrhea—Rates by Race/Ethnicity. Men STD Clinic.000 population) 600 500 400 American Indians/Alaska Natives Asians/Pacific Islanders Blacks Hispanics Whites 300 200 100 0 2001 Figure 23. United States.

Note: See Appendix for included jurisdictions within each state. United States. 2010 Percentage 100 MSM MSW Women 80 60 40 20 0 San California‡ Colorado Francisco Washington Chicago Louisiana Alabama Virginia Baltimore Philadelphia New Connecticut York City * MSM = men who have sex with men.2% had a missing or unknown reporting source.* and Women Among Interviewed† Gonorrhea Cases by Site. 13. 2010 Percentage Private Physician/HMO* 35 STD Clinic 30 Other HD* Clinic Family Planning Clinic 25 Emergency Room 20 15 10 5 0 Men Women * HMO = health maintenance organization. MSW = men who have sex with women only. HD = health department. Of all cases.5% of cases with known reporting source. † SSuN interviews conducted from a randomly selected patient population with gonorrhea (n = 3.446). Figure 25. STD Surveillance 2010 National Profile: Gonorrhea 27 . STD Surveillance Network (SSuN)—Proportion of MSM. ‡ California data excludes San Francisco. Gonorrhea—Percentage of Reported Cases by Sex and Selected Reporting Sources.* MSW. NOTE: These categories represent 69.Figure 24.

3 0.2 0. Gonorrhea—Positivity Among Women Aged 15–24 Years Tested in Family Planning Clinics.4 0.6 0.5 0.9 0.6 1.4 0.2 Puerto Rico 0.1 1.1 2.9 (n = 13) >2.2 0.7 2.2 0.2 1. 2010 Seattle Portland Minneapolis Denver San Francisco Detroit Chicago Kansas City Cleveland Cincinnati Baltimore Richmond Las Vegas Los Angeles Orange Co.8 0.0 (n = 9) * States/areas not meeting minimum inclusion criteria.0 (n = 28) 1.3 2.3 0.4 0. United States and Outlying Areas. Figure 27.7 1.7 2.3 1.9 0. Gonococcal Isolate Surveillance Project (GISP)—Location of Participating Sentinel Sites and Regional Laboratories.8 0.9 Positivity.5 2.2 2.0 1.3 0.1 * (n = 3) <1.Figure 26. Albuquerque San Diego Phoenix New York City Philadelphia Greensboro Oklahoma City Birmingham Atlanta Sentinel Sites Dallas New Orleans Sites and Regional Labs Tripler AMC Honolulu Miami 28 National Profile: Gonorrhea STD Surveillance 2010 . % 2.2 0.3 Virgin Islands 3.1 0.1 0. NOTE: Includes states and outlying areas that reported positivity data on at least 500 women aged 15–24 years who were screened during 2010.1 0.0 VT NH MA RI CT NJ DE MD DC 0.8 0.3 0. United States.5 0.2 1.0–1.4 1.2 1. Infertility Prevention Project. 2010 0.6 1.9 4.1 1.4 0.4 0.8 0.8 1. by State.3 1.

03 0.125 0.03 0.125 0. 2006–2010 Percentage 100 2006 2007 2008 80 2009 2010 60 40 20 0 <0. STD Surveillance 2010 National Profile: Gonorrhea 29 .06 0.5 MICs (µg/ml) NOTE: Isolates were not tested for cefixime susceptibility in 2007 and 2008.Figure 28.25 MICs (µg/ml) Figure 29.015 0.015 0.25 0.008 0.06 0. Gonococcal Isolate Surveillance Project (GISP)—Distribution of Minimum Inhibitory Concentrations (MICs) to Ceftriaxone Among GISP Isolates. 2006 and 2009–2010 Percentage 100 2006 2009 2010 80 60 40 20 0 <0. Gonococcal Isolate Surveillance Project (GISP)—Distribution of Minimum Inhibitory Concentrations (MICs) to Cefixime Among GISP Isolates.

25 0. Gonococcal Isolate Surveillance Project (GISP)—Percentage of Neisseria gonorrhoeae Isolates with Resistance or Intermediate Resistance to Ciprofloxacin. 30 National Profile: Gonorrhea STD Surveillance 2010 .125–0.5 1 2 4 8 16 MICs (µg/ml) Figure 31.06 0.03 0. 1990–2010 Percentage 20 Resistance 15 Intermediate Resistance 10 5 0 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Year NOTE: Resistant isolates have ciprofloxacin minimum inhibitory concentrations (MICs) >1 µg/ml.Figure 30. Isolates with intermediate resistance have ciprofloxacin MICs of 0.125 0. Susceptibility to ciprofloxacin was first measured in GISP in 1990. Gonococcal Isolate Surveillance Project (GISP)—Distribution of Minimum Inhibitory Concentrations (MICs) to Azithromycin Among GISP Isolates. 2006–2010 Percentage 40 2006 2007 2008 30 2009 2010 20 10 0 <0.5 µg/ml.

8% 2. and other less frequently used drugs. gonorrhoeae. gonorrhoeae.Figure 32.9% 2. “Other” includes no therapy (1. STD Surveillance 2010 National Profile: Gonorrhea 31 .5% QRNG 72.0% 6. and QRNG = quinolone-resistant N.4% Susceptible PenR TetR 3.9% 9. Gonococcal Isolate Surveillance Project (GISP)—Penicillin. Figure 33. gonorrhoeae. 2010 0.6% 1. and Ciprofloxacin Resistance Among GISP Isolates.2%). Gonococcal Isolate Surveillance Project (GISP)—Drugs Used to Treat Gonorrhea Among GISP Participants. 1988–2010 Percentage 100 Other Tetracyclines Penicillins Ofloxacin 80 Ciprofloxacin 60 Cefixime 40 20 Ceftriaxone 250 mg Spectinomycin 0 1988 1990 Ceftriaxone 125 mg 1992 1994 1996 1998 Other Cephalosporins 2000 2002 2004 2006 2008 2010 Year NOTE: For 2010. azithromycin 2 g (1. TetR = chromosomally and plasmid mediated tetracycline-resistant N.7%). Tetracycline.8% PenR/TetR PenR/QRNG TetR/QRNG PenR/TetR/QRNG NOTE: PenR = penicillinase producing Neisseria gonorrhoeae and chromosomally mediated penicillin-resistant N.

.

the rate increased annually during 2001–2009 before decreasing in 2010. National Profile: Syphilis 33 . During 2009–2010.3 cases) (Figure 36. PhD.Syphilis Background Syphilis. Of reported male cases with P&S syphilis.5 cases (in 2008) per 100. Syphilis—All Stages (P&S.8 cases (in 2004) to 1. Late. and 16. a decrease of 1. late.834 cases) during 2009–2010 (Table 1).000 population) was 2. P&S Syphilis by Region The South accounted for 45.4% in the South (from 6.5 cases per 100. Untreated early syphilis in pregnant women results in perinatal death in up to 40% of cases and.3–7 The estimated proportion of P&S syphilis cases attributable to MSM increased from 7% in 2000 to 64% in 2004.2% in the West (from 3.5 cases per 100.0 cases). 36. CDC requested that all state health departments report the sex of sex partners for persons with syphilis. This is the first overall decrease in P&S syphilis in 10 years. and the number of cases of late and late latent syphilis increased 4.8. in October 1999 and revised in May 2006.1% (from 13.5 to 5.1 The rate of P&S syphilis reported in the United States decreased during the 1990s.604 cases).830 to 45. and Congenital) During 2009–2010. and congenital) reported to CDC increased 2. cases of P&S syphilis.7 to 4. the 15 states and areas (including the District of Columbia) with the highest rates of P&S syphilis accounted for 72% of all U.066 to 13.8 to 3. 21. The total number of cases of syphilis (P&S.3% in the Northeast (from 3. Late Latent. Overall increases in rates were observed primarily among men (increasing from 3. early latent.2% lower than the rate in 2009 (4.5 cases per 100. 67% of P&S syphilis cases in 44 states and the District of Columbia that provided information about sex of sex partners were among MSM.000 population in 2010.9 cases in 2010).000 population) and increased 5.079 cases) (Tables 1.2 Although the rate of P&S syphilis in the United States declined 89. causes significant complications if untreated and facilitates the transmission of HIV infection. declining to 1.4% in the Midwest (from 2. The low rate of P&S syphilis and the concentration of the majority of syphilis cases in a small number of geographic areas in the United States led to the development of CDC’s National Plan to Eliminate Syphilis. MD.000 population. Table 25). which was announced by Surgeon General David Satcher. Table 26).9 In 2005.774 in 2010.997 in 2009 to 13. Syphilis remains a major health problem in the South and in urban areas in other regions of the country. After persistent declines during 1992–2003. Early Latent.4 cases). The rate of P&S syphilis in the United States in 2010 (4. The rate of P&S syphilis in 14 of these 15 states and areas (including the District of Columbia) exceeded the national rate of 4.0 cases per 100.S.1 cases per 100.338 to 18. in 2000. of these 14 states and areas (including the District of Columbia).7% during 1990–2000. P&S Syphilis—United States P&S syphilis cases reported to CDC decreased from 13.000 population.5% of P&S syphilis cases in 2010 and 53. the rate was the lowest since reporting began in 1941 (Figure 34). and 38). P&S Syphilis by State In 2010.8 to 4. can lead to infection of the fetus in 80% of cases. a genital ulcerative disease. Table 1). rates decreased 15.3% (from 17.0% in 2009.2% (from 44. sex of sex partner information in 2010 was available for 82%. if acquired during the 4 years before pregnancy. STD Surveillance 2010 In 2010. late latent.6 cases) (Figure 34. Increases in cases among MSM (including men having sex with both men and women) have occurred and have been characterized by high rates of HIV co-infection and high-risk sexual behaviors.000 population in 2001 to 7. the rate among women increased from 0. 9 were in the South (Figure 37.6%. the number of cases of early latent syphilis reported to CDC increased 4.

Rates for men are now highest in those aged 20–24 years. During this same period.3 cases per 100.0.000 population).0 cases per 100. 2.8% were white.7% among non-Hispanic blacks (from 18.141 counties (69.0% were black.000 women) (Figure 35. and 75.6% were of other races/ethnicities.6% were Hispanic.8% were Hispanic.000 population).000 population.3 cases per 100.2 in 2010.10 In 2008. Among MSM. P&S Syphilis by Race/Ethnicity During 2009–2010. In 2010. the rate decreased 21.0% were black. and 2.000 men) during 2009– 2010 (Figure 35.0% had primary syphilis.8 to 7.3 cases per 100. nonHispanic white (4.5 to 1. In 2005. half of the total number of P&S syphilis cases was reported from 27 counties and two cities (Table 32).6 per 100. During 2009–2010.4 to 1.000 population).1% were white.000 population) and 13. Among women with P&S syphilis.2 cases per 100. and 3. 19. Table 28). rates of P&S syphilis among men were highest among non-Hispanic black men (28. with the largest decrease in women aged 40–44 years.6 in 2009.8% were white.5 cases per 100.1 cases per 100.5 cases) (Table 26).2% had secondary syphilis.000 population). Among MSW. and 64.0% had secondary syphilis. The rate increased in 29 of these 50 MSAs (58%) during 2009–2010. this ratio decreased to 5.3 cases per 100.000 population).1% were of other races/ethnicities (Figure 44). and Asian/Pacific Islander (2.000 population) (Figure 42). reflecting higher rates in men than women (Figure 35). followed by Hispanic (8.000 population). 35. 16.9 cases per 100.8% had primary syphilis.5 and 11.3% among Asian/Pacific Islanders (from 1.167 of 3. Rates remained highest among women aged 20–24 years (Figures 39 and 40).194 counties (69. 13.6 cases per 100.4% among women (from 1. the rate of P&S syphilis increased 9.0% among non-Hispanic whites 34 (from 2. Among women with P&S syphilis.2.3 to 2. P&S Syphilis by Age In 2010. P&S Syphilis by Race/Ethnicity and Sex In 2010. 72.8% were black. 25. P&S Syphilis by Sex and Sex Behavior The male-to-female ratio for P&S syphilis rates has risen steadily since 1996. In 2010. the rate of P&S syphilis was highest among persons aged 20–24 years and 25–29 years (13. this information was available for 82% of male cases.8 cases per 100. 67. P&S Syphilis by Sex The rate of P&S syphilis increased 1.000 population) men (Figure S). In 2010. and 1. and 5. Table 27). 16. among men who have sex with women only (MSW) with P&S syphilis. 6. and 84.0% had secondary syphilis (Figure 43). compared with 2. 8. when it was 1.7% among American Indians/ Alaska Natives (from 2.0 to 2. CDC began collecting information on the sex partners of patients with P&S syphilis. Table 34). Among MSM. and 7.0%) in the United States reported no cases of P&S syphilis. but increased to 5.P&S Syphilis by Metropolitan Statistical Area The rate of P&S syphilis in 2010 for the 50 most populous MSAs (6.4 to 16.9%) in 2009 (Figure 38).1 cases per 100.000 population) (Table 29) exceeded the overall rate for the United States (4. Rates among women decreased in all age groups in 2010 (except for women aged 55 years and older).5% among Hispanics (from 4.0% had primary syphilis.000 population). National Profile: Syphilis STD Surveillance 2010 . rates for men increased the most in those aged 20–24 years and 25–29 years (Figures 39 and 41.8% were Hispanic. and the rates decrease with age. 37. These data indicate a major shift since 2006. respectively) (Table 34). 14. P&S Syphilis by County In 2010. when the highest rates were in men aged 35–39 years. This increase supports analyses of case report data showing increases in P&S syphilis among MSM during 2005–2008. American Indians/ Alaska Natives (4.5% were of other races/ethnicities.3% among men (from 7.2 to 4.5 cases per 100. 38. The rate decreased 8.

11 In 2010.9 to 8. Table A2).8 cases per 100.3 cases per 100.3%) (Figure 46). 67% of P&S syphilis cases are among MSM.5%) than STD clinics (30. the District of Columbia.2% to 68.5 cases). Congenital Syphilis—United States After an 18% increase in the rate of congenital syphilis during 2006–2008.7 cases per 100. a total of 28 states. In 2010. a total of 33 states and 1 outlying area had 1 or more cases of congenital syphilis (Tables 41).2 cases) and among men aged 20–24 years (6.000 population).8 cases per 100.6 cases) (Table 35B).1 per 100. the rate was highest among women aged 30–34 years and 35–39 years (2.5 cases per 100. the rate was highest among women aged 20–24 years (0. P&S Syphilis by Reporting Source In 1990. patients with P&S syphilis usually sought care from private physicians or STD clinics. the rate of P&S syphilis among non-Hispanic blacks was highest among women aged 20–24 years (23.000 population).S. For non-Hispanic whites.000 men).6% of P&S syphilis cases were reported from sources other than STD clinics.000 population). In 2009. and Asian/Pacific Islander (0. Hispanic (0. the proportion of cases reported from sources other than STD clinics increased from 39.000 women) and among men aged 20–24 years (92.7 cases per 100. syphilis among MSW continues to be a problem. More cases of syphilis among MSM were reported from private physicians (33.9 According to information reported in 44 states and the District of Columbia. this figure increased to 39. a total of 377 cases were reported.4 per 100. while the number reported from STD clinics increased only slightly (Figure 45). a decrease from 429 cases in 2009 and 446 cases in 2008. P&S Syphilis by Race/Ethnicity. STD Surveillance 2010 During 2010. and other populations at higher risk can be found in the Special Focus Profiles.000 population). For Hispanics.000 men) and 25–29 years (74. More cases among women and MSW were reported from STD clinics than from private physicians. the rate was highest among women aged 20–24 years (1. the rate of congenital syphilis decreased during 2009–2010 (from 9. rates of P&S syphilis among women were highest among non-Hispanic black women (6.9 cases) and among men aged 40–44 years (9. and Sex In 2010. 25. Syphilis Among Special Populations More information about syphilis and congenital syphilis in racial and ethnic minority populations. For American Indians/ Alaska Natives. During 1998–2010.8 cases). Syphilis Summary In recent years. followed by American Indians/ Alaska Natives (0. Age. the rate was highest among women aged 20–24 years (1. the number of cases among males reported from non-STD clinic sources increased sharply.1% (Figure 45.000 population) women (Figure S). adolescents.12 National Profile: Syphilis 35 .000 live births) (Table 41). This recent decrease in the rate of congenital syphilis is associated with the decrease in the rate of P&S syphilis among women that has occurred since 2008 (Figure 47).In 2010.4 cases for both) and among men aged 20–24 years (15. During 2001–2010. MSM.2% in 1998. Although the majority of U.000 women) and among men aged 20–24 years (19. nonHispanic white (0.5 cases per 100. younger men and MSM have accounted for an increasing number of syphilis cases in the United States. syphilis cases have occurred among MSM.1 cases). For Asians/Pacific Islanders. and 1 outlying area had 1 or more cases of congenital syphilis (Tables 40 and 41).2 cases per 100.

Lee JH.51:853-6.55:269-73. 2002. 1999–2001 [Letter]. Continuing increases in sexual risk behavior and sexually transmitted diseases among men who have sex with men: San Francisco. California. 2006. Weinstock HS. Dilley JW. 5 Centers for Disease Control and Prevention. 1997–1999. 2002–2007. MMWR Morb Mortal Wkly Rep.1 Ingraham NR. Paffel JM. 2003–2004. Zaidi AA. Primary and secondary syphilis — United States. Acta Derm Venereol. 2003–2008.59:413-7. 2006. 2001.58:463-7.155(3):145-51. 2000. Am J Public Health. Primary and secondary syphilis among black and Hispanic men who have sex with men: case report data from 27 States. Outbreak of syphilis among men who have sex with men — Southern California.S. Swint EB. MMWR Morb Mortal Wkly Rep. 2002.92:1387-8.48:773-7. MMWR Morb Mortal Wkly Rep. Ann Intern Med. Klausner JD. MMWR Morb Mortal Wkly Rep. Beltrami JF. 3 Centers for Disease Control and Prevention. et al. Atlanta: U. 2 Centers for Disease Control and Prevention. 1951:31(Suppl 24):60-88. Outbreak of syphilis among men who have sex with men in Houston. 10 Su JR. Alabama. 2007.30:872-3. Washington. Primary and secondary syphilis among men who have sex with men — New York City. 8 Centers for Disease Control and Prevention. Gibson S. 2003. 2009. Katz MH. Centers for Disease Control and Prevention. MMWR Morb Mortal Wkly Rep. 4 Centers for Disease Control and Prevention. 2001. 12 36 Centers for Disease Control and Prevention. 9 Heffelfinger JD. 2011. National Profile: Syphilis STD Surveillance 2010 . Department of Health and Human Services. Am J Public Health. 7 D’Souza G. The value of penicillin alone in the prevention and treatment of congenital syphilis.97:1076-83. Texas. Sex Transm Dis. Weinstock HS. Schwarcz SK.50(7):117-20. The national plan to eliminate syphilis from the United States. 2010. Berman SM. Primary and secondary syphilis — Jefferson County. 11 6 Chen SY. 1999. Trends in primary and secondary syphilis among men who have sex with men in the United States. Resurgent bacterial sexually transmitted disease among men who have sex with men — King County. Congenital syphilis — United States. MMWR Morb Mortal Wkly Rep.

United States. Syphilis—Reported Cases by Stage of Infection. United States.Figure 34.000 population) Rate Ratio (log scale) 16:1 25 Male Rate Female Rate Total Rate Male-to-Female Rate Ratio 20 8:1 15 4:1 10 2:1 5 0 1990 1992 1994 1996 1998 2000 2002 2004 2006 2008 2010 1:1 Year STD Surveillance 2010 National Profile: Syphilis 37 . 1941–2010 Cases (in thousands) 600 Primary and Secondary Early Latent Total Syphilis 500 400 300 200 100 0 1941 1946 1951 1956 1961 1966 1971 1976 1981 1986 1991 1996 2001 2006 Year Figure 35. 1990–2010 Rate (per 100. Primary and Secondary Syphilis—Rates by Sex and Male-to-Female Rate Ratios.

2 (n = 37) NOTE: The total rate of primary and secondary syphilis for the United States and outlying areas (Guam.6 7.2 4.5 7.3 3.5 3.8 2.6 1.6 2. 2001–2010 Rate (per 100.8 1.1 Virgin Islands 0. Primary and Secondary Syphilis—Rates by Region. 38 National Profile: Syphilis STD Surveillance 2010 .0 5.4 8.0 2.2 (n = 2) 0.0 0.9 0.7 VT NH MA RI CT NJ DE MD DC 2.7 0.6 4.3 3.5 per 100.1 12.9 2.8 22.4 0.4 Guam 0.3 3.4 Rate per 100.0 5.6 2.7 2.6 0.7 4.2 Puerto Rico 5.000 population) 10 West Midwest Northeast South 8 6 4 2 0 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Year Figure 37.9 4.5 0.5 0.7 5. Primary and Secondary Syphilis—Rates by State.5 2.3 0.8 1.2 2. and Virgin Islands) was 4.5 2.21–2.3 0.0 6. United States.Figure 36.4 3.9 0.4 2.000 population.2 (n = 15) >2.7 4.7 5. 2010 4.4 7. United States and Outlying Areas.000 population <0.5 2.7 2.0 0.6 0. Puerto Rico.9 5.

0 30–34 15. United States.2 (n = 2.0%) of 3.0 1.1 National Profile: Syphilis 39 .000 population <0.6 Age 0 15–19 5 13.2 10 3.8 0.8 15 4.2 (n = 592) NOTE: In 2010.Figure 38.7 55–64 0.21–2.2 0. Primary and Secondary Syphilis—Rates by County. 2010 Men 25 Rate (per 100.000 population) 20 15 10 5 0 5.167) 0.5 2.5 25–29 19.0 0.9 STD Surveillance 2010 65+ Total 25 2. Figure 39. 2010 Rate per 100.2 (n = 383) >2.141 counties in the United States reported no cases of primary and secondary syphilis.0 35–39 12. Primary and Secondary Syphilis—Rates by Age and Sex.6 7.7 20 3.9 Women 1.167 (69. 2. United States.4 1.0 20–24 21.8 40–44 45–54 8.

2001–2010 Rate (per 100. Primary and Secondary Syphilis—Rates by Age Among Women Aged 15–44 Years.000 population) 25 Age Group 30–34 35–39 40–44 15–19 20–24 25–29 20 15 10 5 0 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Year 40 National Profile: Syphilis STD Surveillance 2010 .000 population) 6 Age Group 15–19 20–24 25–29 5 30–34 35–39 40–44 4 3 2 1 0 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Year Figure 41.Figure 40. United States. Primary and Secondary Syphilis—Rates by Age Among Men Aged 15–44 Years. United States. 2001–2010 Rate (per 100.

2010 Cases 6.000 Primary 5.3% were missing sex of sex partner information. 18.000 2. † MSW = men who have sex with women only. Sex. and Sexual Behavior.Figure 42. 2001–2010 Rate (per 100.000 population) 25 20 15 American Indians/Alaska Natives Asians/Pacific Islanders Blacks Hispanics Whites 10 5 0 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Year Figure 43. STD Surveillance 2010 National Profile: Syphilis 41 . Primary and Secondary Syphilis—Rates by Race/Ethnicity. Primary and Secondary Syphilis—Reported Cases* by Stage.000 3.000 1. United States. United States.000 0 MSW† Women MSM† * Of the reported male cases of primary and secondary syphilis. MSM = men who have sex with men.000 Secondary 4.

MSM = men who have sex with men.3% were missing sex of sex partner information.Figure 44.000 500 0 MSW‡ Women MSM‡ * Of the reported male cases of primary and secondary syphilis. Figure 45. Men STD Clinic. 2001–2010 Cases (in thousands) 10 Non-STD Clinic .0% of reported male cases with sex of sex partner data were missing race/ethnicity data.000 Whites 2. United States. Sexual Behavior. Men Non-STD Clinic.500 Blacks Hispanics 2. 2. 18. Primary and Secondary Syphilis—Reported Cases* by Sex. † No imputation was done for race/ethnicity.000 Other 1. Women 8 6 4 2 0 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Year 42 National Profile: Syphilis STD Surveillance 2010 . 2010 Cases 3.† United States. Women STD Clinic. Primary and Secondary Syphilis—Reported Cases by Reporting Source and Sex. ‡ MSW = men who have sex with women only.500 1. and Race/Ethnicity.

and 2. † HMO = health maintenance organization.000 women) 4 0. 2010 Percentage Correctional Facility 40 HIV Counseling and Testing Site Private Physician/HMO† 35 STD Clinic 30 25 20 15 10 5 0 MSW† Women MSM† * Of the reported male cases of primary and secondary syphilis. P&S = primary and secondary syphilis.8 CS Cases P&S Rate 0. Congenital Syphilis—Reported Cases Among Infants by Year of Birth and Rates of Primary and Secondary Syphilis Among Women.7% of reported male cases with sex of sex partner data were missing source of information data.6 3 0. MSW = men who have sex with women only. 2001–2010 CS* cases (in thousands) P&S* rate (per 100. MSM = men who have sex with men. Primary and Secondary Syphilis—Percentage of Reported Cases* by Sex. Figure 47. 18. Sexual Behavior.2 1 0. and Selected Reporting Sources.0 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 0 Year * CS = congenital syphilis.4 2 0.Figure 46. United States. STD Surveillance 2010 National Profile: Syphilis 43 .3% were missing sex of sex partner information.

.

56. National Profile: Other Sexually Transmitted Diseases 45 . and HPV-18 in 1. is difficult to culture.4) of sexually active adults aged 18–59 years self-reported a history of a genital wart diagnosis.2–0. Prevalence by age group was 35% in women aged 14–19 years. NHANES data for 1999– 2004 indicated that 5. 18. Testing was performed by using a commercially available test for high-risk HPV DNA (Hybrid Capture 2. 13% in those aged 30–39. Baltimore.7).9–6..7% (95% CI: 4. in the United States. may be increasing. 11% in those aged 40–49. Prevalence was 27% in STD clinics. Since then.8% of female participants: HPV-6 in 2. such as vaccine programs. 52. and primary care clinics in 6 locations (Boston. Table 44).3–44. 16. The overall HPV prevalence of high. a quadrivalent HPV vaccine was licensed for use in the United States in females aged 9–26 years. these data should be interpreted with caution because Haemophilus ducreyi. New Orleans. Denver. Interpreting STD Surveillance Data. 51. family planning. Seattle. in October 2009. the number of cases reported has fluctuated (Figure 48. In 2010. 11. More detailed information about SSuN methodology can be found in the STD Surveillance Network section of the Appendix. a total of 24 cases of chancroid were reported in the United States. Men who have sex with men (MSM) and men who have sex with women only (MSW) were defined by selfreport or by sex of reported sex partners. reported cases of chancroid had declined steadily until 2001.8% (95% CI: 2.7) among U.g.Other Sexually Transmitted Diseases Chancroid Since 1987. HPV-11 in 0. as measured by initial visits to physicians’ offices. In June 2006.6).and low-risk types was 42.6% (95% CI: 4. non-institutionalized female population during 2003–2006 (Figure 49). females aged 14–59 years. 26% in family planning clinics. 59. and Los Angeles) as part of an effort to estimate national burden of disease and guide prevention efforts.S.5). 58. Maryland). and as a result.5). Although the overall decline in reported chancroid cases most likely reflects a decline in the incidence of this disease.9% (95% CI: 1.2–3.5% (95% confidence interval [CI]: 40.1. The vaccine provides protection against HPV types 6.0– 5.3 National population-based data were obtained from NHANES to examine the prevalence of both high-risk HPV and low-risk HPV—including types 6 and 11—in the civilian. Table 1). a bivalent HPV vaccine that provides protection against types 16 and 18 was licensed for use in females aged 10–25 years.3% in those aged 50–65. and 15% in primary care clinics. 33. Genital warts were identified by provider diagnosis or by documentation from the physical examination. 45.2 Human Papillomavirus Persistent infection with high-risk human papillomavirus (HPV) can lead to development of anogenital cancers (e. 35. 31. 39.3% (95% CI: 0. Digene. Only nine states reported one or more cases of chancroid in 2010 (Table 43).5 Data from the National Disease and Therapeutic Index (NDTI) suggest that incidence of genital warts (Figure 50. cervical cancer). STD Surveillance 2010 Results during 2003–2005 documented an overall highrisk HPV prevalence of 23%. enhanced behavioral and demographic information on patients who presented for care in 2010 at the 41 clinics participating in the STD Surveillance Network (SSuN) was used. or 68 was conducted in 26 STD. and 18. Types 6 and 11 are responsible for about 90% of anogenital warts. while types 16 and 18 are high-risk oncogenic types associated with anogenital cancers. Sentinel surveillance for cervical infection with high-risk HPV types 16. 29% in those aged 20–29. this vaccine also was licensed for use in males aged 9–26 years. the causative organism of chancroid.4–2. this condition may be substantially underdiagnosed. resulting in higher HPV prevalence than previously reported for NHANES 2003–2004 data. HPV-16 in 4. HPV detection and typing were performed using the Research Use Only Linear Array genotyping assay (Roche Diagnostics).6 For data reported in Figure 51. In October 2009. Gaithersburg. and 6.4 HPV vaccine-preventable types 6 or 11 (low-risk types) or 16 or 18 (high-risk types) were detected in 8.

2% (95% CI: 14. Prevalence was higher among MSM compared with MSW in Chicago. Baltimore. 3 4 Datta SD.to 59-year-olds in the United States.3). 2003– 2005. Pelvic Inflammatory Disease For data on PID. 1981–1990: evidence for underreporting of cases. 2011. Levine WC.The prevalence of genital warts in 2010 is presented separately for MSM. Los Angeles. 2003–2006: opportunity to measure HPV vaccine impact? J Infect Dis.3% to 12. et al.178:1795-8. McClain T.45(10):1319-26. Genital warts among 18. Berman. 6 Dinh TH. Sternberg M. 1992. Shlay J.1% (95% CI: 2. Ratelle S. Unger ER. Trend data are based on estimates of initial visits in physicians’ offices for this condition from the NDTI (Figure 52. Swan DC. McQuillan G. Prevalence was higher in MSW compared with MSM in the remaining areas (San Francisco. 11. Litchfield B. MMWR Morb Mortal Wkly Rep. 2008.2% for MSM and from 2. 7 Sutton M. Patel S.148(7):493-500. ranging from 4. Markowitz LE. 1999–2004. 2 Mertz KJ.3) in 1999–2004 and 16.9) in 2005–2008. indicate that blacks had higher seroprevalence than whites for each survey period and age group (Figure 53).1–23. Prevalence was lowest in women for all sites and ranged from 1. see Special Focus Profiles. et al. with the highest prevalence observed among blacks (13.41(No. Sternberg M. Swan D. These data. 46 5 Dunne EF. Hartford/New Haven. Human papillomavirus infection and cervical cytology in women screened for cervical cancer in the United States.2% for MSW.3%) (95% CI: 10. Dunne EF. Richmond.0%. Birmingham. et al.0–17. Prevalence of genital human papillomavirus among females in the United States. 1998. During 2005–2008. Table 44). Koumans EH.8–18. from 21% (95% CI: 19.9% to 9.0% (95% CI: 15. Human papillomavirus (HPV) 6.6% to 7.1% to 4.6–17.7). An increase in the number of visits for genital herpes. Sternberg M. Koutsky L. 16 and 18 prevalence among females in the United States-National Health and Nutrition Examination Survey. Schmid GP. 2011. as suggested by NDTI data. Prevalence at these sites ranged from 2. Lewis JS.1) in 1988–1994 to 17. Seroprevalence decreased 1 Schulte JM. Sex Transm Dis. and New York City. Seattle.9% for MSM. SS-3):57-61. Herpes Simplex Virus Case reporting data for genital herpes simplex virus (HSV) are not available. the National Health and Nutrition Examination Survey. 2007. Sternberg M. Clin Infect Dis. J Infect Dis.6% to 9. S.9%. The prevalence of Trichomonas vaginalis infection among reproductive-age women in the United States.7% for MSW and 3. 2008. the percentage of NHANES survey participants aged 20–49 years who reported a diagnosis of genital herpes was 18. Philadelphia. and women by SSuN site.204(4):562-5. 204(4):566-73. Martich FA. STDs in Women and Infants. and New Orleans). Ann Intern Med. National Health and Nutrition Examination Survey. Markowitz LE. National Profile: Other Sexually Transmitted Diseases STD Surveillance 2010 . MSW. Although HSV-2 seroprevalence is decreasing. most persons with HSV-2 have not received a diagnosis. Unger ER. McQuillan G. Table 44). Pettus KS. Markowitz LE. along with data from NHANES survey years 1976–1980. 2001–2004. may indicate increased recognition of infection. J Infect Dis. Trees D. Etiology of genital ulcers and prevalence of human immunodeficiency virus coinfection in 10 US cities.35(4):357-60. Patel SS. Denver.7 National trend data on the seroprevalence of HSV2 among those aged 14–49 years from NHANES 2005–2008 were compared with NHANES survey years 1988–1994 and 1999–2004. Trichomoniasis Trend data for this infection are limited to estimates of initial physician office visits from the NDTI (Figure 54. 2003–2006. NHANES data from 2001–2004 indicated an overall prevalence of 3. Hariri S. Chancroid in the United States. et al.3–4. Dunne EF.

Both high-risk and low-risk HPV types were detected in some females. % 60 Low-risk HPV* High-risk HPV* 50 40 30 20 10 0 14–19 20–24 25–29 30–39 40–49 50–59 Age * HPV = human papillomavirus. Swan D. Prevalence of genital HPV among females in the United States. 2003–2006 Prevalence. United States. the National Health and Nutrition Examination Survey. 2003–2006. NOTE: Error bars indicate 95% confidence interval.Figure 48. SOURCE: Hariri S. Human Papillomavirus—Prevalence of High-risk and Low-risk Types Among Females Aged 14–59 Years.204(4):566-73 STD Surveillance 2010 National Profile: Other Sexually Transmitted Diseases 47 . National Health and Nutrition Examination Survey. et al. 1981–2010 Cases (in thousands) 5 4 3 2 1 0 1981 1983 1985 1987 1989 1991 1993 1995 1997 1999 2001 2003 2005 2007 2009 Year Figure 49. J Infect Dis. Dunne EF. Patel S. 2011. Unger ER. Sternberg M. Chancroid—Reported Cases.

48 National Profile: Other Sexually Transmitted Diseases STD Surveillance 2010 .Figure 50. MSW = men who have sex with women only. IMS Health Report. Genital Warts—Initial Visits to Physicians’ Offices. Figure 51. See Other Surveillance Data Sources in the Appendix and Table 44. 1966–2010.000 range from 18% to 30%. 2010 Percentage MSM* 15 MSW* Women 12 9 6 3 0 San Francisco Seattle Los Angeles Chicago Denver New York Birmingham Baltimore City New Orleans Richmond Philadelphia Hartford/ New Haven * MSM = men who have sex with men. 1966–2010 Visits (in thousands) 500 400 300 200 100 0 1966 1969 1972 1975 1978 1981 1984 1987 1990 1993 1996 1999 2002 2005 2008 Year NOTE: The relative standard errors for genital warts estimates of more than 100. and Site. Sex of Partners. United States. Integrated Promotional Services™. STD Surveillance Network (SSuN)—Genital Warts—Prevalence Among Sexually Transmitted Disease (STD) Clinic Patients by Sex. SOURCE: IMS Health.

STD Surveillance 2010 National Profile: Other Sexually Transmitted Diseases 49 . Genital Herpes—Initial Visits to Physicians’ Offices. Integrated Promotional Services™. See Other Surveillance Data Sources in the Appendix and Table 44.Figure 52. 1966–2010 Visits (in thousands) 400 350 300 250 200 150 100 50 0 1966 1969 1972 1975 1978 1981 1984 1987 Year 1990 1993 1996 1999 2002 2005 2008 NOTE: The relative standard errors for genital herpes estimates of more than 100.000 range from 18% to 30%. United States. IMS Health Report. 1966–2010. SOURCE: IMS Health.

Census civilian. 1976–1980.S. 50 National Profile: Other Sexually Transmitted Diseases STD Surveillance 2010 . Herpes Simplex Virus Type 2—Seroprevalence in Non-Hispanic Whites and NonHispanic Blacks by Age Group. 1999–2004. non-institutionalized population aged 14–49 years as the standard. 2005–2008 Percentage 100 80 Non-Hispanic Whites 60 40 20 0 All Ages* 14–19 20–29 30–39 40–49 30–39 40–49 Age Percentage 100 80 Non-Hispanic Blacks 60 40 20 0 All Ages* 14–19 20–29 Age 1976–1980 1988–1994 1999–2004 2005–2008 * Age-adjusted by using the 2000 U. 1988–1994. National Health and Nutrition Examination Survey. NOTE: Error bars indicate 95% confidence interval.Figure 53.

Trichomoniasis and Other Vaginal Infections—Women—Initial Visits to Physicians’ Offices.700 1. 1966–2010 Visits (in thousands) 4. STD Surveillance 2010 National Profile: Other Sexually Transmitted Diseases 51 . United States. See Other Surveillance Data Sources in the Appendix and Table 44.800 900 0 1966 1969 1972 1975 1978 1981 1984 1987 1990 1993 1996 1999 2002 2005 2008 Year NOTE: The relative standard errors for trichomoniasis estimates range from 16% to 27% and for other vaginitis estimates range from 8% to 13%. Integrated Promotional Services™.Figure 54.500 Trichomoniasis Other Vaginitis 3. SOURCE: IMS Health.600 2. IMS Health Report. 1966–2010.

.

SPECIAL FOCUS PROFILES .

SPECIAL FOCUS PROFILES .

racial and ethnic minorities. as well as throughout this section. These populations are most vulnerable to STDs and their consequences. They include women and infants.Special Focus Profiles The Special Focus Profiles highlight trends and distribution of STDs in populations of particular interest for STD and HIV prevention programs in state and local health departments. STD Surveillance 2010 Special Focus Profiles 53 . adolescents and young adults. The figures cited in this section are located in diseasespecific sections of the National Profile. MSM. and persons entering corrections facilities.

.

rarely. she can transmit the infection to the fetus in utero. income.4 A number of studies have found significant associations between condom use and socio-demographic characteristics. has been identified as an important predictor of her sexual health. Tables 4 and 15). in turn.7 to 610.9–11 These infections are detected primarily through screening. Although topical prophylaxis of infants at delivery is effective for prevention of gonococcal ophthalmia neonatorum. Most cases of congenital syphilis are easily preventable if women are screened for syphilis and treated early during prenatal care.14 Direct Impact on Pregnancy Chlamydia and gonorrhea can result in adverse outcomes of pregnancy. which. Transmission can result in fetal death or an infant born with physical and mental developmental disabilities.15 When a woman has a syphilis infection during pregnancy. thereby increasing the risk for infertility and ectopic pregnancy.3 For example.8 About 80%–90% of chlamydial infections and 50% of gonococcal infections in women are asymptomatic. these types also cause Papanicolaou (Pap) smear abnormalities.16 Observations Chlamydia—United States During 2009–2010. in particular. they are a major concern because persistent infection with specific types of the virus are causally related to cervical cancer. a perceived shortage of available men in a community. can lead to reproductive system morbidity such as ectopic pregnancy and tubal factor infertility. education. a woman’s inability to negotiate safer sexual practices. including neonatal ophthalmia and in the case of chlamydia. and can have serious consequences for pregnant women. and acculturation. prevention of neonatal pneumonia requires prenatal detection and treatment. even a woman who has only one partner may be obliged to practice safer sex such as using condoms. Chlamydia rates exceeded gonorrhea rates among women in all states (Figures A and C. In addition to biological and social factors such as poverty and access to quality STD services. An estimated 10%–20% of women with chlamydia or gonorrhea may develop PID if they do not receive adequate treatment.000 females (Figure 1. Other types cause genital warts. that increases a woman’s risk for STDs. can cause painful outbreaks.6 Women infected with C. low-grade Pap smear abnormalities. neonatal pneumonia. Genital infections with HSV are extremely common.1. ectopic pregnancy in 9%. Although most HPV infections in women resolve within 1 year. recurrent respiratory papillomatosis in infants born to infected mothers. rather than the woman’s own behavior. especially among young sexually active women. the rate of reported chlamydial infections in women increased from 586. can significantly affect her sexual health and subsequently the health of her unborn baby.7 Among women with PID.6 cases per 100. Table 4).12 Data from a randomized controlled trial of chlamydia screening in a managed care setting suggest that such screening programs can reduce the incidence of PID by as much as 60%. including age.2 A woman’s relationship status with her male partner. and chronic pelvic pain in 18%. gonorrhoeae can develop PID.STDs in Women and Infants Public Health Impact Women and infants bear significant long-term consequences of STDs. can cause women to be more accepting of their partners’ concurrent sexual relationships.13 STD Surveillance 2010 HPV infections are highly prevalent in the United States. trachomatis or N. tubal scarring can cause infertility in 20% of women.5 Because it is often the behavior of her male partner. and. The symptoms associated with PID are vague so 85% of women with PID delay seeking medical care. and partner concurrency is a factor associated with increased risk for STDs. such as condom use. Special Focus Profiles: STDs in Women and Infants 55 .

These disparities are consistent with the marked racial disparities observed for chlamydia and gonorrhea. the median state-specific chlamydia test positivity among women aged 15–24 years who were screened in selected prenatal clinics in 16 states.4% (from a peak of 107.2 cases per 100. and the rate of congenital syphilis was 8. Gonorrhea—United States Like chlamydia. the gonorrhea rate among women has been slightly higher than the rate among men for 9 consecutive years (Figure 15. the gonorrhea rate for women (106. gonorrhea rates for both women and men declined steadily throughout the 1980s and early 1990s and then reached a plateau (Figure 15). the District of Columbia.7% to 21.19 However. 56 The rate of P&S syphilis among women was 1.8% (range 0.1 cases per 100. and the Virgin Islands was 8. in part because definitive diagnoses of these conditions can be complex. and have since declined.7%) (Figure 11). Disease rates were two to three times higher among black women than among white women. Trends in congenital syphilis usually follow trends in P&S syphilis among women. and the Virgin Islands was 0. Puerto Rico.3 to 0. The rate of congenital syphilis declined by 92. Table 15). The rate of P&S syphilis among women declined 95.5 cases per 100. The estimated number of initial visits to physicians’ offices for PID from NDTI generally declined during 2000–2009 (Figure H.9% (range: 0.2% (range: 2. Tables 15 and 16).000 females) during 1990–2004 (Figure 34).000 live births in 2010 (Table 41).0% (range: 3. with a lag of 1–2 years (Figure 47). gonorrhea screening is an important strategy for the identification of gonorrhea among women. Puerto Rico. Table 44). Puerto Rico.4% (from 17. The highest rates of P&S syphilis among women and congenital syphilis were observed in the South (Figures E and F.000 women in 2010 (Table 27).6 cases to 8. After declining during 2006–2009.0% to 4. Family Planning Clinics—In 2010. the District of Columbia.1%) (Figure 26). Racial disparities in diagnosed PID have been observed in both ambulatory and hospitalized settings. the median state-specific gonorrhea test positivity among women aged 15–24 years who were screened during visits to selected family planning clinics in 47 states.8% to 13.0% to 4.Prevalence Monitoring Project Congenital Syphilis Prenatal Clinics—In 2010.2%) (Figure B). Although the gonorrhea rate in men has historically been higher than the rate in women. Failure of health care providers to adhere to maternal syphilis screening recommendations also contributes to the occurrence of congenital syphilis. because of the subjective methods by which PID is diagnosed. Puerto Rico.18. However. late or limited prenatal care has been associated with congenital syphilis. the median statespecific chlamydia test positivity among women aged 15–24 years who were screened during visits to selected family planning clinics in all 50 states. racial disparity data should be interpreted with caution. After an initial increase in cases detected through screening.2%) (Figure D). and the Virgin Islands was 7.8 cases per 100.000 females) increased slightly in 2010 (Figure 15. Prevalence Monitoring Project Prenatal Clinics—In 2010.19 Special Focus Profiles: STDs in Women and Infants STD Surveillance 2010 .17 Pelvic Inflammatory Disease Accurate estimates of PID and tubal factor infertility resulting from chlamydial and gonococcal infections are difficult to obtain. Although most cases of congenital syphilis occur among infants whose mothers have had some prenatal care. Large-scale screening programs for gonorrhea in women began in the 1970s. gonorrhea is often asymptomatic in women. hospitalizations for acute PID show modest declines in the last decade whereas hospitalizations for chronic PID have remained relatively constant (Figure G).000 live births) during 1991–2005 (Table 1). Rates of both female and congenital syphilis increased during 2005–2008. Family Planning Clinics—In 2010.7 cases per 100. Table 41). Thus. the median state-specific gonorrhea test positivity among women aged 15–24 years who were screened in selected prenatal clinics in 16 states. and the Virgin Islands was 0. Hospitalizations for PID declined steadily throughout the 1980s and early 1990s.

Ectopic Pregnancy
Evidence suggests that health care practices associated
with clinical management of ectopic pregnancy
changed in the late 1980s and early 1990s. Before that
time, treatment of ectopic pregnancy usually required
admission to a hospital. Hospitalization statistics
were therefore useful for monitoring trends in ectopic

1

Pulerwitz J, Amaro H, De Jong W, Gortmaker SL, Rudd R.
Relationship power, condom use and HIV risk among women in
the USA. AIDS Care. 2002;14(6):789-800.

2

McCree DH, Rompalo A. Biological and behavioral risk factors
associated with STDs/HIV in women: implications for behavioral
interventions, In: Aral SO, Douglas JM,Lipshutz JA (editors).
Behavioral Interventions for Prevention and Control of Sexually
Transmitted Diseases (p. 310-324). New York, NY: Springer.

pregnancy. Data from the National Hospital Discharge
Survey (NHDS) suggest that hospitalizations for
ectopic pregnancy are decreasing. Over the last decade,
hospitalizations have decreased from 34.7 per 100,000
in 2000 to 18.3 per 100,000 in 2009 (Figure I).20 The
data that are available suggest that nearly half of all
ectopic pregnancies are treated on an outpatient basis.21

11

Johnson RE, Berman SM. Sexual transmission: Chlamydia
trachomatis. In: Krämer A, Kretzschmar M, Krickeberg K,
(editors). Modern infectious disease epidemiology. New York:
Springer; 2009:357-80.

12

Hillis SD, Joesoef R, Marchbanks PA, Wasserheit JN, Cates
W Jr, Westrom L. Delayed care of pelvic inflammatory disease
as a risk factor for impaired fertility. Am J Obstet Gynecol.
1993;168:1503-9.

3

El-Bassel N, Gilbert L, Krishnan S, Schilling R, Gaeta T, Purpura
S, et al. Partner violence and sexual HIV-Risk behaviors among
women in an inner-city emergency department. Violence Vict.
1998;13(4):377-393.

13

Scholes D, Stergachis A, Heidrich FE, Andrilla H, Holmes
KK, Stamm WE. Prevention of pelvic inflammatory disease
by screening for cervical chlamydial infection. N Engl J Med.
1996;34(21):1362-6.

4

Hogben M, Leichliter JS. Social determinants and sexually
transmitted disease disparities. Sex Transm Dis. 35(12) S13-S18.

14

5

Manderson L, Chang T, Tye LC, Rajanayagam K. Condom use in
heterosexual sex: a review of research, 1985–1994. In: Catalan J,
Sherr L, Hedge B (editors). The impact of AIDS: psychological and
social aspects of HIV Infection. p. 1-26. The Netherlands: Harwood
Academic Publishers.

Centers for Disease Control and Prevention. Prevention of genital
HPV infection and sequelae: report of an external consultants’
meeting. Atlanta: U.S. Department of Health and Human
Services; 1999.

15

Kimberlin DW. Herpes simplex virus infections of the newborn.
Semin Perinatol. 2007;31(1):19-25.

16

Centers for Disease Control and Prevention. Guidelines for
prevention and control of congenital syphilis. MMWR Morb
Mortal Wkly Rep. 1988;37(No. SS-1).

17

Centers for Disease Control and Prevention. Congenital syphilis
— United States, 2003–2008. MMWR Morb Mortal Wkly Rep.
2010;59:413-17.

18

Rolfs RT, Galaid EI, Zaidi AA. Pelvic inflammatory disease: trends
in hospitalization and office visits, 1979 through 1988. Am J
Obstet Gynecol. 1992;166:983-90.

19

Sutton MY, Sternberg M, Zaidi A, St. Louis ME, Markowitz LE.
Trends in pelvic inflammatory disease hospital discharges and
ambulatory visits, United States, 1985–2001. Sex Transm Dis.
2005;32(12)778-84.

20

Hoover KW, Tao G, Kent CK. Trends in the diagnosis and
treatment of ectopic pregnancy in the United States. Obstet
Gynecol. 2010;3(115):495-502.

21

Centers for Disease Control and Prevention. Ectopic pregnancy in
the United States, 1990–1992. MMWR Morb Mortal Wkly Rep.
1995;44:46-8.

6

O’Leary A. A woman’s risk for HIV from a primary partner:
balancing risk and intimacy. Annu Rev Sex Res. 2000; 11:191-234.

Paavonen J, Westrom L, Eschenbach. Pelvic Inflammatory
Disease. In: Holmes KK, Sparling PF, Stamm WE, Piot P,

7

Wasserheit JN, Corey L, Cohen, MS, Watts DH, (editors).
Sexually transmitted diseases. 4th ed. New York: McGraw-Hill;
2008:1017-1050.

8

9

Westrom L, Joesoef R, Reynolds G, Hagdu A, Thompson SE.
Pelvic inflammatory disease and fertility: a cohort study of 1,844
women with laparoscopically verified disease and 657 control
women with normal laparoscopy. Sex Transm Dis. 1992;9:185-92.
Hook EW III, Handsfield HH. Gonococcal infections in the
adult. In: Holmes KK, Sparling PF, Stamm WE, Piot P, Wasserheit
JN, Corey L, et al, (editors). Sexually transmitted diseases. 4th ed.
New York: McGraw-Hill; 2008:627-45.

10

Stamm WE. Chlamydia trachomatis infections in the adult. In:
Holmes KK, Sparling PF, Stamm WE, Piot P, Wasserheit JN,
Corey L, et al, (editors). Sexually transmitted diseases. 4th ed.
New York: McGraw-Hill; 2008:575-93.

STD Surveillance 2010

Special Focus Profiles: STDs in Women and Infants

57

Figure A.

Chlamydia—Women—Rates by State, United States and Outlying Areas, 2010

469
451

490

415

444
392

Guam
757

488
532
556

585

566

323

594

569

500
681 502

525
552

859

767

706

Rate per 100,000
population

891
658

825

<400.0

(n = 8)

400.1–600.0 (n = 24)

Puerto Rico
236

677

288
269
435
457
512
453
724
675
1,195

305 558

637

891

749

513

654

540

616

1,049

1,178

684

719

394

VT
NH
MA
RI
CT
NJ
DE
MD
DC

269

Virgin
Islands
738

566

>600.0

(n = 22)

NOTE: The total chlamydial infection rate among women in the United States and outlying areas (Guam, Puerto Rico, and Virgin Islands) was 605.8 per
100,000 female population.

Figure B.

Chlamydia—Positivity Among Women Aged 15–24 Years Tested in Prenatal Clinics,
by State, Infertility Prevention Project, United States and Outlying Areas, 2010
VT
NH
MA
RI
CT
NJ
DE
MD
DC

5.6
6.7
Guam

10.4

11.9
6.6
6.5

9.3
6.7

2.7

5.5
7.7

4.7

11.7

Positivity, %

15.1
21.2

Puerto Rico
14.0

Virgin
Islands
17.0

6.0

*

(n = 35)

<5.0

(n = 2)

5.0–9.9 (n = 9)
>10.0

(n = 7)

* States/areas not meeting minimum inclusion criteria in prenatal clinics.
NOTE: Includes states and outlying areas that reported chlamydia positivity data on at least 100 women aged 15–24 years during 2010.

58

Special Focus Profiles: STDs in Women and Infants

STD Surveillance 2010

Figure C.

Gonorrhea—Women—Rates by State, United States and Outlying Areas, 2010

31.3
11.5

43.5

47.2

24.7
8.8

Guam
51.3

7.1
64.0
57.1

111.2

71.3

5.4

47.2

60.7

60.1

77.5
136.2 110.4

87.0

129.1

133.7

139.0

35.1

185.1

182.6

Puerto Rico
6.8

7.6
8.8
29.6
22.3
80.5
70.2
136.3
137.2
338.9

103.5

173.5

120.4

Rate per 100,000
population

209.6
166.1

<19.0

(n = 8)

19.1–100.0 (n = 21)

108.8

209.1

49.0

112.4

169.8

113.2

236.8
207.6

86.8

157.3

74.6

VT
NH
MA
RI
CT
NJ
DE
MD
DC

11.1

>100.0

Virgin
Islands
166.0

(n = 25)

NOTE: The total gonorrhea infection rate among women in the United States and outlying areas (Guam, Puerto Rico, and Virgin Islands) was 105.2 per
100,000 female population.

Figure D.

Gonorrhea—Positivity Among Women Aged 15–24 Years Tested in Prenatal Clinics,
by State, Infertility Prevention Project, United States and Outlying Areas, 2010
VT
NH
MA
RI
CT
NJ
DE
MD
DC

0.0
Guam
396

0.9
1.7

4.2
1.3
0.6

1.0
0.6

0.0

0.3
1.1

0.5

1.9

Positivity, %

2.6
3.2

Puerto Rico
0.2

Virgin
Islands
2.0

0.7

*

(n = 35)

<1.0

(n = 9)

1.0–1.9 (n = 5)
>2.0

(n = 4)

* States/areas not meeting minimum inclusion criteria in prenatal clinics.
NOTE: Includes states and outlying areas that reported gonorrhea positivity data on at least 100 women aged 15–24 years during 2010.

STD Surveillance 2010

Special Focus Profiles: STDs in Women and Infants

59

9 7.1 6. 60 Special Focus Profiles: STDs in Women and Infants STD Surveillance 2010 .6 3.5 0.0 (n = 25) 1.6 0.0 12.3 0.0 Guam 1.5 Rate per 100.0 (n = 3) NOTE: The total rate of primary and secondary syphilis among women in the United States and outlying areas (Guam.3 Virgin Islands 0.5 0. 2010 1.6 Virgin Islands 0.0 0.1 0.2 0.6 13.6 2.7 0.9 1.0 4. Puerto Rico.0 0.0 0.8 2.000 females.0 4.2 0. Primary and Secondary Syphilis—Women—Rates by State.9 0.3 0.9 0. and Virgin Islands) was 1.9 49.4 28. Congenital Syphilis—Infants—Rates by Year of Birth and State.0 Guam 0.0 1.9 0.0 0.0 0.4 0.21–4.4 0.000 population 0. Puerto Rico.7 per 100.0 6.0 0.6 14.0 VT NH MA RI CT NJ DE MD DC 0.0 0.9 Puerto Rico 0.0 2.0 0.3 0.7 1.6 11. and Virgin Islands) was 8.3 0.0 0.7 26.4 25.Figure E.6 1.0 6.1 per 100.0 1.4 1.5 0.1 1.6 0.2 11.3 1.1 0.9 Rates per 100.0 0.0 0.0 <0.1 10.3 2.0 (n = 16) >10.8 14.5 VT NH MA RI CT NJ DE MD DC 0.000 live births <1.6 0.0 19.2 1.0 0.4 5.0 0.2 0.0 7.0 1.0 0.0 (n = 33) >4.8 Puerto Rico 4.1 0.0 0. United States and Outlying Areas.1 0.6 0.6 0.1 0. Figure F.3 0.1 0.0 0.5 0.1 0.5 4.6 2.1 0.1 0.0 (n = 13) NOTE: The total rate of congenital syphilis for infants by year of birth for the United States and outlying areas (Guam.1–10.0 12.3 0.3 0.6 16.0 0.2 (n = 18) 0.1 0.9 0.000 live births.6 0.4 0. 2010 0.4 0. United States and Outlying Areas.4 0.0 0.

SOURCE: 2009 National Hospital Discharge Survey [Internet]. STD Surveillance 2010 Special Focus Profiles: STDs in Women and Infants 61 . United States. SOURCE: IMS Health. United States. Available from: http://www. Pelvic Inflammatory Disease—Hospitalizations of Women Aged 15–44 Years. 2001–2010 Visits (in thousands) 250 200 150 100 50 0 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Year NOTE: The relative standard errors for these estimates are 21. See Other Data Sources in the Appendix and Table 44.6%–30%.cdc. Pelvic Inflammatory Disease—Initial Visits to Physicians’ Offices by Women Aged 15–44 Years.Figure G. Figure H. Unspecified Chronic 15 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 Year NOTE: The relative standard errors for acute and unspecified pelvic inflammatory disease (PID) cases ranges from 8%–18%. Integrated Promotional Services™. The relative standard error for chronic PID cases ranges from 12%–28%.htm. 1966–2010.gov/nchs/nhds/about/nhds. 2000–2009 Hospitalizations (in thousands) 75 60 45 30 Acute. Data only available through 2009. IMS Health Report. Atlanta: Centers for Disease Control and Prevention.

gov/nchs/nhds/about/nhds. Data only available through 2009. United States.cdc.htm. Available from: http://www. 62 Special Focus Profiles: STDs in Women and Infants STD Surveillance 2010 .Figure I. Atlanta: Centers for Disease Control and Prevention. SOURCE: 2009 National Hospital Discharge Survey [Internet]. 2000–2009 Hospitalizations (in thousands) 50 40 30 20 10 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 Year NOTE: The relative standard errors for these estimates are 10%–23%. Ectopic Pregnancy—Hospitalizations of Women Aged 15–44 Years.

000 males).3. Rates in women have been highest each year Special Focus Profiles: STDs in Adolescents and Young Adults 63 .378.000 males in 2009 to 774.4 cases per 100.to 24-Year-Old Women—In 2010. Table 21). During 2009–2010. lack of transportation. rates increased 2. Table 21). Chlamydia rates for women in this age group increased 6.1 Compared with older adults. Traditionally.000 females) compared with any other age or sex group.to 19-Year-Old Women—In 2010. 20.000 males) (Figure 19. as in previous years. Table 21).000 females.5 cases per 100.0% from 730. and concerns about confidentiality. men aged 20–24 years had the highest rate of gonorrhea (421. Table 21). gonorrhea rates for men in this age group increased 2. biological. the rate among women aged 15–19 years was 3. sexually active adolescents aged 15–19 years and young adults aged 20–24 years are at higher risk of acquiring STDs for a combination of behavioral.9% during 2009–2010.314. During 2009–2010.000 (Figure 5.0 cases per 100.STDs in Adolescents and Young Adults Public Health Impact Estimates suggest that even though young people aged 15–24 years represent only 25% of the sexually experienced population. For some STDs.5% for those aged 20–24 years (Table 10). men aged 15–19 years had the second highest rate of gonorrhea (253.8% for those aged 15–19 years and 7. as in previous years. STD Surveillance 2010 15.to 24-Year-Old Men—In 2010. The higher prevalence of STDs among adolescents also may reflect multiple barriers to accessing quality STD prevention services. 15.000 females) compared with any other age or sex group (Figure 19. Table 20). men aged 20–24 years had the highest rate of chlamydia (1. women aged 15–19 years had the highest rate of gonorrhea (570. they acquire nearly half of all new STDs.9 cases per 100. gonorrhea rates for women of this age group increased 0.8%.2%.4%) and 20–24 years (4.0 in 2010.to 24-Year-Old Men—In 2010.4 Observations Chlamydia Rates of reported chlamydial infection among persons aged 15–19 years and 20–24 years continue to increase. Chlamydia rates for men in this age group increased 8. 20. 15. including lack of health insurance or ability to pay.to 24-Year-Old Women—In 2010. During 2009–2010.9%. as in previous years. gonorrhea rates for men in this age group increased 6. During 2009–2010.407.9%). gonorrhea rates for women in this age group increased 3. trachomatis.g.3 cases per 100.9% increase from the 2009 rate of 3. 15. 20.. adolescent females may have increased susceptibility to infection because of increased cervical ectopy.3 cases in 2009. women aged 20–24 years had the second highest rate of gonorrhea (560.9 cases per 100.2 Interventions for at-risk adolescents and young adults that address underlying aspects of the social and cultural conditions that affect sexual risk-taking behaviors are needed. and cultural reasons.7 cases per 100.to 19-Year-Old Men—In 2010. gonorrhea rates increased for persons aged 15–19 years (1.000 females to 3.2 cases per 100. Table 10).1% (Figure 21. women aged 20–24 years had the highest rate of chlamydia (3.to 19-Year-Old Men—Chlamydia rates for men aged 15–19 years increased 6. Primary and Secondary Syphilis Syphilis rates among women aged 15–19 years increased annually from 2004–2009 from 1. Gonorrhea During 2009–2010.000 females) compared with any other age or sex group (Figure 19. During 2009–2010. as in previous years. intervention efforts have targeted individual-level factors associated with STD risk which do not address higher-level factors (e. peer norms and media influences) that may also influence behaviors.187. as in previous years. a 1.7 cases per 100.8% during 2009–2010. discomfort with facilities and services designed for adults.000 in 2010.to 19-Year-Old Women—In 2010.5 cases per 100. such as C.000 males) (Figure 19. 20.0 cases per 100. but decreased to 3. as are strategies designed to improve the underlying social conditions themselves.

Pediatr. et al.9%). and Puerto Rico. However. This educational program for socioeconomically disadvantaged youth aged 16–24 years is administered at more than 100 sites throughout the country. from 5. positivity increased through 2009 and then decreased in 2010.9% (range: 0.000 males to 21.0% to 4. which may be attributable to an increase in reported tests in 2010 due to the implementation of an electronic data system.5% (range: 4.4% (range: 5. Kusunoki Y. rates in this group have increased since 2002. Plowman S.5 cases per 100. The data from NJTP centers that submit gonorrhea specimens from female students aged 16–24 years to the national contract laboratory indicated a high prevalence of gonococcal infection in this population. These changes reflect a significant shift in the age distribution of syphilis. Perspect Sex Reprod Health. 2003–2007. Chlamydia prevalence among women and men entering the National Job Training Program: United States. 3 Chlamydial infection is widespread geographically and highly prevalent among socioeconomically disadvantaged young women and men entering the NJTP. and Puerto Rico.8% (range: 0. the median facility-specific chlamydia positivity was 6.3%) (Figure K). Crosby RA.1% (range: 0.32 (8): 888‑906. about 35.0% to 26. 2004. and Puerto Rico.5% (range: 0. Table 34). the median state-specific gonorrhea prevalence was 0.* Among women entering the program in 44 states. See the STDs in Persons Entering Corrections Facilities section for more details. J. Since 2004. Social and behavioral determinants of self-reported STD among adolescents.2 cases per 100. 5 Special Focus Profiles: STDs in Adolescents and Young Adults STD Surveillance 2010 . National Job Training Program Since 1990 about 20.3 cases per 100. the median facility-specific chlamydia positivity was 14. the median state-specific chlamydia prevalence was 11. rates were highest among men aged 35–39 years during 2002–2005. Bernat DH.000 males to 5. the median state-specific chlamydia prevalence was 7. Mason W. Weinstock H. A clinic-based youth development program to reduce sexual risk behaviors among adolescent girls: prime time pilot study. the District of Columbia. Kriechbaum MJ. the program in 48 states. Rates among men aged 20–24 years have also increased since 2002.7%) (Figure N).37(2):63-7. 2004:36(1):6-10. and Puerto Rico. the median state-specific gonorrhea prevalence in 2010 was 1. 2011.8%). Perspect Sex Reprod Health. the District of Columbia.6 cases in 2010. Among adolescent females entering selected juvenile corrections facilities. they also had the highest rate of syphilis among men of any age group since 2008 (Table 34). the median gonorrhea positivity was 4. A review of STD/HIV preventive interventions for adolescents: sustaining effects using an ecological approach. 2 Sieving RE.000 male entrants have been screened annually.7%) (Figure L). Cates W Jr.2% (range: 1.0% to 2. Psychol. the median gonorrhea positivity rate was 0. Among women entering the program in 43 states. from 1. Oliphant J. San Antonio.0% to 8.000 female NJTP entrants have been screened each year for chlamydia. May 23. Braxton J. Not only did men aged 20–24 years see large increases in rates.8%).9 cases in 2010. Rates among men aged 15–19 years are much lower than the rates among men in older age groups (Figure 39). Salazar LF. Among men entering 64 Upchurch DM. Among adolescent males entering selected juvenile corrections facilities. 2007. * Laboratory data are provided by the Center for Disease Detection. Among men entering the program in 33 states. Prevalence Monitoring Juvenile Corrections Facilities Chlamydia test positivity among women aged 15–19 years screened in selected family planning clinics increased in most of the 10 HHS regions during 2006–2010 (Figure J). 4 Satterwhite CL.0% to 4.among those aged 20–24 years with 4.7%) (Figure M). Test positivity data presented in Figure J are not adjusted for changes in laboratory test methods and associated increases in test sensitivity.5%). Berman S. Health Promot Pract (online). the District of Columbia.8% to 12. Resnick MD. The data presented are from sites where more than 100 persons were screened in 2010. 1 DiClemente RJ.5 to 13. Sex Transm Dis.2% to 21. the District of Columbia. 2000. Texas.36(6):276-287. 2010. Sexually transmitted diseases among American youth: incidence and prevalence estimates. Pettingell S. In region IX. Tian LH.6% (range: 0.000 females in 2010 (Figures 39 and 40. Weinstock H.5 Specimens from students in each state and outlying area were tested by a single national contract laboratory.

8 Guam 8.1 13.5 06 07 08 09 5.0 9.S.9 13.8 14.3 9.6 Puerto Rico 8.6 VT NH MA RI CT NJ DE MD DC 8.8 11.Figure J.5 6. United States and Outlying Areas.0 (n = 7) * Fewer than 100 women who resided in these states/areas and entered the National Job Training Program were screened for chlamydia in 2010.8 7.0 8.4 11.6 11. STD Surveillance 2010 Special Focus Profiles: STDs in Adolescents and Young Adults 65 .0 (n = 16) 10.0 9. 2006–2010 8. Chlamydia—Prevalence Among Women Aged 16–24 Years Entering the National Job Training Program.1 11. Infertility Prevention Project.8 12.7 12.9 9.4 14.1 12.5 14.5 5.9 9.3 8. by U.9 Virgin Islands Prevalence. NOTE: See Definition of HHS Regions in the Appendix for definitions.5 X 10 Region IX II I V VIII 7.7 12. % * (n = 7) <10. Chlamydia—Trends in Positivity Among Women Aged 15–19 Years Tested in Family Planning Clinics.0 IV VI 10 Region II III VII IX 06 07 08 09 10 06 07 08 09 10 Region VIII Region III 7.3 9.9 9.2 7.2 10.5 6.6 8.2 7.6 11. by State of Residence.4 10. 2010 5.2 6.6 14.6 5.8 7.4 6.3 06 07 08 09 10.7 8.0 9.1 8.9 (n = 23) >15.1 10. Department of Health and Human Services (HHS) Region.8 6.6 6.2 9.2 6.4 9.3 7.9 8.9 12.0–14.8 12.7 11.6 7.0 11.9 9.1 6.0 21.0 9.2 06 07 08 09 9.5 9.4 12.1 15.8 7.0 11.3 14.5 06 07 08 09 10 10 06 07 08 09 10 Region VII Region IV Region VI* * 2009 percent positivity for Region VI previously published in the 2009 Surveillance report has been corrected.3 9.4 6.2 15.3 9.6 16.8 5.8 11. Figure K.3 18.5 16.8 11.9 13.5 7.7 8.5 10.4 9.9 11.2 11.2 10.0 19.9 5.4 13.1 06 07 08 09 10 06 07 08 09 10 06 07 08 09 10 Region V Region I Region X 8.6 5.

0 (n = 25) ≥2.8 7.Figure L. % 12. United States and Outlying Areas.3 2.5 0.4 0. 2010 2.0 8.1 4.9 1.4 8.4 5.0 (n = 38) ≥10.4 4.2 7.9 1.7 3.5 7.1 10.7 11.0 1.5 2.0 9.1 8.7 2.7 0.2 3.4 7.2 6.0 1.2 Puerto Rico 0.3 4.4 2. United States and Outlying Areas. gonorrhea test results for students at centers that submitted specimens to the national contract laboratory were included if the number of gonorrhea tests submitted was greater than 90% of the number of chlamydia tests submitted.3 3.2 VT NH MA RI CT NJ DE MD DC 6.4 7.6 2. NOTE: Many training centers use local laboratories to test female students for gonorrhea.7 2.7 7. by State of Residence. by State of Residence.8 1.0 0.6 10.4 6.0 (n = 20) * Fewer than 100 women who resided in these states/areas and entered the National Job Training Program were screened for gonorrhea in 2010.5 9.3 Guam 396 0.9 2.2 4.5 7.7 12.0 12.7 2.8 1.1 1.9 0.5 11. % * (n =8) <2. these results are not available to CDC.4 3.8 0.8 10.0 0.0 0.2 4.3 5.5 0.0 0.7 4. For this map.3 Virgin Islands * (n = 3) <10.3 Prevalence.8 11.0 11.1 11. Figure M.9 2.3 3.8 Virgin Islands Prevalence.8 3.8 2. Chlamydia—Prevalence Among Men Aged 16–24 Years Entering the National Job Training Program.9 4.7 3.9 8.3 Puerto Rico 5.8 VT NH MA RI CT NJ DE MD DC 0.4 2.6 4.8 0.0 2.1 4.7 1.0 (n = 12) * Fewer than 100 men who resided in these states/areas and entered the National Job Training Program were screened for chlamydia in 2010.0 3.6 1.3 3.8 3. 2010 0.8 5.4 Guam 396 2.7 2.2 1.7 12. Gonorrhea—Prevalence Among Women Aged 16–24 Years Entering the National Job Training Program.4 2.3 1.8 9. 66 Special Focus Profiles: STDs in Adolescents and Young Adults STD Surveillance 2010 .7 5.

these results are not available to CDC.0 1.8 0. United States and Outlying Areas.5 2.0 0.0 Guam 396 0.5 1.5 1.6 Prevalence.8 0.9 1.1 2.1 Virgin Islands 0. NOTE: Many training centers use local laboratories to test male students for gonorrhea.Figure N. by State of Residence.8 0. For this map.0 0.8 0. Gonorrhea—Prevalence Among Men Aged 16–24 Years Entering the National Job Training Program.6 1.0 (n = 2) * Fewer than 100 men who resided in these states/areas and entered the National Job Training Program were screened for gonorrhea in 2010.0 0.9 VT NH MA RI CT NJ DE MD DC 0.7 Puerto Rico 0.4 0.4 0.2 0. 2010 0.5 0.6 0.0 1.9 0.0 0.4 1. % * (n = 18) <2.1 0.0 (n = 33) ≥2.8 0.4 0. gonorrhea test results for students at centers that submitted specimens to the national contract laboratory were included if the number of gonorrhea tests submitted was greater than 90% of the number of chlamydia tests submitted.5 0.1 1. STD Surveillance 2010 Special Focus Profiles: STDs in Adolescents and Young Adults 67 .6 1.5 0.

.

1 per 100. ranging by state from 0..9% among American Indians/Alaska Natives. Syphilis—In 2010.3% among whites.3 People who struggle financially are often experiencing life circumstances that increase their risk for STDs.5% of syphilis case reports were missing information on race or ethnicity data. they face a greater chance of encountering an infected partner than those in lower prevalence settings.12 Acknowledging the inequity in STD rates by race or ethnicity is one of the first steps in empowering affected communities to organize and focus on this problem.5 cases per 100.10 Even when health care is available.6–8 Recent data show that nearly one-fifth of blacks do not have health insurance. Because minority populations may use public clinics more than whites.15 Completeness of Race/Ethnicity Data Many cases are reported with race and/or ethnicity missing. the poverty rates. Chlamydia—In 2010.0% increase from the 2009 rate of 1.167.2% of chlamydia case reports were missing race or ethnicity data. there are the additional barriers arising from immigration or undocumented citizenship status. Race and ethnicity in the United States are population characteristics that correlate with other fundamental determinants of health status.0% to 42.7% among Asians/Pacific Islanders.5 As an example.122. individuals may have a more difficult time reducing their risk for infection. and Hispanics were higher than for whites. Observations Chlamydia Chlamydia rates based on reported cases increased during 2009–2010 among all racial and ethnic groups (Figure 6). unemployment rates.STDs in Racial and Ethnic Minorities Public Health Impact Surveillance data show higher rates of reported STDs among some racial or ethnic minority groups when compared with rates among whites. Blacks—In 2010.000. 20.536.9.0% to 19. and low educational attainment.5 and 205. 26.9% (Table A1).000 women. chlamydia rates increased by 26.4 Those who cannot afford basic necessities may have trouble accessing and affording quality sexual health services. respectively) Special Focus Profiles: STDs in Racial and Ethnic Minorities 69 . In many state and STD Surveillance 2010 local health jurisdictions. During 2006–2010.14. Gonorrhea—In 2010. The rate of chlamydia among black women was over seven times the rate among white women (1. and high school drop-out rates for blacks.9% (Table A1). prevalence data from population-based surveys. such as high rates of poverty. fear and distrust of health care institutions can negatively affect the health care-seeking experience for many racial/ethnic minorities when there is social discrimination. unemployment. and 25. a 4. can make it more difficult for individuals to protect their sexual health.5% to 55.9% among blacks.2 cases per 100. 11. 23.2% among states with 10 or more cases of P&S syphilis (Table A1).1.0% among Hispanics.2 Social and economic conditions.g. in 2009.0% of gonorrhea case reports were missing information on race or ethnicity data. With each sexual encounter. differences in rates between minorities and whites may be increased by this reporting bias. provider bias. STD clinics) is thought to be more complete than reporting from private sources.000. the overall rate among blacks in the United States was 1.13 However. such as NHANES and the National Longitudinal Study of Adolescent Health. confirm the existence of marked STD disparities in some minority populations. 2. Rate data presented in this report are not adjusted for missing race or ethnicity. ranging by state from 0. STD Reporting Practices Surveillance data are based on cases of STDs reported to state and local health departments (see Interpreting STD Surveillance Data in the Appendix). 4. ranging from 0. Many people of Hispanic ethnicity face similar challenges. and for some. American Indians/Alaska Natives. reporting from public sources (e. or the perception that these may exist. differences commensurate with observed disparities in STD burden.11 In communities where STD prevalence is higher. income inequality.

6 times the rate among whites (Figure 22. an increase of 5.8 and 69. 13.1 times the rate among white women in the same age group (119. which was 12.1 to 432. the disparity in gonorrhea rates for American Indians/Alaska Natives was higher in the West and Midwest than in the Northeast or South (Figure R). Overall.1) and 0.000 population (Figure 22).000 population.1).9).0 to 105. American Indians/Alaska Natives—In 2010.8 cases per 100. rates among Hispanics—In 2010.2 times) (Figure Q). The overall rate among Asians/Pacific Islanders was lower than the rate among whites. an increase of 7.5).000 men.4 cases per 100.0 times) than for American Indian/Alaska Native men (3.8 cases per 100.000 and nearly three times the rate among whites. 69% of all reported cases of gonorrhea occurred among blacks. In 2010.8 cases per 100.8% from the 2009 rate of 549. This disparity was larger for black men (22.5) (Figure 22). respectively). Figure P).000.000 men.9% among Hispanics (44.4% increase from the 2009 rate of 353. Gonorrhea American Indians/Alaska Natives—In 2010.000.292. The disparity between gonorrhea rates for American Indians/Alaska Natives and whites was larger for American Indian/Alaska Native women (5. Blacks—In 2010.000 population.5 and 415.000 women. 70 Special Focus Profiles: STDs in Racial and Ethnic Minorities STD Surveillance 2010 .000 men. which was 18. which was 37.7 cases per 100.7 times the rate among white women in the same age group (156.2) (Table 22B). which is a 4.3 cases per 100.6 cases per 100.0). The chlamydia rate among black men was almost 11 times the rate among white men (761. the gonorrhea rate among American Indians/Alaska Natives was 105. the chlamydia rate among Hispanics was 369.4 cases per 100.9 cases per 100.000 women. the disparity in gonorrhea rates for blacks in 2010 was larger in the Midwest and Northeast than in the West or the South (Figure R).032. Black women aged 20–24 had a gonorrhea rate of 1. which was lower than the rate among whites (Figure 22.7 times the rate among whites (23. the chlamydia rate among Asians/Pacific Islanders was 115.024. The rate among black women aged 20–24 years was over five times the rate among white women in the same age group (Table 11B).5 cases per 100. 9. the chlamydia rate among American Indians/Alaska Natives was 592.2 times) than for black women (16.0% among whites (21. As in 2009. Similar racial disparities in reported chlamydia rates exist among men. Chlamydia rates were highest for blacks aged 15–19 and 20–24 years in 2010 (Table 11B).3% among blacks (431. which was 6.6 times the rate among white men in the same age group (78.6 cases per 100.1 cases per 100. 11. The chlamydia rate among black females aged 15–19 years was 7. The chlamydia rate among black men aged 20–24 years was almost eight times the rate among white men of the same age group (3.9 cases per 100.4 times the rate among white men in the same age group (27.000 population. The rate of gonorrhea among blacks in 2010 was 432.7 to 15. which was 22. This rate was 17.172.1% among Asians/Pacific Islanders (13.719.5 cases per 100. Black men aged 20–24 years had a gonorrhea rate of 1.(Figure O).1% from the 2009 rate of 109. Black women aged 15–19 years had a gonorrhea rate of 2. Asians/Pacific Islanders—In 2010.1 times the rate among whites (Table 11B).2 to 23. During 2009–2010.6 times the rate among white females in the same age group (1.4). Considering all racial/ethnic and age categories.9 times) (Figure Q). respectively). This disparity has changed little in recent years (Figure P). the rate of chlamydia among American Indians/ Alaska Natives in the United States was more than four times the rate among whites.768.7).997. which was 4.7) (Table 22B).1). This difference is larger for Asian/Pacific Islander women than for Asian/ Pacific Islander men (Figure Q). Among males aged 15–19 years. gonorrhea rates were highest for blacks aged 15–19 and 20–24 years in 2010 (Table 22B).000 population. Black men aged 15–19 years had a gonorrhea rate of 1.6 to 49. In 2010.7 cases per 100.000 women.000 population.7 cases per 100. the rate among blacks was 13.000 men.5% among American Indians/Alaska Natives (87. Figure P). the gonorrhea rate among Asians/Pacific Islanders was 15. Asians/Pacific Islanders—In 2010. gonorrhea rates increased 21.

8 cases per 100.4 to 16. rates among black men aged 20–24 years increased from 39.Asians/Pacific Islanders were again lower than rates among whites in all four regions of the United States (Figure R). In 2010. During 2006–2010. which was 2. This disparity between Hispanics and whites was similar to that in recent years and was higher for Hispanic men than for Hispanic women (Figure Q). STD Surveillance 2010 The largest rate increases among black women during 2006–2010 occurred among women aged 20–24 and 25-29 years (by 8.000 population) (Table 35B). 47.18 During 2006–2010. the rate of P&S syphilis among black men was 7.5% of all cases reported to CDC were among American Indians/ Alaska Natives.3 cases per 100. During the same period. 16. Congenital Syphilis In 2010.16.2% of all cases reported to CDC were among Hispanics.20 American Indians/Alaska Natives—During 2009– 2010.000 population) was the greatest reported regardless of age.4% of all cases reported to CDC were among blacks and 31. the rate of P&S syphilis declined among all racial and ethnic groups (Figure 42). In 2010.000 population. sex.9 cases per 100. In some age groups. rates among men aged 15–19 years increased the most among black men (from 14. disparities have increased markedly in recent years as rates of disease have increased (Figures T and U).1 times the rate among white men. the rate among whites (2.4 cases per 100.000 live births among Hispanics. In 2010. the rate increased among all racial and ethnic groups except American Indians/Alaska Natives (Figure 42). while the 2009 rate was 9.2 times the rate among whites (Figures 22 and P). Hispanics—In 2010. The 2010 rate of P&S syphilis for Asians/Pacific Islanders was 0. 1. Hispanics—During 2009–2010.6 and 6.5% of all cases reported to CDC were among Asians/Pacific Islanders.0% of all cases were among whites. Blacks—During 2009–2010. particularly black men (including men who have sex with men) and women aged 15–19 and 20–24 years. Special Focus Profiles: STDs in Racial and Ethnic Minorities 71 .5% (from 4.7 cases per 100.5 to 1. respectively. In 2010.000 population). the magnitude of this increase (52. Recent trends in syphilis rates in young black men are of particular concern given data indicating high HIV incidence in this population.000 population).6 times the rate for whites (Figure 42). The disparity in gonorrhea rates for Hispanics was highest in the Northeast and lowest in the West (Figure R).0 to 24. rates for black women aged 15–19 years were 38 times the rate for white women of the same age. These rates were 12.1 cases per 100.19. The 2010 rate of P&S syphilis for Hispanics was 2.2 times the rate for whites (Figure 42).7% (from 2. the rate of congenital syphilis was 33. The 2010 rate among black men aged 15–19 years was 25 times the rate for whites.1 times. the rate among black women was 21 times the rate among white women (Figure S). women.000 population.000 population).9 cases per 100. the rate of P&S syphilis among Asians/Pacific Islanders decreased 13.2 times the rate for whites (Figure 42). The 2010 rate of P&S syphilis for American Indians/Alaska Natives was 1.2 times the rate for whites (Figure 42).7% (from 18. Asians/Pacific Islanders—During 2009–2010. or race/ethnicity. Primary and Secondary Syphilis The syphilis epidemic in the late 1980s occurred primarily among men who have sex with women only (MSW).000 live births).6 to 92. respectively).3% (from 1. In 2010.6 cases per 100.5 cases per 100.5 cases per 100.3 to 2.2 to 4. the gonorrhea rate among Hispanics was 49.000 live births among blacks and 8.3 and 3. the rate of P&S syphilis among American Indians/Alaska Natives increased 8. and minority populations.5 cases per 100.000 population (134%). Race/ethnicity for cases of congenital syphilis is based on the mother’s race/ ethnicity. 0. the rate of P&S syphilis among Hispanics increased 9.17 During the 1990s. the rate of P&S syphilis among blacks decreased 8.0 cases per 100.000 population). The overall 2010 rate for blacks was eight times the rate for whites. In 2010.

23:16-23. et al. Washington. DC. Laumann EO. Groseclose SL. 2008. Increase in newly diagnosed HIV infections among young black men who have sex with men--Milwaukee County. Gonorrhea and chlamydia in the United States among persons 14 to 39 years of age. 2001. Berman S. 2008. Morris M. Sex Transm Dis. Heffelfinger JD. Weinstock HS.S.S. The Hidden Epidemic: Confronting Sexually Transmitted Diseases. Department of Labor U. Greenspan JR. Current Population Reports. 2009. Hendriksen ES.S. P60-238. Cornelius LJ. 2011 May. et al. October 1967-October 2009.and provider-level differences in testing. Fortenberry D. Swint EB.35(12 Suppl):S13-8. 19 Centers for Disease Control and Prevention. Schillinger J.S. 2009:13:582-602. the relative importance of personal and community resources. 2007. Sex Transm Dis. Social determinants and sexually transmitted disease disparities. 20 Brewer TH. 2 Cunningham PJ. 2011. Social determinants and sexually transmitted disease disparities. Schmitz JL. U. Wisconsin. Hobbs MM. Sex Transm Dis. Beltrami JF. 14 Datta SD. 2010:9(1):43-60.MMWR Morb Mortal Wkly Rep. Current Population Survey (CPS). Infectious syphilis among adolescent and young adult men: implications for human immunodeficiency virus transmission and public health interventions.26(5):250-61. 2011. Katz BP. Johnson RE. Wang J. and Health Insurance Coverage in the United States: 2009. August 2010. Poverty. Nakashima AK. 1996. The effect of fear on access to care among undocumented latino immigrants. 10 Berk ML. Prevalence of chlamydial and gonococcal infections among young adults in the United States. Collins EM. Income.S. Sex Transm Dis. Racial/ethinic group differences in the prevalence of sexually transmitted diseases in the United States: a network explanation. Safren SA. Duran RE. 1997. Jordahl L. Government Printing Office. Leichliter JS. Soc Sci Med. Bureau of Labor Statistics. J Immigr Health. Epidemiology of chlamydial infection: are we losing ground? Sex Transm Infect. The changing epidemiology of syphilis.32(Suppl 10):S4-10. J Hispanic High Educ. Department of Commerce. 17 Peterman TA. 3 4 5 6 7 8 Gonzalez JS. Schur CL.35(12 Suppl):S13-8.147(2):89-96. 16 Institute of Medicine.155(3):145-51. 1999 to 2002. Washington. 2005. 72 Special Focus Profiles: STDs in Racial and Ethnic Minorities STD Surveillance 2010 . Smith JC. Chlamydia screening among young women: individual. 12 Hogben M. 1941 through 1993. 1999-2008. Health care access among latinos: implications for social and health care reform.60(4):99-102.1 Hogben M. Youm Y. Proctor BD.127(2): e336-44. Primary and secondary syphilis among black and Hispanic men who have sex with men: case report data from 27 States. 1999. 15 Miller WC. Lewis FM. Zaidi AA. U. Papp JR. Rolfs RT. Access to ambulatory care for American Indians and Alaska Natives.291(18):2229-36. Ann Intern Med. Latinos and HIV/AIDS: examining factors related to disparity and identifying opportunities for psychosocial intervention research. Census Bureau. JAMA. Sex Transm Dis. Ann Intern Med. Census Bureau. 1995:40(3): 393-407. AIDS Behav. Sex Transm Dis. Kilmarx P. U. Blank S. Pathela P. DeNavas-Walt C. 11 Wiehe SE. 2011. Ford CA. Labor Force Characteristics by Race and Ethnicity. et al. U. 13 Miller WC. Report 1026. 18 Su JR. Handcock MS.38(5):367-71. Rosenman MB. 2010. Leichliter JS. 2008. 2004. Pediatrics.84:82-6. 9 Pérez-Escamilla R. Epidemiology of syphilis in the United States.3(3):151-156. Flock ML. Sternberg M. DC: National Academy Press. McQuillan G.

2 1.Figure O. United States.7 2.7 Blacks 761.8 1.6 Total * AI/AN = American Indians/Alaska Natives.000 population for a given racial or ethnic minority population divided by the gonorrhea rate per 100.4 69.6 Whites 233.9 2.500 Rate (per 100. United States.500 167. STD Surveillance 2010 Special Focus Profiles: STDs in Racial and Ethnic Minorities 73 . A/PI = Asians/Pacific Islanders.4 A/PI* 59.000 AI/AN* 276.7 184. Gonorrhea—Rate Ratios* by Race/Ethnicity.000 population for non-Hispanic whites. Chlamydia—Rates by Race/Ethnicity and Sex. 2001–2010 Rate Ratio† 32:1 16:1 American Indians/Alaska Natives Asians/Pacific Islanders Blacks Hispanics 8:1 4:1 2:1 1:1 1:2 2001 2002 2003 2004 2005 Year 2006 2007 2008 2009 2010 * Rate ratios are calculated as the gonorrhea rate per 100.536. Any population with a lower rate of gonorrhea than the non-Hispanic white population will have a rate ratio of less than 1:1. Figure P.000 population) 2.500 1. 2010 Men 2. † Y-axis is log scale.000 898.000 500 0 Race/ 0 Ethnicity Women 500 1.1 610.000 1.5 Hispanics 567.500 205.

000 population for a given racial or ethnic minority population divided by the gonorrhea rate per 100.1 Hispanics Whites Total 600 750 133.000 population) 750 0 Race/ 0 Ethnicity 600 450 300 150 150 AI/AN* 77. United States. Figure R. 2010 Men Rate (per 100.7 19.1 A/PI* Women 300 48. Gonorrhea—Rates by Race/Ethnicity and Sex.Figure Q.6 450 430.5 94.5 * AI/AN = American Indians/Alaska Natives.1 26. AI/AN = American Indians/Alaska Natives. 2010 West Rate Ratio† 32:1 Midwest Northeast 16:1 South 8:1 4:1 2:1 1:1 1:2 1:4 Blacks Hispanics A/PI‡ AI/AN‡ * Rate ratios are calculated as the gonorrhea rate per 100. 74 Special Focus Profiles: STDs in Racial and Ethnic Minorities STD Surveillance 2010 .0 Blacks 433. ‡ A/PI = Asians/Pacific Islanders. Any population with a lower rate of gonorrhea than the non-Hispanic white population will have a rate ratio of less than 1:1. A/PI = Asians/Pacific Islanders.5 14. Gonorrhea—Rate Ratios* by Race/Ethnicity and Region.000 population for non-Hispanic whites. † Y-axis is log scale. United States.0 17.6 106.8 51.

4 Hispanics 0.0 7. A/PI = Asians/Pacific Islanders. 2010 Men Rate (per 100.1 * AI/AN = American Indians/Alaska Natives.Figure S.6 28.000 population) 20 American Indians/Alaska Natives Asians/Pacific Islanders Blacks Hispanics Whites 15 10 5 0 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Year STD Surveillance 2010 Special Focus Profiles: STDs in Racial and Ethnic Minorities 75 .3 Race/ 0 Ethnicity AI/AN* 2.5 Women 1. Primary and Secondary Syphilis—Rates by Race/Ethnicity and Sex.5 Whites 0.7 Blacks 8. Primary and Secondary Syphilis—Rates Among Females Aged 15–19 Years by Race/Ethnicity. 2001–2010 Rate (per 100. United States. United States.1 A/PI* 6.2 7 4.000 population) 35 28 21 14 7 0 4. Figure T.9 21 28 35 0.3 Total 14 0.

000 live births) American Indians/Alaska Natives Asians/Pacific Islanders Blacks Hispanics Whites 50 40 30 20 10 0 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Year NOTE: Less than 1% of cases had missing maternal race/ethnicity information and were excluded. United States.000 population) 30 American Indians/Alaska Natives Asians/Pacific Islanders Blacks Hispanics Whites 25 20 15 10 5 0 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Year Figure V. 2001–2010 Rate (per 100. 76 Special Focus Profiles: STDs in Racial and Ethnic Minorities STD Surveillance 2010 . Congenital Syphilis—Infants—Rates by Year of Birth and Mother’s Race/Ethnicity.Figure U. Primary and Secondary Syphilis—Rates Among Males Aged 15–19 Years by Race/Ethnicity. 2001–2010 Rate (per 100. United States.

monitor.10 With the exception of reported syphilis cases. a total of 41 STD clinics at these 12 sites collected enhanced behavioral and demographic information on patients who presented for care to these clinics. Furthermore. privilege. in addition. and Hartford/New Haven (where the proportion for chlamydia was higher). and position in society also play a significant role.12 SSuN currently includes 12 collaborating local and state health departments.8 For example. broader societal factors such as power. the proportion of MSM who tested positive for gonorrhea and chlamydia at SSuN STD clinics varied by city (Figure W). for Hispanic men.. 2010 In 2005. therefore. most nationally notifiable STD surveillance data do not include information on sexual behaviors. reporting. other interpersonal and societal-level factors have also been associated with higher rates of sexually transmitted infections. The median site-specific gonorrhea prevalence was 15.13 For data reported in this section.4%–25. Baltimore. factors such as emotional and social support can drive sexual risk-taking and. and respond rapidly to trends in STDs through enhanced collection. through the MSM Prevalence Monitoring Project. A larger proportion of MSM who visited SSuN STD clinics tested positive for gonorrhea than tested positive for chlamydia in all cities except Birmingham (where the proportions were equal). which are more likely to be symptomatic than pharyngeal or rectal infections. similar enhanced surveillance data were collected in eight STD clinics. especially if they belong to racial and ethnic minority populations. In 2010. social discrimination and financial hardship) and risk for sexually transmitted infections in the United States has been documented. STD Surveillance 2010 STD Surveillance Network—Monitoring Trends in Prevalence of STDs Among MSM Who Visit STD Clinics. about the same number of MSM were tested for gonorrhea (18..7 MSM who have lower economic status are particularly vulnerable to poorer health outcomes. higher rates of partner change and partner acquisition rates. More detailed information about SSuN methodology can be found in the STD Surveillance Network section of the Appendix. including three community-based gay men’s health clinics. data on national trends in STDs among MSM in the United States are not currently available. MSW were defined as men who reported having sex with women only or who did not report the sex of their sex partner.2%). For this report. testing strategies are often suboptimal for detecting STDs in MSM.8%).g. but reported that they considered themselves straight/heterosexual. studies show that for black MSM. and unprotected sex) significantly contribute to the ongoing disparities in the sexual health of MSM. including HIV among MSM.5% (range by site: 9. SSuN was established to improve the capacity of national.1–4 Because STDs and the behaviors associated with acquiring them increase the likelihood of acquiring and transmitting HIV infection. Across the participating sites. including men who have sex with both women and men.5%–19. MSM were defined as men who either reported having a male sex partner or who self-reported as gay/homosexual or bisexual. visualization. analysis. During 1999–2008. Interpreting STD Surveillance Data.9 Similarly. and local STD programs to detect. The median site-specific chlamydia prevalence was 13. a person who tested positive for gonorrhea or chlamydia more than one time was counted only once for each disease.6 Although a number of individual-level risk behaviors (e. Testing for gonorrhea and chlamydia in MSM largely focuses on detecting urethral infections. state. Gonorrhea and Chlamydial Infection In 2010. and interpretation of disease information. the relationship between individual experiences of oppression (e.5 the rise in STDs among MSM may be associated with an increase in HIV diagnoses among MSM. higher numbers of lifetime sex partners.11 Data from enhanced surveillance projects are presented in this section to provide information on STDs in MSM.g.915). are increasing.0% (range by site: 7.462) and chlamydia (17.STDs in Men Who Have Sex with Men Public Health Impact Notifiable disease surveillance data on syphilis and data from GISP suggest that some STDs in MSM. Special Focus Profiles: STDs in Men Who Have Sex with Men 77 .

6 in 2009. Special Focus Profiles: STDs in Men Who Have Sex with Men STD Surveillance 2010 . More information about syphilis can be found in the Syphilis section of the National Profile. The prevalence of P&S syphilis was 2.2% in HIV-positive MSM.3% in MSM who were HIV-negative or of unknown status and 15.6% in 1990 to 28.1% in MSM who were HIV-negative or of unknown status and 14. the prevalence was lower among HIV-negative MSM or MSM of unknown status than among HIV-positive MSM (Figure Y).0%. The median site-specific proportion was 38. or provider diagnosis. MSM accounted for more cases than MSW or women in all racial and ethnic groups (Figure 43). pharyngeal gonorrhea positivity was 6.Co-infection with P&S Syphilis and HIV In 2010.2 in 2010 (Figure 35).4% in HIVpositive MSM. the proportion of MSM who presented to SSuN clinics with P&S syphilis infection who also were infected with HIV ranged from 25% in Hartford/New Haven to 54% in San Francisco (Figure X). 78 Nationally Notifiable Syphilis Surveillance Data In 2008. and MSM aged 15–29 years.3% in MSM who were HIV-negative or of unknown status and 7. particularly among black and Hispanic MSM. gonorrhoeae isolates obtained from MSM. from 4. Rectal gonorrhea positivity was 8. The proportion of isolates from MSM varies geographically.5% among HIV-positive MSM. the male-female rate ratio decreased to 5. Gonococcal Isolate Surveillance Project GISP is a national sentinel surveillance system designed to monitor trends in antimicrobial susceptibilities of strains of N. MSM accounted for 67% of all P&S syphilis cases in 44 states and the District of Columbia that provided information about sex of sex partners. Urethral gonorrhea positivity was 10.14 In 2010. P&S syphilis was identified by provider diagnosis and HIV was identified by laboratory report. rectal chlamydia positivity was 11.6% in HIV-positive MSM. self-report.6% in HIV-positive MSM.6% among HIV-negative MSM or MSM of unknown status and 10. Urethral chlamydia was 7. gonorrhoeae in the United States. the proportion of isolates from MSM in selected STD clinics from GISP sentinel sites has increased steadily.7% in MSM who were HIV-negative or of unknown HIV status and 19.9% in 2010 (Figure Z).4. but increased to 5.4% in HIV-positive MSM. increasing to 7.0. HIV status and STDs When comparing the prevalence of STDs by HIV status in MSM visiting SSuN STD clinics. Overall. with the largest proportion reported from the West Coast (Figure AA). More information on GISP can be found in the Gonorrhea section of the National Profile.15 GISP also reports the percentage of N.8% in MSM who were HIV-negative or of unknown status and 8. These increases support analyses of case report data showing increases in P&S syphilis among MSM during 2005–2008.

Cochran SD. MMWR Morb Mortal Wkly Rep. Cherneskie T. Weinstock HS. 2011 Aug 2. Helms DJ. STD clinics. et al. Atlanta: U. Asbel LE. Special Focus Profiles: STDs in Men Who Have Sex with Men 79 .20(5):731-739. Holmes KK. et al.300(5):520‑9. Abstract No. 2004. Wasserheit JN. cities. Prejean J. Sexual risk as an outcome of social oppression: data from a probability sample of Latino gay men in three U. In: Program and abstracts of the 17th Biennial Meeting of the ISSTDR. 3 Helms DJ. Primary and secondary syphilis among men who have sex with men—New York City. 2004. Golden MR. 2006. Knapp JS. Gratzer B.6. 9 Mays VM.155(3):145‑51. National surveillance of antimicrobial resistance in Neisseria gonorrhoeae. 2002. JAMA. 5 6 Hall HI. Marla JB. HIV prevention research: are we meeting the needs of African American men who have sex with men? J Black Psychol. 10 Díaz RM. Abstract No. JAMA. et al. 2007 Jul 29-Aug 1. Ann Intern Med. Atlanta: U. Madison ME. Sex Transm Infect. Zamudio A. Beltrami JF. Primary and secondary syphilis among black and Hispanic men who have sex with men: case report data from 27 States. AIDS. 2002–2006.51:853-6.91:959‑64.264(11):1413‑7. 2008. et al. Here comes the SSuN—early experiences with the STD Surveillance Network. 2009. Husnik MJ. Zenilman J. Weinstock HS. STD Surveillance 2010 12 Rietmeijer K. Bernstein K.75:3‑17. Chicago. Furness BW. et al. Increases in syphilis among men who have sex with men attending STD clinics. IL. 1 2 Centers for Disease Control and Prevention. 2001. Judson FN.30:78. Pub Health Rep. Sexually Transmitted Disease Surveillance 2008. Asbel LE. Song R.S. Risk factors for HIV infection among men who have sex with men. Department of Health and Human Services. Estimation of HIV incidence in the United States. 2001. Missed gonorrhea infections by anatomic site among asymptomatic men who have sex with men (MSM) attending U. 1990. Hook EW III. An Q. Bein E. del Rio C. Department of Health and Human Services. WA.S. 2009. 2008 March 10-13. Ayala G. P-608. Gonorrhea in the HIV era: a reversal in trends among men who have sex with men. for the HIV Incidence Surveillance Group.10(3):255-267. SC. 14 Su JR. Zaidi AA. 2000–2005. The health of men: structured inequalities and opportunities. Am J Public Health. Rhodes P.Fox KK. Bissette J. 2003.S. Colfax GC. Hook EW III. 11 Mahle KC. Am J Public Health. et al.124(Suppl 2):72‑77. 4 Fleming DT. Martins S. A1d. 2009. Huang Y. 13 Centers for Disease Control and Prevention. Cherneskie T. Schnell D. 15 Schwarcz S. Pathela P. Sexually transmitted disease surveillance 2007 supplement: Gonococcal Isolate Surveillance Project (GISP) annual report 2007. Cultur Divers Ethnic Minor Psychol. Knapp JS. In: Program and abstracts of the 2008 National STD Prevention Conference. et al. Seattle.93:724-731.S. Thompson S. Buchbinder. From epidemiologic synergy to public health policy and practice: the contribution of other sexually transmitted diseases to sexual transmission of HIV infection. Ciesielski C. Lee LM. Centers for Disease Control and Prevention. 8 Williams DR. Donnelly J. 7 Koblin BA. 1999.

NOTE: Includes sites that reported data on at least 5 MSM with P&S syphilis in 2010.Figure W. 2010 Percentage Gonorrhea 30 Chlamydia 25 20 15 10 5 0 San Francisco Los Angeles Seattle Chicago Denver New Birmingham Baltimore New York Hartford/ Richmond Philadelphia Orleans City New Haven * MSM = men who have sex with men. 80 Special Focus Profiles: STDs in Men Who Have Sex with Men STD Surveillance 2010 . STD Surveillance Network (SSuN)—Gonorrhea and Chlamydia—Proportion of MSM* Testing Positive for Gonorrhea and Chlamydia. Figure X. by Site. STD Surveillance Network (SSuN)—Primary and Secondary Syphilis and HIV—Proportion of MSM* with Primary and Secondary Syphilis Who Are Co-infected with HIV. 2010 Percentage 100 90 80 70 60 50 40 30 20 10 0 San Francisco Los Angeles Seattle Chicago Denver New Orleans Richmond Philadelphia Baltimore New York City Hartford/ New Haven * MSM = men who have sex with men.

Gonococcal Isolate Surveillance Project (GISP)—Percentage of Urethral Neisseria gonorrhoeae Isolates Obtained from MSM* Attending STD Clinics. † Figure Z. STD Surveillance Network (SSuN)—Proportion of MSM* Attending STD Clinics with Primary and Secondary Syphilis. STD Surveillance 2010 Special Focus Profiles: STDs in Men Who Have Sex with Men 81 . Gonorrhea or Chlamydia by HIV Status. HIV negative status includes persons of unknown status for this analysis. 2010 Percentage 20 HIV–† HIV+ 16 12 8 4 0 P&S syphilis GC‡ urethral GC pharyngeal GC rectal CT‡ urethral CT rectal * MSM = men who have sex with men.Figure Y. 1990–2010 Percentage 30 25 20 15 10 5 0 1990 1992 1994 1996 1998 2000 2002 2004 2006 2008 2010 Year * MSM = men who have sex with men. ‡ GC urethral and CT urethral include results from both urethral and urine specimens.

NOR = New Orleans. MI. WA. IL. PA. AL. BHM = Birmingham. ATL = Atlanta. NYC = New York City. NY. MO. 82 Special Focus Profiles: STDs in Men Who Have Sex with Men STD Surveillance 2010 . DAL = Dallas. CA. TX. MIN = Minneapolis. OK. CLE = Cleveland. AZ. CA. CO. FL. NM. POR = Portland. by Site. BAL = Baltimore. OH. HI (does not provide sexual risk behavior data). OKC = Oklahoma City. NV. CA. ORA = Orange County. OH. MIA = Miami.Figure AA. HI. CIN = Cincinnati. SFO = San Francisco. VA. MD. LAX = Los Angeles. PHI = Philadelphia. GA. DEN = Denver. HON = Honolulu. GRB = Greensboro. DTR = Detroit. MN. LVG = Las Vegas. 2007–2010 SEA POR MIN DTR CHI SFO DEN LVG BAL CIN KCY LAX RIC GRB ORA ALB PHX OKC HON PHI % of Isolates from MSM 100 BHM ATL DAL SDG NYC CLE 50 TRP NOR MIA 0 07 08 09 10 Year * MSM = men who have sex with men. SDG = San Diego. OR. CHI = Chicago. and TRP = Tripler Army Medical Center. RIC = Richmond. KCY = Kansas City. LA. CA. SEA = Seattle. NOTE: Participating sites include ALB = Albuquerque. Gonococcal Isolate Surveillance Project (GISP)—Percentage of Urethral Neisseria gonorrhoeae Isolates Obtained from MSM* Attending STD Clinics. NC. PHX = Phoenix.

positivity was 6. STD screening data from corrections facilities were reported in 36 states and Puerto Rico for chlamydia and gonorrhea. STD Surveillance 2010 Males in Juvenile Corrections Facilities—Among males aged 12–18 years entering 128 juvenile corrections facilities. Overall.7% for those aged younger than 20 years to 1.7%) was higher than the overall prevalence observed in adolescent males entering juvenile facilities (6. Positivity ranged from 7.489 chlamydia tests of women (25. For example.9% for those aged older than 34 years. and 106.5% for adolescent males aged 12 years to 10. gonorrhea. 112. Overall chlamydia positivity among adult men entering corrections facilities in 2010 was 6. Description of Population In 2010.371 gonorrhea tests of men (72.1–4 Prevalence rates for chlamydia and gonorrhea in these settings are consistently among the highest observed in any venue. Chlamydia positivity ranged from 1.4% for those aged older than 34 years.3% (Figure BB).9%) was substantially lower than that in adolescent females entering juvenile corrections facilities (15.133 chlamydia tests of men (77. Women in Adult Corrections Facilities—Among women entering 32 adult corrections facilities in 2010. Line-listed (i. from 11.9% (Figure BB).4 Screening for chlamydia. Syphilis data from notifiable disease surveillance are reported to CDC by local and state STD prevention programs.925 from adult facilities).401 from juvenile facilities and 21. However. and reduce transmission in the general community.6 Females in Juvenile Corrections Facilities—Among females aged 12–18 years entering 73 juvenile corrections facilities. from 15. The figures and tables presented in this section represent 47.089 from juvenile corrections facilities and 22. the overall chlamydia positivity was 6.9%) (Figure CC). 43. and syphilis at intake offers an opportunity to identify infections.3% for those aged younger than 20 years to 2. prevent complications. Overall chlamydia positivity in women entering adult corrections facilities (6. positivity in men aged younger than 20 years (11. Men in Adult Corrections Facilities—Among men entering 55 adult corrections facilities in 2010. casespecific) data for chlamydia and gonorrhea are provided to CDC through the Infertility Prevention Project (IPP).400 from adult facilities).5 In some locations. chlamydia positivity among women aged younger than 20 years entering adult corrections facilities was similar to that among women entering juvenile corrections facilities.7%. the overall chlamydia positivity was 15. a substantial proportion of all early syphilis cases are reported from corrections facilities. Chlamydia positivity decreased with age.446 from juvenile facilities and 33.2% for females aged 12 years to 17.0% for those aged 16 years.0% for those aged 18 years. Special Focus Profiles: STDs in Persons Entering Corrections Facilities 83 . chlamydia positivity was higher in women than in men for all age groups.027 from juvenile facilities and 35.9% (Figure CC).106 from adult facilities).918 from adult facilities).319 gonorrhea tests of women (21. data from one study in a location with high syphilis incidence suggested that screening and treatment of female inmates for syphilis may reduce syphilis in the general community.STDs in Persons Entering Corrections Facilities Public Health Impact Chlamydia Multiple studies and surveillance projects have demonstrated a high prevalence of STDs in persons entering jails and juvenile corrections facilities. Chlamydia positivity decreased with age.3%)..e.

overall gonorrhea positivity was 1. Rubin SR. 1997. Estimates of Chlamydia trachomatis infections among men: United States. Early syphilis in the United States identified in corrections facilities.35(Suppl 11):S3-7.7% among those aged younger than 20 years to 0. Positivity increased with age.9% (Figure EE). 2009. Masterson MB. Blank S. Weinstock HS. Sex Transm Dis.4% in men aged older than 34 years.1%). Joesoef MR. Chow JM. Greenberg AJ. Chow JM. Neal JJ. 1997–2002. Chlamydia trachomatis and Neisseria gonorrhoeae prevalence and coinfection in adolescents entering selected US juvenile detention centers.6%) had higher gonorrhea positivity than males entering juvenile corrections facilities (1. et al. Birkhead GS.2% (Figure DD). Kent CK. Brome MW. Arch Intern Med. 1999–2002.1% for those aged 18 years. et al. 1993. Voigt R. 2005: implications for screening policy. 2008.153:1799-804. Weinstock H. Sex Transm Dis.9% among those aged older than 34 years. Kahn RH.36(Suppl 2):S67-71.2%).6%) and declined with age to 0. et al. Men aged younger than 1 2 3 Heimberger TS. from 0. 6 Kahn R. Kent CK. DiFerdinando GD. Positivity generally increased with increasing age. Special Focus Profiles: STDs in Persons Entering Corrections Facilities STD Surveillance 2010 .0% (Figure EE). Boudov MR. A potential public health measure to address the syphilis epidemic. Joesoef MR. Women in Adult Corrections Facilities—Among women entering 32 adult corrections facilities in 2010. from 3.8% for those aged 12 years to 5. Finding opportunities for syphilis treatment and congenital syphilis prevention in a women’s correctional setting.1% of those aged 18 years. Datta SD. and 1% among MSM (Figure 46). gonorrhea positivity in women was uniformly higher than in men for all age groups. 3% among women. Sex Transm Dis.1% for those aged 12 years to 2. Sex Transm Dis. et al. High prevalence of syphilis detected through a jail screening program. Swint E. 5 Blank S. Women aged younger than 20 years entering adult facilities (3. reports of P&S syphilis cases from correctional facilities accounted for 5% of P&S syphilis among MSW. Positivity was highest in men aged younger than 20 years (1. New approaches to syphilis control. Parvez FM. Males in Juvenile Corrections Facilities—The overall gonorrhea positivity for adolescent males entering 123 juvenile corrections facilities in 2010 was 1.24:218-26. McDonnell DD. Mosure DJ. 84 20 years entering adult facilities (1. Men in Adult Corrections Facilities—The overall gonorrhea positivity for men entering 55 adult corrections facilities in 2010 was 1.7%) had lower gonorrhea positivity than females entering juvenile corrections facilities (4.1% (Figure DD).29:255-59. Sex and age correlates of chlamydia prevalence in adolescents and adults entering correctional facilities. 2004. Sex Transm Dis.29:271-76. 4 Satterwhite CL. Chang HG. Positivity decreased with age. Females in Juvenile Corrections Facilities—The overall gonorrhea positivity for adolescent females entering 60 juvenile corrections facilities in 2010 was 4. Gunn R. 2005. Boudov MR. Syphilis In 2010. Weinstock H. from 2.Gonorrhea Overall.

Figure BB.

Chlamydia—Positivity by Age and Sex, Juvenile Corrections Facilities, 2010

Men
20

Positivity
16

12

8

4

0
1.5

Age
12

Women
0

4

8

3.8

13.3
16.2

15

7.8

20

10.1

14

6.1

16

7.2

13

2.4

12

17.0

16
17

8.8
10.0

15.0
16.3

18
Total

6.9

15.3

NOTE: Positivity percentage is presented from facilities reporting more than 100 test results.

Figure CC.

Chlamydia—Positivity by Age Group and Sex, Adult Corrections Facilities, 2010

Men
20

Positivity
16

12

8

4

0

Age

Women
0

4

8

12

<20

11.7

5.9

30–34

3.9
1.9
6.7

10.5

25–29

5.5

>35

20

15.3

20–24

9.6

16

4.6
2.4

Total

6.9

NOTE: Positivity percentage is presented from facilities reporting more than100 test results.

STD Surveillance 2010

Special Focus Profiles: STDs in Persons Entering Corrections Facilities

85

Figure DD.

Gonorrhea—Positivity by Age and Sex, Juvenile Corrections Facilities, 2010

Men
20

Positivity
16

12

8

4

0
0.1

Age
12

0.2

13

Women
0

4

8

20

3.4
4.1

14

0.8

15

4.4

1.3

16

4.2

1.3

17

4.2
5.1

18
Total

1.1

16

2.8

0.6

2.1

12

4.2

NOTE: Positivity percentage is presented from facilities reporting more than 100 test results.

Figure EE.

Gonorrhea—Positivity by Age Group and Sex, Adult Corrections Facilities, 2010

Men
20

Positivity
16

12

8

4

0

Age

1.6

<20

1.4

20–24

0.8

25–29

0.7

30–34

0.4
1.0

>35

Women
0

4

8

12

16

20

3.7
2.5
1.9
1.0
0.9

Total

1.9

NOTE: Positivity percentage is presented from facilities reporting more than 100 test results.

86

Special Focus Profiles: STDs in Persons Entering Corrections Facilities

STD Surveillance 2010

TABLES

TABLES .

680 1.6 9.1 163.0 9.0 57.000 Population.4 294.738 10.771 80.0 29.492 360.429 41.8 61.8 57.317 63.452 1.058 1.9 9.5 9.0 28.4 20.2 129.5 168.7 34.5 383.1 195.0 45.560 479. United States.0 270.187 7.311 8.7 159.096 21.9 107.0 13.924 80.9 147.5 53.2 6.1 8.4 0.3 23.872 67.997 91.138 916 626 463 434 332 277 287 259 239 305 329 410 480 741 1.4 368.1 10.725 30.7 1.894 2.5 9.7 24.573 130.0 23.1 12.0 192.420 2.968 14.824 122.2 21.004.3 28.918 16.896 17.6 0.5 11.392 73.7 36.6 7.813 146.176 69.603 24.3 9.629 67.3 59.9 21.1 2.009 39.147 76.7 7.6 86.0 35.598 62.0 85.6 45.870 89.491 5.5 7.656 29.590 128.311 105.743 16.3 3.942 146.658 126.755 359.163 4.9 66.9 27.4 0.332 451.3 10.9 7.5 54.9 10.0 520.392 847 665 2.019 45.532 738.049 68.2 23.950 44.7 17.5 10.569 98.038 96.637 1.0 87 .5 0.348 49.585 42.0 16.3 0.2 65.939 116.5 92.3 17.5 97.4 47.9 4.7 7.986 4.5 11.2 5.836 464.9 7.5 7.832 72.5 62.578 50.7 0.6 4.2 69.6 Chlamydia Gonorrhea Chancroid Cases Rate Cases Rate Cases Rate NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR 7.301 20.235 9.9 169.6 104.855 21.346 214.781 9.697 4.130 44.569 12.977 4.9 0.228 409.340 242.933 264.385 37.454 24.295 18.676 5.9 23.0 47.123 86.454 78.9 78.384 5.8 11.631 537.783 43.621 64.5 181.676 287.033 9.145 68.7 11.017 12.6 8.292 782 607 386 246 189 110 2.6 28.600 16.4 0.394 18.7 35.245 88.874 30.020 380.4 123.414 1.621 906.731 29.181 368.4 22.168 19.5 14.761 64.282 1.5 2.7 160.579 74.289 300.0 11.458 9.131 28.137 114.556 911.229 787.296 20.7 18.419 892.7 36.666 345.169 327.2 53.762 148.215 842.2 21.854 27.104 1.2 3.2 25.675 6.6 79.848 58.0 382.313 23.089 123.7 103.7 16.661 6.354 7.3 41.1 32.435 878.8 26.8 153.2 8.6 11.4 23.4 265.576 66.9 10.919 16.553 7.158 263.698 29.286 104.4 145.074 1.212 3.0 3.617 STD Surveillance 2010 Syphilis Primary and Secondary Rate 51.1 366.4 0.490 26.204 367.950 8.8 20.3 50.904 614.1 460.9 319.070 300.984 202.592 314.0 23.837 3.2 4.2 6.390 116.2 48.4 Rate 109.0 6.7 462.288 4.2 0.8 40.233 3.354 5.950 286.1 276.577 492.200 13.7 385.1 14.1 4.8 93.417 9.2 68.002.826 54.5 160.538 124.4 0.545 218.541 61.268 767.7 464.5 70.666 324.543 19.2 10.925 351.864 960.1 Congenital National Summary Tables Rate§ 651.248 122.1 372.4 0.459 9.628 8.402 7.543 534.397 113.8 19.4 49.3 1.558 174.5 23.2 21.602 392.474 46.713 69.8 87.6 111.9 153.9 3.5 26.1 2.8 10.4 7.6 383.050 236.561 33.7 16.696 4.758 113.6 6.7 31.9 0.7 11.0 17.6 10.164 13.018 82.6 100.9 32.094 8.486 10.7 21.9 12.054 31.6 60.312 116.160 733.3 0.438 1.667 36.9 23.9 160.884 120.758 1.130 4.8 6.515 7.2 9.220 1.135 1.001.0 13.799 68.485 110.416 1.254 258.4 27.1 102.564 54.3 5.9 297.0 28.7 354.266 32.8 190.5 14.2 10.4 75.783 12.785 478.918 502.7 101.0 17.5 0.385 Rate Early Latent Late and Late Latent‡ Cases Cases Cases Rate Cases 202.637 69.649 419.0 130.595 1.904 323.799 75.9 1.5 187.1 24.594 25.584 11.312 447.7 0.3 0.2 179.8 2.251 60.447 17.3 25.4 14.7 424.924 167.585 10.929 19.2 68.905 22.7 9.2 193.657 10.4 27.2 27.2 7.443 282.2 8.9 233.9 10.7 45.526 95.091 9.5 147.363 11.3 35.150 7.593 467.8 17.3 0.9 12.9 15.174 175.738 404.6 24.957 252.641 26.848 142.1 7.564 3.5 29.730 102.655 153.6 16.9 213.6 137.4 24.865 4.204 31.687 122.238 98.7 127.5 0.5 231.2 68.537 1.027 86.6 0.Table 1.7 0.9 13.6 16.656 9.578 12.359 53.9 5.356 71.829 18.796 10.2 0.0 135.2 50.8 196.170 2.931 13.894 9.9 0.250 662.937 1.994 1.416 4.993 43.9 7.3 77.5 121.382 95.1 566.449 95.0 239.9 107.7 5.9 21.6 9.6 0.4 35.8 217.7 57.5 17.7 6.6 19.3 49.1 0.9 42.8 21.4 17.1 0.7 45.1 20.633 900.4 11.0 431.1 0.325 112. 1941–2010 All Stages† Year* 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 Cases 485.8 36.858 444.587 50.233 11.647 355.469 83.9 1.477 8.309 83.8 17.3 2.377 11.1 63.4 0.2 129.339 12.045 4.8 13.546 115.9 12.007 271.468 212.613 31.851 68.746 254.8 414.9 75.6 149.891 4.746 27.694 405.719 79.714 278.6 85.149 87.0 82.3 57.042 621.6 7.5 9.338 54.9 82.647 — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — —­ —­ ­ — — — — — — — 6.2 15.456 37.366 20.338 3.3 94.637 82.5 4.106 12.516 3.4 218.124 73.515 7.6 119.6 145.4 20.6 398.7 130.1 21.607 28.294 690.463 217.363 22.013.631 6.245 124.8 87.2 20.082 843 579 368.2 11.7 0.3 447.4 6.1 19.740 81.4 245.988 27. Cases of Sexually Transmitted Diseases Reported by State Health Departments and Rates per 100.8 247.5 11.8 19.554 7.114 363.3 25.707 4.3 41.6 33.719 114.003 2.029 990.7 19.5 4.8 11.247 982 838 784 845 1.1 11.5 2.979 20.0 149.496 232.5 225.1 442.7 21.5 16.397 22.3 27.913 157.052 1.0 371.799 17.231 363.067 3.1 11.501 317.0 171.663 381.064 251.7 0.9 43.563 67.8 32.320 1.738 3.8 0.414 18.861 15.5 22.612 82.7 19.0 63.9 153.8 143.4 0.1 431.1 20.072 670.982 46.866 5.436 1.399 29.187 125.9 8.825 39.6 3.7 31.0 1.0 456.4 87.1 19.4 135.6 456.7 94.197 224.975 58.470 244.017 10.405 17.6 205.1 32.4 55.054 12.403 275.2 21.716 38.3 290.0 114.7 43.070 4.131 9.957 238.007 12.863 1.089 135.097 91.032 25.649 2.872 600.4 9.0 20.329 9.7 1.2 1.665 356.7 9.9 24.3 178.7 7.076 68.414 52.7 6.854 200.556 9.5 6.6 18.906 1.004.1 12.3 93.313 256.2 324.5 325.798 79.2 205.7 98.952 13.7 10.271 92.3 10.0 301.2 26.025 9.159 102.651 328.053 48.0 10.5 19.4 20.601 575.556 13.392 130.8 193.162 91.6 15.8 11.476 1.297 8.386 240.124 11.5 14.6 20.875 67.6 52.784 9.0 158.001 91.953 2.7 54.969 58.3 8.8 120.842 105.750 27.4 6.256 39.581 96.9 90.533 78.0 48.0 0.344 1.3 25.424 4.0 19.381 2.031 3.8 21.067 66.5 41.067 3.5 6.304 79.201 123.0 123.240 46.046 22.8 18.4 11.6 14.3 0.689 9.7 0.121 999.4 19.9 1.7 97.1 15.9 164.958 202.1 12.7 182.038 21.219 1.8 275.527 1.8 43.045 51.316 28.9 11.0 12.289 35.3 2.5 70.8 16.1 6.6 116.779 87.527 31.8 8.534 4.3 4.3 192.8 56.165 945 700 628 455 521 840 788 850 1.6 236.2 0.878 5.

0 0. United States.523 398.0 Gonorrhea Chancroid Cases Rate Cases Rate 878.617 5.8 478.980 8.779 87.3 10.374 367.0 0.8 6.768 12.991 336.7 25.696 11.103 6.904 205.462 316.1 13.0 0.1 7.3 377 8.284 32.0 171.0 19.1 0.5 9.132 339.250 231.0 110.4 6.7 4.7 14.2 112.4 0.3 50.9 5.3 709.3 13.7 39.212 3.2 8.750 27.7 1.663 160.4 17.6 20.593 358.958 40.607 27.1 3.0 409.414 18.4 2.988 27.168 18.8 579 14.6 2.997 13.0 13.8 120.852 335.5 2.2 976.4 614.9 10.0 115.2 580 14.363 22.2 14.0 451.9 10.9 537.774 12.1 2.492 360.577 187.2 12.925 46.0 11.9 58.366 355.5 339 8.0 0.1 4.490 26.9 3.424 107.0 0.3 435 10.289 35.657 20.590 128.229 787. neurosyphilis.5 446 10.366 20.862 7.527 20.429 8.919 32.724 9.7 0.0 * For 1941–1946.1 163.667 35.854 87.210.7 7.2 7.032 25.0 42.4 11.8 3.244.604 9. ‡ Late and late latent syphilis includes late latent syphilis.830 45.3 1.546 115.612 82.979 6.4 26.689 21.3 0.6 877.2 3.2 21.716 38.5 6.5 9.829 18.8 1.6 381.618 32.0 1.543 11.296 20.3 10.1 6.5 325.4 245.6 15.466 13.0 301.4 11.Table 1.3 4.863 47.534 9.891 4.452 62.2 480 12.082 27.701 8.0 5.848 17.7 16. For more information regarding reporting.9 1.3 11.837 45.0 371.6 7.1 1.7 126.282 32.4 410 10.858 444.594 6.169 327.3 5.174 309.2 36.001 35.1 1.9 1.5 383.286 104.017 26.2 11.447 17.332 178.419 892.0 2.405 8.000 live births.532 738.9 492.046 22.8 11. For 1941–1958.9 6.743 16.0 0. Cases of Sexually Transmitted Diseases Reported by State Health Departments and Rates per 100.445 329.228 179.8 122.2 129.556 7.697 4.242 274.7 98.500 13.8 10.855 49.126.7 2.1 2.5 16.0 6.4 504 12. † Includes stage of syphilis not stated.694 182.9 6.0 0.108.5 843 21.6 5.4 114.9 2.665 356.3 128.6 54.4 2.5 405.030.187 16.256 19.476 1.079 7. data for Alaska and Hawaii were not included.603 24.067 3.5 31.705 351.045 4.4 4.9 147.602 392.7 1.401 13.007 6.049 17. NR = No report. Puerto Rico.1 929.578 42.9 28.1 429 9. 2011 (see Appendix). and late syphilis with clinical manifestations other than neurosyphilis.585 40. The number of cases and the rates shown here supersede those published in previous reports.394 55.319 17.0 7.7 375 9.631 190.1 100.649 419.8 665 2.7 11.1 11.6 4.641 16.756 11. see Interpreting STD Surveillance Data in the Appendix.644 18.240 46.4 432 10.906 1.656 28.4 372 8.186 10.4 834.594 16.1 4. § Rates include all cases of congenitally acquired syphilis per 100.8 741 19.6 4.5 2.8 9.6 91.713 69.176 9. 88 National Summary Tables STD Surveillance 2010 .4 11.556 911.5 23.0 0.725 30.089 135.3 17.826 50.785 192.289 33.7 18.5 14.986 4.904 102. 1941–2010 (continued) All Stages† Year* 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Syphilis Primary and Secondary Early Latent Late and Late Latent‡ Congenital Rate§ Chlamydia Cases Rate Cases Rate Cases Rate Cases Rate Cases Cases Rate 69.2 4.066 13.9 2.911 344.918 502.385 31.288 36.9 44.8 4.180 405.1 9.042 621.6 18.131 27. As of 1995.655 15.009 26.420 85.8 46. Note: Adjustments to the number of cases reported from state health departments were made for hardcopy forms and for electronic data submissions through June 8.9 305 8.0 0.3 2.4 11.0 0.177 7.555 289.6 662.1 0.5 6.9 12.6 4. latent syphilis of unknown duration.913 50.4 3.5 783.3 0. data were reported for the calendar year ending December 31.719 114.1 2.5 1.478 301.4 28.919 34.950 34.563 67.3 19.6 119.2 10.5 5.397 53.5 121.6 14.730 102.631 12.9 297.2 0.7 118.465 8.5 329 8.3 3. From 1947 to the present.359 53.945 17.361 7.834 29.8 17. data were reported for the federal fiscal year ending June 30 of the year indicated.5 460 11.104 330.131 21.968 45.2 129.294 690.3 3.5 0.136 361.4 5.893 426.872 67.0 2.3 7.8 196.9 323.000 Population.768 8.5 200.746 27.2 4. cases of congenital syphilis are obtained in hardcopy and electronic format on the basis of case reporting form CDC 73.5 3.1 12.067 100.813 363.5 11.233 35.4 22.1 3.341 372.338 18.292 782 607 386 246 189 110 78 38 48 54 30 17 19 23 25 28 24 0.292 44.300 16.6 7.6 28.865 92.976 17.6 1.423 33. and Virgin Islands.742 301.929 41. Cases and rates shown in this table exclude the outlying areas of Guam.0 0.307.1 2.9 1.1 276.160 733.7 1.647 247.474 45.1 0.651 328.0 157.6 5.452 251.

049 1.2 196.3 319.9 407.147 28.6 272.6).080 3.7 365.601 3.417 29. STD Surveillance 2010 Chlamydia Tables 89 .3 483.5 340.7 469.960 cases and rate of 150.672 6.6 459.0 379.4 350.920 4.2 185. and Virgin Islands with 609 cases and rate of 554.082 26.352 21.404 9.1 426.2 240.6 330.5 574.2 392.2 443.015 26.327 42.5 648.518 2.443 74.7 725.348 21.9 464.192 45.9 387.3 504.4 459.3 449.041 15.872 60.447 16.4 284.048 51.424 99.2 290.464 49. † Total includes cases reported by the District of Columbia with 5.586 2.257 2. 2010 Rank* 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 State Alaska Mississippi Louisiana New Mexico South Carolina Alabama Arkansas New York Delaware Michigan Texas Illinois Hawaii Maryland Georgia Tennessee North Carolina Ohio Missouri U.893 23.542 9.236 26.649 22. Chlamydia—Reported Cases and Rates by State.0 410.376 47.019 21.S.3 496.6 377.307.7 316.480 12.1 435.302 19.113 14.478 119.9 448.9 390.2.9 582.0 403.7 359.462 Rate per 100. Ranked by Rates. TOTAL† Wisconsin Arizona California Florida South Dakota Virginia Wyoming Oklahoma Colorado Kentucky Pennsylvania North Dakota Nevada Connecticut Indiana Iowa Kansas Rhode Island Oregon Washington Massachusetts Montana New Jersey Minnesota Nebraska Idaho Utah West Virginia Vermont Maine New Hampshire Cases 6.142 15.0 371.7 388.192 30.Table 2.294 5. but excludes outlying areas (Guam with 899 cases and rate of 503.706 26. Puerto Rico with 5.825 10.1 300.797 2.9 320. United States.9 * States were ranked in descending order by rate (rounded to the nearest tenth) and by number of cases.114 4.8 511.861 150.3 533.525 27.0.876 1.5 581.151 11.744 3.589 cases and a rate of 932.8.2 407.5 355.0 202.2 387.4 322.666 12.150 26.690 3.3 213.208 6.000 Population 861.

9 315.7 240.3 390.5 468.887 267.9 196.4 174.024.416 271.177 26.045 2.549 72.8 407.577 1.293 27.2 431.2 239.529 9.923 14.3 448.021 1.0 387.6 648.690 1.911 24.190 31.9 258.4 275.443 10.629 5.0 320.1 464.555 1.015 4.511 390.5 300.7 587.244.633 25.2 584.1 318.6 284.7 329.911 163.0 336.3 599.390 7.6 400.3 652.5 327.686 23.9 355.038 100.049 3.8 372.151 243.615 26.2 469.5 151. TOTAL Northeast Midwest South West Guam Puerto Rico Virgin Islands OUTLYING AREAS TOTAL 90 2006 22.760 4.2 458.0 330.8 279.313 10.608 24.306 21.327 119.470 20.5 502.620 26.712 8.3 357.348 620 7.345 53.744 45.503 44.518 3.493 92.1 417.7 346.849 42.3 1.307.351 2.542 9.9 322.368 48.828 6.6 286.464 5.0 410.410 1.372 9.057 24.162 269.9 308.3 283.6 364.7 293.108.931 39.1 615.4 725.929 5.589 25.577 39.588 244.194 9.6 326.142 11.2 247.210.5 340.9 145.523 192.3 472.861 15.377 232.920 42.7 290.151 2.4 272.753 12.023 11.557 486.541 23.192 21.4 358.2 431.8 373.7 443.6 416.9 387.9 289.0 250.924 71.136 148.323 2.253 24.5 269.069 255.0 344.714 14.145 37.992 9.468 1.7 413.7 739.3 446.9 483.0 250.5 422.7 190.3 213.3 370.9 449.7 496.974 9.6 300.6 314.561 687 6.169.192 28.2 496.1 274.0 158.376 29.4 312.6 228.0 191.2 582.197 23.019 26.3 290.479 6.654 3.132 9.0 380.1 708.6 443.3 932.147 6.874 587 8.2 380.402 3.413 21.796 19.2 419.611 1.3 675.820 40.872 6.615 3.186 11.294 21.9 393.5 331.589 74.236 2.0 306.362 2.575 42.643 8.1 388.405 9.722 55.4 276.950 899 5.6 451.1 471.9 156.1 414.8 341.6 799.4 581.825 10.972 5.4 294.106 12.1 432.747 19.320 75.870 6.1 352.8 182.5 371.5 286.3 361.7 372.1 437.048 2007 25.0 192.169 22.8 317.190 1.4 405.180 199.7 418.510 13.0 402.045 1.0 359.817 3.573 9.8 397.946 3.6 473.3 353.1 296.137 1.1 284.233 3.1 387.9 480.628 2.7 275.6 2007 543.5 307.239 15.5 351. Chlamydia—Reported Cases and Rates by State/Area and Region in Alphabetical Order.243 262.041 6.S.5 417.292 279.5 410.718 6.0 403.359 37.0 1.422 1.487 3.3 294.5 417.529 505.153 4.9 338.2 312.0 392.4 390.4 451.748 5.142 22.002 22.997 20.092 1.8 388.720 33.3 2009 550.9 355.5 339.090 8.9 407.866 9.447 12.5 392.0 258.921 47.5 718.101 5.351 21.706 99.803 10.3 280.2 370.5 281.982 2.4 220.3 468.957 48.3 298.435 832 5.3 464.8 315.5 389.669 17.015 29.1 495.462 26.404 51.2 503.7 533.002 14.2 406.6 343.117.514 2.6 347.866 85.744 42.055 21.711 105.497 43.480 26.1 358.650 5.5 312.109 22.4 197.259 135.861 24.5 184.827 16.784 3.315.9 300.315 45.317 26.194 59.453 Rates per 100.191 24.4 2010 574.029 57.721 1.9 377.3 258.1 444.5 440.935 19.5 401.3 202.525 24.431 2.7 392.590 2010 27.6 316.798 19.7 407.1 404. United States and Outlying Areas.186 30.876 23.910 20.7 405.519 3.6 367.6 394.8 320.5 303.909 348 9.4 2008 531.9 367.2 398.1 743.2 349.434 12.5 435.3 248.145 1.026 3.2 390.4 363.859 8.960 609 7.4 173.048 2.649 4.609 428.069 41.769 14.659 3.9 160.443 19.6 175.361 Chlamydia Tables 2006 498.2 270.079 1.5 449.8 299.913 5.9 427.431 23.4 350.1 437.5 302.1 350.1 393.893 217.9 391.7 190.604 20.4 449.2 554.3 381.5 392.842 60.394 36.885 2.548 3.2 418.868 2.7 185.910 6.102 203 6.9 216.5 129.2 459.586 26.671 2009 25.127 4.092.9 412.7 292.316 20.1 364.789 47.094 279.8 326.8 150.9 723.308 2.717 30.1 174.615 1.3 366.180 12.659 2.786 5.996 1.797 21.3 423.0 1.542 21.406 10.7 198.6 379.1 436.6 365.9 186.082 5.9 231.982 4.543 5.000 Population 2008 24.068 3.8 534.7 200.1 398.3 315.3 406.6 402.557 531.4 471.354 146.7 343.672 22.252.2 533.2 278.0 394.3 351.579 18.940 17.154 9.829 8.955 38.387 3.9 458.9 387.3 170.117 14.218 21.8 349.9 248.9 269.2 459.1 347.6 STD Surveillance 2010 .906 1.037.1 328.030.2 212.262 88.5 511.4 262.0 184.374 181.478 15.4 416.257 30.348 3.469 3.3 321.2 395.6 319.819 2.9 214.4 192.6 160.208 12.4 199.963 1.516 1.666 2.087 17.5 504.4 289.586 19.113 1.5 341.545 822 7.8 341.2 336.954 141.2 371. 2006–2010 Cases State/Area Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming U.0 396.150 16.1 228.798 19.208 60.3 517.903 21.859 15.166 26.398 1.9 513.4 371.150 14.601 16.460 80.168 19.7 419.353 13.1 316.114 9.080 49.017 42.454 3.9 198.868 6.0 379.5 435.915 4.3 337.218.180 8.9 379.3 312.Table 3.0 466.8 453.988 5.829 68.1 344.197 1.8 365.525 3.102 23.7 360.4 283.4 486.417 26.7 320.536 9.302 12.428 8.148 1.956 28.670 2.424 150.163 22.0 369.998 12.2 426.7 207.352 47.6 440.6 579.9 388.302 488 8.3 861.2 465.732 9.0 363.928 17.6 220.

564 1.987 63.1 283.1 688.490 15.243 14.483 9.884 7.9 409.194 36.655 82.0 518.431 10.832 16.311.827 14. STD Surveillance 2010 Chlamydia Tables 91 .336 435 7.2 419.1 480.6 271.000 Population 2008 18.893 101.097 10.9 684.1 663.8 445.808 20.781 267 7.970 42.1 513.295 18.8 NOTE: Cases reported with unknown sex are not included in this table.4 490.0 898.110.8 510.5 393.157 6.116 2.4 354.310 6.577 2.982 204.2 236.175 12.0 538.301 1.185 1.484 16.8 501.172.755 7.283 920.422.130 6.9 438.280 30.227 4.5 323.9 637.6 598.9 524.8 541.303 102.051 775.458 574 5.5 477.0 262.175 27.8 462.001 2010 20.5 575.0 232.513 6.112 16.206 31.291 35.5 859.0 522.8 532.554 3.5 628.0 752.0 730.8 551.5 281.5 1.757 6.2 723.2 453.473 910 22.449 11.049.1 663.335 2.080 2.456 48.8 648.9 307.1 460.6 389.S.352 60.0 586.8 567.2 614.5 559.0 665.9 537.9 416.634 2.231 30.117 7.462 664 4.629 6.4 609.2 557.479 79.4 268.1 677.4 461.1 477.7 989.0 620.014 44.1 661.2 406.5 688.785 8.358 10.239 173.185 20.560 16.5 688.4 692.503 2.6 567.327 3.672 17.6 725.123 7.867 2.2 554.682 13.6 422.7 504.3 511.004 138.7 351.3 585.042 692 4.2 222.223 3.997 396.401 8.030 3.9 510.863 4.399 2.598 16.150 6.229 1.4 890.604 97.3 528.733 15.6 583.3 270.645 14.3 738.2 311.2 421.0 389.334 1.413 3.044 1.8 989.024 3.533 17.124 2.7 891.2 483.175 19.002 1.0 553.3 656.296 3.433 30.7 477.1 542.6 527.175 2.8 257.9 423.300 20.2 649.6 225.136 30.831 18.915 9.5 531.793 1. 2006–2010 Cases State/Area Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming U.559 92.048 43.814 19.2 583.707 8.1 336.7 578.3 288.493 669 6.7 283.834 448 6.5 541.279.4 566.8 1.438 913 825.6 565.1 238.4 603.457 897 17.5 359.1 458.7 1.253 18.717 833.7 600.7 1.318 32.6 812.037 8.3 491.3 353.8 766.344 7.2 785.7 671.1 2010 825.187 912.9 374.5 559.956 6.228 2.625 2.718 68.7 418.021 11.355 7.153 52.612 7.693 33.8 668.7 566.5 595.162 182.239 2.622 17.5 580.209 9.436 197.6 558.621 20.9 891.4 435.8 284.6 511.0 1.336 14.0 621.021 2.2 548.214 21.3 582.689 101.074 4.6 355.515 4.8 467.5 757.3 385.3 488.8 604.055 1.170 12.177.0 824.774 327.134 3.2 605.6 593.5 902.2 329.8 474.002.1 269.3 450.3 488.636 10.8 560.1 652.485 6.4 330.194.3 490.0 414.290 1.7 639.9 675.297 36.3 1.705 14.6 566.8 406.7 569.9 694.882 7.101 8.7 642.0 919.4 858.1 569.825 9.643 104.1 640.1 461.091 144 4.768 44.860 10.657 1.7 472.6 582.860 2009 19.339 11.1 604.9 473.0 947.5 541.6 442.3 443.282 20.205 2.938 1.882 33.858 369.573 4.536 30.067 18.1 592.377 Rates per 100.878 427 5.3 636.0 247.136 13.4 444.859 20.771 2006 756.305 949.3 564.5 680.044 56.3 527.1 455.1 252.890 30.6 285.0 595.6 583.2 551.186 3.128 8.741 2.3 784.0 706.4 295.131 1.011 893.782 13.001 6.6 445.0 365.4 371.204 17.230 11.7 615.9 418.932 3.266 16.4 293.0 653.8 515.907 6.2 579.286 6.7 2007 804.4 611.4 594.348 15.1 457.1 547.542 18.3 391.765 8.361 195.172 15.002 3.7 593.2 616.7 502.7 648.3 760.856 899.2 586.0 406.577 38.684 15.788 119.6 500.693 1.5 351.604 67.0 456.4 274.6 539.7 560.842 2.4 299.681 16.836 1.350 306. TOTAL Northeast Midwest South West Guam Puerto Rico Virgin Islands OUTLYING AREAS TOTAL 2006 17.208 14.231 184.6 452.897 1.744 3.7 200.337 12.1 753.827 4.400 20.719 1.576 6.5 290.6 642.435 39.660 41.715 2007 19.4 533.4 649.7 269.112 1.671 28.8 1.716 14.847 19.9 556.364 19.173 31.2 1.2 567.585 28.366 193.509 2.390 15.1 748.2 597.478 20.958 18. Chlamydia—Women—Reported Cases and Rates by State/Area and Region in Alphabetical Order.8 395.5 659.782 53.0 289.894 19.915 3.724 11.7 546.2 539.077.802 152.789 4.4 658.705 18.422 3.3 229.565 33.1 357.2 622.825 2.0 512.927 780.0 512.157 177.0 539.969 955.511 2.323 18.6 544.9 403.829 18.8 391.982 896 23.0 510.853 16.8 305.4 719.937 3.492 2.8 425.5 438.6 536.7 230.3 404.9 469.340 3.4 407.7 371.966 3.786 33.143 9.965 15.581 2.1 1.9 454.Table 4.2 686.3 475.986 61.107 191.8 552.423 14.3 253.8 423.718 17.847 4.2 429.8 394.438 52.603 21.678 6.161 2.5 1.0 640.606 1.038 1.794 7.201 13.2 495.1 499.019 889 22.5 680.5 465.3 610.9 451.568 27.510 38.5 272.747 29.260 1.923 18.7 573. United States and Outlying Areas.425 512 6.561 6.9 574.184 15.7 544.0 334.7 506.560 7.529 11.753 36.548 18.1 496.5 413.7 515.297 8.1 2008 779.546 4.110 1.188 9.7 775.719 10.926 812 18.646 33.4 402.194 3.718 142.3 1.793 2.4 378.5 664.322 191.6 468.590 25.3 694.660 131.341 9.1 525.6 599.750 381.000.6 2009 799.551 4.1 444.1 385.1 665.0 391.960 19.1 705.

254 83.605 3.8 148.0 159.3 155.808 123.926 4.692 4.2 254.012 5.7 266.608 6.488 6.0 173.302 12.6 181.8 632.885 5.2 328.635 294 6.7 184.1 207.0 194.1 190.7 212.993 5.1 163.959 11.3 258.2 204.202 253.647 6.3 165.1 112. 2006–2010 Cases State/Area Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming U.3 232.233 1.6 187.0 233.376 10.9 197.513 1.073 132.4 209.9 182.6 239.5 NOTE: Cases reported with unknown sex are not included in this table.690 1.362 11.034 139 1.213 4.007 1.6 186.6 153.1 129.8 197.390 2.0 291.5 844.359 281.307 4.4 568.7 196.3 167.043 851 1.1 126.7 174.372 634 4.9 151.798 654 10.0 154.7 233.6 96.439 4. 92 Chlamydia Tables STD Surveillance 2010 .4 183.2 188.3 174.8 199.5 251.044 709 1.2 219.055 2.934 892 5.7 237.8 209.7 125.052 5.606 3.7 98.4 201.390 20.2 110.1 262.8 162.9 203.7 155.845 3.2 313.5 249.7 171.616 6.907 4.812 2.0 244.259 3.1 180.211 513 3.786 14.8 169.9 243.5 191.986 31.621 2.6 156.573 808 353.9 252.426 1.044 6.5 271.588 1.6 263.6 127.228 716 1.049 83.5 240.490 11.089 1.688 140 1.832 2007 5.3 201.543 2.060 40.297 1.346 68.966 2.9 193.606 2.2 351.653 883 7.314 2.1 185.7 53.9 158.9 2010 301.700 1.9 195.1 118.2 221.4 402.8 252.6 169.3 280.779 53.593 10.1 113.7 171.748 26.7 290.904 3.0 206.4 155.302 2.451 2.2 54.5 252.457 8.1 212.991 744 5.1 225.981 962 3.079 2.0 234.051 15.4 92.6 232.931 560 5.0 208.5 217.1 63.4 193.169 2.539 561 4.4 215.4 191.6 210.272 27.6 245.393 108 957 53 1.968 15.193 8.444 153 1.4 248.4 134.9 254.964 5.4 182.9 194.2 73.740 776 328.226 761 5.002 5.807 3.901 2010 6.431 1.6 731.437 113 1.985 5.8 176.045 5.384 4.333 1.6 178.0 221.2 147.2 209.397 5.502 2.331 4.7 217.384 895 13.9 197.4 172.6 300.5 181.877 925 2.1 170.1 120.401 2.7 119.368 20. United States and Outlying Areas.1 206.039 3.491 44.955 1.1 248.459 7.711 1.200 2.8 174.707 563 313.441 2.978 3.152 4.9 218.493 594 10.9 176.9 124.8 241.3 249.4 230.2 196.133 16.264 1.5 223.1 59.559 21.4 195.732 4.9 2008 266.056 6.6 165.1 204.6 200.2 221.224 8.125 81 1.783 57.4 184.7 86.2 158.5 157.276 2.881 4.4 78.5 187.802 67.7 2007 265.2 112.8 258.4 216.4 188.5 350.415 24.311 11.5 178.5 245.112 47.3 220.3 134.560 1.0 304.3 207.5 125.3 80.930 6.190 1.4 117.7 174.626 1.3 229.1 160.549 725 7.0 54.171 7.8 204.1 217.9 129.5 255.178 1.8 107.675 3.6 213.0 56.9 83.007 55 1.6 420.968 6.8 168.0 178.6 178.930 2.000 Population 2008 6.645 920 5.410 8.1 171.549 2.8 186.5 135.314 588 9.841 726 4.5 95.630 44.3 238.6 112.2 176.399 2.1 59.6 214.701 865 1.2 137.5 236.1 142.8 251.239 5.319 3.2 285.572 2.0 50.2 79.9 147.1 84.508 5. TOTAL Northeast Midwest South West Guam Puerto Rico Virgin Islands OUTLYING AREAS TOTAL 2006 4.894 74.7 173.736 5.4 217.5 256.4 173.0 191.2 381.687 1.6 117.118 329.849 60.055 23.003 4.1 121.0 217.433 4.085 4.8 168.2 153.7 85.7 241.3 2009 285.4 98.5 256.580 3.1 247.923 63.236 79.3 144.8 97.874 2.675 1.6 455.3 151.060 5.4 155.7 239.418 788 8.007 4.767 825 5.0 237.272 709 6.1 217.069 10.6 185.145 2.723 767 7.493 355.656 629 10.9 160.7 150.4 211.S.337 49.6 148.7 219.957 6.4 103.4 80.262 17.6 136.3 221.3 200.847 3.2 232.0 188.5 163.3 220.034 15.0 300.9 177.2 194.808 1.030 822 12.5 250.320 3.3 169.6 100.479 2.9 158.9 262.032 2.852 3.363 2.5 66.696 Rates per 100.3 102.9 181.592 5.039 294 7.416 2006 223.072 58.5 267.228 3.2 161.8 121.664 44.361 12.997 3.9 201.2 206.4 164.7 294.9 150.9 259.4 215.760 7.076 182 1.9 212.0 192.1 152.3 218.5 220. Chlamydia—Men—Reported Cases and Rates by State/Area and Region in Alphabetical Order.3 240.148 6.5 142.460 522 4.Table 5.081 99.7 160.5 175.548 2.438 18.655 38.301 3.1 161.336 6.065 2009 6.992 10.5 175.741 990 819 10.0 152.4 179.0 234.963 70.500 28.551 371 252.215 347 8.9 169.2 497.551 2.877 2.6 147.168 1.4 190.798 698 5.985 1.442 5.6 103.329 5.1 346.9 149.3 180.616 66.058 7.030 13.182 888 1.126 297 8.4 199.458 5.0 231.965 1.1 208.5 182.879 3.9 871.768 654 5.658 768 6.722 915 5.0 449.4 216.401 3.490 1.795 245 6.5 216.3 296.5 224.4 177.2 175.183 15.508 1.4 171.5 194.907 235 1.0 173.090 284 280.724 3.5 143.849 2.789 21.758 708 4.5 179.0 182.4 106.4 145.105 115.802 6.3 119.6 205.5 208.149 6.286 315.839 11.435 77.

8 450.6 504.883 13.S.4 456.016 8.691 Seattle-Tacoma-Bellevue.120 6.2 364.8 434.5 332.4 469.0 446.053 13.4 438.4 553. OH 7. FL 12.562 3.2 557.2 513.654 5.947 New York-Newark-Edison.1 397.9 500. NV 6.833 5.6 420. United States.1 495.035 22.5 452.358 9.128 19.3 409.294 5.403 45.892 5. MI 17. RI-MA 4.116 28.6 262.441 10.093 Kansas City.0 468.4 432.0 326.1 292.2 334.065 Richmond.0 418.4 479.512 Minneapolis-St.537 12.201 17.4 337.8 350.100 21.582 6.300 4.7 483.024.467 4.575 Sacramento-Arden-Arcade-Roseville.6 312.650 5.544 718.7 318.8 519.3 302.5 308.565 16.9 328.285 14.753 8. STD Surveillance 2010 Chlamydia Tables 93 .5 274.0 502.197 4. TN 4.199 9.8 414.953 5.6 309.835 12.4 320.9 439. WI 10. FL 5.9 464.8 378.6 713.033 Louisville.8 442.987 25.4 337.814 7.4 955.734 11.2 657. Census.910 3.319 3.015 9.076 4.144 Austin-Round Rock.691 Tampa-St.263 Rochester.8 403.843 7.0 489.3 385.6 329.4 436.5 482.705 New Orleans-Metairie-Kenner.972 5.8 430.1 292.3 409.8 470.710 14.9 297.3 528.9 738.095 Milwaukee-Waukesha-West Allis.6 314.455 635.510 St. MN-WI 9.514 10.9 634.781 4.092 14.934 12.294 6.069 20.9 443.5 335.230 11.6 513.320 Detroit-Warren-Livonia.5 561.616 10.116 19.1 565.8 362.8 450.693 14.126 Boston-Cambridge-Quincy.351 8. GA 20.6 599.158 Virginia Beach-Norfolk-Newport News.4 358.616 6. TX 14.8 399. Louis.7 389.6 478.2 1.701 6. AL 5.3 344.0 426.690 6.424 3.925 10.731 10.294 6.314 9. DC-VA-MD-WV 15.814 8. MO-IL 13.7 455.557 16.0 511. NOTE: 2008 Milwaukee County STD morbidity data were misclassified.5 311.8 338.865 4.588 11.4 509.325 6.551 4.0 475.4 353.3 305.8 359.954 11.462 9. CA 9. UT 2.6 319.373 14.6 541.579 6.4 539.9 407.934 24.397 11.0 482.9 429.896 13.5 429.2 268.6 408.2 280.1 499.522 Indianapolis.306 83. resulting in incomplete case counts for MSA-Milwaukee-Waukesha-West Allis. TN-MS-AR 10.3 390.6 401.4 426.8 334.4 435.5 469.7 478.1 467.704 Orlando.320 8.0 402. OR-WA 5.349 11.5 436.443 Las Vegas-Paradise.150 1.816 5.2 393.745 7.3 529.499 7.4 492.854 13.716 8.7 421.458 Chicago-Naperville-Joliet.970 6.263 Rates per 100.WI.870 Nashville-Davidson-Murfreesboro.439 11.2 519.918 10.2 437.727 9.3 277.9 556.3 623.3 264.805 Cleveland-Elyria-Mentor.395 6.710 17.7 400.8 499.5 244.4 510.4 446.3 357.825 8.6 373.726 Cincinnati-Middletown.521 41. CA 5.142 29.173 8.546 14.109 6.3 280.6 301.3 299.4 285.395 3.992 5. CA 11.6 429. KY-IN 3. OH-KY-IN 8.910 4.597 7.8 378. TX 17.456 8.5 451.767 6. CO 7. PA 5.717 San Antonio.616 Houston-Baytown-Sugar Land.7 255.509 13.493 4.2 340.614 Los Angeles-Long Beach-Santa Ana.637 690.9 680.1 886.2 555.338 6.1 393.3 414.501 11.368 12.341 San Francisco-Oakland-Fremont.751 Hartford-West Hartford-East Hartford.1 289.573 5.8 331.6 570.3 362.4 367.5 474.7 283.3 426. TX 7. CT 3.8 260.334 74.415 Providence-New Bedford-Fall River.2 695.5 390. TX 8.6 394.6 238.1 494.803 14.1 541.5 410. Chlamydia—Reported Cases and Rates in Selected Metropolitan Statistical Areas (MSAs)* in Alphabetical Order.2 271.8 344.4 477.1 222.430 San Diego-Carlsbad-San Marcos.9 499.287 9.5 563.642 17.843 752.101 19. 2006–2010 Cases MSAs 2006 2007 2008 2009 2010 Atlanta-Sandy Springs-Marietta.3 331.789 6.314 Denver-Aurora.3 436.475 9.0 678.274 Jacksonville.892 9.8 557.5 368.0 477.770 8.5 554.9 297.338 8. PA-NJ-DE-MD 27.4 409.314 15. MD 11.169 15.869 7.1 380.555 16.780 8.539 10.1 348.2 344.3 925.032 27. Paul-Bloomington.071 80.2 507.157 8. AZ 15. NY 4. CA 15.216 7. OK 4.3 514.6 283.559 9.1 301.0 264.4 397.4 397. IL-IN-WI 41.417 28.094 8.5 303. MSAs TOTAL 584.6 222.870 U.561 5.078 5.7 362.1 338.6 331.627 4.388 Washington-Arlington-Alexandria.215 7.318 6.545 Dallas-Fort Worth-Arlington.196 21.4 372.9 401.799 4.7 715.4 468.093 9.4 484.8 329.537 5.4 464.2 93.000 Population 2006 2007 2008 2009 2010 408. VA Riverside-San Bernardino-Ontario.3 441.1 427.0 272. NY-NJ-PA 62.8 408.292 22.6 485.271 9.096 Portland-Vancouver-Beaverton.177 7.6 * MSAs were selected on the basis of the largest population in the 2000 U.4 387.7 385.0 500.615 16.S.6 360.1 802.0 508.8 410.456 18. IN 7.347 27.519 Pittsburgh.245 14.511 Baltimore-Towson.996 11.0 309.344 Memphis.1 489.7 370.Table 6.4 321.8 294.761 18.5 472.943 20.8 598. FL 7.6 330. WA 9.505 45.913 6.934 9.413 8.8 330.1 383.592 7.7 575.383 11.5 478.4 564.297 4.867 11.0 303.046 8.704 Oklahoma City.224 11.080 10. CA 12.0 454. MO-KS 7.090 27.1 421.6 404. VA-NC 9.722 20.498 10.352 55.449 33. MA-NH 9.9 420.3 422.2 319.1 397.7 478.646 5. NY 4.574 5.142 13. CA 50.3 507.6 630.4 408.2 553.697 11.168 4. LA 3.4 370.609 20.938 Charlotte-Gastonia-Concord.4 326.803 46.044 5.769 5.472 14.139 9.979 21.783 6.7 422.9 534.904 90.2 254.796 5.1 583.0 296.276 54.641 17.759 5.463 Miami-Fort Lauderdale-Miami Beach.9 419.5 294.491 Philadelphia-Camden-Wilmington.825 8.608 Columbus.475 4.617 13. OH 5.920 6.291 Buffalo-Cheektowaga-Tonawanda.084 Salt Lake City.9 367.988 Birmingham-Hoover.980 12.050 Phoenix-Mesa-Scottsdale.3 415.3 438.1 406.401 4.501 7. NC-SC 5.0 438.892 56.316 13.533 11. FL 6.333 7.5 440.749 30.913 52.292 26.7 462.532 11.278 15.7 296.681 7. Petersburg-Clearwater.5 386.898 5.8 442.6 361.1 384.778 10.686 San Jose-Sunnyvale-Santa Clara.872 9.8 485.555 12.

1 564.251 20.392 4.482 3.937 Buffalo-Cheektowaga-Tonawanda.4 605. LA 2.8 968.292 Orlando. United States.012 10.014 5.069 5.2 645.6 425.178 14. CA 6. VA Riverside-San Bernardino-Ontario.0 489.413 3.254 2.1 640.7 400.4 718.394 3. MSAs TOTAL 432.508 Austin-Round Rock.020 7.3 721.8 653. TX 5.136 4.951 Seattle-Tacoma-Bellevue.2 684.352 5.7 603.134 33.981 4.8 727.7 485.1 531.975 8.3 658.972 San Diego-Carlsbad-San Marcos.826 36.243 7.6 447.8 644.344 2.553 9.7 1.1 697.000 Population 2006 2007 2008 2009 2010 622. TX 13.3 462.1 637.4 529.7 450.815 56.8 572.2 438.3 673.1 551.267 4.617 10.187 10.549 5.0 572.2 653.4 718.501.2 735.3 644.065 New York-Newark-Edison.466 17. Paul-Bloomington.6 594.412 7.332.7 536.1 829. FL 5.2 754.5 472.859 4.8 811.890 3.0 451.173 2.7 564.5 1.6 548.428 6.0 472.5 593.170 4.5 545.376 Minneapolis-St.5 630.3 417. MI 13.0 468.789 8.9 428.7 368.753 5.940 San Jose-Sunnyvale-Santa Clara.4 * MSAs were selected on the basis of the largest population in the 2000 U.1 514.0 571.0 528.2 691.9 970.813 20.9 611.985 13.619 6.530 4. 2006–2010 Cases MSAs 2006 2007 2008 2009 2010 Atlanta-Sandy Springs-Marietta.3 573.870 20.747 8.122 3.7 439.299 2.2 477.810 Rochester.235 22.529 Miami-Fort Lauderdale-Miami Beach.627 5.754 Salt Lake City.5 462.874 5.7 446.722 13.092 4.434 San Antonio.199 10.852 Las Vegas-Paradise.7 346.3 822.1 416.277 5. CA 35.2 364. MO-KS 5.8 403. KY-IN 2.273 4.458 9.884 8.566 8.503 8.727 7. OH 4.821 4.218 3.747 5.3 716.791 6.426 10.8 770. MN-WI 6.2 1.8 595.997 4.6 699.829 59. PA-NJ-DE-MD 19.007 52.708 21.1 594.144 13. NV 5.5 432. Petersburg-Clearwater.7 788. NY-NJ-PA 45.8 340.983 466. VA-NC 6.2 563.468 5.191 Kansas City. AL 4.8 1.7 516.5 773. IN 5.520 Rates per 100.514 10.5 779.3 900.202 33.936 6.556 Columbus.6 725.8 376.863 Phoenix-Mesa-Scottsdale.3 392.091 Providence-New Bedford-Fall River.2 582.344 10.567 7.037 7.9 695.826 18.632 Jacksonville.7 407.430 5.7 311.377.935 8.337 3.846 9.109 4. GA 16.5 673.433 3.203 6.189 3.0 404.2 679.S.7 376.808 6.4 544.965 37.239 501. 94 Chlamydia Tables STD Surveillance 2010 .326 5.933 6.1 579.2 774.503 3.1 629.6 504.2 485.6 699.8 140.600 31.6 714.673 3.160 6.5 763.5 652.6 590.430 5.620 5.5 700.620 9.769 4.6 811.4 520.4 450. AZ 11.469 6.2 436.140 7.023 6.0 749.020 6. WA 6.489 Tampa-St.6 503.8 695.4 564.503 3.5 831.5 528.115 7.2 731.594 3.4 1.027 6.146 Portland-Vancouver-Beaverton. OH 5. FL 4.4 620. OK 3.486 Louisville.254 4.7 592.165 4.941 2.527 Virginia Beach-Norfolk-Newport News.170 9.257 10.4 577. UT 1.418 11.740 6.194 14.5 633.462 6.8 634.324 Houston-Baytown-Sugar Land.2 433.8 425.4 627.870 5.9 730.481 10.474 3.125 21.280 Oklahoma City.5 642.1 627. NY 2.1 374.118 11.165 15.1 539.3 443.0 559.9 638.0 637.1 500.827 7.618 10.8 504.448 Sacramento-Arden-Arcade-Roseville.646 Memphis.916 4.7 803.8 662.7 512.274 63.098 Washington-Arlington-Alexandria.2 616.653 1.7 335.7 754. TN 3.028 7.675 10.9 423.212 Baltimore-Towson.128 4.843 5.369 9.7 533.842 5.7 1.9 605.4 417.6 654. CA 9.4 631.777 Philadelphia-Camden-Wilmington.7 507.0 605.7 614.4 702.0 660.4 728.WI. PA 4.892 Pittsburgh.859 11. IL-IN-WI 30.231 7.100 36.7 751.5 495.4 456.3 525.9 690.119 3.0 628. Louis.6 528.952 10.099 8.405 11.049.3 623.7 559.520 38.553 14. FL 5.170 17.744 Birmingham-Hoover.818 4.737 21.778 4.725 11.755 8.000 St. Cases reported with unknown sex are not included in this table.7 686.886 Dallas-Fort Worth-Arlington.6 685.504 3.871 8.5 426.7 632.3 660.132 20.5 692.5 511.3 411.7 497.4 992.5 592.031 7.187 10.0 728.1 671.1 590.9 836.703 538. RI-MA 2. CO 5.788 13. TX 12.S.875 5.7 403.8 651.2 740.614 6.3 421.1 790. FL 9.8 351.989 3. Chlamydia—Women—Reported Cases and Rates in Selected Metropolitan Statistical Areas (MSAs)* in Alphabetical Order.1 789.4 855.Table 7.0 570.3 638.287 16.4 530.5 398.262 4.0 468.4 547.589 5.5 689.786 3.824 8. MA-NH 7.5 520.4 486.2 590. NY 3.5 477. resulting in incomplete case counts for MSA-Milwaukee-Waukesha-West Allis.6 850.8 644.1 359.566 Milwaukee-Waukesha-West Allis.722 4.1 578.166 10.764 Chicago-Naperville-Joliet. TX 6.8 945.617 3.1 485.6 489.761 7. OH-KY-IN 6.4 549.4 789.651 6.206 8.278 6.5 820.749 Cleveland-Elyria-Mentor.4 688.146 U.538 San Francisco-Oakland-Fremont.925 Indianapolis.1 469.1 601.7 1.305 8.282 Richmond. NOTE: 2008 Milwaukee County STD morbidity data were misclassified.4 480.874 5.7 543.6 579.6 425.4 691.2 1. CA 10.062 8.0 647.750 518. MO-IL 9.3 398.3 588.4 475.050 10.967 14.898 14.596 5.721 8.4 677.096 13.6 760.1 506.5 628.537 Los Angeles-Long Beach-Santa Ana.009 12.2 698.0 422.360 Cincinnati-Middletown.458 Detroit-Warren-Livonia.1 473.841 8.773 10.774 10. TN-MS-AR 7.7 427.250 3. MD 9.0 389.232 6.7 910.9 753.2 506.323 8.9 594.487 7.082 8.0 668.416 10.406.0 572.458 7.7 611.220 34.5 497.3 721.116 3.580 18.027 New Orleans-Metairie-Kenner.208 15.327 3. Census.429 14. NC-SC 4.076 4.445 3.710 Nashville-Davidson-Murfreesboro.004.530 Hartford-West Hartford-East Hartford.037.9 741.297 22.232 4.5 758.884 5. WI 7.386 Charlotte-Gastonia-Concord.310 5. CA 4.9 714.0 744.915 7.912 3.202.967 3. CA 8.525 Boston-Cambridge-Quincy.948 4.2 598. CT 2.1 609.7 569.8 840.6 542.0 646.116 7. OR-WA 3.9 355. DC-VA-MD-WV 11.0 677.762 3.876 Denver-Aurora.

787 3. TN 1.5 198.5 262.0 174.4 190. FL 1.323 Providence-New Bedford-Fall River.6 2009 219.465 5. OH 1.962 5.7 276.885 1.285 2. OH 1.4 253.165 23.8 242.897 5.527 1.8 199.0 436.016 Columbus.912 1.591 212.0 307.494 3.383 3.146 2.231 Birmingham-Hoover.252 1. NC-SC 887 786 1.7 165. MSAs TOTAL 150.586 4.873 1.5 377.5 131.1 405.6 176.349 1. WA 2.272 1.340 2.9 316.6 209.636 Jacksonville. DC-VA-MD-WV 3.4 175.9 2008 210.4 140.536 1.4 97.233 1.908 2.700 1.0 195.251 1.485 1. KY-IN 961 1.3 203.509 St.639 16.7 197.3 266.0 248.4 216.0 284.3 170.624 2.6 224.334 Buffalo-Cheektowaga-Tonawanda.9 363.9 277.384 1.3 263.947 Portland-Vancouver-Beaverton. Louis.921 15.346 1.387 2.8 295.5 203. FL 1.1 214.1 282.557 3.740 1.134 Hartford-West Hartford-East Hartford.3 327.7 272. CT 1.8 226.410 3.1 239.3 224.4 274.3 292.7 97.923 6.431 2.050 3. Paul-Bloomington.7 209.134 Minneapolis-St.1 254.3 214.2 161.6 214.9 161.522 1.1 231.7 185.S.278 1.4 195.197 2.7 175.078 4. LA 676 985 1.102 1.275 2.9 292.0 161.8 294.3 301.658 1.4 175.304 5.8 188.4 187.275 2. Petersburg-Clearwater.3 232.697 3.623 5.4 147.6 144.117 2.1 277.260 1.5 201. GA 4.745 1.3 118.771 4.0 203.5 205.2 255. NY-NJ-PA 17.9 307.292 Houston-Baytown-Sugar Land.437 Rochester.9 233.6 235.430 2.817 1.2 172.793 1.0 418.7 161.000 Population 2006 180.762 2.0 171.2 208.903 6.6 233.670 New Orleans-Metairie-Kenner.6 208.548 4.911 2.432 Denver-Aurora.1 302.319 2.6 192.2 211.767 3.985 3.011 1.7 199.077 168.5 211.754 2.0 204.325 1.5 105.0 244.1 266.687 New York-Newark-Edison.7 260.503 2.216 2.5 351.1 279.184 3. OK 1.1 280.996 6.523 Milwaukee-Waukesha-West Allis.5 42.2 249.3 218.210 4. MO-IL 3.6 203.9 221.698 3. Census.645 San Jose-Sunnyvale-Santa Clara.1 326.987 5.0 190.691 1.3 309. NV 1.2 * MSAs were selected on the basis of the largest population in the 2000 U.3 179.220 5.868 1.167 2.519 3.627 Dallas-Fort Worth-Arlington.1 196.0 160. IL-IN-WI 10.9 193.862 Detroit-Warren-Livonia.8 174.056 2. CA 5.284 Washington-Arlington-Alexandria.410 Orlando.9 286. RI-MA 1.0 279.029 2.7 165.127 Sacramento-Arden-Arcade-Roseville.7 294. FL 2.7 200.785 San Francisco-Oakland-Fremont.451 2.259 5.360 1.229 1.3 205.804 1.720 2.4 264.622 3.160 Nashville-Davidson-Murfreesboro.6 218.473 321 2. CA 2.3 269.034 187. NY 1.963 3.7 267. TX 3.496 1.682 2.7 295.3 260.728 18.905 10.614 2.9 306.9 229. MO-KS 2.8 182.2 2007 226.0 116.6 177.680 U. VA Riverside-San Bernardino-Ontario. CA 3.4 466.8 283.329 7.273 12.013 1.925 4.289 198.8 192. Cases reported with unknown sex are not included in this table.896 5.515 1.6 243. Chlamydia—Men—Reported Cases and Rates in Selected Metropolitan Statistical Areas (MSAs )* in Alphabetical Order.1 164.535 2. MN-WI 2.963 1.6 174.S.3 213.5 193.828 1. AL 1. CA 1.9 157.5 231.532 3.886 17.972 8.934 5.5 178.3 264.303 1.3 209. United States.471 3.497 1.986 3.6 509.6 253.3 182.4 184.097 4.849 5.7 127.704 1.250 Cincinnati-Middletown.034 2.1 154.863 2. AZ 3.558 4.8 225.065 4. MA-NH 2.585 5. TX 2.7 293.0 224.096 1.686 Memphis.471 Austin-Round Rock.139 Rates per 100.8 297.0 172.0 401.3 133.9 167.040 9.8 143.809 2.6 2010 239.549 2.626 Pittsburgh.022 Cleveland-Elyria-Mentor.4 286.891 4.7 257.3 248. CO 2. 2006–2010 Cases MSAs 2006 2007 2008 2009 2010 Atlanta-Sandy Springs-Marietta.705 Philadelphia-Camden-Wilmington.064 3.452 2.684 Chicago-Naperville-Joliet. PA 1.2 149.569 3.107 2.076 Los Angeles-Long Beach-Santa Ana.2 175.290 Baltimore-Towson.Table 8.7 187.053 2.723 1.591 Las Vegas-Paradise.620 2.9 237.3 209.5 232.0 280.578 12.8 208.0 180.4 287.1 250.029 3.513 1.5 263.0 221.574 5.5 220.7 194.953 2.776 4.4 190.935 1.8 178.565 2.178 1.2 184.3 372. resulting in incomplete case counts for MSA-Milwaukee-Waukesha-West Allis.7 296.WI.665 3.5 211.4 113.058 5.545 Boston-Cambridge-Quincy.893 Kansas City.449 2.8 270.222 1.712 1. NOTE: 2008 Milwaukee County STD morbidity data were misclassified.146 Phoenix-Mesa-Scottsdale. STD Surveillance 2010 Chlamydia Tables 95 .9 190.4 136.706 2.6 150.3 237.8 153.058 1.436 1.0 251.538 3.481 2.423 1.928 Miami-Fort Lauderdale-Miami Beach.283 San Antonio.601 Virginia Beach-Norfolk-Newport News.968 5. OH-KY-IN 1.759 Richmond.1 312.217 1.458 San Diego-Carlsbad-San Marcos.9 189.160 2.2 257. CA 3.4 237.5 420.6 208. PA-NJ-DE-MD 7.3 158.9 297.7 168. OR-WA 1.576 1.161 3.6 152.259 12. NY 1. IN 2.0 315.5 175.4 127.588 3.2 336. CA 14. MD 2.3 245. MI 4.7 226.897 3.200 Tampa-St.250 2.422 3.5 231.7 273.127 2. FL 1.1 218.649 Seattle-Tacoma-Bellevue.6 188.2 160.223 1.308 1.861 2.3 340.6 259.5 299.343 Louisville.8 248. TX 2.4 261.147 2.6 269.6 204.558 1.0 230.560 Indianapolis.4 189.0 411.1 237.514 1.0 307.588 1.7 167.579 3.5 368.3 254.472 2.178 1.027 4.289 2.2 377.301 21.134 3.441 3.2 301.6 137.5 290.7 186.527 2.309 1.6 292.1 88.602 27.473 1.5 290.3 222.7 288.301 2.3 257. VA-NC 2.9 294.7 174.8 265.9 150.9 259.457 4.460 1.909 6.9 185.3 218.633 1.1 221.9 259.600 7.0 169.287 Salt Lake City.2 322.966 3. WI 2.7 332.5 274.324 Oklahoma City.104 2.4 244.3 210.5 171.7 247. UT 969 1.552 Charlotte-Gastonia-Concord.5 256.1 217.441 24.129 10. TN-MS-AR 2.444 2.745 1.680 1.637 4. TX 2.652 3.6 232.

4 675. CA Sacramento County.6 548.053 6. 2010 County/Independent City Los Angeles County. CA Queens County.5 386.303.6 448.567 15.155 20. PA Honolulu County. FL San Bernardino County. TX New York County.3 558.160 6.9 561. NC Orleans County. KY Mecklenburg County.8 792. HI Jefferson County.8 658.000 Population 482.8 655.707 10. MI Kings County.832 5. Rank† 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 Chlamydia—Counties and Independent Cities* Ranked by Number of Reported Cases. AL Hennepin County.1 422.2 587.298 7. IL Harris County. AZ Dallas County.255. TN Cuyahoga County. D.515 8.8 595.4 1. NY Bexar County.626 4.084.865 8.340 5.8 695.4 505.596 Rates per 100. CA Hamilton County. TX San Diego County.9 634.042 4. † Counties and independent cities were ranked in descending order by number of cases reported in 2010.3 393.7 413.628 4. FL Alameda County.080 5.293. TX Wayne County. TX Duval County.020 6.0 315. FL Monroe County. NY Philadelphia County.441 11.C. MD Franklin County.8 506. CA Suffolk County.247 8.034 7.489 8.268 5.496 9.744 5. WA Fresno County.5 809. MO Erie County.7 Cumulative Percentage 3 6 7 9 11 12 14 15 16 17 18 19 20 21 21 22 23 24 24 25 26 26 27 27 28 28 29 29 30 30 31 31 32 32 33 33 34 34 35 35 35 36 36 37 37 37 38 38 39 39 39 40 40 40 * Accounting for 40% of reported chlamydia cases.428 18.9 400.1 819. OH Fulton County.322 21.9 693.0 280.507 5. LA San Francisco County.655 8.9 1. CA Essex County.978 9.242 5.3 670.884 5. NY Milwaukee County. CA Cook County.827 4.321.745 5.3 782. NJ Jefferson County. Louis County.341 11.544 34. MO Kern County.589 5.9 655. NY Maricopa County.614 7. United States. FL Broward County.8 531.664 22.3 1.328 10. MD Travis County.Table 9.667 11.5 705.585 6. OH Miami-Dade County.5 1.5 502.465 15. Santa Clara County.956 6.8 711.719.377 6. TX Clark County.6 1.5 1.732 4. CA Orange County.8 443. IN Hillsborough County. NY Washington.4 527. WI Denver County.115.017 5.0 309.457 5. MN St.233 5. CA Jackson County.095 6.184 8.2 470.1 453. NY Allegheny County.8 692. 96 Chlamydia Tables STD Surveillance 2010 .9 932.0 568. CA Cases 47. OH Tarrant County. PA Bronx County.790 19. FL King County. MA Prince George’s County. CO Shelby County.9 1.3 773.610 6.0 745.2 780.7 1.3 346. NV Marion County.098.025 6.557 15. GA Orange County.518 5.3 798.6 563. CA Baltimore (City).

251.227 58.8 8.4 15.831 809 3.860 354.263 15.901 47.477 13.279 291.221.4 143.861 9.2 9.757 21.3 1.5 171.594 8.424 453 2.090.437 28.160 54.525 7. 2006–2010 Age Group Rates* Male 11.064 887 3.354 44.161 503 240 119 68 53 6 7 226 47 851 839 336 159 73 46 32 5 3 281 81 1.163 188.741 113.8 9.9 462.737 36.049.304 392 2.725 120.975 62.597 332.447 347.9 1.2 774.3 30.925 22.570 131.760 190.9 606.2 145.1 10.1 502.0 72.159 14.834 464 636 2006 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–54 55–64 65+ Unknown Age 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–54 55–64 65+ Unknown Age 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–54 55–64 65+ Unknown Age 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–54 55–64 65+ Unknown Age 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–54 55–64 65+ Unknown Age Cases Total 13.975 322.5 83.3 2.523 954 2.5 141.315 119.to 9-year age group is not shown because some of these cases may not be due to sexual transmission.3 1.1 72. therefore.0 33.3 2.168 13.580 6.2 2.8 26.996 197.977 22.870 5.423 1.111.3 14.6 2.2 419.0 153.583 378.408 38.674 481 1.9 3.832 1.0 2.994 130.173 454.5 1.9 2.6 130. NOTE: This table should be used only for age comparisons.510 9.0 6.1 268.767 1.107 401.187.242 66.251 11. rates are not calculated.5 69.3 33.7 9.531 441.3 87.054 126.805.384 19.103 21.948 60.5 2.554 13.474 299.405 80.236.050.789 13.295 48.7 390.8 187.286 18.7 3.6 2.230 15.835 1.629 26.3 10.4 827.0 83.314.1 94.3 77.525 83.521 413 1.3 29.8 25.164 33.750 7.6 2.6 2.4 67.039 12.6 124.4 174.125 40.4 36.7 32.7 2.270.033 74.992.4 846.9 1.421 9.634 427 939 1.1 11.196 69.350 5.4 2009 Unknown Sex 36 802 729 309 128 74 31 31 5 4 336 38 827 698 282 135 75 33 30 6 4 242 40 1.707 8.3 39.075.2 354.7 554.252 355.552 19.520 1.470 31.787 472 839 1.493 283.740 14.8 2.510 12.9 7.8 71. STD Surveillance 2010 Chlamydia Tables 97 .153.9 932.0 598.503 2007 Male 1.1 158.173 174.6 3.656 7.6 774.7 730.6 533.033 3.2 3.1 7.344 14.070 465 3.303 310.4 381.931 7.386 1.561 51.529 16.9 93.018 111.8 65.0 69.407.907.899 429.760.0 695.501 30.1 2.5 561.686 66.9 3.310 1.358 * No population data are available for unknown sex and age.9 881.7 1.316 494 253 102 89 48 15 9 219 2008 Female 12.0 309.4 186.1 2.1 2.097.6 1.7 1.003 12.1 2.378.4 13.2 118.271 3.9 220.940.991 14.2 1.573 471 2.1 2.908 8.859 8.0 495.8 8.0 462.6 322.966.644.4 3.7 Female Unknown Sex 122.444 1.8 131.3 878.9 27.8 127.7 2.297 419.774.106 3.2 91.481 77.209.806 101.708 49.3 75.542 350.7 2.3 247.4 31.8 1.1 2010 Total 65.946 127.7 32.4 1.560 24.947.323 420 1.000 Population by Age Group and Sex.398 6.293 2.495 1.781.226 1.187.7 87.168 1.7 280.7 2.183 1.8 10.3 8.6 10.794 15.091 2.342 488.627 376.332 92.467 7.026 437.1 79.411 63.042 160.3 1.6 27. The 0.064 7. Chlamydia—Reported Cases and Rates per 100.3 31.2 911.4 1.747 7.590 85.1 506.009 12.7 2.7 2.0 209.377 12.398 889 4.5 206.9 1.Table 10.816 340.606 36.1 530. United States.818 1.996 18.2 66.2 176.3 1.365 946 3.3 35.537 17.160.354 9.635 1.7 9.7 224.920 14.7 90.614 16.1 8.441 76.1 129.5 421.941 6.

529 80.356 1. Age Group.497 1.154 617 276 239 84 14 12.839 6.524 2.586 Blacks.849 60.125 1.281 3.717 4.688 1.054 2.752 1.044 170.671 2.146 522 234 203 43 4 15.597 1.084 720 165 260.395 43.935 147.612 171 9.430 208 3.593 4.652 1.542 2.469 5.298 9 460 1.991 3.965 2.973 2.271 9.045 4.323 891 457 320 197 186 46 19 3.799 645 163 251.500 3.948 71.229 814 165 452.010 630 117 32 41.188 74 2.861 45.519 1.006 551 263 208 58 8 10.539 2.342 4.609 923 161 50 125.324 191 66 246.538 26.697 1.804 3.399 1.102 1.877 756 352 174 148 23 5 11.770 7.009 473 263 208 30 10 14.354 939 176 58 172.007 10.388 9. The 0.658 812 483 98 28 34.392 731 39.030 2.275 2.680 1.230 96.483 5.022 1.819 12.897 5.007 25.408 2.886 6.657 1.551 1.891 5.100 4.223 1.540 76 2.593 3.169 1. unknown. See Table 10 for age-specific cases and rates and Tables 3-5 for total and sex-specific cases and rates.420 16.013 188 44 127. age was unknown for 0.446 823 452 349 109 16 13.714 1.634 1.604 27.591 7.274 225 53 210.145 12.497 17.563 1.845 3.575 13.705 10 758 1.897 6.337 13.996 60.2% of cases.638 71.258 226 78 146.173 800 173 420.602 46.064 2.062 24.007 31.667 676 321 170 108 11 3 10.144 4.859 987 496 286 197 47 5 10.101 649 321 264 69 14 12.237 3.142 162.682 1.380 5.377 3.890 481 106 62. and Sex.075 2.156 861 184 434.445 3.512 1.979 13.177 14.463 1.Table 11A.902 4.204 571 279 113 71 62 13 4 3.857 122.462 5.346 36.397 142 3.782 38.621 566 149 236.965 4.504 461 85 141. race/ethnicity was unknown (i.037 2. 2006–2010 2010 2009 2008 2007 2006 Age Group 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–54 55–64 65+ TOTAL 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–54 55–64 65+ TOTAL 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–54 55–64 65+ TOTAL 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–54 55–64 65+ TOTAL 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–54 55–64 65+ TOTAL Whites.486 1.532 31.793 2.399 4.318 561 156 345. missing.495 5.527 41.690 4.065 1.671 933 453 420 132 28 16.762 1.289 2.977 25.067 12 793 1.384 30.276 890 517 316 177 181 48 14 3.054 13.536 106.855 28.644 4.190 12.146 234 56 192.436 10.487 8.748 24.504 49.016 475 238 181 36 8 14.455 514 96 133.873 4.576 1.310 721 36.578 381 99 53.627 5.427 717 179 279.450 Asians/Pacific Islanders American Indians/ Alaska Natives Male Female Total Male Female Total Male Female 168 7.166 15.785 67.677 6.012 4.390 850 154 42 115. United States.253 115.653 411 107 58.796 1.383 1.068 114. In 2010.862 3.094 107.730 34.501 2.022 534 240 121 73 58 10 3 2.663 633 27.725 353 80 311.127 597 253 121 89 60 7 5 3.525 495 92 126.876 221 4.027 15 735 1.924 4.052 1.149 600 329 261 71 13 12.762 1.885 3. Chlamydia—Reported Cases by Race/Ethnicity.698 5.957 167.660 136.830 2.577 8.445 2.978 1.631 22.283 37.057 826 365 160 155 31 2 11.355 69 2.098 3.913 85.715 1.153 492 126 69.457 1.916 1.915 4 486 1.851 737 362 167 119 23 4 11.278 3.687 4.888 63.115 2.144 3.460 16.339 198 9.261 14.924 20.774 1.698 50. Non-Hispanic Total 1.131 5.212 1.457 102 10.181 9.099 61.564 4.533 4.647 52.701 54.to 9-year age group is not shown because some of these cases may not be due to sexual transmission.830 3.992 4. or invalid data values) for 26.734 4.769 1.474 1.072 1.276 1.051 87.084 1.386 1.888 6 470 1.252 5.292 19.818 Male Female 60 7.469 39.015 746 440 272 189 141 51 8 3.734 168.735 10.995 1.782 1.243 75 3.282 95.402 720 320 157 74 48 12 2 3.086 1.900 1.229 2.745 783 40.110 5.248 1.768 3.268 306 77 48.682 5.737 4.205 6.062 714 125 34 43.784 132.727 313 78 170.345 1.866 2.013 19.004 587 368 225 198 37 17 4.994 370 90 99.160 917 431 245 159 16 6 13.242 5.982 8.226 128.694 11.312 23.672 1.621 116 11.149 2.909 6 430 1.976 20.252 3.230 985 468 267 175 36 12 13.635 5.043 185 50 183.604 75 9.987 1.102 152 4.106 18.233 159 3.711 3.641 2.820 42.415 449 88 114.287 4.654 179 9.053 4.554 45. and they are not included in the totals.683 70 3.932 5.615 3.585 6.028 1.995 23.763 858 564 90 33 36.312 13 769 1.161 37.313 775 128 50 111.096 2.527 267 75 271.e.653 5.416 3. and sex was unknown for 0.696 745 347 194 117 26 9 11.392 724 426 336 77 12 13.942 716 163 385..683 45.514 2.525 1.337 87 3.422 1.118 9.075 66.290 1.818 1.815 2.313 4.331 1.110 171 3.860 76.921 2.423 151 3.302 49.312 21.938 167 7.127 2.492 2.725 7.194 6.773 17.332 4.552 90 11.285 8. Non-Hispanic Hispanics Total Male Female Total 5.155 21.228 5.2% of reported chlamydia cases.795 8.613 3.317 23.151 105.261 130.472 13.902 80.007 93 3.627 13.600 10.498 6.792 101.364 41.060 185 44 132.045 682 32.954 2.098 87 2.380 3.945 6.728 82.017 546 462 106 31 17.213 3.047 22.422 83 3.387 37.606 920 526 447 117 32 16.749 5.788 1.378 40.692 1.730 77.840 2.917 6.433 27.414 244 75 151.273 20.778 9.619 1.450 166 4.593 53.421 126.850 8.037 49.279 2.162 21.326 2.969 3.938 1.244 1.802 1.025 5.155 8.197 14.084 103.397 1.325 26.479 23.022 2.509 5.246 1.399 5.3% of cases.767 1.786 11.843 13 700 1.553 1.506 8.850 5.086 41.183 73.960 2.806 35.194 239 59 197.220 9.468 42.085 1.514 43.953 184 4.847 2.144 12.653 13.553 278 82 166.953 4.757 44.884 11.302 5.648 305 81 293.352 1.890 NOTE: These tables should be used only for race/ethnicity comparisons.135 1.967 1.578 115.900 325 78 178.184 11.799 55.722 2.012 1.896 1.492 4.022 62.777 1.800 70.014 493 241 110 75 51 5 3 2.284 1.981 79 3.088 4.433 10.207 482 135 221.698 8.844 90.148 2.501 1.599 4.723 87.300 171 4.707 2.321 3.574 10.684 37.050 1.850 29.797 73.232 1.057 11. 98 Chlamydia Tables STD Surveillance 2010 .635 34.263 22.920 69.914 59.866 11.364 2 337 955 666 405 228 140 139 30 7 2.441 2.131 156.246 7.945 148.560 29.666 53.701 347 88 300.172 1.652 3.513 5.222 9.611 55.148 2.916 10.797 1.198 840 140 34 46.

0 2009 31.9 3.6 30.6 394.833.350.713.721.8 82.6 645.8 2.3 1.506.4 806.8 0.0 6.8 249.6 286.9 23.6 130.515.2 330.0 24.1 21.8 15.9 385.2 1.158.043.4 140.4 87.5 1.0 326.4 18.3 188.2 668.6 61.2% of reported chlamydia cases.7 69.7 9.3 14.985.2 18.7 314.8 9.2 1.6 56.9 665.8 190.316. age was unknown for 0.7 3.793.0 94.1 21.0 81.606.5 46.8 193.3 1.1 87.9 1.0 2.0 1.1 24.4 217.9 927.032. and sex was unknown for 0.4 654.1 2.0 18.9 487.574.7 4.4 115.7 0.4 162.5 0.2 164.8 68.4 661.4 373.3 343.776.5 2.1 68.813.6 1.453.5 22.2 691.8 180.5 49.2 82.3 653.9 433.7 1.6 7.2 369.0 3.328.7 1.9 49.4 72.1 166.9 4.8 542.6 142.1 293.1 8.5 2.7 16.7 47.0 2.8 196.5 55.1 437.4 4.8 70.7 2.8 61.5 961.4 7.1 129.5 290.5 105.2 9.3 50.2 159.0 417.2 215.1 75.7 4.0 3.1 286.9 60.2 139.1 46.9 232.246.2 80.2 353.7 4.0 93.159.8 311.9 3.2 646.2 198.9 1.801.8 721.2 413.035.7 9.262.8 401.8 364.0 80.2 8.9 31.8 275.8 216.8 109.0 8.7 2.0 6.663.0 2.8 70.7 106.8 143.0 324.4 358.6 2.3 34.8 3.0 1.7 44.9 1.311.1 33.740.000 Population by Race/Ethnicity.8 409.1 404.6 64.6 355.6 1.2 1.4 258.3 442.2 1.8 19.5 8.6 2.2 46.064.5 339.3 189.4 1.1 1.8 6.9 3.2 26.6 130.0 170.1 8.4 324.2 273.9 202.7 3.226.2 28.1 1.8 67.8 5.1 59.7 2008 0.5 8.7 292.1 1.9 377.1 188.7 800.6 51.2 319.5 173.1 2.5 364.0 3.8 275.8 695.3 215.0 55.5 801.8 34.9 5.3 229.1 3.0 956.2 350.2 78.7 819.4 8.8 0.2 188.3 231.1 1.209.3 51.0 1.7 235.7 669.2 0.1 0.150.0 33.9 2.042.5 314.4 430.2 113.2 200.7 149.5 1.6 28.0 1.740.1 332. and they are not included in the totals.4 15.040.0 772.6 705.3 210.6 126.3 97.2 275.4 2.0 47.7 24.5 58.4 2.7 893.7 104.0 3.6 8.3 662.4 329.9 178.1 8.208.2 243.0 10.3 2.1 0.7 409.8 0.3 200.093.9 2.7 0.3 15.042.1 2006 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–54 55–64 65+ TOTAL 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–54 55–64 65+ TOTAL 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–54 55–64 65+ TOTAL 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–54 55–64 65+ TOTAL 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–54 55–64 65+ TOTAL NOTE: These tables should be used only for race/ethnicity comparisons.8 71.5 197.7 612.360.2 42.1 75.9 80.6 1.0 10.8 114.3 9.8 1.0 1.3 1.8 2.8 52.5 102.6 7.2 91.3 49.8 10.1 41.0 144.5 14.5 140.017.2 2.2 1.7 22.435.7 10.7 160.0 19.417.0 59.5 2.1 194.3% of cases.6 194.7 479.4 462.0 44.8 7.0 1.781.108.5 36.9 658.4 292.1 6.320.7 18.7 913.e.247.5 21.650.0 71.3 30.4 155.630.2 133.2 422.8 8.5 1.3 0.1 109. missing.2 31.0 259.0 1.130.2 816.9 1.576.8 24.8 8.2 66. In 2010.9 38.4 76.9 218.5 2.to 9-year age group is not shown because some of these cases may not be due to sexual transmission.3 127.7 629.8 3.9 4.993.137.2 99.7 389.8 2.0 103.3 171.4 503.0 8.7 10.809.6 86.338.2 458.8 39.0 146.2 160.5 38.911.1 22.468.4 207.0 27.471.6 68.0 64.4 12.8 2.4 73.3 413.5 200.6 293.9 233.0 78.2 5.6 36.5 3.282.9 88.9 884.3 352.3 88.7 86.6 419.310.1 954.7 614.4 371.4 64.7 428.6 156.2 1.5 57.974.9 57.607.0 354.1 327.2 51.2 5.528. Chlamydia­—Rates per 100.6 686.2 3.6 1.0 422.8 31.6 594.5 866.5 19.9 4.8 24.408.3 1.5 165.3 1. Asians/Pacific American Indians/ Non-Hispanic Non-Hispanic Hispanics Islanders Alaska Natives Age Group Total Male Female Total Male Female Total Male Female Total Male Female Total Male Female 38.4 1.6 39.4 0.9 1.3 909.2 1.8 5.8 48.2 2.0 23.7 2.8 29.6 730. or invalid data values) for 26.0 106.070.4 7.0 3.1 369.071.5 4.0 49.1 3.4 1.1 2007 15.6 950.541.2 87.3 672.7 3. United States.5 2.6 100.1 781.2 760.5 1.3 24.5 468.0 432.1 16.5 9.7 12.5 102.507.915.2 134.5 4.0 825.4 877.6 0.8 10.0 2.2 4.357.5 1.0 894.005.4 13.0 1.222.2 105.8 17.2 70.7 153.132.045.9 1.8 16.7 7.5 697.8 8.873.3 831.2 10.2 85.214.5 390.8 1.8 3.0 1.5 2.2 11.2 7.4 27.6 209.2 720.5 677.5 1.7 56.8 79.7 31.1 140.5 1.0 841.6 970.9 3.6 25.4 6.094.9 1.6 2.003.7 47.7 189.292.6 1.8 386.5 151.8 25.3 994.6 40.7 638.1 161.229.3 29.146.5 665.7 127.1 18.3 1. See Table 10 for age-specific cases and rates and Tables 3-5 for total and sex-specific cases and rates.906.7 3.987.115.7 36.9 107.1 17.8 119.9 44.190.1 19.0 7.7 20.2 1.9 412. Blacks.9 45.2 6.6 405.7 655.4 1.8 9.1 16.1 1.6 68.4 1. race/ethnicity was unknown (i.506.000.653.9 8.1 7.9 458.5 294.0 2.7 37.1 3.296.5 2.193.7 42.4 298.9 2.8 21.4 153.0 606.636.0 147.8 67.0 146.4 60.4 176.1 661.5 301. The 0.3 42.9 545.6 3.3 16.1 656.2 1.9 157.893.9 79.4 99.0 17.5 59.986.4 565.3 149.5 495.4 1.9 650.1 23.8 987.187.0 201.097.8 2.4 1.3 193.3 911.3 451.7 5.4 124.081. STD Surveillance 2010 Chlamydia Tables 99 .4 142.5 6.8 208.6 1. and Sex.1 192.1 4.6 26.1 2.4 7.5 904.0 5.4 2.3 2.219.044.6 2.6 1.1 123.1 166.8 1.Table 11B.457.2 31.2 2.8 4.0 283.8 118.0 866.0 3.6 59.4 359.0 8.2% of cases.003.376.9 3.0 87.0 616.3 697.5 1.1 15.4 176.0 8.0 3.2 56.0 528.8 142.1 91.9 46.4 991.0 8.3 974.6 7.6 339.4 49.7 74.9 27.172.6 286.5 132.4 581.1 24.1 448.4 89.0 6.4 190.7 0.4 2.6 186.5 166.7 0.1 66.9 1.8 17.3 6.8 262.8 32.887.5 15.1 132.5 22.5 77.1 2.2 12.9 6.4 7.3 4.8 36.3 158.5 308.7 10.2 1.457.3 5.9 335.383.1 281.0 1.8 537.9 2.6 144.5 382.9 130.927. 2006–2010 Whites.4 8.2 90.6 7.8 385.3 335.6 8.4 576.714.4 11.8 4.4 1.4 224.7 3.1 5.9 4.0 32.991.1 85.3 54.7 171.0 2.4 105.661.8 38.6 0.602. unknown.5 180.9 7.3 145.6 655.2 61.319.3 2.747.6 415.2 1.1 2.3 24.0 753.1 40.0 77.5 19.5 145.2 3.6 1.253.5 770.8 3.0 37.9 31.4 778.0 3.2 157.9 17.2 738.9 1.5 9.0 153.5 2.1 1.6 29.0 2.4 2.301.5 14.9 3.6 1.3 392.2 1.8 447.3 1.3 90.6 164.3 6.4 55.9 190.2 98.0 180.7 413.0 199.4 0.3 2.3 2.9 250.9 116.031.4 10.4 303. Age Group.2 12.6 93.9 154.2 40.0 36.5 9.4 784.719.3 83.9 101.345.0 558.7 240.4 1.9 21.7 603.3 209.0 68.6 50.5 5.4 52.330.5 2.3 91.140.5 60.473.4 1.9 12.5 82.0 285.5 20.3 3.1 366.2 58.250.1 1.0 12.4 6.2 1.4 39.9 593.0 23.290.8 467.6 9.0 34.9 590.5 1.8 21.6 42.1 12.2 506.5 1.7 2.4 208.4 15..5 1.1 11.0 264.0 98.0 0.2 2010 179.4 106.7 17.9 2.8 2.6 38.653.5 36.5 1.1 136.3 833.746.6 190.344.9 10.7 691.9 733.9 8.8 16.5 7.480.1 190.6 914.6 1.6 598.6 306.4 1.1 63.366.5 6.7 8.6 451.1 874.0 1.4 4.206.863.8 0.

893 43.9 4.3 4.037.929. 100 Chlamydia Tables STD Surveillance 2010 .080 96.937.260 80.778 55.674 69.755 56.132 49.066 41.064.2 1.532.000 Population 1.4 4.233 73.911.481.398 78.581 97.2 2.6 4. Chlamydia—Women 15–25 Years of Age.089 100. Cases with unknown sex are not included in this table.7 2.801.234 34.9 1.773 25.465 25.752.1 1.4 3.2 2.1 2.362 43.302.738.917.892 74.2 4.Table 12.558.139.143.4 1. United States.246.7 2.697.461 87.118 47.397 52.308 35.6 4.4 3.213 92.729 45.3 3.624 39. 2006–2010 2010 2009 2008 2007 2006 Age 15 16 17 18 19 20 21 22 23 24 25 15 16 17 18 19 20 21 22 23 24 25 15 16 17 18 19 20 21 22 23 24 25 15 16 17 18 19 20 21 22 23 24 25 15 16 17 18 19 20 21 22 23 24 25 Cases 23.131.1 2.264 46.3 3.436.344.390 23.6 2.775.5 4.099 99.261.1 3.865 73.720.091.060 59.0 1.589 32.741.244.168.650 64.126 37.3 3.752 65.4 3.134.9 3.370.434.662 72.9 3.710.882.432 48.399 107.160 86.339 25.123.9 4.008.3 3.5 3.215.468 47.2 3.1 2.905 35.294.677.0 4.3 2.449.6 2.384.7 3.122.014.3 2.3 2.466.155 Rates per 100.981 87.5 4.157 81.822 103.283.568 62.626.5 2.316.782 98.816 63.275 46.641 43.1 2.3 4.0 3.700.481.3 4.131 67.653.2 1.631 53.6 3.9 NOTE: This table should be used only for age comparisons.1 1.0 1.197.705.724.096.823 70.993 79.9 1.6 4.615 75.0 2.175 84.029.3 1.6 2.283.557.

United States.341 4.4 66.5 9.2 59.864 2.091 2.9 73.010 7.1 108.5 28. STD Surveillance 2010 Gonorrhea Tables 101 .5).777 7.7 31.8 100.076 291 162 151 310 102 147 58 40 Rates per 100.5 67. 2010 Rank* 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 State Mississippi Louisiana Alaska South Carolina Alabama Arkansas Georgia North Carolina Ohio Michigan Maryland Texas Illinois Missouri Oklahoma Delaware Tennessee Florida Pennsylvania Indiana U.3 174. † Total includes cases reported by the District of Columbia with 2.0 40.3 150.8 31.S.320 5.5 165.9 58.3 43.0 73.3 * States were ranked in descending order by rate (rounded to the nearest tenth) and by number of cases.2 101.852 14.496 309.5 49.000 Population 209. Gonorrhea—Reported Cases and Rates by State.627 7.345 7.1 27.496 13.273 7.3 11.9 136.970 7.872 1.5 9.084 2.6 118.0 71.7 130.0 161.6 55.883 6. Ranked by Rates.104 cases and a rate of 350.728 1.1 128.249 2.187 1.9 198.9.441 5.2 119.569 26.4.9 93.9.3 7. but excludes outlying areas (Guam with 97 cases and a rate of 54.483 579 204 1.7 168.229 1.163 12.2 37. TOTAL† Kentucky Virginia New York Wisconsin Kansas Connecticut California New Jersey Nebraska Nevada New Mexico Iowa Hawaii South Dakota Colorado Arizona Washington Minnesota Massachusetts West Virginia North Dakota Oregon Rhode Island Maine New Hampshire Utah Montana Idaho Vermont Wyoming Cases 6.6 57.912 1.787 3.7 90.121 20.4 61.3 122.6 12.195 8.769 15.788 15.111 16.4 11.5 114.4 182.1 113.1 100.1 65.1 10.4 142.369 1.7 93.402 18.803 759 468 2.413 31.933 4.159 4.8 102.119 2. Puerto Rico with 312 cases and a rate of 7.Table 13. and Virgin Islands with 151 cases and a rate of 137.

476 4.3 110.3 118.459 17.348 171.5 134.4 6.2 76.2 81.7 23.835 659 269 20.3 118. 2006–2010 Cases State/Area Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming U.005 97 312 151 560 309.327 1.282 3.7 245.4 8.269 3.8 10.403 17.320 367 9.7 54.0 120.687 631 110 19.4 66.3 154.5 92.790 1.455 96 6.5 284.966 2.492 1.0 234.1 47.0 31. United States and Outlying Areas.4 108.912 162 7.066 77.441 2.933 1.129 17.163 15.2 62.9 18.5 153.466 508 10.4 67.8 112.303 7.0 116.223 92.210 3.1 158.5 37.066 4.7 136.7 150.2 141.2 8.104 20.2 137.9 161.S.949 4.6 65.627 2.3 49.7 66.9 137.0 114.9 88.0 135.460 23.4 55.726 113 4.3 138.4 11.514 25.1 154.4 149.3 160.326 16.062 4.740 3.8 87.6 238.0 154.883 291 7.6 61.000 Population 2009 7.3 39.0 102.4 17.5 56.728 151 5.732 1.673 1.2 139.988 4.449 11.791 180 5.9 108.4 156.972 143 16.8 104.7 448.082 17.3 7.803 2.9 138.249 4.2 53.7 109.498 990 3.9 160.2 47.3 32.274 4.073 821 64 6.8 91.1 88.9 29.762 1.4 127.186 8.460 2.704 2.0 324.7 200.872 1.376 1.7 198.6 58.669 885 206 20.0 131.653 930 6.677 3.8 56.4 30.6 139.172 100 5.524 2008 9.927 120 358.827 1.5 81.695 2.326 261 9.694 30.449 4.947 86.0 91.045 2.2 11.2 30.8 150.1 112.9 51.295 341 50 7.991 42.187 1.3 119.1 80.6 STD Surveillance 2010 .5 54.312 153 19.561 20.3 120.789 2.2 81.7 49.860 37.885 579 5.4 33.353 90.084 4.8 77.7 155.511 152.5 126.137 118 6.4 42.8 173.6 10.3 26.5 132.777 6.6 69.195 7.277 10.369 1.4 130.7 74.2 27.656 23.852 759 147 15.2 210.1 108.835 1.8 170.9 118.706 402 10.377 43.402 2.2 255.827 8.1 9.796 17.1 350.7 60.1 128.298 1.5 34.578 2010 7.250 4.4 195. Gonorrhea—Reported Cases and Rates by State/Area and Region in Alphabetical Order.142 56.2 76.5 403.787 2.018 109 273 120 502 337.1 67.666 116 21.320 14.511 10.769 1.8 161.345 8.665 630 5.0 147.7 90.878 13.8 168.740 578 3.9 83.6 182.3 88.127 746 6.9 100.928 2.733 17.429 15.1 68.201 74 301.121 31.0 77.0 10.548 9.5 64.2 58.366 40.376 2.5 82.800 2007 10.5 129.174 37.1 183.8 46.6 113.6 98.7 41.9 43.3 10.091 40 309.4 52.901 Gonorrhea Tables 2006 231.0 147.004 13.225 11.8 34.3 11.996 143 6.666 2.7 31.459 8.2 48.3 81.3 108.3 165.395 1.2 22.064 3.241 6.113 10.3 8.610 1.5 122.5 15.674 8.087 124 336.1 92.3 259.306 33.8 14.494 8.7 33.229 18.3 56.433 2.3 65.742 38.757 2.801 1.887 23.7 79.2 31.569 1.159 102 1.0 85.7 9.014 122 1.4 7.9 81.4 9.488 80 1.3 134.3 17.496 1.373 23.244 Rates per 100.Table 14.7 53.0 71.5 118.5 84.883 137 7.8 12.285 475 5.2 106.7 80.314 9.0 111.3 100.341 42.337 3.5 214.5 96.2 84.6 116.3 63.8 153.7 62.2 72.5 41.357 138 6.2 2007 235.5 73.2 12.2 93.6 2008 208.293 2.231 953 6.6 106.0 47.190 4.076 12.5 7.185 1.6 9.3 125.5 77.204 194 1.523 98 302 34 434 358.5 28.400 168.9 147.2 52.036 42.7 183.0 70.7 70.0 119.485 1.1 167.5 43.976 14.482 3.3 168.1 5.1 70.318 344 7.9 84.7 136.0 96.273 3.564 32.108 15.9 80.7 7.2 101.236 12.6 174.413 2.259 170.138 322 8.970 468 7.8 90.305 141 323 69 533 356.1 59.9 88.2 92.780 32.204 51.5 13.9 73.2 138.434 2.733 59 230 115 404 301.6 81.3 142.697 16.0 77.7 29.3 146.4 12.8 13.6 81.9 129.1 102.4 32.449 888 72 6.2 38.076 1.3 58.7 87.0 133.4 62.9 118.0 98.0 13.505 3.461 11.515 148.4 31.111 204 16.496 4.9 109.8 155.976 19.1 73.6 12.294 3.9 10.658 2.9 6.4 61.3 32.5 70.0 7.8 11.7 61.4 12.5 182.951 1.9 258.3 93.1 80.787 3.071 307 9.8 46.037 7.3 138.1 65.483 13.9 94.119 6.769 26.2 209.7 73.864 579 5.327 17.0 12.5 174.2 23.5 210.1 37.823 2.5 57.3 132.6 20.8 186.272 610 187 20.7 66.870 151 15.5 51.7 427.2 8.6 141.789 72.7 40.1 174.0 157.7 133.876 122 1.228 2.803 5.3 10.442 375 8.5 55.2 91.010 2.4 2009 159.926 29.168 31.700 2.7 57.4 7. TOTAL Northeast Midwest South West Guam Puerto Rico Virgin Islands OUTLYING AREAS TOTAL 102 2006 10.752 81 355.813 8.4 124.9 253.5 24.8 109.695 15.328 2.199 477 37 10.303 7.9 2010 168.3 130.5 142.962 6.9 23.768 2.8 127.558 971 2.9 119.788 310 58 7.2 99.5 66.

7 176.8 168.568 18.6 157.2 60.1 9.047 1.0 125.240 516 1.192 82.3 132.814 4.901 5.3 27.3 12.9 108.9 347.5 135.5 48.7 150.282 8.941 66 11.2 78.0 20.718 86 10.003 8.1 87.2 7.5 75.2 110.4 101.1 12.602 3.2 185.182 15.8 54.522 425 3.409 83.824 75 4.822 45 3.780 609 6.536 1.876 2008 5.7 153.2 58.577 20.514 1.0 78.858 504 4.132 5.1 228.0 118.2 236.0 213.197 26.404 49.886 92.5 46.247 16.693 21.0 134.8 10.3 165.233 10.606 564 6.744 71 182.6 71.598 1.5 151.5 85.177 43 3.687 298 90 11.6 28.604 1.582 321 1.1 192.047 71 187.6 26.924 3.257 97 2.930 4.876 93 9.5 8.7 6.365 16.887 5.7 162.5 68.257 2007 6.0 54.0 32.369 1.372 699 1.6 75.324 8.1 57.104 15.4 40.508 2.3 79.771 2.073 10.884 1.7 121.164 19 165.5 43.0 63.3 15.1 11.0 210.640 153 5.0 45.5 66.647 17.951 56 675 830 59 3.0 117.770 45.435 570 7.5 99.358 16.6 5.5 14.3 35.0 99.1 15.7 24.4 74.7 254.0 249.3 142.034 2.8 123.7 80.7 38.868 88 9.5 144.809 505 5.8 28.5 44. United States and Outlying Areas.542 92 891 1.9 121.3 150.4 90.5 77.270 4.682 50.427 10.0 5.9 197.3 166.971 1.2 NOTE: Cases reported with unknown sex are not included in this table.5 243.7 9.2 32.400 5.2 2010 182.8 56.6 173.312 4.1 9.7 153.718 8.7 74.975 2006 252.279 8.1 6.8 57.9 164.6 135.6 182.033 20.3 338.5 2007 255.7 112.1 106.7 200.475 2.2 74.491 564 1.9 173.0 79.5 77.066 63 3.378 66 165 51 282 187.2 26.6 131.806 1.024 1.4 46.5 31.541 2.8 154.2 27.729 49 152 23 224 187.457 976 8.7 74.1 60.1 6.905 290 3.502 1.8 51.2 209.5 115.432 698 1.3 63.4 22.577 2.219 273 5.5 30.1 95.3 49.6 175.847 2.4 7.7 11.000 Population 2009 4.335 3.342 2.850 1.0 157.0 12.984 1.349 8.4 27.235 2.849 Rates per 100.2 82.2 188.342 5.2 127.6 69.807 1.7 77.3 121.8 94.0 8.228 20.0 285.7 63.459 2.113 44 162.4 152.5 110.8 36.8 46.3 9.7 403.9 248.6 29.066 41 187.9 46.0 102.8 136.4 160.3 84.289 52.6 82.4 29.2 150.1 2008 232.911 24.6 84.287 1.8 129.625 1.2 9.3 7.847 1.4 7.0 69.071 70 29 4.Table 15.3 143.334 295 152 11.709 5. STD Surveillance 2010 Gonorrhea Tables 103 .7 77.479 8.964 553 6.533 1.7 122.1 137.3 15.833 42.1 6.179 1.594 21.1 145.5 169.2 6.879 1.425 89.401 1.0 160.553 2.9 108.7 48.0 325.S.449 621 1.1 60.5 10.8 133.3 188. Gonorrhea—Women—Reported Cases and Rates by State/Area and Region in Alphabetical Order.044 326 3.7 67.5 167.246 75 24 4.314 949 281 3.2 61. 2006–2010 Cases State/Area Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming U.3 160.8 105.478 829 808 12.210 135 5.804 45 141 96 282 165.240 8.059 974 8.0 8.6 63.3 129.6 171.0 97.6 97.6 173.8 70.1 100.297 314 68 8.4 147.5 150.100 10.3 47.4 29.275 14.9 51.8 193.650 146 5.016 89.5 8.766 2.8 166.5 114.3 6.253 264 51 11.3 68.0 92.0 2009 174.493 477 7.7 97.1 97.3 85.5 104.3 56.8 83.9 132.5 38.2 133.8 29.2 287.0 147.5 26.784 2.1 79.926 4.314 140 10.829 1.2 107.688 1.0 132.004 190 4.7 139.1 155.6 103.938 488 4.028 1.259 12.056 1.121 1.562 9.2 41.2 193.2 117.8 173.1 49.4 173.095 326 2.0 123.3 20.1 145.927 7.4 77.146 1.6 60.2 148.5 72.3 209.481 75 847 1.248 3.049 1.6 150.2 24.9 122.8 293.7 135.406 215 5.4 16.6 144.619 369 39 3.983 356 2.4 52.4 156.511 5.1 27.248 3.4 117.012 49 2.1 11.7 8.729 10.546 1.9 108.4 103.268 121 4.3 109.793 9.8 31.6 83.978 1.004 7.801 17.745 7.2 87.686 606 1.8 389.125 62 3.002 476 113 10.2 97.7 261.3 120.813 783 8.4 156.0 113.704 247 4.214 8.4 45.1 86.605 54 3.5 36.7 94.816 2010 4.029 137 19 5.900 1.1 222.357 4.8 63.2 103.077 11.1 111.2 178.0 88.8 12.4 139.520 11.8 166.4 124.9 97.0 76.5 136.179 1.8 28.248 32 126 90 248 162.1 73.8 173.6 11.3 80.5 74.487 4.2 54.3 86.2 49.529 1.945 169 5. TOTAL Northeast Midwest South West Guam Puerto Rico Virgin Islands OUTLYING AREAS TOTAL 2006 5.430 1.5 6.6 47.2 29.2 263.059 58 128 86 272 182.327 1.884 17.1 166.985 1.0 192.3 67.585 46 821 826 54 2.4 79.192 345 30 3.6 64.115 610 8.752 123 865 1.657 4.2 19.5 87.9 165.6 207.

873 599 5.6 70.906 2.6 122.4 57.7 91.4 10.0 18.818 253 1.056 177 3.3 36.8 79.665 107 4.6 89.634 871 2.135 3.923 29.9 135.2 130.810 51 145 34 230 153.333 Rates per 100.2 63.160 51 2.1 220.693 676 815 2.1 95.1 107.6 12.1 12.5 41.3 91.0 32.0 64.594 67 8.5 39.3 109.6 97.099 6.489 3.4 40.1 7.975 2010 3.510 409 92 9.710 2.995 7.0 12.3 100.1 121.8 78.1 9.4 14.1 122.2 2007 213.690 3.7 116.413 4.4 114.3 158.638 81.8 24.961 26.483 619 8.9 7.2 101.8 127.5 128.452 71 552 1.4 123.9 131.6 58.501 3.293 465 2.028 9.524 235 33 3.7 156.1 156.122 17.0 143.0 21.0 62.7 101.3 65.6 65.5 152.331 3.7 469.8 45.869 1.777 1.2 10.1 62.2 46.4 142.7 84.738 1.4 11.250 474 1.0 75.903 34 553 900 59 2.0 220.9 58.727 619 9.5 137.8 138.030 4.023 50 6.6 100.5 15.8 11.103 18.4 76.6 73.004 1.1 42.4 68.9 198. TOTAL Northeast Midwest South West Guam Puerto Rico Virgin Islands OUTLYING AREAS TOTAL 2006 4.0 85.208 46 512 898 92 2.546 9.0 75.7 48.9 66.3 6.072 11.3 27.113 439 1.9 52.199 21.590 14.860 172 3.752 22.8 5.247 235 4.215 271 21 3.3 85.7 73.685 20.902 62 6.529 3.054 1.4 64.260 3.1 100.273 1.7 461.4 117.5 146.6 12.332 53 153.696 2.6 93.6 5.4 40.8 71.1 77.748 2006 209.Table 16.658 39.569 955 594 1.076 52 171 55 278 142.9 33.9 141.472 29 568 1.368 367 58 8.9 2009 142.235 14.212 672 4.479 5.994 67.895 787 883 1.2 53.238 1.0 96.4 38.0 10.4 19.0 151.2 109.4 119.890 16.9 62.2 6.0 98.2 87.559 5.0 21.5 95.819 476 34 2.061 30 137.3 56.9 32.3 92.8 83.895 1.979 15.3 84.1 69.4 393.8 59.3 85.5 119.6 105.0 63.7 56.593 3.0 174.7 128.922 996 6.7 80.038 15.5 68.591 49 150 11 210 170.212 6.477 1.319 1.3 16.906 7.0 35.8 19.0 206.377 1.0 73.854 3.8 91.9 8.0 34.6 91.0 60.6 132.6 9.4 154.7 8.1 67.899 152 4.2 45.7 131.3 111.289 153 3.5 232.5 139.8 13.824 2.1 52.014 822 9.6 43.233 53 3.7 64.1 112.773 1.884 624 849 1.976 8.120 389 1.0 59.601 5.221 672 5.527 36.3 11.6 11.0 249.3 75.7 95.9 89.6 7.291 75 3.363 7.5 45.0 102.4 153.4 75.0 13.8 10.712 64 6.6 7.0 91.1 63.795 426 2.5 155.067 407 1.3 86.1 45.0 64.3 9.3 48.673 40 167.284 11.5 76.0 105.477 24.916 40.2 31.4 66.1 241.186 83 3.3 98.632 1.5 51.4 19.0 120.1 114.951 66.097 2.4 122.4 63.4 130.6 163.8 170.401 364 112 9.0 46.484 176 3.421 445 78 6.9 9. 104 Gonorrhea Tables STD Surveillance 2010 .6 162.395 47 583 1.6 19.7 114.0 55.412 6.7 134.533 83 2.508 19.9 57.447 1.1 122.5 33.7 146.2 50.7 136.705 1.725 50 9.5 10.328 10.1 99.461 1.812 519 33 3.8 150.4 203.7 31.831 609 964 1.164 2.775 1.111 4.1 83.S.0 89.0 15.2 7.383 10.751 7.9 121.718 2007 4.7 51. Gonorrhea—Men—Reported Cases and Rates by State/Area and Region in Alphabetical Order.9 97.1 54.3 34.387 27 104 25 156 137.0 124.816 1.326 512 9.2 103.2 110.2 130.2 104.9 155.2 33.6 28.0 106.025 1.7 48.600 321 2.8 31.5 15.9 84.334 194 2.014 75.026 6.9 38.248 1.5 48.0 56.6 125.560 13.7 14.621 29.7 87.8 54.712 128 3.849 81 2.5 179.9 2010 150.7 248.561 5.132 656 1.693 2.4 148.856 1.0 118.4 2008 183.2 90.187 2.3 144.8 71.9 124.8 66.493 2.3 217.0 67.657 730 8.5 71.9 79.150 340 18 4.791 75 158 18 251 167.857 608 4.9 53.0 NOTE: Cases reported with unknown sex are not included in this table.2 197.1 124.421 1.786 253 2.4 147.5 126.1 37.8 115.1 107.7 123.993 14.527 8.2 108.880 807 881 1.7 117.033 2.430 575 1.8 176.0 15.0 68.9 36.2 137.017 79.5 55.3 158.3 56.470 20.1 21.876 1.819 18.8 12.1 94.758 232 4.9 117.201 73 3.282 31.3 112. United States and Outlying Areas.5 363.0 54.615 170 3.1 57.380 3.6 35.6 102.072 5.171 852 5.8 62.0 64.870 49 170.3 65.3 71.1 76.540 86 3.898 13.936 2008 4.2 120.1 7.6 12.0 66. 2006–2010 Cases State/Area Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming U.6 105.068 1.6 58.317 15.1 74.926 21 142.465 1.4 124.2 8.000 Population 2009 3.7 494.6 94.151 257 1.465 312 97 9.678 274 3.6 53.718 1.6 153.2 181.6 29.

464 1.572 6.995 9.0 148.800 1.6 50.5 46. TN New Orleans-Metairie-Kenner.4 84.0 94.921 1.199 3.057 1.683 2.7 153.0 239. CA Rochester.4 235. VA-NC Washington-Arlington-Alexandria.5 140.554 920 7.780 1.079 6. CA San Francisco-Oakland-Fremont.676 204 3.9 124.553 9.4 59.9 81.9 169.321 181.3 39.979 3.1 65.625 10.3 150.757 4.5 87.7 110. TX San Diego-Carlsbad-San Marcos.292 1.2 177.604 11.315 3.S.5 170.2 191. NOTE: 2008 Milwaukee County STD morbidity data were misclassified.0 28.697 1.6 157.0 109.4 129.066 5.6 119.918 9.653 2.969 2. OK Orlando.410 2.5 115.2 146.2 29.773 8.8 174.932 4.2 59.0 161. NY-NJ-PA Oklahoma City.7 167.6 49.9 154.504 4.163 4.991 17.9 154.0 80. OH Columbus.3 81.2 212.6 103.446 4.6 151.8 97.771 346 3.3 113.4 141.6 148.9 128.0 85.7 52.5 79.9 64.2 321.3 79.0 148. UT San Antonio.393 8.6 113. TX Indianapolis.335 2.601 2.4 175.4 137.0 159.475 5.1 101.380 3.033 455 2.507 1.1 58.5 77.774 2. CO Detroit-Warren-Livonia. TN-MS-AR Miami-Fort Lauderdale-Miami Beach.724 2.4 140.124 244 3.3 30.700 3.542 2.466 1.770 3.7 231.068 3.6 217.075 4. NY Charlotte-Gastonia-Concord.1 181.0 153.869 1.429 5.181 3.6 171.900 1.8 214.2 68.053 621 2.9 * MSAs were selected on the basis of the largest population in the 2000 U.5 39.2 132.4 78. CA Salt Lake City. PA-NJ-DE-MD Phoenix-Mesa-Scottsdale.4 81.2 140.128 693 1.8 282.6 132.239 3.156 3. KY-IN Memphis.9 74.286 4.126 7.588 1.371 8.4 38.7 245.9 128.315 573 2.547 3.6 181.223 2. MN-WI Nashville-Davidson-Murfreesboro.2 102.113 2.7 120.0 55.289 2.742 1.2 82.962 14.0 139.667 2.834 1.714 7. CA Louisville. DC-VA-MD-WV U.541 2.960 2. NY Sacramento-Arden-Arcade-Roseville.317 1. MO-IL Tampa-St.4 168.8 162. FL Philadelphia-Camden-Wilmington.125 4.1 105.574 3. STD Surveillance 2010 Gonorrhea Tables 105 . GA Austin-Round Rock. LA New York-Newark-Edison.3 23.344 9.0 87.2 263.045 15.8 181. VA Riverside-San Bernardino-Ontario.700 2.663 7.363 1. MA-NH Buffalo-Cheektowaga-Tonawanda.3 111.388 14.1 53.1 366. MSAs TOTAL Rates per 100.5 313.862 4.3 146.2 88.1 135.1 83.4 127.3 160.069 926 382 1.669 3.1 79.225 2. WA St.8 155.4 115.2 151.152 4.665 5.970 1.979 4.396 2.1 94.5 220.867 586 2.975 2.713 15.5 87.7 46.852 4.065 712 2.4 136.189 4.373 2.8 138.5 77. CA Seattle-Tacoma-Bellevue.5 226.6 180.6 172.6 117. Census.127 3.084 2.5 191.059 1. PA Portland-Vancouver-Beaverton.0 98.0 168.8 43.0 204.356 5.106 9.234 189.000 Population 2006 2007 2008 2009 2010 2006 2007 2008 2009 2010 10.4 230.182 5.2 36.665 1.743 8.819 2.866 826 427 1. MO-KS Las Vegas-Paradise.583 4.385 5.3 48.7 143. FL Kansas City.7 154.756 5.300 4.333 2.5 49.8 163.6 94.3 77. TX Baltimore-Towson.089 3.0 66.930 1.Table 17. IL-IN-WI Cincinnati-Middletown.3 143.3 214.444 1.853 9.337 1.9 129.465 1. TX Denver-Aurora.7 31.260 2.3 46.238 8. RI-MA Richmond.9 101.0 78.3 93.197 2.478 12. WI Minneapolis-St.5 155. 2006–2010 Cases MSAs Atlanta-Sandy Springs-Marietta.9 140. Louis.457 2.4 208.S.1 53.4 53.0 217.425 1. United States.4 106.4 94.268 1.287 199. FL Milwaukee-Waukesha-West Allis.2 128.7 177.5 119.1 99.704 7.3 91.8 198.908 4.620 3.5 186.254 2.608 3.994 1.770 2.207 2.064 2.1 144.8 163.5 52.192 1.060 2.0 83.935 5.3 86.949 2.2 112. CT Houston-Baytown-Sugar Land.5 202.345 1.388 4.375 563 1.3 139.424 12.365 2.029 7.749 4.351 8. AL Boston-Cambridge-Quincy.5 220.128 3.1 194.8 18. MD Birmingham-Hoover.1 183.7 80.818 3.4 139.2 155.379 3.4 197.6 75.352 1.4 184.8 204.7 108.6 109.898 3.9 41.924 1.249 16.7 32.850 1. OH Dallas-Fort Worth-Arlington.219 3.112 11.483 3.536 5.253 8.003 3.8 26.345 1.086 5. Paul-Bloomington.2 86.3 244.4 95.9 168.665 208.3 127.7 80.4 170. MI Hartford-West Hartford-East Hartford.7 231.8 191.192 7.2 138.652 2.506 3.9 140.303 8.113 3.0 77.369 2.2 170.1 130.1 130.516 3.6 129.692 2.065 3.199 1.557 197.7 79.116 2.8 28.954 3.1 264.318 4.9 135.4 180. AZ Pittsburgh. WI.3 162.8 95.194 2.881 1.1 152.319 1.136 10.0 91.3 219.8 72.2 135.767 6.2 123.543 3. Gonorrhea—Reported Cases and Rates in Selected Metropolitan Statistical Areas (MSAs)* in Alphabetical Order.6 191.8 21.6 94.891 1.3 139. OH-KY-IN Cleveland-Elyria-Mentor.6 178.407 2.926 2.495 9.729 2.8 190.1 132. IN Jacksonville.1 182.0 104.694 2.535 988 7.165 15.4 144.599 1.829 4.832 2.4 127.9 41. NC-SC Chicago-Naperville-Joliet.544 4. NV Los Angeles-Long Beach-Santa Ana.0 331.029 1.569 1.272 4.082 15.973 3.137 3.9 31.9 144.3 51.358 209.6 99. FL Virginia Beach-Norfolk-Newport News.8 118.211 2.3 165.698 2.8 268.2 147.227 2.2 131.0 222. OR-WA Providence-New Bedford-Fall River.6 175.160 1.3 185.7 371.647 5.146 2.471 446 2. Petersburg-Clearwater.210 1.864 3.066 2.734 1. resulting in incomplete case counts for MSA-Milwaukee-Waukesha-West Allis.4 258.015 3.129 1.366 961 6.235 623 2.701 2.766 2.9 297.1 110.2 155.5 86.822 2.5 199.778 2.232 2.021 4.3 234.006 2.0 136.8 52.695 893 2.8 347.8 348.8 76.388 15.403 2. CA San Jose-Sunnyvale-Santa Clara.2 109.8 208.156 2.166 1.0 180.213 1.6 140.4 130.663 3.290 4.8 90.2 34.

9 75.756 2.3 100.7 72. NC-SC Chicago-Naperville-Joliet.805 2.171 5.7 85.174 436 374 824 1.1 99. NY-NJ-PA Oklahoma City.8 145.2 57.718 2.472 2.2 175.1 115.5 196.7 95.010 1.0 65.164 246 1.3 61.129 1.9 34.290 1. RI-MA Richmond.2 95.000 Population 2006 2007 2008 2009 2010 2006 2007 2008 2009 2010 5. AL Boston-Cambridge-Quincy.142 4.3 145.8 135.7 40.1 159. United States.279 961 2.253 3.594 2.3 135.1 149.161 322 196 1.8 191.040 954 5.5 51.071 1.4 93.973 1.2 93.8 105.181 1.0 201.4 166. PA Portland-Vancouver-Beaverton.Table 18.4 77.500 800 1.3 103.9 102. resulting in incomplete case counts for MSA-Milwaukee-Waukesha-West Allis.179 1.6 286.070 950 597 1.3 96. NY Sacramento-Arden-Arcade-Roseville.0 25.128 4.6 140.228 2.0 103.8 90.7 72.6 * MSAs were selected on the basis of the largest population in the 2000 U.2 28.444 2.497 4.530 446 282 1.026 1.3 178.6 143.001 1.3 211.4 126.153 1.6 99. Census.5 153. IL-IN-WI Cincinnati-Middletown.4 86.8 142.436 1.4 201.9 374.6 72.397 1.035 5.9 138.7 154.1 230.810 779 3.3 109.6 128.953 1.158 2.6 179.5 151.8 56.0 38.9 84.093 3.708 2.5 49.3 53.4 166. VA-NC Washington-Arlington-Alexandria. LA New York-Newark-Edison.5 141. MD Birmingham-Hoover.226 609 3.587 1. CA Seattle-Tacoma-Bellevue. OH Dallas-Fort Worth-Arlington.8 198. TX Indianapolis.0 40.2 87.056 624 878 1.884 2.556 1.5 137.539 1.026 2.6 85. CA Louisville.0 47.S.217 633 4.0 31.0 96.3 142.6 37.9 275.8 79.6 181.0 196. CT Houston-Baytown-Sugar Land.2 82.098 988 1.2 168.124 962 1.905 1.2 40.5 149.059 1.813 2.7 65.302 1.788 1.1 83.0 154. PA-NJ-DE-MD Phoenix-Mesa-Scottsdale.421 248 604 1.673 95. KY-IN Memphis.4 32.7 230.174 1. MN-WI Nashville-Davidson-Murfreesboro. WI Minneapolis-St.006 2.0 196.7 104.8 209.1 117.947 1. FL Milwaukee-Waukesha-West Allis.5 91.7 109.0 107.1 162.1 244.6 26.188 7.9 206.377 4. CO Detroit-Warren-Livonia.9 226.190 229 1.2 138. FL Philadelphia-Camden-Wilmington.808 1.641 1.6 113.0 177.9 55.9 196.134 2.3 241.8 180.1 173.024 744 557 37 1.0 64.863 312 965 2.3 98.2 78.5 271.661 300 1.858 2.1 157.7 125.4 137.237 744 917 88 1.330 2.062 4.294 1. MSAs TOTAL Rates per 100. TN-MS-AR Miami-Fort Lauderdale-Miami Beach.6 174.603 1.0 192.873 4.821 746 3.9 46.853 2.917 4.3 172.4 94.1 214.2 57.497 1.177 2.082 1.274 371 159 994 976 714 907 41 1.954 910 2.1 190.6 35.8 85.6 85.6 128.6 257.204 551 3.5 276.S.0 42.364 3.4 185. TX Denver-Aurora. CA San Francisco-Oakland-Fremont.188 1.5 209.750 8. TX Baltimore-Towson.412 1. Gonorrhea—Women—Reported Cases and Rates in Selected Metropolitan Statistical Areas (MSAs)* in Alphabetical Order.8 158. Louis.2 81.098 928 625 1.633 980 2.4 227.9 134.6 23.721 522 3.4 236.3 49.4 234.5 99.258 1.439 2.5 141.1 127.044 4. Petersburg-Clearwater. WA St.188 1.789 2. WI.015 1.2 262.1 161.0 149.416 1.263 2.9 60.697 8.2 164.8 43.6 115.749 2.0 130. MA-NH Buffalo-Cheektowaga-Tonawanda.0 171.9 166.5 135.548 2.7 35.2 140.9 262.7 46.3 141.5 127. MO-KS Las Vegas-Paradise.6 135.6 182. OK Orlando.3 79.7 244.637 92.261 5.334 6.4 131.0 207.875 2.2 370.2 265.8 70. Paul-Bloomington.515 992 2.888 880 4.8 158.098 6.1 169. 2006–2010 Cases MSAs Atlanta-Sandy Springs-Marietta.710 249 686 2.099 1.385 1.711 102.181 1.584 7.122 1.008 2.9 74.0 33.545 1.9 19.2 112.323 708 669 1.979 1.300 3. NY Charlotte-Gastonia-Concord.637 3.123 5.355 2.3 179.6 307.806 2. 106 Gonorrhea Tables STD Surveillance 2010 .1 160.2 216.9 376.180 2.1 337.7 246.322 6.532 2.923 1.3 125. CA Rochester.2 134.7 83.1 87. GA Austin-Round Rock. VA Riverside-San Bernardino-Ontario.506 2.6 129.7 141.967 1.125 1.014 1.268 105.7 229.470 1.907 2.886 1. CA San Jose-Sunnyvale-Santa Clara. MI Hartford-West Hartford-East Hartford. TX San Diego-Carlsbad-San Marcos.7 72.6 154.9 86.1 179.712 2.7 44.8 131.6 205.838 193.048 1.688 4.277 1.5 27.7 189.2 142.0 150.705 608 1.537 2.613 521 3.022 1.655 720 1.2 200.285 2.972 1.469 2. OR-WA Providence-New Bedford-Fall River.1 7.6 386. FL Virginia Beach-Norfolk-Newport News.886 535 1.089 1.048 105.064 1.8 83.486 794 965 7.4 130.7 169.657 887 2.8 56.122 488 1. OH Columbus.921 620 1.133 2.3 87.602 748 1.9 162.275 1.8 122.696 1.2 107. NV Los Angeles-Long Beach-Santa Ana.9 95.3 111.4 100.1 79.7 123. Cases reported with unknown sex are not included in this table.7 6.210 783 984 7.424 4.202 1.4 95.0 112.345 6.834 1.4 31.0 339.6 215.0 196.205 3.465 2.9 210.014 8.7 35.8 134.152 1.4 230.511 728 1.5 180.741 2. CA Salt Lake City. FL Kansas City.557 803 1. TN New Orleans-Metairie-Kenner.7 177.8 195. DC-VA-MD-WV U.0 181.3 146.0 110. OH-KY-IN Cleveland-Elyria-Mentor.8 77. IN Jacksonville.9 27.1 231.3 150. MO-IL Tampa-St.908 1.7 74.758 4.2 30.302 1.3 156.7 142.5 229.6 16.761 773 1.7 264.305 2.3 259.3 40.6 141.6 47.3 166.6 71.4 156. AZ Pittsburgh.214 1.4 201. NOTE: 2008 Milwaukee County STD morbidity data were misclassified.174 385 1.297 1.257 2.811 1.4 378.3 420.4 79. UT San Antonio.480 2.524 420 209 1.

9 116.421 973 1.405 7.106 1.173 558 1.024 1.586 1.3 150.023 881 1.5 58.150 1.4 229.5 94.2 54. WA St.156 1.786 398 3.406 1.5 160. TX Baltimore-Towson.403 825 7.8 166.7 155.9 62.501 1.786 991 1.569 2.6 324.179 398 1.2 69.8 164.4 71.242 883 692 318 954 1.7 154. OR-WA Providence-New Bedford-Fall River. MI Hartford-West Hartford-East Hartford.080 1.5 208.7 187.4 133. AL Boston-Cambridge-Quincy. TX San Diego-Carlsbad-San Marcos.129 4.208 1.2 173.2 57.3 83.5 145.887 1. RI-MA Richmond.267 1.5 117.8 225.4 186. CO Detroit-Warren-Livonia.842 1.1 106.531 3.975 1.380 1.5 128.6 119. VA Riverside-San Bernardino-Ontario.3 175. MO-IL Tampa-St. WI.024 1.2 138.3 113.5 178.7 177. MN-WI Nashville-Davidson-Murfreesboro.135 758 1.3 56. OH Dallas-Fort Worth-Arlington.1 152.277 3.450 599 1.5 318.8 152.643 1.975 1.1 169.2 174.0 43.040 1.7 107. KY-IN Memphis.5 52.9 211.517 1.5 64.148 2. CA San Francisco-Oakland-Fremont.0 149.7 217.9 129.254 1.091 1.0 82.7 231.482 3.9 89.610 1.0 49.1 142.648 2.626 1.930 2.9 126.1 85.2 133.543 1.3 151. UT San Antonio.4 88.6 182. DC-VA-MD-WV U.069 607 338 1.7 140.083 1.7 103.537 4.3 125.3 86.6 62.6 142. NOTE: 2008 Milwaukee County STD morbidity data were misclassified.6 100.237 2.9 204. GA Austin-Round Rock.0 28. FL Virginia Beach-Norfolk-Newport News. Paul-Bloomington.7 145.3 138.5 33.4 199.2 80.261 961 601 835 258 1.043 1.081 1.902 1.5 42.1 33.264 795 555 223 745 944 605 756 163 1.0 150.019 1.7 46.926 1.7 126.070 2.1 185.3 100.7 184.005 410 2.3 99.8 161.1 53.320 4.295 704 504 231 886 895 721 558 207 1.054 1.9 94.0 198.0 140.3 231.9 40.352 8.800 3.565 1.4 68.003 2.704 3.0 107.2 32.058 2.929 1.8 186.8 28. NC-SC Chicago-Naperville-Joliet.1 138.1 248.801 145 1.924 493 3.4 19. OH Columbus.243 1.890 467 3.5 96.7 282. CA Salt Lake City.723 1. NY Sacramento-Arden-Arcade-Roseville.083 5. PA-NJ-DE-MD Phoenix-Mesa-Scottsdale.4 193.556 1.0 153.366 1.081 990 1.7 136.171 1.0 45.Table 19.5 135.834 1.322 1.804 7. TN New Orleans-Metairie-Kenner.7 45.6 148.334 892 1.5 84.4 193.1 135.4 45.7 167. FL Kansas City.3 128.2 144. MO-KS Las Vegas-Paradise.3 109.976 1. TN-MS-AR Miami-Fort Lauderdale-Miami Beach.9 128.933 314 1.1 128.9 86.5 181.161 1. CA Louisville. STD Surveillance 2010 Gonorrhea Tables 107 .1 142.2 36.0 125.4 70.0 98. CA Seattle-Tacoma-Bellevue.2 122.822 2.5 101.431 3. CT Houston-Baytown-Sugar Land.2 87.4 149. NY Charlotte-Gastonia-Concord.127 333 1.7 * MSAs were selected on the basis of the largest population in the 2000 U.038 5.000 Population 2006 2007 2008 2009 2010 2006 2007 2008 2009 2010 5.8 82.505 858 2.6 160.031 1. Gonorrhea—Men—Reported Cases and Rates in Selected Metropolitan Statistical Areas (MSAs)* in Alphabetical Order.5 102.045 611 246 1.5 125.224 1. Census.110 3.5 31. Petersburg-Clearwater.7 168.6 92.354 715 694 919 9.230 1.S.5 128.117 2.2 106.4 99.3 164.254 3.294 940 981 7. PA Portland-Vancouver-Beaverton.5 156.390 709 1.2 29.9 253.7 216.967 2.074 1.0 74.0 124.504 2.7 164.502 418 3.358 736 1. CA San Jose-Sunnyvale-Santa Clara.0 77.493 506 1.674 2.6 99.7 123.2 117.6 119.8 83.6 150.2 70.123 1.366 4.9 141.5 166.098 344 1.8 159.4 257.017 1. resulting in incomplete case counts for MSA-Milwaukee-Waukesha-West Allis.8 130 171.354 6.6 123.2 167.367 996 1.082 4.153 3.0 135.3 96.S.0 104.6 37.829 1.367 2.371 807 6.0 83.094 1.4 140.9 45.1 80.904 2.0 273.291 103.985 5.2 153.581 1.7 84.1 170.3 191.8 111.5 92.5 72. WI Minneapolis-St.0 119.7 176.250 1.5 92.4 56.8 140.199 7. MSAs TOTAL Rates per 100.633 2.247 1. 2006–2010 Cases MSAs Atlanta-Sandy Springs-Marietta.1 131.7 119.031 200.675 913 726 696 1.2 165.6 78. AZ Pittsburgh.141 1. Cases reported with unknown sex are not included in this table.8 180.278 4.3 55. OH-KY-IN Cleveland-Elyria-Mentor.5 53.593 1.5 35.9 102. IL-IN-WI Cincinnati-Middletown.706 1.306 1.1 70.2 160. MA-NH Buffalo-Cheektowaga-Tonawanda.7 77.6 135. NY-NJ-PA Oklahoma City.369 966 1.602 1.5 90.678 1.385 103. TX Indianapolis. NV Los Angeles-Long Beach-Santa Ana.998 2. United States.779 2.6 110.4 43.949 1.2 180.9 44.209 3.7 147.0 161.6 207.484 1.295 1.392 1.5 151. LA New York-Newark-Edison.2 229.8 163.373 2.841 1.554 93.2 146.712 1.7 182.9 94.297 3.216 2.525 1.7 139.8 95.9 101.0 344.0 122. VA-NC Washington-Arlington-Alexandria.4 109. IN Jacksonville.775 1.843 1.2 170.1 158.7 61.1 318. CA Rochester.681 88.374 958 4.7 173.083 3.0 199.8 261.8 87.0 178.7 189.158 6.007 1.2 125.3 88.180 932 812 913 1.5 159.968 1.103 1.235 742 839 1.788 4.232 4.8 143.9 149.882 570 1.470 872 600 976 8. FL Milwaukee-Waukesha-West Allis. TX Denver-Aurora.9 132.6 145.6 232.022 1.310 2.289 1.9 286.9 101.206 2.4 103.0 113.046 377 1.289 3.363 876 1.415 3.0 122.050 8. Louis.8 136.799 1. OK Orlando.448 1.3 95.944 1.0 141.9 117.7 72.465 1.0 69.2 72.4 258.2 111.2 121. MD Birmingham-Hoover.4 103.8 124.542 7.1 209.0 89.7 255.222 1.4 64. FL Philadelphia-Camden-Wilmington.5 119.823 95.

PA Harris County.8 Cumulative Percentage 3 6 8 11 13 14 16 17 18 19 20 21 22 23 24 25 26 27 28 28 29 30 30 31 32 33 33 34 34 35 36 36 37 37 38 39 39 40 40 41 41 42 42 43 43 44 44 45 45 45 46 46 47 47 47 48 48 49 49 49 50 50 50 * Accounting for 50% of reported gonorrhea cases. NV Sacramento County.566 2. SC Erie County.495 1.021 1. AL Richland County. KY Hillsborough County.102 1. Queens County.529 5.604 1.4 56.099 1.073 Rates per 100. FL Allegheny County. NY Marion County.1 84.951 1. FL Washington. United States.0 121.544 3.8 144.138 1.9 236.1 139.536 1.309 3. NY Cuyahoga County.0 237. OH Baltimore (City).123 9.437 1.1 163.2 249.516 1. FL Maricopa County.8 276. Louis (City).511 2.C.8 206.109 1. Louis County. NY Bexar County. MD Essex County.2 84.7 339.1 249. MD Franklin County. NY Wake County.301 3.9 222.533 6.4 310. CO Prince George’s County.1 154.2 273.5 496.257 2.2 165.093 2.479 3. MN Cases 10.263 1.1 344.170 3. CA Jefferson County.3 109.824 1.3 154.033 3. MO Pulaski County.838 2. GA Alameda County.2 237. CA Mobile County. WA Clark County.Table 20.1 92. FL Montgomery County.178 1. CA Duval County.2 220.993 7.4 302.4 221. TX Dallas County.732 1. TX Orange County.163 3.2 160. OH Miami-Dade County.9 66. OH Fulton County.5 350.2 172.877 2.648 1. FL San Francisco County. AR Tulsa County. TX St.0 445.4 205.000 Population 191.1 135.895 1.611 1.2 276.104 2. AZ Jefferson County. IN Tarrant County. OK Travis County. MO Orange County. WI Bronx County. 2010 County/Independent City Cook County.5 101.8 146.2 422.8 299.2 176. CA Denver County. TX Shelby County.936 1.027 2.281 2. LA Mecklenburg County. CA Orleans County.163 1.329 1.126 1.694 1. CA Wayne County.6 143. OK Pinellas County. NY Hinds County. † Counties and independent cities were ranked in descending order by number of cases reported in 2010.2 248.251 1.3 475. FL DeKalb County.7 140. TN Milwaukee County. 108 Gonorrhea Tables STD Surveillance 2010 .1 214. D. NC Caddo County. MI Philadelphia County. Rank† 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 Gonorrhea—Counties and Independent Cities* Ranked by Number of Reported Cases.8 358. TX Hamilton County.495 6.9 589. OH Hennepin County. OH Monroe County.992 1.7 56. LA Oklahoma County.862 1. PA King County.957 3.516 1.674 1.188 2.368 1.4 293. CA San Bernardino County.444 2. IL Los Angeles County.9 87. NY San Diego County.146 2.149 3.146 1.5 203. TX Kings County. NC Bell County.6 427.2 38.7 97.711 1. GA New York County.445 1. NJ St.329 1.727 1.6 378.460 1.2 122.4 412.327 1. MO Broward County.7 122. AL Jackson County.6 318.3 283. MS Lucas County.5 389.

7 226.1 11.4 448.7 88.3 234.016 14.260 111.717 18.8 94.821 3.890 25.647 27.4 161.9 59.809 8.561 16.0 123.4 11.946 98.294 2.773 3.510 4.490 1.186 545 379 507 27.738 12.573 14.5 264.123 6.769 9.353 56.8 72.8 20.186 3.654 27.194 520 554 2006 Group 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–54 55–64 65+ Unknown Age 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–54 55–64 65+ Unknown Age 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–54 55–64 65+ Unknown Age 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–54 55–64 65+ Unknown Age 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–54 55–64 65+ Unknown Age * No population data are available for unknown sex and age.4 99.645 484 89 522 3.9 403.2 181.777 3.168 707 1.5 3.313 66.138 13.0 49.7 68.563 11. The 0.554 31.015 61.495 2. NOTE: This table should be used only for age comparisons.899 48.444 43.0 248.3 8.0 44.336 3.471 59. and Sex.3 451.0 282.3 566.668 639 838 619 31.607 13.875 2.5 15.4 29.812 6.612 2.378 11.941 12.907 10.3 297.1 7.8 6.418 61.1 409.8 127.867 58.3 230.954 363 108 394 2.848 446 300 486 28.0 2.552 7.3 17.555 2.9 118.7 19.3 9.1 187.0 51.3 11.818 14.4 0.622 655 801 2.1 Male 6. United States.5 450.9 6.387 5.7 523.6 2.712 10.504 7.002 46.3 224.3 64.157 30.000 Population by Age Group.928 16.299 3.8 127.4 18.3 4.997 6.9 60.0 281.1 64.383 6.7 25.016 88.719 10.2 34.6 128.4 273.2 516.4 25.170 2.8 253.4 12.1 21.1 48.077 10.481 423 103 350 2.4 457.7 309.6 2.3 31.043 338 105 229 2008 Male 671 29.0 3.1 55.8 9.7 490.6 78.747 56.3 635.4 1. rates are not calculated.619 50.975 9.0 1.2 158.436 23.983 86.3 396.558 10.4 639.5 11.640 2.465 61.059 66.9 33.9 2.708 26.468 46.0 2.463 2.5 48.3 31.401 28.928 2.0 2.6 570.721 13.5 603.090 48.5 85.5 450.1 64.6 17.660 97.9 0.to 9-year age group is not shown because some of these cases may not be due to sexual transmission.996 100.446 1.7 613.0 42.123 2.232 96.0 241.5 4.4 6.313 28.4 23.020 11.6 140.7 39. Gonorrhea—Reported Cases and Rates per 100.7 0.5 234.766 449 150 648 3.745 7.5 Unknown Sex 2010 Unknown Sex 5 190 201 99 60 40 29 28 4 7 158 14 209 169 81 49 44 24 14 9 1 96 5 275 304 163 97 53 41 30 13 7 72 5 199 223 120 65 46 25 29 1 0 72 32 381 337 165 82 50 22 22 4 4 68 2009 Female 3.4 5.556 66.648 9. 2006–2010 Age Cases Rates* Total 20.7 5.961 62.3 431.983 2.6 104.3 107.262 9.645 49.3 1.4 265.191 19.848 32.498 59.9 2.796 28.651 10.2 23.2 25.9 0.9 33.6 529.462 13.7 290.364 8.1 97.104 110.7 67.121 796 1.4 13.951 32.9 560.9 61.019 12. therefore.8 30.5 14.0 0.809 8.3 51.178 4.028 13.4 154.Table 21.907 2.0 540.644 3.8 9.855 24.2 118.4 601.986 26. STD Surveillance 2010 Gonorrhea Tables 109 .3 146.6 89.326 61.1 Female 35.212 554 766 3.401 13.6 265.5 125.4 421.0 283.135 18.574 23.852 411 257 2007 Total 4.311 1.8 276.675 617 568 596 30.069 108.1 298.7 34.7 1.971 8.1 142.2 31.164 20.9 467.1 86.250 105.8 1.2 632.

234 2.579 3.374 5.108 14.731 3.614 1.083 967 493 246 167 36 4 12.017 60.085 6.845 4.732 355 1.988 2.651 1.626 4.156 58.866 712 187 54. 110 Gonorrhea Tables STD Surveillance 2010 .230 1.496 1.090 3 17 100 306 284 391 225 215 133 114 111 49 76 25 85 36 22 11 4 4 1.605 1.282 737 524 421 78 19 10.789 5. Gonorrhea—Reported Cases by Race/Ethnicity.028 134 185 19 90.022 9.092 666 540 93 16 27.829 2.494 1.785 2.121 696 766 81 118 18 80.307 1.213 26.531 9. The 0.731 19.433 4.308 3.387 63.616 893 710 101 20 33. In 2010.917 4.407 1.957 2.422 269 5.591 9.265 57.821 5.920 5.152 733 1.388 31 1.207 6.894 1.921 4.793 846 433 206 141 32 10 10.647 22 2 20 515 114 401 707 209 498 381 150 231 173 67 106 123 60 63 72 21 51 61 37 24 10 9 1 3 3 0 2.453 967 635 474 85 29 12.456 3.081 2.336 851 629 117 37 24.818 7.446 5.757 2.691 52. unknown.295 7.022 4.641 1.866 2.758 7. Non-Hispanic 2010 2009 2008 2007 2006 Age Group Total 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–54 55–64 65+ TOTAL 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–54 55–64 65+ TOTAL 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–54 55–64 65+ TOTAL 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–54 55–64 65+ TOTAL 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–54 55–64 65+ TOTAL 442 12.945 916 3.740 1.108 2.635 8.156 47 1.861 3.633 3.748 22 1.956 229 5.244 17.801 171 5.469 5.930 2.316 756 613 83 25 30.056 1 5 126 280 337 387 286 181 172 99 141 56 78 36 77 23 16 9 4 0 1.883 848 3.657 37.503 1.231 130 219 31 99.313 5.729 33.151 13.307 15.e.621 9.792 2.Table 22A.817 847 136 167.108 2.765 95. United States.609 5.000 732 112 19 34.4% of cases.647 26 1.128 1.883 7.101 559 456 82 19 25.322 15.306 5.778 4.813 1.430 1.361 7.246 28.263 1.001 19.927 867 483 240 151 27 8 11.067 672 1.594 947 1.188 19.364 15.999 3.054 5.672 1.241 115 249 35 98. 2006–2010 Whites.878 2.941 2.043 7.211 12 412 601 398 228 149 100 103 30 7 2.221 5.521 6.765 NOTE: These tables should be used only for race/ethnicity comparisons.788 9.269 198 4.316 Hispanics Total 271 6.938 2.413 4.003 2.413 140 3.382 2. Non-Hispanic Total 2.728 51.531 1.206 609 152 21.508 582 133 46.362 2.484 253 9.305 Blacks.309 1.395 785 623 133 34 23.547 853 611 478 90 29 12.157 62.288 1.322 909 1.174 4. Age Group.055 20 406 675 440 247 160 101 121 33 8 2.751 986 1.593 2.186 12.640 2.076 American Indians/ Alaska Natives Total Male Female 26 1 25 667 193 474 825 288 537 490 190 300 243 89 154 141 68 73 85 44 41 93 56 37 19 14 5 5 4 1 2.147 1.982 896 176 166.423 13.427 2.478 2.318 32.468 27.657 2.231 2.410 1.093 Male 49 1.500 29.135 300 1.829 4.968 489 117 19.709 896 1.513 990 1.938 721 171 55.617 1.741 86.703 2.939 14.129 2.238 1.151 330 10. missing.889 7. and they are not included in the totals.180 0 16 95 289 242 372 230 181 164 109 92 49 62 27 49 36 24 9 7 2 965 1.945 10.948 11.860 11.356 284 189.974 155 3.891 15.928 3.728 3.419 18 3 15 556 128 428 725 228 497 408 160 248 229 97 132 137 62 75 78 38 40 81 48 33 25 19 6 4 3 1 2.266 222 3.285 6.597 1.229 12.480 6.551 913 662 119 38 25.516 181 5.169 19.486 10.498 2.864 2. race/ethnicity was unknown (i.266 30.368 91.101 5.802 4.478 1.716 1.339 87.693 1.386 54.504 304 8.862 15.688 33.168 1 11 92 320 265 336 214 184 132 96 109 40 75 25 73 30 17 13 6 1 984 1.644 2.655 Male Female 385 2.922 4.040 6 406 724 467 271 197 114 100 25 4 2.912 246 7.771 34.757 2.137 8.2% of cases.181 11. age was unknown for 0.202 338 9.637 2.611 2.266 4.049 16.056 6.876 1. or invalid data values) for 20.025 2.415 2.741 4.141 1.284 698 800 96 145 31 80.074 5.037 2.390 2.248 4.917 33.043 1.391 17.250 10.149 31.870 20.445 4.753 503 147 17.261 786 1.114 13.343 1.197 5.414 1.127 96.702 4.573 395 1.214 10.347 1.939 2.185 Female 222 4.669 8.395 24 4 20 522 122 400 726 245 481 405 145 260 187 71 116 111 50 61 78 34 44 76 42 34 16 14 2 7 6 1 2.588 2.415 8.799 30.879 2.150 973 500 250 164 35 7 12.740 1.370 887 570 430 84 21 11.687 31 1.951 300 1.570 14.908 Asians/Pacific Islanders Total 17 423 640 434 276 182 106 91 21 4 2.555 33.119 2.428 17.043 1.382 6.800 22 1.329 Female 405 10.231 1.642 9.194 61.045 1.715 3.565 1.998 4.475 15 3 12 660 168 492 900 290 610 546 215 331 278 121 157 151 72 79 100 52 48 79 48 31 18 15 3 4 2 2 2.314 Male Female 1 16 97 326 272 368 223 211 162 114 117 65 77 29 53 38 10 11 2 2 1.241 4.to 9-year age group is not shown because some of these cases may not be due to sexual transmission.. and sex was unknown for 0.196 17.387 820 594 119 28 23.107 4.0% of reported gonorrhea cases.666 1.832 4.078 584 278 188 34 9 13.669 450 138 16.014 1.239 4.835 2.125 532 157 42.947 353 12.574 1.745 15 2.114 2.624 6.504 5.443 902 539 456 97 30 11.170 730 562 110 29 21.494 2.754 4.311 3.643 31.112 3.980 1.634 Male 37 2.050 35.542 26 1.712 268 9. and Sex.859 2.768 4.156 611 167 20.645 27.105 3.736 231 7.618 12.086 57.121 37.861 3.754 30.998 5.175 1.015 5.144 30.896 3. See Table 21 for age-specific cases and rates and Tables 14-16 for total and sex-specific cases and rates.173 4.366 586 172 48.434 2.361 250 195.162 204 186.194 16 384 614 411 273 141 89 85 33 9 2.889 3.

7 294.7 18.1 2.1 86.6 0.0 16.7 1.5 112.232.8 13.7 72.1 233.4 0.1 37.2 Male Female Total 2.5 547.7 5.0 3.7 2.3 338.2 7.4 0.3 82.2 7.0 196.7 613.9 259.3 4.7 50.0 2.2 10.0 31.9 44.1 1.6 1.0 53.024.5 13.9 4.6 29.1 70.0 69.7 1.5 87.5 13.0 24.5 16.199.5 70.6 197.1 69.8 103. age was unknown for 0.2 2009 Female 6.1 5.8 900.6 19.6 0.6 71.3 72.8 34.9 42.2 64. and they are not included in the totals.2 3.7 152.1 4.5 14.9 1.4 3.2 12.3 52. race/ethnicity was unknown (i.3 212.0 1.4 612.962.7 3.4 2.0 156.6 47.4 25.7 384.1 60.2 133.0 7.6 774.3 28.4 191.7 139.6 455.0 112.9 89.6 1.5 498.7 1.7 56.176.9 82.2 2.5 16.3 66.8 987.8 0.2 1.9 181.5 27.6 3.3 7.9 36.7 46.2 25.0 0.4 75.9 1.9 13.8 9. See Table 21 for age-specific cases and rates and Tables 14-16 for total and sex-specific cases and rates.1 60.4 1.8 15.5 0.0 241.1 93.6 38.5 241.4 2.0 1. The 0.1 48.8 25.6 187.7 7.9 60.019.9 60.768.0 4.1 0.7 7.3 44.9 134.9 1.3 3.8 186.5 84.2 3.8 38.7 22.4 2.5 23.0 1.1 73.9 2.3 2.4 0.7 74.3 1.0 2010 Total 73.5 0.2 4.0 551.9 43. Non-Hispanic NOTE: These tables should be used only for race/ethnicity comparisons.2 126.5 15.7 18.4 4.8 2.0 16.4 17.8 1.0 6.6 48.8 661.7 319.9 63.009.9 37.6 25.8 3.4 43.2 1.3 438.7 79.6 80.7 179.6 25.9 336.0 129.0 56.8 1.5 2.9 15.3 393.2 63.5 53.7 1.0 188.3 24.7 1.1 16.6 8.0 5.9 7.8 0.239.7 Male 0.3 17.0 77.3 0.7 288.8 119.1 89.3 0.9 164.9 1.9 1.4 201.2 20.5 2.1 33.4 237.2 520.5 1.3 11.4 65.8 91.9 22.8 132.2 0.6 95.2 127.3 1.0 72.8 20.9 215.3 53.0 Hispanics 2006 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–54 55–64 65+ TOTAL 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–54 55–64 65+ TOTAL 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–54 55–64 65+ TOTAL 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–54 55–64 65+ TOTAL 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–54 55–64 65+ TOTAL Blacks.2 17.7 13.0 4.9 18.7 86.2 72.6 71.1 16.4 6.2 61.0 19.8 128.5 3.1 129.3 43.3 917.0 52.4 21.1 4.1 174.0 20.1 1.3 131.4 11.092.3 0.2 2.8 17.7 8.9 13.6 12.8 22.3 17.3 0.0 5.018.6 29.8 32.8 36.7 59.6 0.3 153.0 116.5 13.2 59.6 16.9 5.9 75.5 60.1 28.6 238.4 22.9 1.7 0.7 226.5 49.9 84.3 35.0 68.3 0.9 77.4 256.2 18.3 202.6 92.3 38.2 1.1 29.6 1.4 41.3 65.2 17.6 4.6 23.3 140.9 116.8 4.3 20.9 0.8 4.997.9 139.4 38.4 7.9 47.7 98.8 92.4 2.5 7.1 4.3 23.4 2.2 6.1 22.0 60.1 1.1 10.4 26.8 880.4 9.7 2.0 2.8 15.8 19.7 5. 2006–2010 Whites.0 13.1 121.9 74.2 563.5 40.9 4.3 1.3 1.1 66.0 0.6 349.8 82.171.3 2.to 9-year age group is not shown because some of these cases may not be due to sexual transmission.7 5.3 19.6 0.6 1.8 0.1 4.8 69.5 1.2% of cases.4 112.8 7.8 0.0 19.5 8.5 4.4 250.4 110.8 6.8 12.2 179.8 18.4 192.7 62.1 20.7 17.1 25.5 1.4 2.6 35.6 199.1 46.028.1 155.7 112.7 4.3 1.4 188.1 Female 24.2 31.7 123.8 5.6 6.2 1.7 2.1 33.9 562.154.5 23.075.1 170.6 246.2 18.3 23.7 43.4 25.6 30.0 10.3 29.8 2.4 28.2 76.4 262.6 352.4 27.1 233.7 3.1 27.9 1.9 37.8 44.6 66.6 17.4 139.6 165.3 119.6 0.6 18.1 2.5 150.1 373.3 108.133.4 78.4 9.4 22.1 415.6 10.7 0.1 6.2 58.832.6 9.9 128.0 147.Table 22B.4 2.7 9.4% of cases. United States.5 94.6 92.353.5 66.7 3.3 45.0 11.677.6 2.9 323.1 146.3 69.713.1 1.8 17.8 155.3 54.8 31.3 247.0 7.2 2.1 56.9 20.5 51.6 51.4 72.4 9.2 146.9 16.3 4.8 3.1 396.6 35.2 302.2 96.4 29.6 30.1 512.0 2.6 35.5 293.0 37.6 108.4 Female 126.3 523.0 12.3 1.1 0.954.8 495.6 32.3 187.0 128.1 1.9 3.9 29.6 36.7 27.4 65.5 10.2 24.3 12.8 72. and sex was unknown for 0.8 1.3 1.4 2.9 59.4 49.6 59.7 34.5 64.5 13.8 0.8 547.0 1.5 67.4 69.9 0.1 340.2 43.8 251.6 317.0 121.8 184.7 16.4 2.6 21.032.6 75.8 162.3 1.1 40.7 3.5 3.6 5.6 16.9 0.4 21.8 20.2 860.7 59.6 32.9 35.7 12.6 793.3 1.0 445.9 504.7 18.0 1.6 24.6 8.3 0.9 2.8 American Indians/ Alaska Natives 2008 Male 0.8 1.3 509.0 2.0 15.6 381.3 68.2 4.4 40.2 3.8 11.1 92.1 7.5 9.9 169.3 17.1 10.6 68.9 14.633.881. or invalid data values) for 20.3 3.8 0.9 6.9 659. and Sex.1 45.4 0.1 17.1 600.9 101.2 19.2 44.5 964.2 20.2 37.8 80.151.0 0.6 31.8 0.5 13.6 2.8 2.6 6.4 214. missing.9 613.4 218.8 14.0 20.2 72.0 2.5 148.5 1.8 2.4 13.2 8.9 34.400.6 572.7 0.0 187. Gonorrhea—Rates per 100.8 82.8 61.7 7.5 441.6 4.1 20.9 Total 6.7 0.8 24.986.3 28.1 869.6 1.5 619.5 120.3 233.2 21.1 105.1 0.6 45.1 382.4 259.7 46.4 40.8 0.5 475.9 22.3 4.6 1.4 34.4 28.7 112.1 89.1 91.9 1.000 Population by Race/Ethnicity.9 91.7 26.9 47.3 22.8 9.6 0.9 1.9 79.7 222.4 9.1 762.9 21.1 64.2 1.6 0.0 0.0 99.2 38.9 1.7 157.7 14.0 184.8 4.e.8 98.3 133.2 41.4 4.7 26.5 34.4 184.6 158.2 93.1 4.8 103.9 39.0 1.9 6.2 6.1 239.2 65.4 16.8 50.4 920.3 68.4 4.8 85.0 118.2 242.1 29.0 2.8 2.2 14.6 38.5 140.3 578.4 28.3 0.6 116.4 11.7 481.7 67.9 42.5 1. unknown.9 232.3 61.4 33.6 8.9 5.137.2 20.6 212.7 5.8 110.3 215.0 97.5 8.8 44.1 142.8 55.9 104.1 18.888. Age Group.2 9.4 1.5 1.9 193.7 27.1 2.4 114.0 84.175.3 7. Non-Hispanic Age Group Total Male 23.0 4.0 2.9 153.0 11.0% of reported gonorrhea cases.5 36.2 1.8 211.1 46.0 95.3 63.8 12.0 70.0 166.8 16.8 527.7 238.3 24.6 100.6 11.4 20.6 5.3 354.1 5.5 0.8 7.3 400.3 18.6 65.4 373.3 227.8 5.0 76.7 92.3 7. STD Surveillance 2010 Gonorrhea Tables 111 .2 254.5 1.2 3.5 64.4 27.3 8.6 382.6 0.2 140.8 16.6 1.5 100.1 205.8 11.7 596.7 3.2 25..3 15.7 154.4 64.987.2 40.2 1.1 350.521.8 3.1 1.2 111.8 0.1 0.7 25.2 2.1 125.6 24.4 57.2 59.1 7.2 73.0 324.1 Male Female Total 0.0 47.0 39.1 636.0 122.2 20.1 14.6 33.046.6 0.5 14.0 317.7 0.0 105.2 0.4 436.3 20.4 20.6 15.9 20.3 178. In 2010.147.4 14.701.1 22.496.4 27.0 96.0 57.3 31.8 53.3 12.1 Asians/Pacific Islanders 2007 3.3 81.2 2.1 36.8 141.2 85.1 1.2 66.

9 7.7 7.8 9.7 16.8 6.0 0.915 324 65 151 239 1.9 1.7 6.6 3.0 6.6 6.3 1.6 27.8 15.086 38.833 68 26 1.9 9.2 10.6 7.6 2.2 8.8 0.7 18.3 11.1 17.7 16.0 10.945 1.933 66 12 1.5 11.2 6.5 1.891 8.8 5.6 20.739 9.8 6.033 269 179 87 431 3.5 32.6 2.2 10.4 17.608 17.2 6.1 25.0 1.1 17.6 24.3 4.1 9.3 8.9 9.0 2.7 21.7 21.1 19.068 5 1.8 7.1 9.4 1.623 1.2 4.1 11.135 Rates per 100.9 13.4 4.6 27.6 2010 16.417 8.975 55 1 755 322 32 166 7 44.4 6.7 15.2 15.1 8.883 11 723 4 738 46.7 9.038 378 384 189 520 430 2 34 389 35 799 237 4.2 4.1 1.478 3.3 7.515 999 4 763 257 97 902 55 412 6 1.2 6.7 1.853 5.5 25.7 1.S.1 5.024 27 1.834 7.5 6.8 2.1 23.8 12.484 41 1.2 3.9 6.0 * See Syphilis Morbidity Reporting in the Appendix for definition.000 Population 2009 1.2 9.2 5.2 3.4 3.5 0.0 8.3 1.3 3.015 639 680 350 823 512 5 33 412 43 947 151 4.006 16 1.3 14.7 12.6 0.193 6.7 21.6 25.8 5.2 0.093 2 549 216 59 844 76 411 12 1.8 21.7 18.1 2.6 6.6 10.4 0.8 10.309 4.5 28.572 2006 20.6 16.8 5.0 16.7 54.044 2007 1.3 19.1 25.7 2.9 5.187 9 1.7 20.9 8.390 22 1.138 4 1.6 4.4 5.2 1.3 20.3 15.5 8.132 8.6 8.1 14.918 2.5 8.9 15.6 1.7 15.009 189 5.3 10.2 9.2 7.0 12.5 23.2 8.4 3. United States and Outlying Areas.2 13.4 5.8 18.717 88 31 1.4 12.544 12 725 2 739 45.524 8 795 296 132 1.6 9.8 7.9 2.2 7.868 45 797 1 843 47.1 0.2 5.9 4.7 1.6 13.1 6.2 1.565 351 75 125 218 2. 2006–2010 Cases State/Area Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming U.2 3.394 508 6.8 17.2 9.8 6.8 1.9 25.3 19.3 2009 24.9 10.5 5.8 9.1 12.2 3.7 23.9 8.2 0.504 21.9 7.1 6.8 11.2 20.1 45.0 2.6 1.681 23.5 19.3 1.6 5.8 10.585 2.1 4.5 4.5 3.983 3.7 18.874 37 1.311 42.007 79 579 12 1.6 4.0 82.4 14.2 12.9 12.1 1.3 1.7 1.2 21.3 17.269 5 1.7 1.220 216 65 97 153 1.8 2008 25.3 5.9 3.114 342 234 44 495 4.5 5.7 17.911 352 173 60 370 4.4 4.5 2.808 21 1.466 23.088 479 546 266 745 542 10 36 325 41 1.7 5.476 13 1.6 13.5 24.925 7.5 2.1 16.7 3.3 21.6 13.473 250 68 87 188 1.411 133 4 800 535 26 186 6 45.7 2.8 27.3 23. 112 Syphilis Tables STD Surveillance 2010 .5 4.069 8.1 0.233 6 1.347 73 20 2.5 3.2 7.9 62.2 5.0 1.3 70.6 20.9 28.3 7.0 2.5 4.6 7.964 15 993 473 635 217 745 514 5 45 306 37 890 208 4.084 552 6.0 3.2 1. All Stages of Syphilis*—Reported Cases and Rates by State/Area and Region in Alphabetical Order.956 68 7 701 423 30 170 1 36.284 6.Table 23.6 6.069 2. TOTAL Northeast Midwest South West Guam Puerto Rico Virgin Islands OUTLYING AREAS TOTAL 2006 931 25 926 246 6.6 17.9 6.6 3.0 29.3 7.7 12.292 8.8 6.1 25.2 0.5 3.5 5.6 31.0 14.1 13.9 14.171 399 473 186 708 484 8 30 396 52 926 180 5.6 0.3 3.3 3.845 24.236 2008 1.336 40 18 789 438 44 187 9 46.001 1.9 23.1 11.5 21.5 12.0 13.5 5.5 20.2 0.4 2.9 20.9 19.7 26.6 3.5 43.3 32.569 2010 781 15 904 534 6.254 58 14 1.2 4.4 2.7 15.0 1.015 4.236 412 68 110 311 2.8 1.9 0.2 12.212 5.3 1.6 42.4 16.3 12.0 1.076 272 173 1.317 6.323 157 148 63 416 3.1 13.1 0.7 5.9 25.8 16.5 3.8 2.2 18.8 71.1 17.9 15.3 3.859 1.219 4.5 2.830 7.8 0.0 2.5 16.1 0.1 2.5 1.4 5.1 2.5 18.4 4.027 64 507 10 1.586 962 3 491 251 99 888 71 397 29 1.7 9.4 7.2 6.245 371 6.958 6.2 4.4 19.506 45 11 736 367 27 170 6 40.0 1.5 2007 21.046 182 197 74 314 2.6 2.7 9.0 7.2 55.4 9.9 7.860 2.8 3.1 4.3 6.

CA Rochester. MA-NH Buffalo-Cheektowaga-Tonawanda.116 77 83 222 1.6 19.9 43. TX Denver-Aurora.3 7. OH Columbus.7 20. VA-NC Washington-Arlington-Alexandria.3 8.0 4.4 34. CA Louisville.6 4.7 6.2 10.2 5.3 11.1 39.9 20.2 2. GA Austin-Round Rock.5 8.048 95 198 268 364 3.4 43.594 101 612 1.3 10.5 1.7 4.581 77 761 1.5 10.5 28.7 3.187 352 567 412 411 40 345 1.6 28. TN New Orleans-Metairie-Kenner. OK Orlando. United States. FL Philadelphia-Camden-Wilmington.3 41.8 26.4 17. WA St.7 6.7 8.5 7.087 210 408 959 682 70 114 76 207 416 52 212 40 739 495 932 141 256 294 631 236 1.9 4.9 3.0 22.2 10.6 8. TX San Diego-Carlsbad-San Marcos. FL Virginia Beach-Norfolk-Newport News.1 26. PA Portland-Vancouver-Beaverton. All Stages of Syphilis*—Reported Cases and Rates in Selected Metropolitan Statistical Areas (MSAs)† in Alphabetical Order.1 38.334 148 391 930 644 72 153 95 213 428 66 183 95 730 607 1.4 11.2 4.8 16. MN-WI Nashville-Davidson-Murfreesboro.4 5.904 234 650 483 324 28 301 1.3 58. Louis.408 138 223 277 491 6.2 13. TN-MS-AR Miami-Fort Lauderdale-Miami Beach.9 17.3 15.9 26.3 25. CA San Francisco-Oakland-Fremont.695 1.4 23.8 9.891 233 228 145 389 3.0 4.3 12.7 20.2 2.3 34.038 156 235 220 273 3. FL Kansas City.004 33.044 156 359 322 680 248 956 34.7 58.0 20.4 21.7 13.191 34.9 17.4 23.641 212 642 561 329 42 303 1.7 11.4 24.4 8.6 24.643 120 339 51 2.7 8.259 121 309 258 684 5.2 13.969 117 182 302 462 5. OH-KY-IN Cleveland-Elyria-Mentor.0 12.3 6.3 15.3 6.1 32. AL Boston-Cambridge-Quincy.9 11.678 141 284 65 1.6 3. PA-NJ-DE-MD Phoenix-Mesa-Scottsdale.0 21.1 19. NC-SC Chicago-Naperville-Joliet.148 223 411 67 2. IL-IN-WI Cincinnati-Middletown. STD Surveillance 2010 Syphilis Tables 113 .6 19.000 Population 2006 2007 2008 2009 2010 2006 2007 2008 2009 2010 1.1 18.1 51.7 20.0 23.9 14.9 20.8 16. MSAs TOTAL Rates per 100.780 269 304 71 2.8 54.002 1.9 6.4 5.278 123 777 1. OH Dallas-Fort Worth-Arlington.503 114 583 778 866 122 51 100 129 340 76 117 35 420 788 783 159 309 252 612 232 1.7 10.1 14.6 16. Census.4 5.1 17.1 6.1 29.0 3.7 19.2 18.6 21.3 18. MO-KS Las Vegas-Paradise.5 5.4 27.8 27.3 57.9 20.3 32.2 7. FL Milwaukee-Waukesha-West Allis.4 18.3 8.8 2.6 8.1 4.0 26. Petersburg-Clearwater.7 6.097 161 460 812 857 98 64 71 226 452 51 243 35 598 828 1.4 3.6 9.7 45.2 11.7 17.570 121 165 228 355 3.2 19.916 362 531 234 544 43 287 2.3 5.5 18.S.9 9.5 11.3 13. KY-IN Memphis.9 11.6 20.386 58 53 229 1.6 15.2 19.4 8.7 5.3 48. UT San Antonio.0 33. TX Baltimore-Towson. CA Seattle-Tacoma-Bellevue. VA Riverside-San Bernardino-Ontario.7 16.9 17. MO-IL Tampa-St.9 14.7 13.459 2.9 15.1 13.1 13.709 2.6 24.1 15.1 36.572 91 748 2.7 9.0 5.8 8.5 9.370 31.7 11.3 8.455 100 161 194 352 4.8 36.7 7.0 36.8 59. OR-WA Providence-New Bedford-Fall River.6 3.8 10. WI Minneapolis-St.6 7.2 59.4 26. RI-MA Richmond.9 19.2 2.1 8.3 29.5 8.150 183 439 403 502 236 1.1 21.5 13.5 3.6 8.5 17.7 15.2 9.6 3. TX Indianapolis.3 20.7 5.7 10.8 22.0 17.6 14.3 27.8 21. † MSAs were selected on the basis of the largest population in the 2000 U.3 14.5 14.9 5.9 12.7 26.2 15. DC-VA-MD-WV U.3 19.4 19. 2006–2010 Cases MSAs Atlanta-Sandy Springs-Marietta.6 2.9 14.0 10.452 105 127 311 1. MD Birmingham-Hoover.797 227 170 252 2.3 22.6 7.6 34.9 35. NY Sacramento-Arden-Arcade-Roseville.5 11.0 21.5 16. CA San Jose-Sunnyvale-Santa Clara.8 25.9 6.8 6. IN Jacksonville.9 6.5 35.0 3. CO Detroit-Warren-Livonia.5 19. MI Hartford-West Hartford-East Hartford.5 28.6 6.955 293 456 85 1.243 344 685 504 383 20 224 1.8 15.8 9.4 9. NY Charlotte-Gastonia-Concord.2 9.2 44. NV Los Angeles-Long Beach-Santa Ana.0 27.1 18.1 40.0 12. CA Salt Lake City.5 35.5 18.4 7.9 6.6 10.5 5.0 24.3 7.8 24.6 4.Table 24.1 14.8 13.S.085 484 182 245 1.863 127 170 240 560 5.088 189 308 237 299 3.5 28.6 14.6 30.4 17.6 5.8 3.003 197 758 2. Paul-Bloomington.0 7.3 36.0 14.0 5. LA New York-Newark-Edison.4 3. AZ Pittsburgh.0 27.3 9.9 17.4 13. NY-NJ-PA Oklahoma City.7 16.7 * See Syphilis Morbidity Reporting in the Appendix for definition.8 18.1 14.163 31.3 10.4 8.7 7.9 7.924 116 403 773 757 152 74 92 106 376 90 136 41 473 572 741 94 356 186 428 245 928 28. CT Houston-Baytown-Sugar Land.9 6.4 35.7 7.5 10.2 21.2 21.8 5.

Table 25.
Rank*
1
2
3
4
5
6
7
8
9
10
11
12
13

14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49

Primary and Secondary Syphilis—Reported Cases and Rates by State, Ranked by Rates,
United States, 2010
State

Louisiana
Georgia
Mississippi
Arkansas
Illinois
Florida
Maryland
New York
California
Alabama
Texas
Nevada
Ohio
U.S. TOTAL†
Tennessee
Massachusetts
North Carolina
Washington
Rhode Island
Virginia
Arizona
South Carolina
Kentucky
Pennsylvania
Minnesota
New Jersey
Connecticut
Colorado
Indiana
Hawaii
New Mexico
Missouri
Oklahoma
Maine
Michigan
Utah
Oregon
New Hampshire
Delaware
Wisconsin
Kansas
Nebraska
Vermont
Iowa
South Dakota
North Dakota
Alaska
Idaho
West Virginia
Montana
Wyoming

Cases

546
795
228
205
908
1,184
328
1,098
2,065
260
1,230
130
528
13,774
277
285
396
266
41
279
230
155
139
369
149
244
98
138
175
35
53
152
92
32
235
65
71
22
9
49
19
12
4
19
4
3
3
6
6
3
0

Rate per 100,000 Population
12.2
8.1
7.7
7.1
7.0
6.4
5.8
5.6
5.6
5.5
5.0
4.9
4.6
4.5
4.4
4.3
4.2
4.0
3.9
3.5
3.5
3.4
3.2
2.9
2.8
2.8
2.8
2.7
2.7
2.7
2.6
2.5
2.5
2.4
2.4
2.3
1.9
1.7
1.0
0.9
0.7
0.7
0.6
0.6
0.5
0.5
0.4
0.4
0.3
0.3
0.0

* States were ranked in descending order by rate (rounded to the nearest tenth) and by number of cases.

Total includes cases reported by the District of Columbia with 134 cases and a rate of 22.3, but excludes outlying areas (Guam with 1 case and rate of 0.6, Puerto
Rico with 228 cases and rate of 5.7, and Virgin Islands with 0 cases and rate of 0.0).

114

Syphilis Tables

STD Surveillance 2010

Table 26.

Primary and Secondary Syphilis—Reported Cases and Rates by State/Area and Region in
Alphabetical Order, United States and Outlying Areas, 2006–2010
Cases

State/Area
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
U.S. TOTAL
Northeast
Midwest
South
West
Guam
Puerto Rico
Virgin Islands
OUTLYING AREAS
TOTAL

STD Surveillance 2010

2006
319
11
203
77
1,835
69
64
20
116
719
581
18
3
431
93
19
27
73
342
9
300
124
118
47
86
168
1
7
137
13
173
79
736
309
1
184
70
29
264
14
66
13
249
1,064
21
3
190
182
11
68
0
9,756
1,400
1,176
4,592
2,588
3
150
1
154
9,910

2007
380
7
296
122
2,038
57
39
18
178
913
680
9
1
464
54
21
28
56
533
9
345
155
123
59
133
239
8
4
111
30
227
46
1,068
323
1
194
65
18
263
36
91
7
367
1,160
20
10
230
154
6
66
4
11,466
1,837
1,260
5,600
2,769
8
169
0
177
11,643

2008
449
1
317
206
2,204
128
34
16
146
1,044
914
29
7
554
140
16
30
93
707
10
378
216
210
116
184
224
7
15
77
20
226
44
1,217
287
0
351
86
26
272
18
98
1
413
1,405
25
11
266
181
13
65
3
13,500
2,024
1,722
6,705
3,049
6
167
0
173
13,673

Rates per 100,000 Population
2009
417
0
231
275
1,900
105
65
27
163
1,041
953
33
3
750
158
23
32
92
741
4
314
238
230
71
237
173
4
5
91
14
212
61
1,182
579
4
360
97
57
341
20
123
0
403
1,644
31
0
299
139
8
44
3
13,997
2,076
1,850
7,413
2,658
2
227
0
229
14,226

Syphilis Tables

2010
260
3
230
205
2,065
138
98
9
134
1,184
795
35
6
908
175
19
19
139
546
32
328
285
235
149
228
152
3
12
130
22
244
53
1,098
396
3
528
92
71
369
41
155
4
277
1,230
65
4
279
266
6
49
0
13,774
2,193
2,253
6,263
3,065
1
228
0
229
14,003

2006
6.9
1.6
3.3
2.7
5.0
1.5
1.8
2.3
19.9
4.0
6.2
1.4
0.2
3.4
1.5
0.6
1.0
1.7
8.0
0.7
5.3
1.9
1.2
0.9
3.0
2.9
0.1
0.4
5.5
1.0
2.0
4.0
3.8
3.5
0.2
1.6
2.0
0.8
2.1
1.3
1.5
1.7
4.1
4.5
0.8
0.5
2.5
2.8
0.6
1.2
0.0
3.3
2.6
1.8
4.2
3.7
1.8
3.8
0.9
3.7
3.3

2007
8.2
1.0
4.7
4.3
5.6
1.2
1.1
2.1
30.3
5.0
7.1
0.7
0.1
3.6
0.9
0.7
1.0
1.3
12.4
0.7
6.1
2.4
1.2
1.1
4.6
4.1
0.8
0.2
4.3
2.3
2.6
2.3
5.5
3.6
0.2
1.7
1.8
0.5
2.1
3.4
2.1
0.9
6.0
4.9
0.8
1.6
3.0
2.4
0.3
1.2
0.8
3.8
3.4
1.9
5.1
4.0
4.6
4.3
0.0
4.2
3.8

2008
9.6
0.1
4.9
7.2
6.0
2.6
1.0
1.8
24.7
5.7
9.4
2.3
0.5
4.3
2.2
0.5
1.1
2.2
16.0
0.8
6.7
3.3
2.1
2.2
6.3
3.8
0.7
0.8
3.0
1.5
2.6
2.2
6.2
3.1
0.0
3.1
2.4
0.7
2.2
1.7
2.2
0.1
6.6
5.8
0.9
1.8
3.4
2.8
0.7
1.2
0.6
4.4
3.7
2.6
6.0
4.3
3.4
4.2
0.0
4.1
4.4

2009
8.9
0.0
3.5
9.5
5.1
2.1
1.8
3.1
27.2
5.6
9.7
2.5
0.2
5.8
2.5
0.8
1.1
2.1
16.5
0.3
5.5
3.6
2.3
1.3
8.0
2.9
0.4
0.3
3.4
1.1
2.4
3.0
6.0
6.2
0.6
3.1
2.6
1.5
2.7
1.9
2.7
0.0
6.4
6.6
1.1
0.0
3.8
2.1
0.4
0.8
0.6
4.6
3.8
2.8
6.5
3.7
1.1
5.7
0.0
5.4
4.6

2010
5.5
0.4
3.5
7.1
5.6
2.7
2.8
1.0
22.3
6.4
8.1
2.7
0.4
7.0
2.7
0.6
0.7
3.2
12.2
2.4
5.8
4.3
2.4
2.8
7.7
2.5
0.3
0.7
4.9
1.7
2.8
2.6
5.6
4.2
0.5
4.6
2.5
1.9
2.9
3.9
3.4
0.5
4.4
5.0
2.3
0.6
3.5
4.0
0.3
0.9
0.0
4.5
4.0
3.4
5.5
4.3
0.6
5.7
0.0
5.4
4.5

115

Table 27.

Primary and Secondary Syphilis—Women—Reported Cases and Rates by State/Area and
Region in Alphabetical Order, United States and Outlying Areas, 2006–2010
Cases

State/Area
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
U.S. TOTAL
Northeast
Midwest
South
West
Guam
Puerto Rico
Virgin Islands
OUTLYING AREAS
TOTAL

2006
116
2
33
35
128
5
2
4
6
98
41
1
2
37
10
6
2
7
123
2
61
7
26
4
36
19
0
1
34
0
12
22
29
67
0
43
19
0
34
0
11
5
73
261
3
0
23
4
1
3
0
1,458
86
156
982
234
1
46
0
47
1,505

2007
143
1
64
50
115
2
2
1
5
153
53
1
1
39
8
3
6
9
209
0
47
10
27
1
35
27
2
0
12
0
16
15
32
60
0
28
24
2
34
2
10
2
113
297
0
0
16
6
2
6
1
1,692
96
147
1,227
222
4
56
0
60
1,752

2008
171
0
56
81
110
3
0
6
7
193
96
7
1
38
16
3
5
14
307
0
77
6
60
5
66
29
1
3
14
0
21
6
52
44
0
63
25
2
21
0
12
1
119
450
1
0
25
5
4
14
2
2,242
100
237
1,697
208
1
29
0
30
2,272

Rates per 100,000 Population
2009
137
0
22
104
79
6
1
11
10
147
101
6
0
55
13
6
9
4
349
0
42
5
40
0
73
15
0
0
7
0
26
6
55
108
1
63
24
1
42
1
10
0
122
490
0
0
22
6
2
10
1
2,232
130
212
1,756
134
1
23
0
24
2,256

2010
75
0
20
82
74
2
5
1
2
147
82
7
0
108
20
3
1
8
251
0
26
16
23
9
69
3
0
3
7
1
16
3
47
55
1
132
16
1
36
2
9
0
49
333
2
2
20
5
0
6
0
1,780
125
309
1,225
121
1
18
0
19
1,799

2006
4.9
0.6
1.1
2.4
0.7
0.2
0.1
0.9
1.9
1.1
0.9
0.2
0.3
0.6
0.3
0.4
0.1
0.3
5.6
0.3
2.1
0.2
0.5
0.2
2.4
0.6
0.0
0.1
2.8
0.0
0.3
2.2
0.3
1.5
0.0
0.7
1.0
0.0
0.5
0.0
0.5
1.3
2.4
2.2
0.2
0.0
0.6
0.1
0.1
0.1
0.0
1.0
0.3
0.5
1.8
0.7
1.2
2.3
0.0
2.2
1.0

2007
6.0
0.3
2.0
3.5
0.6
0.1
0.1
0.2
1.6
1.6
1.1
0.2
0.1
0.6
0.2
0.2
0.4
0.4
9.5
0.0
1.6
0.3
0.5
0.0
2.3
0.9
0.4
0.0
1.0
0.0
0.4
1.5
0.3
1.3
0.0
0.5
1.3
0.1
0.5
0.4
0.4
0.5
3.6
2.5
0.0
0.0
0.4
0.2
0.2
0.2
0.4
1.1
0.3
0.4
2.2
0.6
4.7
2.7
0.0
2.7
1.1

2008
7.1
0.0
1.7
5.6
0.6
0.1
0.0
1.3
2.2
2.1
2.0
1.1
0.1
0.6
0.5
0.2
0.4
0.6
13.5
0.0
2.6
0.2
1.2
0.2
4.4
1.0
0.2
0.3
1.1
0.0
0.5
0.6
0.5
0.9
0.0
1.1
1.4
0.1
0.3
0.0
0.5
0.2
3.7
3.7
0.1
0.0
0.6
0.2
0.4
0.5
0.8
1.5
0.4
0.7
3.0
0.6
1.2
1.4
0.0
1.4
1.5

2009
5.6
0.0
0.7
7.1
0.4
0.2
0.1
2.4
3.2
1.6
2.0
0.9
0.0
0.8
0.4
0.4
0.6
0.2
15.1
0.0
1.4
0.1
0.8
0.0
4.8
0.5
0.0
0.0
0.5
0.0
0.6
0.6
0.5
2.3
0.3
1.1
1.3
0.1
0.6
0.2
0.4
0.0
3.8
4.0
0.0
0.0
0.5
0.2
0.2
0.4
0.4
1.4
0.5
0.6
3.0
0.4
1.1
1.1
0.0
1.1
1.4

2010
3.1
0.0
0.6
5.6
0.4
0.1
0.3
0.2
0.6
1.6
1.6
1.1
0.0
1.6
0.6
0.2
0.1
0.4
10.9
0.0
0.9
0.5
0.5
0.3
4.5
0.1
0.0
0.3
0.5
0.1
0.4
0.3
0.5
1.1
0.3
2.2
0.9
0.1
0.6
0.4
0.4
0.0
1.5
2.7
0.1
0.6
0.5
0.1
0.0
0.2
0.0
1.1
0.4
0.9
2.1
0.3
1.1
0.9
0.0
0.9
1.1

NOTE: Cases reported with unknown sex are not included in this table.

116

Syphilis Tables

STD Surveillance 2010

0 2.9 1.7 0.8 3.8 3.2 2.0 7.113 4.8 6.4 5.000 Population 2009 280 0 208 171 1.2 0.5 6.3 3.2 4.3 3.969 2010 185 3 210 123 1.5 7.610 2. United States and Outlying Areas.8 2010 8.3 7.3 2.9 1.4 1.4 3.0 3.2 7.372 2.6 1.9 5.0 5.6 1.2 5.6 11.400 2007 237 6 230 72 1.0 10.4 0.8 7.0 4.0 5.8 0.6 7.2 0.886 2008 278 1 261 125 2.2 1.9 1.9 3.9 1.1 5.0 9.0 10.191 2006 9.3 4.5 0.3 5.0 7.2 1.2 0.7 7.2 4.7 1.4 0.3 8.3 0.0 5.523 1 204 0 205 11.5 1.2 13.9 40.7 9.5 1.5 7.9 3.9 46.921 55 37 17 173 760 626 8 0 425 46 18 22 47 324 9 298 145 96 58 98 212 6 4 99 30 211 31 1.0 8.398 Rates per 100.0 3.2 5.0 9.1 2.0 5.2 0.4 7.7 3.3 4.638 5.3 5.7 7.2 0.9 NOTE: Cases reported with unknown sex are not included in this table.127 471 3 297 73 56 299 19 113 0 281 1.990 136 93 8 132 1.2 10.1 6.0 0.3 1.0 2.7 3.5 1.5 2.6 2007 10.981 2.3 11.924 1.8 5.2 9.1 0.821 99 64 16 153 894 852 27 3 695 145 17 23 88 392 4 272 233 190 71 164 158 4 5 84 14 186 55 1.769 1.3 5.2 3.Table 28.8 1.5 3.6 9.8 3.4 7.6 3.4 1.5 1.5 2009 12.6 5.6 0.2 11.6 6.6 6.8 3.8 6.3 5.8 0.6 4.4 10.1 1.4 7.1 7.4 8.7 4.7 1.657 2.9 3.1 1.5 2.1 0.6 11.4 0.7 1.4 4.2 1.9 12.7 11.0 4.6 4.6 6.543 4 113 0 117 9.314 1.1 6.3 6.6 1.3 8.6 7.4 2.0 6.3 0. STD Surveillance 2010 Syphilis Tables 117 .4 5.1 4.7 5.8 2.4 4.0 7.1 62.0 8.3 0.0 6.6 1.2 0.5 3.020 3.9 7.9 8.1 6.6 4.0 5.2 6.1 3.4 11.6 2.5 5.7 10.839 5 138 0 143 11.2 8.1 0.8 18.0 10.0 2.9 1.3 7.4 49.4 0.7 3.0 4.8 7.6 0.944 5.6 2.092 125 34 10 139 850 818 22 6 516 124 13 25 79 400 10 301 210 150 111 118 195 6 12 63 20 205 38 1.764 1.007 2.0 1.9 0.9 1.8 1.706 64 62 16 110 621 540 17 1 394 83 13 25 66 219 7 239 117 92 43 50 149 1 6 103 13 161 57 707 242 1 141 51 29 230 14 55 8 176 803 18 3 167 178 10 65 0 8.7 6.068 1.3 5.0 11.0 10.7 5.741 1.3 6.4 8.2 17.0 7.0 6.1 8.154 31 0 277 133 6 34 2 11.9 2.9 4.0 6.3 5. TOTAL Northeast Midwest South West Guam Puerto Rico Virgin Islands OUTLYING AREAS TOTAL 2006 203 9 166 42 1.7 4.036 263 1 166 41 16 229 34 81 5 254 863 20 10 214 148 4 60 3 9. 2006–2010 Cases State/Area Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming U.7 54.8 3.5 13.6 3.9 0.9 1.0 0.4 14.9 0.5 11.1 2.0 1.9 2.5 2.0 6.3 0.6 3.946 1.7 7.4 1.6 2008 12.943 0 210 0 210 12.4 0.9 11.5 5.6 0.7 2.8 3.0 9.9 0.0 7.7 3.6 5.5 9.0 4.037 713 28 6 800 155 16 18 131 284 32 302 269 212 140 159 149 3 9 123 21 228 50 1.3 0.9 7.1 9.6 6.4 5.7 7.9 10.1 3.1 3.3 0.8 12.2 2.1 8.2 2.0 4.8 0.255 1.4 1.9 3.1 9.7 3.0 0.8 6.5 0.0 11.7 0.0 7.7 1.2 3.3 12.1 7.2 5.6 1.8 17.4 17.6 5.2 4.026 2.3 2.7 6.1 4.8 1.3 15. Primary and Secondary Syphilis—Men—Reported Cases and Rates by State/Area and Region in Alphabetical Order.1 10.7 2.9 9.485 5.1 0.1 5.3 8.0 11.8 5.2 4.2 1.4 1.6 4.7 5.349 2 104 1 107 8.4 5.8 8.1 4.9 7.165 243 0 288 61 24 251 18 86 0 294 955 24 11 241 176 9 51 1 11.1 3.6 4.3 0.0 9.051 341 2 396 76 70 333 39 146 4 228 896 63 2 259 261 6 43 0 11.4 7.9 5.6 1.5 3.8 2.0 3.S.1 2.293 1.7 8.3 5.2 10.

1 2.2 5.8 3.5 1.7 3.1 2.4 1.479 10.8 2.3 7.1 2.7 6. CT Houston-Baytown-Sugar Land.6 3.3 1.3 4.6 5. AL Boston-Cambridge-Quincy.1 16.6 4.2 2.8 2.5 9.0 3.3 2.2 2.7 2. CO Detroit-Warren-Livonia.4 11.9 4.9 7.8 4. UT San Antonio.8 1.8 1. IL-IN-WI Cincinnati-Middletown.2 3.1 5.2 14.9 5.3 5.3 3.6 16.6 2.9 11.9 6.8 2.3 12.7 2.5 0.9 3.2 2.9 7.7 7.9 3. Petersburg-Clearwater.5 1.8 3.5 4.9 17.9 3.3 2.6 0. MSAs TOTAL Rates per 100.132 809 99 204 145 203 10 138 732 124 71 115 502 92 151 25 432 81 57 80 86 858 57 189 518 28 67 92 138 1.9 4.0 12.9 1.4 0.6 11.3 4.2 4.2 5.7 3.0 8.5 3.8 1. CA Salt Lake City.4 6.6 7.3 6.1 11. PA Portland-Vancouver-Beaverton.4 4.2 6.S.7 3.6 7.1 5. VA Riverside-San Bernardino-Ontario.2 1.1 2.9 2.1 6.8 1.8 4.9 6.6 12. MA-NH Buffalo-Cheektowaga-Tonawanda.4 7.6 5.3 4. MN-WI Nashville-Davidson-Murfreesboro. MO-KS Las Vegas-Paradise.8 5.5 2.6 2. WI Minneapolis-St.4 2. NC-SC Chicago-Naperville-Joliet. FL Virginia Beach-Norfolk-Newport News.000 Population 2006 2007 2008 2009 2010 2006 2007 2008 2009 2010 529 84 213 244 117 18 121 416 13 18 107 320 56 82 23 396 47 41 112 132 945 41 145 369 38 43 40 90 811 24 94 173 157 91 25 18 28 108 14 32 15 136 235 363 52 160 65 110 84 250 7.7 4.8 0. Paul-Bloomington.8 9.1 3. TX Denver-Aurora.9 6. FL Philadelphia-Camden-Wilmington.5 10. FL Milwaukee-Waukesha-West Allis.182 651 107 212 82 240 11 106 881 272 82 120 342 120 146 32 330 108 49 43 125 766 105 165 652 29 140 73 92 1.116 765 107 270 188 173 3 58 535 62 64 135 328 103 100 8 456 80 67 102 72 920 36 234 509 45 105 85 170 1.4 7. MI Hartford-West Hartford-East Hartford.5 16.1 4. OH Columbus.4 3.S.0 22.7 5.353 61 126 214 211 38 21 25 92 157 9 102 23 195 345 478 42 153 121 191 98 297 10.1 3.4 6.3 * MSAs were selected on the basis of the largest population in the 2000 U. CA Rochester.6 4.7 7. LA New York-Newark-Edison.6 1.9 6. DC-VA-MD-WV U.6 4.9 4.Table 29.3 5. OK Orlando.9 2.5 11.2 4.6 5.4 2.7 5.0 1.7 4.5 4.4 4.6 2. CA Seattle-Tacoma-Bellevue.3 3.6 3. MD Birmingham-Hoover. CA San Jose-Sunnyvale-Santa Clara.0 4.4 0.1 7.5 5.3 2. RI-MA Richmond.2 5.4 2.0 1.0 7.8 2.1 5.7 8.6 1. Louis.1 3. TX Baltimore-Towson.7 5.2 5. OH-KY-IN Cleveland-Elyria-Mentor.2 3.3 1.7 3.7 8.3 2.5 15.6 6.2 4.5 14.845 608 74 211 189 131 11 103 427 34 29 76 265 46 91 15 501 26 44 149 102 1.5 6.1 4.6 4.9 4.9 6.9 11.8 1.9 7.5 2.1 5.3 1.9 2.2 12.8 1.7 1.6 14.6 7. CA Louisville.5 2. TX San Diego-Carlsbad-San Marcos.5 10.1 5.0 6.9 7. KY-IN Memphis.7 5.208 36 145 205 193 60 11 44 38 95 16 59 19 157 347 308 56 138 112 195 88 377 9.0 4.7 1. Census.2 3.8 5.4 7.9 4.3 3.0 5.7 4.1 3.9 7.8 5.1 2.0 6. GA Austin-Round Rock. WA St.6 7.4 7.6 1.5 3.4 1. PA-NJ-DE-MD Phoenix-Mesa-Scottsdale.3 7.1 3.6 11.7 7.6 6.9 7.061 32 208 414 53 57 84 168 1.0 7.0 8.6 8.3 4.0 5. MO-IL Tampa-St.1 9.2 7. VA-NC Washington-Arlington-Alexandria.4 4.4 2.9 18.8 3.2 9. 118 Syphilis Tables STD Surveillance 2010 .5 5.4 1.8 8. IN Jacksonville. OH Dallas-Fort Worth-Arlington. TX Indianapolis.7 5.8 3.4 5.1 7.9 1. CA San Francisco-Oakland-Fremont.9 1. NY-NJ-PA Oklahoma City. NV Los Angeles-Long Beach-Santa Ana.5 8.7 7.1 3.4 6.2 6.3 3. TN New Orleans-Metairie-Kenner.1 9.7 4.9 6. FL Kansas City.2 4.2 2.2 10.301 70 109 289 169 29 53 28 97 115 11 73 28 216 190 438 59 115 83 180 102 324 10.1 2. OR-WA Providence-New Bedford-Fall River.1 6.6 6.8 11.5 6.5 3. NY Sacramento-Arden-Arcade-Roseville. AZ Pittsburgh.5 1.219 55 103 307 161 36 66 47 89 157 16 57 54 183 274 543 91 236 118 183 92 311 10.3 4.0 7. NY Charlotte-Gastonia-Concord.4 2.9 1.8 0.3 7. United States.9 5.3 8.3 1.8 7.2 1. Primary and Secondary Syphilis—Reported Cases and Rates in Selected Metropolitan Statistical Areas (MSAs)* in Alphabetical Order.7 6.9 8.5 4. 2006–2010 Cases MSAs Atlanta-Sandy Springs-Marietta.3 0. TN-MS-AR Miami-Fort Lauderdale-Miami Beach.

4 0.5 0.9 0.3 0.5 0.0 1. TN-MS-AR Miami-Fort Lauderdale-Miami Beach.2 0.2 2.3 0.1 1.1 3. MSAs TOTAL 2006 33 11 53 94 7 2 28 43 5 2 30 112 3 20 1 65 1 11 17 32 72 3 52 40 2 3 2 25 31 6 14 6 18 28 0 0 1 10 0 3 1 32 12 7 7 2 3 15 18 11 994 2007 40 12 40 80 10 0 20 31 6 5 11 93 1 22 1 108 3 11 25 11 58 2 87 60 5 1 13 51 42 13 13 14 29 25 1 2 3 4 1 2 0 35 12 12 4 4 9 52 10 12 1. Louis. WA St. MO-KS Las Vegas-Paradise.5 0.6 0.6 1. UT San Antonio. NV Los Angeles-Long Beach-Santa Ana.5 1.7 2.1 1.2 0.0 1.4 1. OK Orlando.6 3.6 2. CA Seattle-Tacoma-Bellevue.6 0.3 1.2 3.0 0.2 0.3 1.4 1.9 1. MD Birmingham-Hoover.9 0.2 3.8 0.9 0.1 0.2 1.8 0. FL Milwaukee-Waukesha-West Allis.7 2.6 0.6 4.0 0.1 13.0 0.7 9.0 0. OH Dallas-Fort Worth-Arlington.6 0.8 16.5 1.3 1.6 1.Table 30.4 2.2 0.6 0.0 4. TX Denver-Aurora.7 0.6 0.1 2.8 0.6 0.106 2008 51 16 70 77 4 0 9 40 14 13 19 116 1 27 0 114 8 16 20 11 31 3 71 74 11 5 14 53 60 16 21 17 24 6 0 0 6 5 0 18 1 58 12 12 3 2 16 54 12 15 1.4 0.2 1.2 0.0 0. PA Portland-Vancouver-Beaverton.6 0.9 2.2 0.2 0.S.9 1.7 1.2 0.4 0.1 2.9 0. AZ Pittsburgh.6 1.8 9.1 1. MI Hartford-West Hartford-East Hartford. OR-WA Providence-New Bedford-Fall River. NC-SC Chicago-Naperville-Joliet. TX Baltimore-Towson.3 0.4 0. Petersburg-Clearwater.9 2.4 0.0 0.1 0.2 9.4 0.4 0.2 9. NY Charlotte-Gastonia-Concord.1 0.1 0.3 4.7 0.2 0.3 1.8 0.3 3. IN Jacksonville.1 0.0 0.3 0.3 1.7 0.5 3. TX Indianapolis.4 3.2 0.7 0.0 2. VA-NC Washington-Arlington-Alexandria.3 1.1 0. Paul-Bloomington. FL Philadelphia-Camden-Wilmington.0 0.5 10.9 0.6 0.3 0.2 0.2 1.2 1.8 0.3 0.2 0.0 2.9 1.9 1. CA Rochester. CO Detroit-Warren-Livonia.1 0.6 1. DC-VA-MD-WV U. PA-NJ-DE-MD Phoenix-Mesa-Scottsdale. WI Minneapolis-St.0 0. 2006–2010 Cases MSAs Atlanta-Sandy Springs-Marietta.5 1.2 1.0 1.0 4.2 2.6 1.2 0.6 2. RI-MA Richmond.5 0.4 2.1 1.3 0.1 0.5 2.5 0.7 3.0 0. GA Austin-Round Rock. CA Salt Lake City.0 5.5 0.4 0.4 3.3 13.0 0.7 1.4 0.3 0.8 1. LA New York-Newark-Edison.9 0.9 0.9 2.5 2. MO-IL Tampa-St.6 2.9 0.8 0.6 0.3 0.0 1.6 0.6 2.2 1.2 0.5 0.6 0.7 1. VA Riverside-San Bernardino-Ontario.S.5 0. OH-KY-IN Cleveland-Elyria-Mentor. TN New Orleans-Metairie-Kenner.3 0.8 1.4 0. Primary and Secondary Syphilis—Women—Reported Cases and Rates in Selected Metropolitan Statistical Areas (MSAs)* in Alphabetical Order.2 4.1 0.246 Rates per 100. NOTE: Cases reported with unknown sex are not included in this table.1 1.5 1. KY-IN Memphis. FL Kansas City.2 0.4 7.5 0.1 0.0 3.3 1.2 0.6 4.5 7.4 1.3 0.9 2.5 1.1 3.2 0.1 0.0 1.1 1.1 0.2 5.7 2. CA San Jose-Sunnyvale-Santa Clara.4 0.3 0.1 1.0 0. OH Columbus.5 0.9 13.2 0.2 0.000 Population 2009 59 14 33 44 3 0 14 46 26 14 15 153 3 26 0 113 6 11 8 7 22 1 67 54 9 0 23 36 69 16 19 37 8 4 0 1 3 5 1 16 0 42 6 9 5 4 9 29 11 19 1.0 0.6 0. AL Boston-Cambridge-Quincy. IL-IN-WI Cincinnati-Middletown.8 0.2 3.9 0.7 1.5 2.3 1.5 1. MA-NH Buffalo-Cheektowaga-Tonawanda.5 0.5 0.7 1.0 0.5 0.2 0.0 1. CA San Francisco-Oakland-Fremont.2 0.0 0.3 0.8 1. MN-WI Nashville-Davidson-Murfreesboro.3 0.3 0.2 3.7 1.6 0.3 1.4 0.0 0.7 1.120 2010 2006 2007 2008 2009 2010 44 18 19 21 12 0 6 107 107 6 11 103 0 9 3 77 12 11 1 6 17 4 33 55 5 5 10 30 52 12 7 33 12 2 2 3 6 1 3 12 0 28 3 20 3 2 3 33 3 13 985 1.2 0.7 2.2 3.9 0.2 0. CA Louisville.5 0. FL Virginia Beach-Norfolk-Newport News.4 0.5 1.3 0. NY Sacramento-Arden-Arcade-Roseville.0 0.2 2.7 0.2 0.8 0. CT Houston-Baytown-Sugar Land.2 * MSAs were selected on the basis of the largest population in the 2000 U.7 0.6 2.4 2.0 3. TX San Diego-Carlsbad-San Marcos. NY-NJ-PA Oklahoma City.9 5. United States.3 1. Census. STD Surveillance 2010 Syphilis Tables 119 .0 2.

TX San Diego-Carlsbad-San Marcos.6 8.000 Population 2009 750 85 171 101 200 10 124 686 98 57 100 349 89 125 25 319 75 46 72 79 836 56 122 464 19 67 69 102 1.1 6.5 4.2 2. DC-VA-MD-WV U.1 3.3 21.7 9.847 2007 567 62 171 109 121 11 83 396 28 24 65 172 45 69 14 393 23 33 124 91 1. Primary and Secondary Syphilis—Men—Reported Cases and Rates in Selected Metropolitan Statistical Areas (MSAs)* in Alphabetical Order. VA Riverside-San Bernardino-Ontario.6 13.8 3.6 3.1 4. MN-WI Nashville-Davidson-Murfreesboro.1 2.1 5.Table 31.1 12.6 14.2 18.7 12.4 15.4 11.0 8.0 22. TX Denver-Aurora. WI Minneapolis-St.8 9.1 8.6 3.1 2.6 4.6 12.1 3.2 8.5 6.3 7.5 3.1 9.9 5.7 0.6 10.3 8.8 11.9 11.1 7.1 10.0 8.0 0. PA Portland-Vancouver-Beaverton.4 5.6 3.6 6. RI-MA Richmond.1 0.9 11. KY-IN Memphis. FL Kansas City.9 11. 120 Syphilis Tables STD Surveillance 2010 .7 6. NY Sacramento-Arden-Arcade-Roseville. CA Rochester.1 22.4 17.6 5.7 3.6 2. OH Columbus. CO Detroit-Warren-Livonia.4 2.9 15. OR-WA Providence-New Bedford-Fall River.6 5. FL Philadelphia-Camden-Wilmington.9 8.166 23 132 191 162 35 10 42 35 90 15 57 19 122 335 296 52 134 103 143 78 365 8.9 4.8 14.1 9. NC-SC Chicago-Naperville-Joliet.4 12.4 9.2 14.3 5. NY Charlotte-Gastonia-Concord.293 45 105 197 187 32 21 25 86 150 9 84 22 137 333 466 39 151 105 137 86 282 8.2 10.4 13. MO-IL Tampa-St.9 13. CA San Jose-Sunnyvale-Santa Clara. Petersburg-Clearwater.7 9. Paul-Bloomington. TX Baltimore-Towson.3 11.7 10. MSAs TOTAL 2006 496 73 160 150 110 16 93 373 8 16 77 208 53 62 22 331 46 30 95 100 873 38 93 329 36 40 38 65 780 18 80 167 136 63 25 18 27 98 14 29 14 104 223 355 45 158 62 95 66 239 6.4 11.5 28.5 5.2 6.3 6.8 1.9 4.9 4.7 7.8 13.4 6.1 12.6 9.487 2006 2007 2008 2009 2010 19.0 7. NV Los Angeles-Long Beach-Santa Ana.8 15. FL Virginia Beach-Norfolk-Newport News.1 12.7 11.4 5.6 9.4 5.2 9.8 11. TX Indianapolis.1 8.2 12.5 15. TN New Orleans-Metairie-Kenner.3 10.4 4.0 20.1 11.232 54 90 252 161 25 53 27 94 110 10 57 28 174 184 429 54 111 74 151 91 305 9.0 5.4 7. LA New York-Newark-Edison.5 6.0 26.4 11.2 5.9 17.4 2. CA San Francisco-Oakland-Fremont. VA-NC Washington-Arlington-Alexandria.6 10.1 8.2 2.5 5.2 4.3 4.5 2.6 5.0 10.9 2.6 21.7 5. NOTE: Cases reported with unknown sex are not included in this table.3 9. CA Seattle-Tacoma-Bellevue.4 15.3 7.7 8.3 9.5 23.0 27.4 14.6 4.7 4.8 13.1 11.4 16. OK Orlando.2 9. MA-NH Buffalo-Cheektowaga-Tonawanda.1 13.005 2008 714 91 200 111 169 3 49 495 48 51 116 212 102 73 8 342 72 51 82 61 889 33 163 435 34 100 71 117 1.7 5.6 11.4 13.002 30 121 354 48 56 71 117 1.9 5.0 6.9 10.7 3.8 22.2 10. Louis.7 16.8 3. TN-MS-AR Miami-Fort Lauderdale-Miami Beach.7 8.S.6 13.3 2.5 7.S.2 13. OH-KY-IN Cleveland-Elyria-Mentor. IN Jacksonville. NY-NJ-PA Oklahoma City.8 8.2 9. CA Louisville.2 8. United States.8 7.9 17.7 2.4 21. MO-KS Las Vegas-Paradise. 2006–2010 Cases MSAs Atlanta-Sandy Springs-Marietta.9 13.4 3.1 7.5 9.5 8.3 13.5 4.8 4.8 2.0 5.8 8.5 9.2 17.9 4.5 7.9 8.2 5.8 7.6 4.7 5.6 10.9 8. AZ Pittsburgh.0 7.1 9. AL Boston-Cambridge-Quincy.167 43 96 274 149 34 64 44 83 156 13 45 54 155 271 523 88 234 115 150 89 298 9.5 14.3 11.8 7.9 5.4 3.5 14.4 7.4 26.8 7.8 1.9 2. UT San Antonio.7 7.1 17. CA Salt Lake City.4 11.4 1.7 24.2 5.3 10. WA St.8 3.4 12.1 21.9 8.0 5.3 8.8 9.5 6.7 16.0 5. Census. PA-NJ-DE-MD Phoenix-Mesa-Scottsdale.7 13.3 8.1 19.2 14.9 10.3 8.4 10.7 8.884 Rates per 100.6 7. MI Hartford-West Hartford-East Hartford.6 7. CT Houston-Baytown-Sugar Land.6 20.1 3.9 1. GA Austin-Round Rock.3 1.5 22.6 12.5 4.9 2.8 5.0 11. OH Dallas-Fort Worth-Arlington.6 7.6 2.9 6.8 11.4 13. IL-IN-WI Cincinnati-Middletown. FL Milwaukee-Waukesha-West Allis.3 9.4 4.2 10.9 2.062 2010 607 89 193 61 228 11 100 774 165 76 109 239 120 137 29 253 96 38 42 119 749 101 132 597 24 135 63 55 1.3 20.9 9.9 3.6 * MSAs were selected on the basis of the largest population in the 2000 U.7 15.4 15.6 10.1 13. MD Birmingham-Hoover.0 19.2 8.5 5.3 2.3 2.0 5.5 2.

9 5.3 6.000 Population 15.1 9. AL Davidson County.5 11.8 17.9 9.7 25. TX Dallas County.9 31.2 7.6 23.2 8.1 9.6 12.0 8.7 24.5 46. 2010 County/Independent City Cook County. Louis County.4 8.6 9. CA St. WA Caddo County.6 16. GA Maricopa County.8 2. FL Hinds County.4 21. FL Travis County. FL Guilford County.0 25. NC San Bernardino County. TX Bronx County.7 24. Queens County.3 71. MO Pinellas County. TX Hamilton County.0 3. GA Middlesex County. FL Harrison County. GA Salt Lake County.4 3. TX Prince George’s County. FL Clayton County. LA Cuyahoga County.3 22. CA Harris County. TN Washington. MN Marion County. CA Franklin County.9 8. CA Miami-Dade County.0 4. NV Hillsborough County.1 Cumulative Percentage 5 10 13 16 19 21 23 25 27 29 30 32 33 35 36 37 38 40 41 42 43 44 45 46 47 48 49 50 50 51 52 53 53 54 55 55 56 57 57 58 58 59 59 60 60 61 61 62 62 62 63 63 64 64 64 65 65 66 66 66 67 67 67 68 68 68 69 69 69 69 70 70 70 * Accounting for 70% of reported primary and secondary syphilis cases.9 7. AZ Sacramento County. GA San Diego County.C. Rank† 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 Primary and Secondary Syphilis—Counties and Independent Cities* Ranked by Number of Reported Cases.4 7.5 7. FL Polk County.5 18.0 14. NY Broward County. PA Kings County.4 15.2 12. LA Pima County.6 6.6 6.2 11.9 5. MS Multnomah County. FL King County. MD DeKalb County. OH Forsyth County.4 3.4 9. NY San Francisco County. OH Denver County. STD Surveillance 2010 Syphilis Tables 121 .Table 32. LA Wake County. TX Hudson County.6 10. United States. NY Suffolk County. MD Orange County.3 5. OH Philadelphia County. NJ Lafayette County. AZ Tarrant County.0 9.0 10.2 5.0 89.1 7.0 5.0 6. OR East Baton Rouge County. NC Jefferson County. TN Palm Beach County.5 9.8 9.4 21. LA Bexar County. CA Alameda County. CO Hennepin County. FL Fulton County. MS St. NC Cases 799 689 415 375 373 320 274 272 245 238 235 220 216 180 180 176 163 162 160 155 151 141 134 133 132 125 118 116 112 110 99 99 97 97 93 90 89 87 83 82 77 71 70 68 65 59 59 58 57 57 56 54 53 53 52 52 52 51 51 50 47 47 46 45 44 44 42 41 41 40 39 39 39 Rates per 100. D. NC Jefferson County.0 8. NJ Duval County.4 16.5 6. OK Essex County.5 20.7 4.7 15. CA Oklahoma County. MA Clark County.2 12.3 5. KY Santa Clara County. † Counties and independent cities were ranked in descending order by number of cases reported in 2010. IL Los Angeles County. MI Mecklenburg County.7 28.0 6. CA Orleans County. MA Richmond (City). TX Shelby County.3 20. MO Miller County. NY Baltimore (City). AR Escambia County.3 4. VA Jefferson County. CA Orange County. Louis (City).5 5. CA New York County. FL Riverside County.6 2.0 10.9 8.1 5.5 25. UT Cobb County. IN Wayne County.

7 30.6 4.2 25.3 0.4 0.8 102.4 0.8 10. Broward County.5 49.3 25.0 4.8 0.9 16.5 6.3 8. NY Franklin County.7 5. GA Fulton County.1 13. GA Cook County. TN Bexar County.2 Male-to-Female Rate Ratio 2009 19.1 1.7 8.0 22.0 2.8 3.8 18.2 16.0 1.5 72. WA Cases 157 65 747 87 184 310 153 154 87 280 187 368 594 66 118 112 79 164 282 430 118 92 79 191 113 172 206 256 122 96 Rates 7.0 35.6 2.2 2.3 8.5 56.0 33.7 0.7 26.7 1.4 12.3 11.3 23. CA Los Angeles County.4 25. NV Bronx County.2 17.1 19.2 14.5 0.7 12.7 7.7 10.0 12. TX King County.8 9.0 74.3 2010 14.9 14.3 2.3 1.8 34. MA Clark County. IL Caddo County.6 18.8 0.7 16.9 4.3 17. TX Tarrant County.5 1.5 0.5 30.3 0.7 8. TX Harris County.8 41.0 Female 2010 Cases 146 104 676 116 271 369 132 208 98 339 149 302 705 85 148 125 119 150 226 406 130 101 146 212 113 153 122 217 105 214 Rates 7.3 3.0 3.4 3.5 2.9 9.6 5.1 59.3 27.5 16.3 2010 Cases 9 8 13 0 3 6 2 12 20 34 11 18 94 94 14 7 6 13 9 9 3 9 99 26 28 27 54 55 46 2 Rates 0.7 89.8 46.6 27.6 1.7 2. OH Hamilton County. Primary and Secondary Syphilis—Reported Cases and Rates* Among Men and Women and Male-To-Female Rate Ratios in the Counties and Independent Cities Ranked in the Top 30 for Cases in 2010.2 5. NY New York County.2 50.4 77.9 51.0 * Cases per 100.4 0.7 12.0 2.3 2009 Cases 8 4 21 4 6 4 10 18 14 33 20 28 40 75 23 1 7 11 26 9 1 15 26 27 62 40 88 71 60 3 Rates 0. LA Baltimore (City). MD Suffolk County.0 74.1 0.6 29.0 6.5 12.0 0. FL DeKalb County.4 7.3 6.5 13.0 5.8 18.4 19.6 5.5 1.9 13.8 21. NY Kings County.8 88.8 1.5 22.000 population.7 22. CA Riverside County.6 47.4 70.6 24.7 1.9 17.9 2.2 3.Table 33. NY Queens County.0 6. OH Philadelphia County.6 5.3 12. CA Washington.4 5.8 39.1 0.2 55.6 52.8 15.8 3.4 8.4 10.2 4.4 1.3 3.9 2.9 54.7 18.2 12.1 0.0 10. United States.5 59.5 38.5 2.3 14.9 3.2 1.3 26.0 11.6 9.1 46.1 17.3 22.2 4. 2009–2010 Male 2009 County/Independent City† Maricopa County.3 1.8 0.1 54.9 9.6 15.3 12.8 22. D. FL Miami-Dade County. † Counties and independent cities are in alphabetical order by state.6 1.1 0.4 1.9 1.6 38.3 2.3 16.2 5.4 105.6 11. FL Hillsborough County. TX Dallas County. CA San Diego County.3 3.3 112. AZ Alameda County.8 10.0 23. 122 Syphilis Tables STD Surveillance 2010 .3 3.5 70.3 20.2 3. CA San Francisco County.C.1 20.6 12. PA Shelby County.1 2.

573 1.6 6.733 1.4 12.720 1.809 1.877 1.573 1.9 2.1 2.000 Population by Age Group and Sex.3 7.489 1.0 0.5 6.8 0.1 3.to 9-year age group is not shown because some of these cases may not be due to sexual transmission.2 0.3 4.2 2.080 1.1 4.0 4.7 1.4 0.4 4.1 2.8 1.6 6.2 7.0 1.6 1.3 17.9 0.0 Unknown Sex 2010 Unknown Sex 0 0 2 2 1 0 0 0 0 0 0 0 0 0 1 3 0 1 0 0 0 0 0 0 0 1 0 0 1 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 2 4 2 0 1 1 3 0 0 0 2009 Female 11 233 299 241 163 154 153 165 35 2 0 8 248 356 265 193 191 192 200 30 9 0 19 318 520 404 244 241 202 236 46 8 1 15 344 570 377 286 203 167 218 42 7 1 11 313 474 322 197 140 104 176 36 5 1 2008 Male 2 332 1.1 5.0 0.515 1. Primary and Secondary Syphilis—Reported Cases and Rates per 100.1 7.571 1.815 475 83 1 7 617 2.9 2.2 0.6 8.5 1.2 Male 0.8 8.6 1.0 1.8 1.455 1.7 13.2 0.2 3.0 2.2 0.851 1. United States.4 1.6 14.4 0. NOTE: This table should be used only for age comparisons.476 1.7 0.2 18.3 2. therefore.9 15.9 12.9 19.8 12.3 1.529 1.1 2.2 15.303 1.6 2.0 0.4 0.429 2.9 1.5 0.442 375 81 8 13 664 1. STD Surveillance 2010 Syphilis Tables 123 .3 0.5 13.0 6.3 1.027 458 105 6 19 1.2 11.1 6.1 9.5 3.381 1.6 0.0 0.776 2.4 10.1 3.461 1.426 1.812 2.553 2.8 8.817 1.256 1.362 1.7 13.220 1.277 340 79 8 5 416 1.0 7.0 20.551 1.857 1.242 2.027 1.8 2.7 7.0 0.5 Female 0.597 1. rates are not calculated.131 1.8 4.0 1.5 2.1 11.6 13.6 21.397 2.0 3.1 8.2 0.3 13.454 1.5 0.6 10.663 409 91 4 27 903 2.2 0.499 1.1 4.3 0.5 7.0 0.5 14.8 13.612 1.0 2.2 15.6 8.574 1.463 379 82 4 8 585 1.1 5.907 2.1 7.7 8.6 0.4 1.4 0.0 14.7 0.409 1.0 9.3 5.568 1.9 2.6 8.3 16.4 14.5 3.2 6.3 0.005 2.313 1.6 1.Table 34.6 2.877 457 102 3 2007 Total 13 565 1.5 2.580 1.840 1.8 0.0 3.1 3.0 0.405 1.056 1.3 9.5 11.5 0.4 3.2 0.8 0.448 1.794 1.3 0.6 8.2 14.2 0.744 1.033 517 90 2 18 932 2. 2006–2010 Age Cases Rates* Total 0.1 4.7 3.8 14.5 0.1 8.2 3.8 7.0 5.790 412 97 5 4 661 2.6 13.5 2.643 2.9 3.6 1.2 2.056 493 107 4 2006 Group 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–54 55–64 65+ Unknown Age 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–54 55–64 65+ Unknown Age 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–54 55–64 65+ Unknown Age 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–54 55–64 65+ Unknown Age 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–54 55–64 65+ Unknown Age * No population data are available for unknown sex and age. The 0.330 1.

062 286 64 4.375 833 513 491 599 139 22 6. and they are not included in the totals. and Sex.085 909 583 644 570 584 148 36 5.400 896 646 586 734 178 34 7. race/ethnicity was unknown (i.118 Female Total 0 27 30 33 20 18 14 14 2 0 158 0 25 39 32 26 12 11 15 3 0 163 2 28 48 36 32 27 15 18 2 0 208 1 19 34 22 18 21 12 12 5 0 144 0 19 32 19 15 14 11 7 1 0 118 0 1 12 35 32 31 28 23 2 0 164 0 0 14 33 36 29 25 22 2 1 162 0 7 33 43 46 28 23 21 7 2 210 0 9 36 34 43 45 22 27 2 0 218 0 7 39 28 42 29 25 23 7 1 201 American Indians/ Alaska Natives Male Female Total 0 1 11 33 29 30 27 21 2 0 154 0 0 12 32 33 29 24 22 2 1 155 0 5 33 39 46 26 22 21 7 2 201 0 8 34 31 41 41 21 25 2 0 203 0 5 33 28 40 29 25 22 7 1 190 0 0 1 2 3 1 1 2 0 0 10 0 0 2 1 3 0 1 0 0 0 7 0 2 0 4 0 2 1 0 0 0 9 0 1 2 3 2 4 1 2 0 0 15 0 2 6 0 2 0 0 1 0 0 11 1 0 7 7 13 13 14 9 5 5 74 0 7 13 14 18 14 6 9 0 0 81 0 2 11 14 11 5 5 5 2 0 55 0 3 12 13 9 11 5 5 1 0 59 0 7 19 14 7 5 4 8 0 0 64 Male Female 0 0 6 6 10 8 9 5 4 5 53 0 2 6 7 14 9 4 7 0 0 49 0 0 8 11 8 2 4 4 1 0 38 0 2 10 10 7 9 5 3 1 0 47 0 7 18 13 5 3 4 5 0 0 55 1 0 1 1 3 5 5 4 1 0 20 0 5 7 7 4 5 2 2 0 0 32 0 2 3 3 3 3 1 1 1 0 17 0 1 2 3 2 2 0 2 0 0 12 0 0 1 1 2 2 0 3 0 0 9 NOTE: These tables should be used only for race/ethnicity comparisons.007 274 62 3.542 0 92 326 463 479 657 787 772 204 44 3.120 0 94 476 555 530 554 649 1. or invalid data values) for 2.865 1.075 15 228 376 269 151 130 121 149 32 5 1. Age Group. and sex was unknown for 0.e.047 2 119 441 415 319 298 314 271 42 15 2.476 13 283 446 280 199 111 108 128 27 7 1. United States.824 2 120 440 560 525 653 740 946 218 58 4. 124 Syphilis Tables STD Surveillance 2010 .535 5 425 1.125 693 431 426 495 117 19 5. missing. Non-Hispanic Total Male Female 1 69 282 412 409 670 756 728 182 33 3.051 2 109 392 392 333 279 257 235 42 6 2.5% of reported primary and secondary syphilis cases.120 697 535 478 606 151 27 5.296 Asians/Pacific Islanders Hispanics Total 0 71 210 289 230 262 214 136 33 16 1.157 736 705 652 742 176 28 6.303 0 63 277 303 282 263 237 160 36 5 1.349 16 762 1.885 1.247 0 47 260 410 430 610 731 723 201 42 3.262 1 106 431 502 508 571 707 973 276 45 4.1% of cases.973 1 32 43 49 37 43 45 37 8 0 295 0 45 66 53 49 47 56 49 3 2 370 1 49 86 81 52 71 63 59 9 3 474 1 37 79 64 56 60 42 70 9 0 418 0 28 56 46 34 40 24 55 12 2 297 Total 11 404 827 761 471 497 420 477 131 24 4.498 1.873 3 479 1.903 2 100 409 396 304 284 303 264 41 15 2.602 10 253 367 250 140 82 65 104 22 3 1. Primary and Secondary Syphilis—Reported Cases by Race/Ethnicity. unknown. age was unknown for 0.081 4 287 848 744 478 524 454 457 124 29 3..270 0 37 239 363 372 627 711 691 174 33 3.461 0 88 316 335 308 275 248 175 39 5 1.702 0 66 420 509 496 514 625 1. Non-Hispanic Blacks.499 1.023 12 453 1.843 1 90 358 370 315 258 245 223 37 6 1. 2006–2010 2010 2009 2008 2007 2006 Age Group 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–54 55–64 65+ TOTAL 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–54 55–64 65+ TOTAL 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–54 55–64 65+ TOTAL 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–54 55–64 65+ TOTAL 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–54 55–64 65+ TOTAL Whites. In 2010.949 7 404 1.236 Male 0 44 180 256 210 244 200 122 31 16 1.to 9-year age group is not shown because some of these cases may not be due to sexual transmission.123 888 585 575 531 593 144 23 4.789 2 124 346 395 332 327 267 214 34 10 2.530 Male 2 235 608 610 374 414 335 373 108 22 3. See Table 34 for age-specific cases and rates and Tables 26-28 for total and sex-specific cases and rates.788 0 69 352 438 452 511 665 903 267 45 3.626 0 96 298 359 300 300 252 196 32 10 1.234 Female 9 169 219 151 97 83 85 104 23 2 942 8 166 237 165 105 120 116 127 24 7 1.Table 35A.454 1 71 354 479 473 582 677 887 209 55 3.024 22 632 1. The 0.137 15 678 1.439 1.0% of cases.

8 15.2 6.7 0.6 1.0 0.2 0.9 2.2 0.3 3.0 0.0 2.7 13.5 0.4 6.7 10.1 5.3 3.0 0. age was unknown for 0.8 7.0 0.8 0.2 0.5 0.0 6.2 0.6 8.0 9.0 1.5 0.000 Population by Race/Ethnicity.1 33.2 2.7 34.3 16.0 4.9 0.7 0.1 2.5 3.9 1.0 0.7 9.6 24.9 5.5 2.2 0.2 1.9 7.1 0.7 1.0 1.4 0.8 1.6 0.8 9.6 8.7 31.6 10.0 3.1 4. and they are not included in the totals.7 1.2 3.0 5.2 3.8 8.0 13.7 6.0 0.0 0.1 0.7 8. See Table 34 for age-specific cases and rates and Tables 26-28 for total and sex-specific cases and rates.5 2007 0.8 4.4 0.5 5.6 5.6 0.3 0.0 0.0 1.8 0.8 8.3 9.5 0.0 2.1 0.6 0.6 1.1 18.7 2.3 45.3 0.6 3.3 0.0 0.0 0.3 3.3 0.0 2.4 6.9 16.0 1.3 0.2 2.2 11.0 0.0 3.9 9.0 7.8 4.0 6.2 18.3 1.0 1.4 2.3 0.0 1.7 3.1 0.3 5.2 0.2 27.9 0.0 1.6 3.5 7.4 8.0 0.4 14.0 0.7 0.9 1.9 8.6 3.6 22.0 0.0 0.1 3.5 2.0 0.8 1.5 10.1 8.4 0.2 27.6 4. or invalid data values) for 2.3 2.4 3.3 0.0 0.0 1.0 2.1 4.1 9.9 6.3 0.5 0.3 2008 0.2 3.8 7.1 4.0 2.0 1.4 0.2 1.8 3.6 0. unknown.2 3.1 1.4 0.8 3.1 2.7 0.3 0.8 0.8 1.0 0.3 4.6 10..7 2.0 5.1 1.1 0.1 15.2 0.0 0.7 0.3 4.0 1.3 5.0 0.2 0.4 4.7 4.4 7.7 3.0 0.8 28.0 0.9 12.5 7.8 3.9 52.5 3.1 1.3 8. STD Surveillance 2010 Syphilis Tables 125 .8 2.0 1.7 2.0 0.8 11.5 5.3 6.1% of cases.8 0.3 6.6 24.to 9-year age group is not shown because some of these cases may not be due to sexual transmission.0 1.6 0.2 17.3 0.0 1.0 5.0 3.1 3.4 4.0 3.3 0.5 2.1 38.0 2.0 0.4 9.0 23.1 0.5 0.9 6.0 0.0 0.6 1.2 9.4 4.8 2010 0.3 0.5 4.0 1.2 4.7 3.6 0.2 3.0 10.1 0.4 13.4 5.2 5.9 5.1 0.0 4.1 0.2 5.3 8.4 4.0 0.6 1.0 0.7 4.7 10.7 0.0 39.8 19.3 1.8 2.4 2.4 71.0 0.1 7.0 3.6 5.2 25.4 1.0 0.0 0.4 2.4 0.1 6.0 0.0 0.2 0.3 0.9 3.7 0.0 3.6 0.0 5.0 1.9 9.6 0.6 0.0 5.9 0.5 43.0 0.2 2.1 0.9 19.7 0.9 0.9 4.9 2.2 0.4 10.3 0.0 7.0 0.8 3.9 0.2 4.0 42.0 0.5 4.5 8.4 7.2 2.1 1.9 6.5 1.9 46.4 2.0 0.8 4.0 1.8 1.4 55.0 1.0 17.1 1.2 0.1 1.0 0.2 0.9 0.4 2.7 6.8 48.0 2.7 9.8 0.7 0.5 8.6 2.1 2.4 4.6 0.0% of cases.7 0.4 1.6 16.3 0.9 0.5 5.1 0.8 55.5 4.5 4.4 0.2 2.0 2.4 2.8 54.8 4.7 3.0 9.4 0.2 0.0 1.3 0.5 1.6 20.3 4.5 0.8 58.4 0.8 1.9 0.9 5.6 8.7 5.7 2.0 0.3 9.0 0.8 2. The 0.0 8.1 0.9 5.0 0.3 0. United States.9 0.3 0.6 2.2 5. race/ethnicity was unknown (i.0 0.8 0.4 0.1 24.1 0.2 0.3 4.9 1.1 35.0 0.1 0.0 1.0 0.0 1.2 7.0 4.8 19.9 6.2 14.6 88.Table 35B.5 5.3 3.1 0.2 0.4 0.8 0.6 0.1 10.0 0.3 1.0 3.2 1.4 23.9 6.2 1.0 0.2 27.3 13.1 0.9 1.9 2.6 2.8 0.1 0.6 0.0 1.4 0.4 0.7 18.3 14.5 0.1 6.4 8.1 6.6 13.0 3.5 1.1 0.9 7.1 1.4 9.3 0.1 0.6 18.6 0.6 0.3 3.3 1.3 34.3 17.5 0.3 8.7 20.6 44.0 5.5 1.3 0. and sex was unknown for 0.8 12.2 15.5 1.e.0 1.0 3.5 23.8 3.3 0.3 0.9 1.9 0.5 14.1 1.2 9.4 2.0 2.1 0.2 0.7 8.6 1.3 0.0 0.1 9.0 1.2 24.9 5.3 7.6 7.0 0. missing.8 2.7 1.6 0.5 0.8 2.3 13.3 24.0 0.3 3.4 0.5 15.0 2.2 12.2 3.2 4.3 5.0 2.1 0.5 31.0 5.2 0.7 2.9 0.7 0.2 1.5 0.0 0.4 0.8 0.2 0.0 15.0 2.0 0.0 7.6 0.0 0.1 7.2 2.1 0.8 1.4 6.9 1.5 0.1 10.4 4.9 2.9 4.8 12.5 4.0 2.4 26.3 6.9 1.5 19.4 0.0 0.2 5.2 2.9 74.2 24.4 4.5 2.4 0.8 0.0 14.1 0.6 4.0 1.5 22.0 1.7 0.2 8.2 0.1 1.4 2.0 0.9 0.4 7.6 0.8 6.5 0.0 13.5 0.2 7.8 24.0 0.4 12.9 0.7 4.7 7.2 0.0 4.5 5.1 0.6 6.3 0.6 1.9 0.3 0.7 0.6 7.7 9.4 2.2 2.3 15.7 11.2 14.0 1.6 0.0 1.3 2.5 48.0 11.8 3.6 0.7 0.2 5.2 0.6 2.7 0.1 0.7 14.4 4.2 0.4 0.0 0.3 10.7 0.3 58.3 12.3 0. Age Group.4 1.7 15.3 4.0 13.1 2. Primary and Secondary Syphilis—Rates per 100.0 2.0 0.0 0.5 0.0 0.1 1.5 0.6 12.4 0.8 6.8 0.0 13.3 0.4 1.4 2.1 3.9 6.0 0.8 3.5 5.6 3.0 0.0 6.3 0. Asians/Pacific American Indians/ Non-Hispanic Non-Hispanic Hispanics Islanders Alaska Natives Age Group Total Male Female Total Male Female Total Male Female Total Male Female Total Male Female 0.3 1.9 9.9 0.2 10.1 0.5 2.8 0.1 1.5 31.3 3.5 10.7 4.7 39.2 20.3 14.4 3.0 2.0 1.0 0.4 0.0 0.0 2.4 2006 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–54 55–64 65+ TOTAL 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–54 55–64 65+ TOTAL 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–54 55–64 65+ TOTAL 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–54 55–64 65+ TOTAL 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–54 55–64 65+ TOTAL NOTE: These tables should be used only for race/ethnicity comparisons.1 3.4 9.8 11.5 92.3 16.7 0.0 0.6 0.6 4.6 18.0 2009 0.0 0.0 9.1 34.8 0.0 0.2 16.8 0.8 17.8 0.2 0.2 9. 2006–2010 Whites.5 7.8 15.4 5.0 0.0 26.4 0.7 60.7 0.7 5.3 7.8 32.0 11.7 5.7 3.9 0.0 0.0 10.0 0. Blacks.1 14.4 8.0 1.3 0.2 0.8 6.4 0.3 0.0 0.5 74.9 7.0 7.5 18.0 7.4 6.1 8.1 29.1 0.5 33.8 20.8 35.5 1.3 6.0 0.7 0.2 8.4 35.7 3.1 5.7 11.0 0.4 1.8 0.0 0.4 8.1 0.0 4.7 0.4 19.4 2. In 2010.5 4.7 2.3 0.2 5.9 41.0 0.0 3.7 2.0 0.5 0.0 2.4 46.4 39.3 4.0 1.1 0.9 3.0 2.0 5.2 0.9 4.0 1.3 3.9 1.6 0.0 0.3 7.6 0.5 0.4 2.7 3.0 0.0 21.5 3.7 1.5 9.7 4. and Sex.0 0.4 8.2 3.1 1.0 0.0 4.7 0.5% of reported primary and secondary syphilis cases.4 0.3 7.5 7.9 8.3 0.0 1.7 1.5 6.9 2.0 0.4 1.2 1.4 0.0 0.

3 0.0 0.3 2.4 1.6 2.8 7.9 1.3 4.3 5.2 3.8 1. TOTAL Northeast Midwest South West Guam Puerto Rico Virgin Islands OUTLYING AREAS TOTAL 126 2006 341 6 186 67 1.788 129 51 14 239 1.4 5.4 3.0 4.1 1.9 3.9 6.3 3.1 0.3 2.4 0.1 1.0 0.6 2.2 0.4 13.4 1.186 1.4 4.1 18.2 0.2 2.372 221 2 224 117 18 309 7 192 3 312 1.9 1.2 0.421 35 20 14 84 1.8 0.5 0.8 1.9 13.1 3.0 0.7 0.0 3.0 1.Table 36.1 4.3 0.8 2.0 1.8 2.7 4.8 16.874 20 0 275 109 4 52 3 13.9 7.6 26.494 2.0 6.2 0.6 0.231 2010 277 5 166 202 1.0 1.1 6.2 1.3 0.7 0.9 5.8 0.2 4.6 4.5 4.2 3.2 0.9 2.2 0.1 0.1 4.7 0.0 6.9 0.4 0.0 1.8 1.066 3 408 1 412 11.9 0.8 0.7 1.0 1.9 4.0 0.8 2.369 38 27 16 77 760 366 2 3 267 46 6 18 36 481 7 193 82 43 58 197 93 0 1 119 2 314 85 993 294 0 115 121 19 286 6 174 6 233 1.0 6.6 0.000 Population 2009 419 0 196 172 1.3 1.6 3.0 6.966 775 5.2 2.2 4.1 0.6 13.0 16.0 2.0 3.8 1.5 3.2 1.3 2010 5.6 4.1 6.9 6.7 4.0 0.9 3.1 3.733 10 6 238 98 16 78 1 12.1 3.6 0.7 2008 9.6 1.493 0 191 3 194 13.0 5.9 0.4 1.0 5.1 2007 7.0 1.719 713 4.839 1.8 0.768 1.3 0.6 2.4 1.376 1.2 0.3 0.9 3.8 0.6 0.5 0.6 0.3 0.6 0.7 0.4 0.5 2.1 6.1 0.0 4.2 2.252 563 9 6 271 83 11 54 47 809 10 313 149 99 47 232 145 1 0 168 4 415 45 1.2 5.7 6.266 357 0 221 172 29 361 14 284 2 333 1.0 3.8 0.3 6.2 0.S.0 3.8 7.1 0.1 0.0 7.175 1 164 0 165 13.2 2.6 4.241 7.5 0.017 6.5 17.2 3.3 0. Early Latent Syphilis—Reported Cases and Rates by State/Area and Region in Alphabetical Order.2 6.8 4.0 0.7 2.0 4.2 0.2 1.5 7.4 6.0 0.0 2.1 2.5 0.8 5.557 2007 363 3 269 115 1.9 9.0 1.3 7.4 0.3 1.3 0.4 5.5 2.234 1.9 0.7 3.4 2.0 5.1 4.8 0.355 2 241 0 243 12.180 2008 440 2 258 144 1.0 3.8 0.155 423 11 3 224 39 6 25 34 722 5 320 116 73 55 269 120 0 3 174 13 343 66 1.2 3.3 6.2 4.8 3.1 9.6 4.648 91 28 23 77 1.5 1.401 2.6 3.7 3.5 0.4 1.4 0.9 10.7 0.6 14.254 768 15 3 344 55 9 58 64 799 10 261 135 155 46 312 146 0 6 137 6 401 40 1.1 1.5 6.3 4.8 1.4 1.3 0.915 3 368 0 371 9.0 3.0 4.9 4.4 0.5 4.149 247 0 135 115 6 309 10 143 4 304 1.294 636 15 4 502 103 4 63 88 742 6 279 195 121 73 386 133 2 1 178 5 386 41 1.108 7.6 0.7 0. United States and Outlying Areas.5 4.4 2.0 3.961 2.4 2.9 7.2 2.0 0.1 2.729 2.7 0.8 0.9 1.3 5.2 0.0 1.6 4.3 7.5 0.644 Rates per 100.8 2.0 6.1 2009 8.9 1.8 0.467 2 1 177 76 9 91 0 10.7 0.4 4.798 Syphilis Tables 2006 7.4 0.5 0.4 4. 2006–2010 Cases State/Area Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming U.6 0.3 4.0 3.549 2.0 3.066 2.9 3.9 11.3 1.604 2.6 2.5 1.3 4.0 0.300 1.358 328 0 189 149 33 355 20 344 0 363 1.1 0.9 3.1 0.8 1.9 0.2 0.5 3.2 0.932 7 1 233 64 8 66 0 13.3 0.6 39.0 8.2 1.5 1.9 0.6 1.9 0.0 4.4 STD Surveillance 2010 .8 9.2 0.4 2.8 5.3 1.8 0.4 0.7 1.4 1.0 6.2 0.5 0.312 7 2 165 81 6 60 0 9.2 2.0 2.2 5.9 1.8 2.3 1.6 4.621 63 40 23 158 1.7 0.7 10.6 1.3 1.3 6.9 0.9 2.1 1.9 7.2 0.7 4.1 2.5 1.8 3.7 0.5 0.3 2.2 0.0 3.

1 1. OR-WA Providence-New Bedford-Fall River.8 2.6 2.0 17. TX Indianapolis.7 3.3 4.1 4.4 5.0 6.2 5.3 3.0 20.3 5. Petersburg-Clearwater.3 1.6 8.2 3.3 0.8 5.3 3.1 4.7 3.9 10.000 Population 2006 2007 2008 2009 2010 2006 2007 2008 2009 2010 293 51 136 220 65 14 98 269 7 11 55 532 32 34 10 291 18 56 41 112 851 18 174 304 46 52 42 127 1.2 1.9 1. LA New York-Newark-Edison.3 2. STD Surveillance 2010 Syphilis Tables 127 .3 3.7 1.3 1. NY Sacramento-Arden-Arcade-Roseville. CA Salt Lake City.0 2.4 8.2 4. FL Milwaukee-Waukesha-West Allis.9 2. FL Philadelphia-Camden-Wilmington.2 1.6 4.8 0. TN New Orleans-Metairie-Kenner.7 2.1 8. Early Latent Syphilis—Reported Cases and Rates in Selected Metropolitan Statistical Areas (MSAs)* in Alphabetical Order.0 6. NY Charlotte-Gastonia-Concord. DC-VA-MD-WV U.3 1. WI Minneapolis-St.2 0.0 1.2 6.0 2.7 8. KY-IN Memphis.1 6.0 1.5 7.6 9.0 2.2 5.3 6.1 * MSAs were selected on the basis of the largest population in the 2000 U. MO-KS Las Vegas-Paradise.0 1.4 0.8 5. AZ Pittsburgh.2 2.6 2. MO-IL Tampa-St.551 529 137 148 67 161 0 90 476 88 20 42 647 109 76 18 370 70 91 59 174 991 46 256 749 35 68 70 193 1. MA-NH Buffalo-Cheektowaga-Tonawanda.6 1.3 10.4 4. VA-NC Washington-Arlington-Alexandria.4 6.8 0.0 17.7 19.1 6.5 9.3 5. NC-SC Chicago-Naperville-Joliet.4 2.2 2.3 6. CA San Francisco-Oakland-Fremont.2 5.0 5.5 0. OH Columbus.1 1. GA Austin-Round Rock. TX Denver-Aurora.7 4.1 4.2 1.4 16.5 10. CA Seattle-Tacoma-Bellevue. OH-KY-IN Cleveland-Elyria-Mentor.3 6.6 6. WA St. UT San Antonio.2 2.6 5.6 2.2 4.9 3.4 19.5 13.6 1.7 21. NV Los Angeles-Long Beach-Santa Ana.0 6.3 6.9 7.5 8.4 2.5 6.6 15.5 3.7 9.9 12.8 3.628 72 148 305 160 43 11 13 81 89 5 39 10 203 179 281 25 91 70 275 69 224 9.0 10. CO Detroit-Warren-Livonia.0 4.0 1.1 20.0 1. OH Dallas-Fort Worth-Arlington.5 5.034 402 109 214 199 124 10 62 251 23 48 89 496 68 45 10 555 56 86 79 166 910 20 199 563 60 43 54 239 1. MI Hartford-West Hartford-East Hartford.1 1.4 1.8 0.178 74 91 280 166 43 9 9 29 64 8 23 5 172 123 220 18 74 30 177 74 171 6.1 7. RI-MA Richmond.2 6.1 0. PA-NJ-DE-MD Phoenix-Mesa-Scottsdale.5 3. CA Rochester.8 6.3 4.997 363 66 185 196 95 6 63 209 12 21 47 468 30 47 8 468 20 51 70 170 893 12 222 440 65 54 56 222 1.6 0. TN-MS-AR Miami-Fort Lauderdale-Miami Beach.3 6. FL Kansas City.3 6.1 7.9 1.0 0.2 0.070 17 259 644 46 45 64 243 1.4 6.7 3.9 1.2 5.5 2.6 3.2 5.6 1.9 8.4 14.0 4.6 2.9 3.9 4.2 8.1 4.2 4.2 7.7 3.Table 37.0 10.5 0.3 5.5 3.8 11.3 1.6 13.1 0.7 1. CT Houston-Baytown-Sugar Land.5 3. IN Jacksonville.1 7.8 2. MN-WI Nashville-Davidson-Murfreesboro.1 8.9 1.1 0.5 1. CA Louisville. OK Orlando.0 6.8 0.9 5.5 10.7 3.360 65 160 310 165 45 5 12 45 49 5 16 2 115 156 200 25 70 57 294 54 265 8.8 0.7 1. United States.7 5. TX Baltimore-Towson.8 8.3 1.3 8.S.3 4.8 9.0 7.8 4.5 6.595 76 138 348 126 27 33 26 77 86 7 43 12 305 177 373 29 91 106 117 84 441 10.2 8.5 6.1 2.0 2.2 2.1 3.9 4.4 2.1 1.1 6.2 3.6 1.5 0.0 4.8 1.5 1. Paul-Bloomington.6 1. 2006–2010 Cases MSAs Atlanta-Sandy Springs-Marietta.7 5.6 6.7 8.1 6.0 1. AL Boston-Cambridge-Quincy.8 2.4 1.530 123 132 362 131 25 22 16 59 88 6 38 4 290 80 253 22 56 90 225 78 306 9.7 13.5 21.5 1.9 0.9 3. IL-IN-WI Cincinnati-Middletown.5 3.9 9.9 1.1 2.9 1.2 3. Louis.2 2.6 4.9 5.0 5.2 8. FL Virginia Beach-Norfolk-Newport News.7 3.2 0.1 14.6 3.6 11.9 3.4 3. TX San Diego-Carlsbad-San Marcos.1 0.9 7.8 0.097 5.1 1.7 2.S.7 5.6 5.9 17.7 0.7 7.6 5.0 4.3 0.7 1.1 0.2 4. VA Riverside-San Bernardino-Ontario.6 1.4 7.6 2. MD Birmingham-Hoover.0 8. MSAs TOTAL Rates per 100.7 2.8 0. Census.5 0.2 0.2 1.9 1.6 2.8 2. NY-NJ-PA Oklahoma City.6 1.3 1.2 5. PA Portland-Vancouver-Beaverton.8 1.201 613 135 153 150 116 3 78 324 42 70 64 592 57 88 13 421 27 82 64 135 1. CA San Jose-Sunnyvale-Santa Clara.0 7.9 2.

833 352 2 192 58 51 335 51 155 10 527 2.392 2006 5.4 6.2 0.2 2008 6.8 3.945 3.773 73 106 38 120 1.1 1.1 2.8 1.6 8.2 3.1 3.8 0.3 1.4 3.8 12.2 4.1 1.6 5.2 1. 2006–2010 Cases State/Area Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming U.2 2.9 0.5 20.8 1.2 1.0 3.6 8.0 3.547 982 39 24 805 110 33 58 81 413 1 387 100 246 99 188 189 1 34 75 17 270 107 2.3 4.345 30 13 720 128 48 41 77 485 7 374 114 227 102 320 171 2 21 71 17 364 96 2.5 9.7 1.1 1.256 3.2 0.5 12.6 1.9 2.1 0.6 1.1 2.8 1.3 0.6 7.6 26.0 10.4 2.0 7.0 0.9 6.1 2.4 2.9 5.338 2.9 0.5 3.8 2.5 7.8 0.259 2.7 0.000 Population 2009 289 4 629 95 2.847 8. and late syphilis with clinical manifestations other than neurosyphilis.777 63 87 31 153 1.411 3.0 6.2 5.8 3.1 6.1 2.0 12.272 1.1 1.3 2.3 4.223 75 83 19 121 1.572 898 23 9 799 134 45 28 84 1.040 4.5 2.S.0 2.1 18.6 1.079 3.142 38 10 522 121 37 44 63 516 7 482 128 262 72 305 124 0 23 104 9 345 62 2.190 2007 254 6 650 122 2.1 8.1 20.3 4.6 1.9 9.614 9 328 2 339 17.822 1.Table 38.0 10.4 14.2 0.5 1.9 25.1 5.686 8.6 5.5 3.8 2.7 2.1 0.8 1.5 9.2 1.9 5.3 4.7 4.0 0.279 3.5 2.690 10.1 14. TOTAL Northeast Midwest South West Guam Puerto Rico Virgin Islands OUTLYING AREAS TOTAL 2006 262 8 521 92 2.2 0.677 2010 235 7 493 116 2.5 3.0 1.0 2007 5.7 3.9 0.4 5. United States and Outlying Areas.8 0.1 21.0 4.0 0.3 7.6 0.9 3.3 8.6 2.7 0.966 2008 286 6 789 149 2.5 1.0 8.1 5.5 4.8 1.3 3.0 0.5 9.8 0.903 480 2 185 51 53 313 30 120 2 548 3.438 9.0 2.995 133 109 20 147 2.6 2.6 0.7 4.2 2.9 1. neurosyphilis.6 13.6 2.5 3.2 8.1 1.9 5.2 8.8 2.4 3.071 5 1 281 159 14 43 5 19.6 1.271 17 0 221 118 16 56 4 17.160 578 3 206 25 46 321 29 100 8 568 3.3 8.4 1.3 3.6 7.7 4.0 10.1 0.7 1.4 2.7 11.4 1.1 0.903 24 682 4 710 18.8 7.7 10.0 1.5 1.6 6.8 17.7 1. latent syphilis of unknown duration.4 3.449 101 72 36 110 1.2 0.4 10.2 1.3 5.9 1.8 12.8 14.6 4.5 2.0 0.5 8.3 2.6 2.2 8.9 12.2 8.2 2.7 1.3 4.9 1.9 * Late and late latent syphilis includes late latent syphilis.0 5.5 4.9 10.204 47 0 245 159 16 84 3 18.7 13.8 0.0 6.9 2.3 7.9 2.6 6.830 1.264 10 302 1 313 18.1 6.6 0.6 1.5 0.0 2.8 4.7 0.4 3.0 4.5 2.4 0.6 5.644 3.4 0.3 24.6 2.6 2009 6.357 37 381 1 419 20.0 1.4 2.3 11.907 3.7 4.7 1.858 1.501 38 2 343 160 13 42 1 17.4 2.9 6.0 1.2 2.8 8.2 0. 128 Syphilis Tables STD Surveillance 2010 .6 0.8 11.445 977 46 6 760 111 43 41 78 551 6 526 172 210 83 237 166 1 26 117 20 297 66 2.0 9.2 6.0 9.8 2.6 2.364 Rates per 100.9 0.0 0.2 8.7 0.5 2.9 5.8 6.0 5.636 1.163 3 386 158 322 128 200 225 0 20 99 16 314 57 2.3 1.4 5.6 1.9 0.9 1.145 9.8 0.9 0.3 2.0 8.7 1.0 1.5 0.7 1.3 1.7 1.0 0.9 12.5 6.3 6.6 0.1 1.0 13.861 7 535 4 546 18.0 2.2 1.8 12.275 3.2 3.780 23 0 328 135 11 12 2 18.1 2.387 499 3 349 31 69 280 18 80 8 542 3.9 1.6 12.1 2.5 0.1 1.4 6.970 1.6 0.9 2.6 5.4 5.7 2010 5.3 10.3 0.8 1.1 13.5 0.2 5.9 2.0 4.8 0.5 1.0 2.8 0.6 3.9 7.0 3.0 3.9 9.0 1.6 16.4 3.1 6.2 8.9 6.4 13.6 9.1 0.2 0.6 1.5 3.766 516 1 219 33 33 264 30 176 1 537 2.9 7.4 2.2 1. Late and Late Latent Syphilis*—Reported Cases and Rates by State/Area and Region in Alphabetical Order.6 1.7 5.0 6.0 1.6 0.5 1.6 1.

AZ Pittsburgh.4 2.6 5.2 8. Petersburg-Clearwater.5 1.2 15.2 6.8 24.5 1. Late and Late Latent Syphilis*—Reported Cases and Rates in Selected Metropolitan Statistical Areas (MSAs)† in Alphabetical Order.1 4.0 2.3 5.7 6.588 33 326 997 9 59 100 157 2.2 5.8 4.2 6.9 6.9 13.7 10.9 6.S.3 4.8 2.7 1.0 4.6 4.1 3.8 5.8 2.9 10.5 14.3 0.7 25.977 723 118 162 84 142 32 91 703 117 79 82 941 64 232 34 1. Louis.5 4.4 3.1 3.0 7. OR-WA Providence-New Bedford-Fall River. TX Baltimore-Towson.0 9.1 3.4 4.759 42 287 773 16 65 112 133 2.8 7.3 17.7 2.913 12 277 253 486 17 34 44 46 194 55 40 14 142 273 263 76 99 82 119 89 514 13.2 3.9 6.8 1.9 0.4 2.0 8.2 4.5 4.6 2.2 6.3 1. DC-VA-MD-WV U. NY-NJ-PA Oklahoma City.5 7. NC-SC Chicago-Naperville-Joliet.9 3.5 9.6 1.069 756 116 193 112 92 27 127 727 58 29 71 1. AL Boston-Cambridge-Quincy.5 4. MA-NH Buffalo-Cheektowaga-Tonawanda.6 16.1 9.7 1.1 7. MSAs TOTAL Rates per 100.9 9.1 8.139 48 95 70 49 1. KY-IN Memphis.5 4.3 3. PA Portland-Vancouver-Beaverton.3 4.6 3.9 0.032 49 102 49 85 1.5 4.6 5.1 5.3 2.7 14. TX Denver-Aurora.8 2.238 46 326 853 57 101 115 391 2.5 5.9 7.9 2.7 6.6 5.6 14.2 2.4 3.4 19.9 15.237 16 165 304 368 16 39 31 50 210 34 94 8 221 211 239 58 84 120 223 55 362 12.3 2.8 2. CT Houston-Baytown-Sugar Land.1 2.9 1. CA Rochester. Census.4 3.0 15.5 2.4 7.332 48 316 797 43 70 145 78 2. OK Orlando.S.7 1.089 26 184 287 468 17 32 33 53 202 37 100 2 190 292 277 84 115 129 212 80 425 15.7 25.7 3.6 14. and late syphilis with clinical manifestations other than neurosyphilis.0 7. neurosyphilis.5 2.9 4. CA Seattle-Tacoma-Bellevue.8 1.9 3.585 929 94 236 93 98 9 133 469 31 33 99 881 43 187 27 1.1 2.4 7.4 3.4 4.9 3.5 7.7 4.3 7.6 3.8 13.6 11.3 7.1 1.1 2.2 4.8 19.990 1. GA Austin-Round Rock.2 2.544 2006 2007 2008 2009 2010 15.4 17.7 3.0 15.3 1.4 8.0 4.2 5. MI Hartford-West Hartford-East Hartford.2 7. CA Salt Lake City.7 2.5 18.8 8.7 3.6 4. NY Charlotte-Gastonia-Concord.4 3.6 3.2 1. latent syphilis of unknown duration.6 7.2 9.5 10.9 0.4 2. IN Jacksonville.3 2.8 8.7 13.3 7. OH Dallas-Fort Worth-Arlington.4 3.1 3.020 74 171 29 1.9 13. TX San Diego-Carlsbad-San Marcos.8 4.4 9.000 Population 2006 2007 2008 2009 2010 814 74 283 94 147 7 83 687 37 24 67 809 51 155 32 856 56 63 75 95 1. TN-MS-AR Miami-Fort Lauderdale-Miami Beach.2 6.3 11.9 5.6 19.6 2.2 9.2 3.7 1. WI Minneapolis-St.722 34 306 1.6 3.3 6.2 13. PA-NJ-DE-MD Phoenix-Mesa-Scottsdale. MO-IL Tampa-St. STD Surveillance 2010 Syphilis Tables 129 .4 2.6 2.6 8. TX Indianapolis.4 9.3 3. † MSAs were selected on the basis of the largest population in the 2000 U.2 0.6 3.0 6.8 6.9 10.8 4. UT San Antonio.1 4.9 1.9 8. RI-MA Richmond. FL Philadelphia-Camden-Wilmington.3 2.068 127 186 110 86 7 100 650 20 15 84 934 98 154 51 1.502 17 149 271 345 9 54 22 47 185 43 81 29 232 148 230 62 112 177 195 59 425 13.9 3.3 6.8 7.8 4. MO-KS Las Vegas-Paradise. CA Louisville.7 1.6 11. FL Milwaukee-Waukesha-West Allis.7 23.7 4.7 8.9 7. LA New York-Newark-Edison.4 2.2 9.6 5. CA San Francisco-Oakland-Fremont.6 10. 2006–2010 Cases MSAs Atlanta-Sandy Springs-Marietta.7 15. CO Detroit-Warren-Livonia.0 2.5 0.8 4.2 7.0 5.4 5.5 2.3 8.4 10.8 5. TN New Orleans-Metairie-Kenner.9 5.8 1.8 24.2 3. OH Columbus.1 11. IL-IN-WI Cincinnati-Middletown. NV Los Angeles-Long Beach-Santa Ana.905 18 217 315 424 18 40 65 49 203 68 78 21 156 202 156 22 122 89 140 85 496 13.8 0.1 * Late and late latent syphilis includes late latent syphilis.Table 39. CA San Jose-Sunnyvale-Santa Clara.4 1.9 3.5 3.0 13.1 4.0 6.1 9.5 3.8 3.6 15.6 12.4 1.2 9.4 2. MD Birmingham-Hoover.149 55 87 43 85 1. Paul-Bloomington. OH-KY-IN Cleveland-Elyria-Mentor.1 3.4 0.8 7.6 2.4 2. VA Riverside-San Bernardino-Ontario.9 2.9 5.326 32 75 138 75 3.3 32.1 1.6 0.7 1.3 18.024 53 153 55 52 1. United States.9 0.8 13.8 5.2 3.8 6.5 3.3 7.9 4.4 0.9 3.9 4. WA St.3 4.7 0. MN-WI Nashville-Davidson-Murfreesboro.8 2. NY Sacramento-Arden-Arcade-Roseville.4 0.4 22.6 7.7 7. FL Kansas City.2 14.8 8. FL Virginia Beach-Norfolk-Newport News.8 5. VA-NC Washington-Arlington-Alexandria.7 1.3 13.

‡ Total includes cases reported by the District of Columbia.6 6.0 0. 2010 State† Louisiana Maryland Arkansas Texas Mississippi Delaware Illinois Arizona Alabama Tennessee Nevada Georgia YEAR 2020 TARGET U.0 0.4 2.3 4.0 * States were ranked in descending order by rate (rounded to the nearest tenth) and by number of cases.2 26.8 1. Puerto Rico with 2 cases and rate of 4.4 14.8 28.0 0.1 0.9 0.0 0.3 1.3 19.0 0.0 0. 130 Syphilis Tables STD Surveillance 2010 .8 4.0 0.0 0.9 9.1 11.0 0.6 6. with 1 case and a rate of 11.0.9 7.6 25.0 0.0 0.0 0.Table 40. Ranked by Rates.7 7.000 Live Births 49.9 12.0 0. Rank* 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 Congenital Syphilis—Reported Cases and Rates in Infants by Year of Birth.0). but excludes outlying areas (Guam with 0 cases and rate of 0.0 0.0 0.0 0.6 1.0 0. TOTAL‡ Florida North Carolina California Ohio New York Connecticut Idaho New Jersey Missouri Pennsylvania Utah Michigan Wisconsin Massachusetts Washington Virginia Alaska Colorado Hawaii Indiana Iowa Kansas Kentucky Maine Minnesota Montana Nebraska New Hampshire New Mexico North Dakota Oklahoma Oregon Rhode Island South Carolina South Dakota Vermont West Virginia Wyoming Cases 33 22 11 103 9 2 27 15 9 11 5 18 377 19 10 38 10 16 2 1 3 2 3 1 2 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Rates per 100.6 2. United States.1 8.0 2.9 14. by State.0 0.7 6.0 0.7 12.3.6 13. States with no cases were not ranked.0 0.3.S.0 1. † Mother’s state of residence was used to assign case.4 16.4 1.0 0. and Virgin Islands with 0 cases and rate of 0.

8 0.1 8.3 0.8 0.1 0.1 0.6 7.0 0.0 12.6 24.0 2.4 9.2 3.0 4.0 0.1 5.0 3.3 8.4 0.3 5.0 4.1 9.3 0.9 0.0 15.0 2.6 6.2 24.0 3.7 11.0 27.9 4.0 0.4 13.9 6.0 9.6 0.7 0.3 5.7 34.4 2.0 0.8 0.1 5.0 0.2 7.1 16.4 2009 20.0 17.0 2.0 0.9 8.3 0.0 0.0 0.3 0.7 8.3 7.5 9.0 8.7 8.2 0.0 10.0 6.0 0.1 0.0 29.0 0.8 3.0 0.0 4.5 10.9 0.7 6.0 21.0 2010 13.4 16.9 12.3 0.0 13.9 0.0 15.0 0.0 8.0 1.0 2.5 0.0 15.4 19.5 1.0 11.0 0.4 0.0 29.0 0.9 0.0 0.1 0.0 39.0 0.1 0.2 4.8 4.2 0.0 17.0 0.7 0.6 0.4 4.4 0.000 Live Births 2009 13 0 28 10 63 0 2 1 0 18 14 1 1 16 1 0 3 2 11 0 31 0 4 1 8 6 0 0 3 0 7 0 15 10 1 8 2 0 4 1 0 0 13 128 0 0 2 1 0 0 0 429 29 40 263 97 0 6 0 6 435 2010 9 0 15 11 38 0 2 2 1 19 18 0 1 27 0 0 0 0 33 0 22 1 2 0 9 2 0 0 5 0 3 0 16 10 0 10 0 0 3 0 0 0 11 103 1 0 1 1 0 1 0 377 25 42 249 61 0 2 0 2 379 2006 14.4 2.6 24.8 1.1 7.0 5.0 2.9 2.0 1.8 8.0 0.0 0.6 10.5 21.7 25.0 4.0 31.1 19.4 10.8 16.0 27.0 7.0 2.4 1.3 3.0 0.0 12.7 3.0 8.0 12.2 0.0 2.7 0.2 1.0 19.5 2.7 0.7 0.0 28.4 6.2 10. STD Surveillance 2010 Syphilis Tables 131 .6 0.2 0.0 12.1 5.0 3.9 11.0 0.8 0.9 0.0 0.2 0.5 1.0 11.0 5.8 0.7 0.0 3.6 5.3 2.5 19.1 9. Congenital Syphilis—Reported Cases and Rates in Infants by Year of Birth by State/Area and Region in Alphabetical Order. United States and Outlying Areas. 2006–2010 Cases State/Area* Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming U.2 11.5 0.0 0.6 26.0 7.8 0.6 0.2 1.0 0.0 11.0 0.0 30.5 0.1 3.7 25.0 5.2 0.4 0.0 3.0 0.0 0.1 21.3 7.2 1.0 14.4 13. TOTAL Northeast Midwest South West Guam Puerto Rico Virgin Islands OUTLYING AREAS TOTAL 2006 9 0 16 10 69 2 0 0 1 21 9 0 0 15 0 0 1 1 16 0 19 0 13 1 0 3 0 0 16 0 15 7 24 7 0 0 2 0 3 0 2 0 6 79 2 0 3 0 0 0 0 372 42 33 185 112 0 15 0 15 387 2007 9 0 30 12 87 2 2 0 1 20 9 0 0 10 2 1 0 0 37 0 24 0 15 0 1 1 0 0 7 0 11 6 18 7 0 1 3 2 8 0 1 0 4 99 0 0 1 2 1 1 0 435 39 31 229 136 2 10 0 12 447 2008 12 0 30 9 64 0 2 1 0 17 11 0 0 20 0 0 0 1 23 0 23 0 10 1 9 2 0 0 9 0 4 4 23 11 0 3 3 0 8 0 2 0 11 127 0 0 4 0 1 1 0 446 37 37 265 107 0 8 0 8 454 Rates per 100.6 0.0 40.4 11.4 12.0 2.9 9.6 15.4 16.0 8.0 9.2 0.0 0.6 0.7 5.0 0.0 0.7 * Mother’s state of residence was used to assign case.0 6.0 30.0 15.3 0.1 0.6 4.0 11.0 7.0 0.0 0.4 0.0 0.Table 41.0 4.2 0.0 7.2 4.0 1.1 0.3 1.4 0.7 0.5 0.0 10.3 1.S.8 1.0 23.0 0.2 2008 18.3 0.3 5.0 3.0 9.9 7.0 2007 13.0 3.9 0.7 0.0 0.0 7.4 17.2 2.2 0.0 6.4 0.0 0.7 31.0 8.8 11.6 57.0 5.0 0.9 0.5 0.2 4.3 0.9 0.1 0.9 1.3 0.4 2.0 29.4 0.0 12.6 0.6 11.3 0.4 0.0 4.2 5.0 1.0 4.0 49.0 24.0 55.0 14.0 1.1 29.0 0.6 0.0 0.4 4.2 1.7 3.8 8.0 3.0 10.1 0.0 0.0 23.4 0.4 0.

7 24.5 NA NA 9.0 12.7 NA = Not applicable.3 2.8 34. Non-Hispanic Hispanics Asians/Pacific Islanders American Indians/Alaska Natives Other Unknown Total Whites.3 14.1 8.3 NA NA 8.8 12.0 4.7 2. Non-Hispanic Hispanics Asians/Pacific Islanders American Indians/Alaska Natives Other Unknown Total Cases 39 151 151 10 5 5 11 372 53 192 144 20 8 4 14 435 67 226 135 7 6 1 4 446 65 215 128 11 5 2 3 429 62 209 89 9 1 3 4 377 Rates per 100.Table 42. 2006–2010 2010 2009 2008 2007 2006 Year of Birth Race/Ethnicity Whites. Non-Hispanic Hispanics Asians/Pacific Islanders American Indians/Alaska Natives Other Unknown Total Whites. Non-Hispanic Blacks.7 33.9 13.2 18.5 8.3 30.000 Live Births 1. Non-Hispanic Hispanics Asians/Pacific Islanders American Indians/Alaska Natives Other Unknown Total Whites.5 11.7 2. Non-Hispanic Blacks. Non-Hispanic Blacks. Non-Hispanic Blacks.5 4.9 35.4 3. United States. Non-Hispanic Hispanics Asians/Pacific Islanders American Indians/Alaska Natives Other Unknown Total Whites. Congenital Syphilis—Reported Cases and Rates in Infants by Year of Birth by Race/Ethnicity of Mother. 132 Syphilis Tables STD Surveillance 2010 .1 2.4 13.3 11.9 2.3 NA NA 10.8 NA NA 10.7 NA NA 8.7 2. Non-Hispanic Blacks.

0 0.0 0.0 0.0 0. United States and Outlying Areas.0 0.0 0.0 2009 0.0 0.0 0.0 0.0 2008 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 2010 0.0 0.000 Population 2009 2010 0 0 0 0 1 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 1 0 0 8 0 0 1 0 0 6 0 28 0 0 0 0 28 Chancroid Tables 1 0 0 0 5 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 1 12 0 0 0 1 0 0 0 24 0 0 0 0 24 2006 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 133 .0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.S.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0. Chancroid—Reported Cases and Rates by State/Area in Alphabetical Order.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.1 0.0 0.0 0.0 2007 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.1 0.0 0.0 0.0 0.0 0.0 0. 2006-2010 Cases State/Area Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming U.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.Table 43.0 0. TOTAL Guam Puerto Rico Virgin Islands OUTLYING AREAS TOTAL STD Surveillance 2010 2006 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 5 5 0 0 0 0 0 0 0 0 0 5 0 0 1 0 0 0 0 19 0 0 0 0 19 2007 0 0 0 0 1 0 0 0 0 3 0 0 0 0 0 0 0 0 4 0 0 1 0 0 0 0 0 0 0 0 0 0 5 2 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 2 0 23 0 0 0 0 23 2008 0 0 0 0 2 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 2 4 0 1 0 0 0 0 1 0 0 8 0 0 0 1 0 0 0 25 0 0 0 0 25 Rates per 100.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.

000 221. National Disease and Therapeutic Index.000 422.000 3.000 72.000 312.000 357.000 51.000 216.000 1.000 3.000 204.000 1.000 16.932.000 are from 9% to 13%.118.000 1.000 191.000 are from 20% to 30%.000 358.000 377.000 36.000 149.690.000 128.000 369. and 1.000 371.281.000 124.000 3.000 291.000 3.000 100.000 165.000-1.000 4.000 205.000 1.810.000 172. Selected STDs and Complications—Initial Visits to Physicians’ Offices.000 250.000 269.000 167. 600.000 290.000 1.000 239.000 197.000 244.000 1.000 148.000 191.474.000 Pelvic Inflammatory Disease† NA NA NA NA NA NA NA NA NA NA NA NA NA NA 423.000 57.000 3.000 335.000 1.155.000 1.859. The relative standard errors for estimates 100. NA = Not available.000 266.365.919.000-600.000 463.000 2.000-300.927. NOTE: Standard errors for estimates under 100.000 165.071.000 3.000 1. See Other Data Sources in the Appendix for more information.000.000 424.583.000 61.087.000 574.000 338.000 134.000 150.000 1.662.000 421.000 3.000 157.000 182.000 199.000 254.000 264.000 179.000 132.000 3.000 116.000 260.000 146.723.000 240.000 207.315.000 119.000 203.000 83.000 1.000 181.000 381.000 266.000 316.200.000 4.000 3.000 3.000 235.460.000 15.000 263.000 1.000 332.000-5. 300.000 133.000 are from 16% to 20%.000 142.000 191.000 268.000 208.000 * Women only.000 224.000 163.000 1.858.571.000 171.000 87.000 484.000 282.100.000 292.000 473.000 457.000 3.000 403.390.000.000 233.000 are from 13% to 16%.000 385.374.000 363.516.000 413.000 26.000 3.000 198.000 221.000 Other Vaginitis* 1.000 Genital Warts 56.000 Vaginal Trichomoniasis* 579.000 424.000 220.000 217.000 157.000 3.000 358.500.000 113.000 293.000 176.123.000 529.000 1.000 3.713.000 306. † Women aged 15-44 years only.000 431.000 17.000 218.000 188.000 220.000 3.000 317.000 200. SOURCE: National Disease and Therapeutic Index (IMS Health).000 160.000 139.Table 44.000 179.602.000 49.000 202.000 216.000 407.000 106.000 2.000 515.000 232.000 275.000 203. United States.000 164.000 176.000 218.670.000 172.428.000 376.000 3.000 256.000 3.000 3.000.000 15.000 136.470.000 104.000 245.000 286.000 213.000 141.000 427.000 165.000 106.000 76.000 2.000 262.000 211.000 1.000 75.000 233. 134 Selected STDs STD Surveillance 2010 .000 57.000 3.000 4.472.000 224.000 200.000 381.000 283.277.000 123. 1966-2010 Year 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Genital Herpes 19.000 1.000 198.063.000 269.000 500.000 222.000 3.000 351.000 3.755.077.891.000 357.742.000 253.192.000 425.000 102.728.000 466.000 145.907.450.000 374.000 275.000 210.000 3.149.000 329.000 are not available.000 324.000 176.822.

APPENDIX .

APPENDIX .

This quarterly hard copy reporting form was used during 1963–2002 to report summary data for all stages of syphilis. San Francisco. FORM CDC 73. and TB Prevention. and independent nations in free association with the United States to the Division of STD Prevention. and the District of Columbia).126: Congenital Syphilis (CS) Case Investigation and Reporting. Nationally Notifiable STD Surveillance Nationally notifiable STD surveillance data are collected and compiled from reports sent by the STD control programs and health departments in all 50 states.126 form described later in this section. Puerto Rico.2638: Report of Civilian Cases of Primary & Secondary Syphilis. congenital syphilis.Interpreting STD Surveillance Data Sexually Transmitted Disease Surveillance 2010 presents surveillance information derived from the official statistics for the reported occurrence of nationally notifiable sexually transmitted diseases (STDs) in the United States. possessions. These entities are identified as “outlying areas” of the United States in selected figures and tables. National Center for HIV/AIDS. gonorrhea. sex. Gonorrhea. and outlying areas of the United States. and national health care services surveys. FORM CDC 73. chlamydia. Los Angeles. Appendix: Interpreting STD Surveillance Data 135 .998: Monthly Surveillance Report of Early Syphilis. and Age Group. and the Virgin Islands. FORM CDC 73. gonorrhea. Congenital syphilis was dropped from this aggregate form in 1995 and replaced by the casespecific CDC 73. and outlying areas of the United States. and Chlamydia by Reporting Source. seven large cities (Baltimore. Puerto Rico). STD Surveillance 2010 2. and independent nations are Guam. Reporting Formats STD morbidity data presented in this report are compiled from a combination of data reported on standardized hard copy reporting forms and electronic data received through the National Electronic Telecommunications System for Surveillance (NETSS). Race/Ethnicity. and chlamydia by age. and the form was modified to support reporting of chlamydia that year. Note: Chlamydial infection became a nationally notifiable condition in 1996. Viral Hepatitis. Sex. New York City. the District of Columbia. and the form was modified to support reporting of chlamydia that year. Centers for Disease Control and Prevention (CDC). and other STDs by sex and source of report (private versus public) for all 50 states. This annual hard copy form was used during 1981–2002 to report summary data for P&S syphilis. 64 selected cities (including San Juan. dependencies and possessions. Chicago. FORM CDC 73. test positivity and prevalence data from numerous prevalence monitoring initiatives. the District of Columbia. race. STD. Summary Report Forms The following hard copy forms were used to report national STD morbidity data: 1. Philadelphia. U.S.688: Sexually Transmitted Disease Morbidity Report. and source (public versus private) for all 50 states. This monthly hard copy reporting form was used during 1984–2002 to report summary data for primary and secondary syphilis and early latent syphilis by county and state. 4. 3. This case-specific hard copy form was first used in 1983 and continues to be used to report detailed case-specific data for congenital syphilis in some areas. sentinel surveillance of gonococcal antimicrobial resistance. selected cities. chancroid. Note: Chlamydial infection became a nationally notifiable condition in 1996. Included among the dependencies.

S.National Electronic Telecommunications System for Surveillance Notifiable STD data reported electronically through NETSS make up the nationally notifiable disease information published in CDC’s Morbidity and Mortality Weekly Report. In most instances.000 live births during 1995–2005. Data received after this date will appear in subsequent STD surveillance reports. This 136 report uses the first published population estimate for a given year. as specified in the 1997 Office of Management and Budget (OMB) standards. these discrepancies are less than 5% of total reported cases and have minimal effect on national case totals and rates.census.e. Census Bureau with support from the National Cancer Institute. The 2009–2010 rates for outlying areas were calculated by using the 2009 population estimates. are included in this report. discrepancies may exist in the total number of cases reported in the figures and tables in earlier STD surveillance reports. These estimates resulted from bridging the 31 race categories used in the 2000 census. case-specific) STD data through NETSS (42 reporting areas submit congenital syphilis surveillance data through NETSS). and case counts Appendix: Interpreting STD Surveillance Data STD Surveillance 2010 . The data presented in the figures and tables in this report supersede those in all earlier publications. 2003. Population estimates for Guam. resident populations that are based on counts from the 2000 U. Guam and the Virgin Islands continue to report STD data through summary hard copy forms.S. live births now are used as the denominator for congenital syphilis.. Once published.html. depending on the database used. for a specific jurisdiction.gov/ipc/www/ idb/tables. and the Virgin Islands were obtained from the U. and annual reports. To allow for trends in congenital syphilis rates to be compared for the period 1941 through 2010.000 population during 1941–1994 and rates for cases diagnosed at younger than 1 year of age per 100. Jurisdictions differ in their ability to resolve differences in total cases derived from summary hard copy monthly. Because of the use of the updated population data. Census. to the five race/ethnicity groups specified in the 1977 OMB standards.1. The latest available year for bridged-race population estimates at the time this report was written was 2009.S. 1990–1999 Rates and Population The population counts for 1990 through 1999 incorporated the bridged single-race estimates of the April 1. 2000. the discrepancies may be larger. rates for 2001–2009 may be different from those presented in previous STD surveillance reports.S. quarterly. all 50 states and the District of Columbia had converted from summary hard copy reporting to electronic submission of line-listed (i. Population Denominators and Rate Calculations 2000–2010 Rates and Population CDC’s National Center for Health Statistics (NCHS) released bridged-race population counts for the 2000– 2009 U. Thus. Previous publications presented congenital syphilis rates per 100. Puerto Rico converted to electronic reporting in 2006. Surveillance data and updates sent to CDC through NETSS and on hard copy forms through June 8.S. thus 2009 population estimates were used to calculate 2010 rates. Census Bureau and are currently maintained by CDC’s Division of STD Prevention.S. However. Puerto Rico.2 1941–1980 Rates and Population Rates for 1941 through 1980 were based on population estimates from the U. Census Bureau Web site at http://www. As of December 31. the 2010 population estimates will be used to calculate rates in the upcoming 2011 STD Surveillance Report. U. 1941–2010 Congenital Syphilis Rates and Live Births The congenital syphilis data in Table 1 of this report represent the number of congenital syphilis cases per 100.S. as well as from electronically submitted line-listed data. These files were prepared by the U. 2011. resident population. Census Bureau population estimates for 1981 through 1989. 1981–1989 Rates and Population Rates were calculated by using U.000 live births for all years during 1941–2010.

case reports) is assigned by year of birth.. missing.000. Missing. In short. these data were derived from county data. MSAs are not intended to be a general purpose geographic framework for nonstatistical activities or for use in program funding formulas. Thus. Race/ Ethnicity.gov/population/ estimates/metro-city/03mfips. STD clinics) has been more complete than from other sources (e. The MSA concept has been used as a statistical representation of the social and economic links between urban cores and outlying. MSAs are defined by the OMB to provide nationally consistent definitions for collecting. the state’s incidence and population data were excluded from the tables that presented data stratified by one or more of these variables. the names of the second largest and third largest principal cities appear in the title in order of descending population size. trends should be minimally affected by these differences. MSAs do not equate to an urban-rural classification.g. which were used to estimate city-specific disease rates. or invalid data for age group. Management of Unknown.3 Congenital syphilis rates for 1989 through 2005 were calculated by using live birth data that are based on information coded by the states and provided to the NCHS through the Vital Statistics Cooperative Program. and sex exceeded 50% for any state. If there are multiple principal cities. Prior to the publication of Sexually Transmitted Disease Surveillance 2010. and by disease for reported STDs (Table A1). race/ethnicity. In many state and local STD jurisdictions. and sex varies from year to year. Because county data were used to estimate cityspecific morbidity and because current STD project areas’ reporting practices do not support direct identification of city-specific morbidity reports. STD surveillance reports published before 2005 presented data by selected cities.are no longer limited to those diagnosed within the first year of life. missing. and sex. tabulating. comparisons of case numbers and rates between jurisdictions should be interpreted with caution.4 STD Surveillance 2010 An MSA is associated with at least one urbanized area that has a population of at least 50. STD programs that treat all parts of an MSA as if they were as urban as the densely settled core ignore the rural conditions that may exist in some parts of the area. However. integrated areas. The title of an MSA includes the name of the principal city with the largest 2000 census population.txt. or Invalid Data for Age Group. or invalid values for age group. all counties included in MSAs and many other counties contain both urban and rural territory and populations. because case definitions and surveillance activities within a given area remain relatively stable over time.. Thus. missing. Rates for 2006 through 2010 were calculated by using live birth data for 2007. race/ethnicity. MSAs were chosen as a geographic unit smaller than a state or territory for presentation of STD morbidity data. or invalid data were redistributed on the basis of the state’s distribution Appendix: Interpreting STD Surveillance Data 137 . the values for unknown. and Sex The percentage of unknown. Rates of congenital syphilis for 1963 through 1988 were calculated by using published live birth data. The MSA comprises the central county or counties containing the central county. outlying counties that have a high degree of social and economic integration with the central county as measured through commuting..e. go to: http://www. state to state. private practitioners). race/ethnicity. differences in policies and systems for collecting surveillance data may exist. the reporting from publicly supported institutions (e.g. However. For the states for which 50% or more of their data were valid for age group. when the percentage of unknown. For more information on the MSA definitions used in this report. Reporting of Surveillance Data by Metropolitan Statistical Area Sexually Transmitted Disease Surveillance 2010 continues the presentation of STD incidence data and rates for the 50 metropolitan statistical areas (MSAs) with the largest populations according to 2000 census data. Reporting Practices Although most state and local STD programs generally adhere to the national notifiable STD case definitions collaboratively developed by the Council of State and Territorial Epidemiologists and CDC. Congenital syphilis morbidity (i. and publishing federal statistics for a set of geographic areas.census. trends may not be representative of all segments of the population. plus adjacent.

Beginning in 2005. Kansas. Analysis of the data reported electronically after 1996 confirmed that the new STD clinic source of report data corresponded to the earlier public source category. Definition of HHS Regions The 10 regions of the U. As states began reporting morbidity data electronically in 1996. Therefore. neurosyphilis was no longer classified or reported as a distinct stage of syphilis. and other unspecified sources. Georgia. California. All reporting areas had implemented the new case definition for reporting congenital syphilis by January 1. Department of Health and Human Services (HHS) include the following jurisdictions: Region I = Connecticut. Montana. New Hampshire. prenatal/obstetrics clinics. late latent. and Wisconsin. South Carolina. North Dakota. blood banks. secondary. the military.. during 1996–2005. South Dakota. drug treatment clinics. Virgin Islands. private physicians/health maintenance organizations. family planning clinics. neurosyphilis. As a result. Oklahoma. Region II = New Jersey. as well as because of increasing morbidity. mental health providers. and congenital syphilis. school-based clinics. Massachusetts. Region IX = Arizona. states classified the source of case reports as either private source (including private physicians. Michigan.of known age group. The counts presented in this report are summations of all valid data reported in reporting year 2010. Hawaii. Pennsylvania. Region IV = Alabama. and Nevada. Ohio. many state and local STD programs have greatly enhanced active case finding for congenital syphilis since 1988. source of case report data during 1984–2010 are presented as STD clinic or non-STD clinic only (Table A2). Utah. District of Columbia. Virginia. Idaho. redistribution methodology is not applied to any of the data. the National Job Training Program (NJTP). nucleic acid amplification tests).5 In addition. and Nebraska. Syphilis Morbidity Reporting The category of “total syphilis” or “all stages of syphilis” includes primary. In particular. and Wyoming. Region III = Delaware. the syphilis stage “late syphilis with clinical manifestations other than neurosyphilis (late benign and cardiovascular syphilis)” was added to the syphilis case definition (see STD Surveillance Case Definitions in the Appendix). New York. and Tennessee. screening. and U. and latent syphilis of unknown duration). hospitals (inpatient). North Carolina. VI = Arkansas. For these reasons. Region VII = Iowa. correctional facilities. Maine. race/ethnicity. and West Virginia. Although neurosyphilis can occur at almost any stage of syphilis. Oregon.g. 1992. late (including late syphilis with clinical manifestations other than neurosyphilis). Appendix: Interpreting STD Surveillance Data STD Surveillance 2010 . Indiana.S. Minnesota. Region V= Illinois. laboratories. Mississippi. This case definition has greater sensitivity than the former definition. Louisiana. Region VIII = Colorado. the Indian Health Service. and sex data. and Vermont. hospitals. HIV counseling and testing sites. Chlamydia Morbidity Classification of STD Morbidity Reporting Sources Before 1996. rate data that are stratified by one or more of these variables reflect rates based on reported data only. the classification categories for source of case reports expanded to include the following data sources: STD clinics.S. and institutions) or public source (primarily STD clinics). morbidity trends are likely to be influenced by changes in test technology as laboratories expand their use of more sensitive tests (e. New Mexico. Puerto Rico. Kentucky. and Region X = Alaska. and reporting practices than of actual trends in disease incidence. Guam. the surveillance case definition for congenital syphilis was changed. In 1996. Region 138 Trends in chlamydia morbidity reporting from many state and local jurisdictions are more reflective of changes in diagnostic. it was classified and reported as one of several mutually exclusive stages of syphilis. Missouri. tuberculosis clinics. and Texas. the number of reported cases increased dramatically during 1989–1991. Congenital Syphilis Morbidity Reporting In 1988. latent (including early latent. emergency rooms. Florida. and Washington. Maryland. Rhode Island. Beginning with the publication of Sexually Transmitted Disease Surveillance 2010.

Henrico County and Chesterfield County Clinics). and respond rapidly to trends in STDs through enhanced collection. No adjustments for laboratory test type and sensitivity were made to any figures that present test positivity or prevalence data.126) in 1990 (revised April 2010). these data sources may include more than one test from the same person if that person was tested more than once during a year. and laboratory information collected from all patients at 41 STD clinics within the jurisdictions of SSuN health departments. Baltimore City Health Department.In addition to changing the case definition for congenital syphilis. CA (San Francisco City Clinic). The majority of NJTP’s chlamydia screening tests are conducted by a single national contract laboratory. these data are not available to CDC. County of Los Angeles Department of Public Health (in collaboration with California State Department of Public Health). Birmingham. Virginia Department of Health. Various laboratory test methods were used for all of these data sources. The SSuN data contained in this report include demographic. Louisiana Office of Public Health. state. Seattle. cases are classified by the race/ethnicity of the mother. CO (Denver Metro Health Clinic). To increase the stability of the annual prevalence estimates from NJTP. chlamydia or gonorrhea prevalence data are presented when valid test results for 100 or more students per year are available for the population subgroup and state. CA (12 STD clinics in Los Angeles County). Philadelphia Department of Public Health. analysis. Gonorrhea screening tests for male and female students in many training centers are conducted by local laboratories. These clinics are located in San Francisco. PA (Philadelphia STD Clinics 1 and 5). Except for the screening data from NJTP. and local STD programs to detect. Connecticut Department of Public Health. behavioral. LA (Delgado Personal Health Center).and state-specific figures were published with permission from the Infertility Prevention Project (IPP). This form is used to collect individual case information. MD (Druid STD Clinic and Eastern STD Clinic). Cases for previous years are added to CDC’s surveillance databases throughout the year. Congenital syphilis cases were reported by state and city of residence of the mother during 1995–2010. Los Angeles. Test results for students at centers that submit specimens to the national contract laboratory are included only if the number of gonorrhea tests submitted is greater than 90% of the number of chlamydia tests submitted from the same center for the same period. STD Surveillance 2010 Prevalence data for region. Chlamydia and Gonorrhea Prevalence Monitoring Chlamydia and gonorrhea test positivity or prevalence were calculated for women visiting family planning clinics and prenatal clinics. monitor. visualization. Since 1995. Twelve collaborating local or state health departments participate in SSuN: Alabama Department of Public Health. Appendix: Interpreting STD Surveillance Data 139 . and NJTP. and New Haven. Richmond. and men and women entering corrections facilities. and Washington State Department of Health. IL (6 public STD clinics in Cook County). Chicago. NY (9 public STD clinics in 5 boroughs). Hartford. which allows more thorough analysis of case characteristics. CDC established the STD Surveillance Network (SSuN) as a dynamic STD surveillance network comprised of local enhanced STD surveillance systems that follow common protocols. Baltimore. the data collected on this form have been used for reporting congenital syphilis cases and associated rates. San Francisco Department of Public Health. CT (New Haven STD Clinic). and interpretation of disease information. Chicago Department of Public Health. VA (Richmond City. New York City. Congenital syphilis data reported after publication of the current annual STD surveillance report will appear in subsequent reports and are assigned by the case patient’s year of birth. CT (Hartford STD Clinic). AL (Jefferson County STD Clinic). WA (Seattle-King County Clinic). Denver. The purpose of SSuN is to improve the capacity of national. reporting. STD Surveillance Network (SSuN) In 2005. Colorado Department of Public Health and Environment. CDC introduced a new data collection form (CDC 73. men and women entering NJTP. New York City Department of Health and Mental Hygiene. New Orleans. which provides these data to CDC. For the purpose of analyzing race/ ethnicity. Congenital syphilis reporting may be delayed as a result of case investigation and validation. clinical. Philadelphia. selected state STD prevention programs.

but reported that they considered themselves straight/heterosexual (asked at 9 of the 12 sites). Telephone: (800) 523-5334. azithromycin. NHANES became a continuous survey with data released every 2 years. cefixime. The estimates generated by using NHDS data are based on statistical surveys and therefore have sampling variability associated with the estimates. and the collection of biological samples in special mobile examination centers. minimum inhibitory concentration (MIC) ≥0. The antimicrobial susceptibility criteria used in GISP for 2010 are as follows: • Ceftriaxone. • Ciprofloxacin.5 µg/ml (decreased susceptibility). MIC ≥0. For more information.* • Azithromycin. is an ongoing. non-institutionalized population. Gonococcal Isolate Surveillance Project Data on antimicrobial susceptibility in Neisseria gonorrhoeae were collected through the Gonococcal Isolate Surveillance Project (GISP).gov/std/GISP. National Disease and Therapeutic Index The information on the number of initial visits to private physicians’ offices for STDs was based on analysis of data from the National Disease and Therapeutic Index (NDTI) (machine-readable files or summary statistics for 1966 through 2010).gov/nchs/nhds. cefixime. gov/nchs/nhanes. multistage. e-mail: ServiceCenter@ us. For 2010.htm. MIC ≥2.0 µg/ml (resistance). gonorrhoeae.* • Cefpodoxime. Data are collected through household interviews. For more details on findings from GISP. * The Clinical Laboratory Standards Institute criteria for decreased susceptibility and resistance to ceftriaxone.0 µg/ml (decreased susceptibility). For more information. MIC ≥2.0 µg/ml (resistance). MIC ≥1. ciprofloxacin. MIC ≥1. see: http://www.5 µg/ml (intermediate resistance). NDTI is a probability sample survey of private physicians’ clinical management practices. National Hospital Discharge Survey The information on patients hospitalized for pelvic inflammatory disease (PID) or ectopic pregnancy was based on analysis of data from the National Hospital Discharge Survey (NHDS) (machine-readable files for 1980 through 2009. MIC 0. civilian. go to: http:// www. Men who have sex with women (MSW) were defined as men who reported having sex with women only within the 3 months before STD testing or who did not report the sex of their sex partner.125–0. The majority of these criteria are also recommended by the Clinical and Laboratory Standards Institute (CLSI). For more information on this database. • Penicillin. and azithromycin and for susceptibility to azithromycin have not been established for N.cdc. cefpodoxime. MIC ≥2. which is conducted by NCHS.* • Spectinomycin. the antimicrobial agents tested by GISP were ceftriaxone. probability cluster design that selects a sample representative of the U.S.cdc.* • Cefixime. standardized physical examinations.htm.0 µg/ml (decreased susceptibility). a sentinel system of selected STD clinics located at 25–30 GISP sentinel sites and 4–5 regional laboratories in the United States.0 µg/ml (resistance). • Tetracycline.com. • Ciprofloxacin. NHDS.0 µg/ml (resistance).imshealth.Men who have sex with men (MSM) were defined as men who either reported having sex with another man in the 3 months before STD testing (asked at all SSuN sites) or who did not report sex with men but reported that they considered themselves gay/homosexual or bisexual (asked at 9 of the 12 sites).5 µg/ml (decreased susceptibility). and tetracycline. The sampling plan of the survey is a stratified. MIC ≥128.cdc. cefpodoxime. In 1999. nationwide sample survey of medical records of patients discharged from acute care hospitals in the United States. spectinomycin. contact IMS Health. 140 Appendix: Interpreting STD Surveillance Data STD Surveillance 2010 . penicillin. see: http://www.6 Other Surveillance Data Sources National Health and Nutrition Examination Survey The National Health and Nutrition Examination Survey (NHANES) is a series of cross-sectional surveys designed to provide national statistics on the health and nutritional status of the general household population in the United States.

gov/2020/default. 1045]. Census Bureau. DC: U. 3 Office of Management and Budget.S.65(249):82228-38.8 cases per 100. Census Bureau. contains objectives and measures related to STDs. Wiesner PJ.Healthy People 2020 Objectives For three decades. to improve service delivery. 1990. and improve the health of all groups. Hyattsville (MD): U. Vital statistics of the United States 1988. HP2020 is the result of a multiyear process that reflects input from a diverse group of individuals and organizations. U.000 population and gonorrhea (males aged 15–44 years). Jones OG. prevention.S. 4 5 Kaufman RE. yet achievable. In: Current population reports [Series P-25.000 population. Achieve health equity. 198. Promote quality of life. 1990.” STD Surveillance 2010 U. Washington. The majority of the STD-related HP2020 targets were set using a standard percentage improvement with a standard default of a “10 percent improvement over the baseline. 2010. Questionnaire survey of reported early congenital syphilis: problems in diagnosis. and annual progress toward the targets are reported in Table A3.S.200 measures designed drive action that will support its four overarching goals: Government Performance and Results Act of 1993 The Government Performance and Results Act (GPRA) of 1993 was enacted by Congress to increase confidence in the capability of the federal government to increase the effectiveness and accountability of federal programs. M100-S20. 30(1).S. P&S syphilis (females).000 population congenital syphilis.4:135-9. United States population estimates by age. Department of Health and Human Services. Sex Transm Dis. 8. Healthy People 2020 Web site. Blount JH. GPRA requires each agency to have a performance plan with long-term outcomes and annual. 2000. Federal Register. Government Printing Office. Wayne (PA): Clinical and Laboratory Standards Institute. 4. 6 Clinical and Laboratory Standards Institute.0 cases per 100. and focus action. Create social and physical environments that promote good health for all.aspx. 257. Attain high-quality. 2. Washington. and premature death.000 population. Standards for defining metropolitan and micropolitan statistical areas. Sexually Transmitted Diseases. sex and race: 1989.S. No. which are outlined in Table A4. to provide federal agencies a uniform tool for internal management. measurable performance goals and to report on these plans annually. Department of Health and Human Services. sex and race: 1980–1988. United States population estimates by age. with more than 1.1 . 2 Centers for Disease Control and Prevention. 1. and healthy behaviors across all life stages. An additional target is to reduce the Chlamydia trachomatis test positivity to 3% among females aged 15–24 years who visit family planning and STD clinics. HP2020 is organized into 42 topic areas. Healthy People has provided a comprehensive set of national 10-year health promotion and disease prevention objectives aimed at improving the health of all Americans. 1990.0 cases per 100. 1977. Performance standards for antimicrobial susceptibility testing. Baselines. Appendix: Interpreting STD Surveillance Data 141 . gonorrhea (females aged 15–44 years). 7 U. Government Printing Office.7 It is grounded in the principle that establishing objectives and providing benchmarks to track and monitor progress over time can motivate.1 cases per 100. 10-year agenda for improving the Nation’s health. Healthy People 2020 (HP2020) continues in the tradition of its ambitious. eliminate disparities.natality. injury. In: Current population reports [Series P-25. DC: U.4 cases per 100. The year 2020 targets for the diseases addressed in this report are as follows: P&S syphilis (males). 9. vol. 1 3. There are two GPRA goals for STD: reducing PID and eliminating syphilis. longer lives free of preventable disease. 1057]. No. and to help Congress make decisions. twentieth informational supplement. http://healthypeople. The topic area. Each of these goals has specific measures of progress. and treatment. healthy development. HP2020 targets.000 live births. comparing results with annual goals. disability.S. guide. 1.

1 0.9 1.3 * Percentages for primary and secondary syphilis are based on less than 10 cases.6 1.1 0.1 0.0 16. Selected STDs—Percentage of Unknown.0 0.0 0.6 30.2 0.0 0.0 0.0 0.6 28.8 18.0 100.5 18.0 3.0 2.7 21.3 0.0 0.0 0.8 13.0 0.9 6.0 2.0 0.0 0.1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.3 0.0 0.2 0.0 0.3 1.0 0.5 9.5 0.1 0.0 32.0 0.0 0.9 0.5 7.0 0.9 24.7 30.0 0.0 0.0 0.9 0.1 0.8 23.5 0.0 0.3 33.4 29.5 3.0 0.5 0.2 32.0 0.9 4.3 0.0 44.0 0.6 3.0 0.0 26.0 0.9 35.4 0.1 0.5 0.0 0.0 0.1 0.0 5.1 100.0 0.1 0.1 0.2 0.0 0.0 0.6 0.7 0.6 11.9 0.0 0.0 0.0 0.0 23.3 33.0 0.9 25.0 0.0 0.0 15.3 0.9 17.0 0.4 3.0 0.0 0.0 24.7 0.5 27.6 2.4 0.6 0.2 0.0 0.2 18.9 4.1 0.0 0.5 33.3 0.6 51.2 0.0 4.9 100.0 0.1 0.0 0.0 0.0 0.9 0.4 0.0 0.9 8.0 0.0 0.5 0.4 6.3 6.0 0.0 0.0 0.0 0.0 0.7 22.0 0.0 0.5 0.0 0.0 0.0 0.0 0.0 0.Table A1.3 0.5 17.7 12.0 0.1 6.6 0.0 0.0 0.2 0.1 0.7 13.2 0.4 0.1 0.0 0.1 0.0 0.8 0.6 13.9 0.2 10.0 0.3 23.0 0.0 0.0 0.7 0.0 0.0 0.0 0.0 0.1 100.3 21.0 0.0 0.7 10.1 0.0 0.9 19.1 22.4 15.7 9.1 0.0 0.1 15.7 42.0 0.0 0.0 0.0 3.0 0.3 0.8 28.6 22.2 0.2 0.6 0.1 1.2 0.0 0.8 8.0 0.5 34.8 22.0 0.5 0.0 0.9 10.0 0.6 0.0 40.2 0.0 0. NOTE: Unknown includes unknown.2 0.2 0.6 4.9 24.0 17.3 0.2 20.0 0.2 0.1 0.4 18.8 3.0 0.9 5.0 0.1 17.9 0.0 0.0 0.0 0.0 0.8 2.0 0.0 0.1 0.0 0.0 0.0 0.0 0.0 0.3 0.0 0.1 0.0 0.3 28.1 0.7 6.5 55.9 5.1 0.0 0.0 0.1 0.5 15.2 35. TOTAL Gonorrhea Chlamydia Percentage Percentage Unknown Percentage Percentage Percentage Unknown Percentage Percentage Race/ Unknown Unknown Unknown Race/ Unknown Unknown Ethnicity Age Sex Sex Partner Ethnicity Age Sex 0.2 2.1 0.0 0.9 39.0 0.0 0.3 60.1 19.7 0.1 4.1 0.1 20.0 0.7 1.0 0.5 0.0 0.0 0.2 2.0 0.4 0.2 0.2 0.0 0.0 16.0 0.2 33.0 0.6 3.6 18.0 0.9 16.0 0.0 0.0 0.0 0.0 0.1 0.6 36.0 0.7 12. or invalid data values.1 0.0 0.0 0.3 17.0 0.0 2.2 27.0 0.0 0.7 32.0 12.0 0.0 0.3 0.5 20.4 0.0 0.0 1.1 28.0 0.0 0.2 41.0 0.0 0.6 0.6 7.0 0. 142 Appendix: Percentage Unknown STD Surveillance 2010 .0 2.0 0.0 0.0 0.2 1.1 0.0 0.0 0.4 Percentage Unknown Percentage Percentage Race/ Unknown Unknown Ethnicity Age Sex 30.2 0. or Invalid Values for Selected Variables by State and by Nationally Notifiable STD.0 0.S.0 0.1 11.6 0.0 3.0 0.0 26.4 0.2 2.2 0.2 1.0 0.2 0.0 0.8 0.4 31.0 0.0 19.3 12.2 21.0 0.4 0.6 0.2 6.1 47.0 0.2 17.6 37.0 0.0 0.0 0.4 4.4 26.0 0.0 19.0 0.2 0.2 9.4 26.0 0.0 0.7 7.6 13.0 0.6 100.0 0.0 0.0 0.0 0.0 0.0 0.4 30.0 0.0 0.0 0.0 0.0 0.9 32.4 9.9 34.7 37.3 0.1 0.0 0.2 0.3 66.4 35.0 1.5 19.1 0.1 0.0 0.2 0.3 0.0 0.2 0.1 14.4 2.0 0.5 0.7 58. 2010 Primary and Secondary Syphilis State Alabama Alaska* Arizona Arkansas California Colorado Connecticut Delaware* District of Columbia Florida Georgia Hawaii Idaho* Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana* Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota* Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota* Tennessee Texas Utah Vermont* Virginia Washington West Virginia* Wisconsin Wyoming* U.0 0.6 28.0 0.0 0.1 0.1 0.7 46.6 21.0 0.7 5.1 0.3 0.2 22.6 0.0 0.6 41.0 0.2 35.0 0.1 0.8 2.0 0.0 0.3 2.1 0.0 18.1 0.1 4.0 40.1 0.0 0.9 28.0 0.3 17.0 0.0 0.1 0.0 0.0 0.0 0.5 0.0 0.0 0.2 0.0 0.6 0.6 0.0 8.0 0.0 0.0 0.0 0.0 0.0 0.8 0.1 0. Missing.2 0.4 0.2 8.3 0.1 0.4 0.0 0.0 0.0 0.0 1.7 0.0 0. missing.0 0.0 0.6 32.4 0.4 14.1 1.0 0.3 10.2 0.0 0.0 0.8 21.2 19.0 0.9 0.0 0.

† Total includes unknown reporting source.302 190 1.095 7.550 3.893 309.731 10. neurosyphilis.902 37. Reported Cases of STDs by Reporting Source and Sex.058 4.899 86.561 12.237 13.359 9.250 8.832 1. 2010 Non-STD Clinic Disease Chlamydia Gonorrhea Primary syphilis Secondary syphilis Early latent syphilis Late and late latent syphilis§ Chancroid Male 222. ‡ § Total includes unknown sex and reporting source.496 3.598 11 Total* 985.802 165. STD Surveillance 2010 Appendix: STD Reporting Source 143 .681 73 359 785 885 2 Total Total* 170. and late syphilis with clinical manifestations other than neurosyphilis.808 2.034 210.827 19 STD Clinic Male 89.728 123.096 10 Female† 949.431 13. Late and late latent syphilis includes late latent syphilis.470 3.341 3.568 1.169 2 Female 80.155 9.923 142.732 2. United States.173 2.693 284 1.221 7.149 57.007 5.307.689 3.604 18. latent syphilis of unknown duration.330 2.062 4 Male† 353.079 24 * Total includes unknown sex.762 2.Table A2.861 13 Total‡ 1.537 10.029 6.055 2.100 2.166 8 Female 759.091 19.

4% 54. CDC NHANES..9 8. Females aged 21 to 24 years 5 Reduce the proportion of females aged 15 to 44 who have ever required treatment for pelvic inflammatory disease (PID) 6 Reduce gonorrhea rates a. NCHHSTP.2% 6.7% 11.8% 45.1% 43.99% 40.4% 12.5% N/A N/A N/A N/A N/A N/A N/A 9. NCHS and the National Health Interview Survey (NHIS).4 6. NCHHSTP.. Females with types 6 and 11 b. National Committee for Quality Assurance (NCQA) Healthcare Effectiveness Data and Information Set (HEDIS). NCHS NHANES.. CDC.. CDC Healthcare Effectiveness Data and Information Set (HEDIS).5% N/A N/A N/A 2005-2008 Data Source STD Surveillance System (STDSS).5% 2008 7.5% 3.3% 74. NCHHSTP.Table A3.3 N/A N/A 2008 2008 52.8% 8.6% 62. CDC.0% 7.0 2008 2008 2008 1. National Committee for Quality Assurance (NCQA) National Survey of Family Growth (NSFG). CDC. CDC NHANES. CDC STD Surveillance System (STDSS)..5 7. b 7 a.7% N/A 65. Females aged 21 to 24 years 4 Increase the proportion of sexually active females aged 24 years and under enrolled in commercial health insurance plans who are screened for genital Chlamydia infections during the measurement year a.4% 80.59% 2008 2008 284.7% 59.0% 11. Among females b. Among males aged 24 years and under enrolled in a National Job Training Program 2 Reduce Chlamydia rates among females aged 15 to 44 years (DEVELOPMENTAL) 3 Increase the proportion of sexually active females aged 24 years and under enrolled in Medicaid plans who are screened for genital Chlamydia infections during the measurement year a. Healthy People 2020 (HP 2020) Sexually Transmitted Diseases Objectives HP2020 Objectives 1 Reduce the proportion of adolescents and young adults with Chlamydia trachomatis infections a.4 258. Females aged 16 to 20 years b. NCHHSTP.1 10.6 10. NCHS Appendix: Healthy People 2020 STD Surveillance 2010 . CDC STD Surveillance System (STDSS). STD Surveillance System (STDSS). b 5 6 a. NCHS.0 198. Males aged 15 to 44 years 7 Reduce sustained domestic transmission of primary and secondary syphilis a.3% 1.0 219.7 1. Females with other types 10 Reduce the proportion of young adults with genital herpes infection due to herpes simplex type 2 HP2020 Objective 1a 1 b. Females aged 16 to 20 years b. Females with types 16 and 18 c. Among males 8 Reduce congenital syphilis 9 Reduce the proportion of females with human papillomavirus (HPV) infection (DEVELOPMENTAL) a.493. CDC STD Surveillance System (STDSS). b 9c 10 144 Baseline Year Baseline 2010 HP 2020 Target 2008 2008 7. Among females aged 24 years and under enrolled in a National Job Training Program c. CDC National Job Training Program. NCHHSTP.9% 78.4 257.8 9. c 2 3 a. CDC STD Surveillance System (STDSS). NCHHSTP.7 205. Among females aged 15 to 24 years attending family planning clinics b.3% 3..0% 2008 2008 2006-2008 40.1 7. Females aged 15 to 44 years b. b 4 a.1 1. b 8 9 a.4% 6.

CDC STD Surveillance System (STDSS).0:1 10. 000 population.3% 11.2 2.0 9.0:1 7. NCHHSTP. Incidence of gonorrhea/100.1 17.Table A4.000 12.6 1. NCHHSTP. P&S= primary and secondary. CDC STD Surveillance System (STDSS).000 89.000 population) a.4 8. CDC STD Surveillance System (STDSS).7 9. men b.4% 11. Incidence of congenital syphilis/100.8% 11. PID= pelvic inflammatory disease. STD Surveillance 2010 Appendix: GPRA Goals 145 .7 8. Incidence of P&S syphilis/100. NCHHSTP.5 4.7% 285 255 259 288 4.8 1.5 6.9 1.000 100.5 10. GPRA= Government Performance and Results Act. STD Surveillance System (STDSS). Prevalence of chlamydia in women <25 years at high-risk* b.5:1 Data Source National Disease and Therapeutic Index (IMS Health) National Job Training Program Regional Infertility Prevention Projects (IPP). 000 population in women 15–44 years of age Goal 2: Elimination of Syphilis (as measured by incidence of P&S Syphilis/100. NCHHSTP. CDC *Median state-specific chlamydia prevalence/positivity. NCHHSTP. CDC STD Surveillance System (STDSS).6 4.0 7.000 113. Government Performance and Results Act (GPRA) Sexually Transmitted Diseases Goals and Measures Actual Performance GPRA Goals Goal 1: Reduction in PID (as measured by initial visits to physicians in women 15–44-years of age) a. Incidence of P&S syphilis/100.4 10. 000 live births d. 000 population.1 8. NCHHSTP. women c. Black:white rate ratio of P&S syphilis GPRA Goals 1 1–a 1–b 2 2–a 2–b 2–c 2–d Long-term Goal 2008 2009 2010 2011 104. CDC STD Surveillance System (STDSS).1:1 7.

ducreyi from a clinical specimen Case classification Probable: a clinically compatible case with both a) no evidence of Treponema pallidum infection by darkfield microscopic examination of ulcer exudate or by a serologic test for syphilis performed ≥7 days after onset of ulcers and b) either a clinical presentation of the ulcer(s) not typical of disease caused by herpes simplex virus (HSV) or a culture negative for HSV. Case definitions for infectious conditions under public health surveillance. Laboratory criteria for diagnosis • Isolation of C. The disease is caused by infection with Haemophilus ducreyi. cervicitis. cervicitis. 1997. or salpingitis.STD Surveillance Case Definitions PART 1. the infection is often asymptomatic in women. acute salpingitis. MMWR Morb Mortal Wkly Rep. 146 Appendix: STD Surveillance Case Definitions STD Surveillance 2010 . epididymitis. or other syndromes when sexually transmitted. RR-10). trachomatis include lymphogranuloma venereum (see Lymphogranuloma Venereum) and trachoma. CASE DEFINITIONS1 FOR NATIONALLY NOTIFIABLE INFECTIOUS DISEASES Chancroid (Revised 9/96) Clinical description A sexually transmitted disease characterized by painful genital ulceration and inflammatory inguinal adenopathy. trachomatis in a clinical specimen by detection of antigen or nucleic acid Case classification Confirmed: a case that is laboratory confirmed Gonorrhea (Revised 9/96) Clinical description A sexually transmitted infection commonly manifested by urethritis. Other syndromes caused by C. Laboratory criteria for diagnosis • Isolation of H.46(No. Infection may be asymptomatic. 1 Centers for Disease Control and Prevention. Infection (Revised 6/09) Clinical description Infection with Chlamydia trachomatis may result in urethritis. 1997. trachomatis by culture or • Demonstration of C. Perinatal infections may result in inclusion conjunctivitis and pneumonia in newborns. Confirmed: a clinically compatible case that is laboratory confirmed Chlamydia trachomatis. however.

pallidum and characterized by localized or diffuse mucocutaneous lesions. The primary chancre may still be present. Syphilis. gonorrhoeae in a clinical specimen by detection of antigen or nucleic acid. or equivalent methods Case classification Probable: a clinically compatible case with a nontreponemal (VDRL or RPR) titer ≥4 Confirmed: a clinically compatible case that is laboratory confirmed STD Surveillance 2010 Appendix: STD Surveillance Case Definitions 147 . secondary Clinical description A stage of infection caused by T. DFA-TP. direct fluorescent antibody (DFA-TP). primary Clinical description A stage of infection with Treponema pallidum characterized by one or more chancres (ulcers). chancres might differ considerably in clinical appearance. oxidase-positive diplococci (presumptive Neisseria gonorrhoeae) from a clinical specimen.Laboratory criteria for diagnosis • Isolation of typical gram-negative. or equivalent methods Case classification Probable: a clinically compatible case with one or more ulcers (chancres) consistent with primary syphilis and a reactive serologic test (nontreponemal: Venereal Disease Research Laboratory [VDRL] or rapid plasma reagin [RPR]. pallidum [MHA-TP]) Confirmed: a clinically compatible case that is laboratory confirmed Syphilis. Classification by a clinician with expertise in syphilis may take precedence over the following case definitions developed for surveillance purposes. Laboratory criteria for diagnosis • Demonstration of T. pallidum in clinical specimens by darkfield microscopy. treponemal: fluorescent treponemal antibody absorbed [FTA-ABS] or microhemagglutination assay for antibody to T. or • Demonstration of N. often with generalized lymphadenopathy. or • Observation of gram-negative intracellular diplococci in a urethral smear obtained from a male Case classification Probable: a) demonstration of gram-negative intracellular diplococci in an endocervical smear obtained from a female or b) a written morbidity report of gonorrhea submitted by a physician Confirmed: a case that is laboratory confirmed Syphilis (All Definitions Revised 9/96) Syphilis is a complex sexually transmitted disease that has a highly variable clinical course. Laboratory criteria for diagnosis • Demonstration of T. pallidum in clinical specimens by darkfield microscopy.

late. Case classification Probable: latent syphilis (see Syphilis.Syphilis. Case classification Probable: latent syphilis (see Syphilis. latent) in a patient who has no evidence of having acquired the disease within the preceding 12 months (see Syphilis. VDRL or RPR). latent) in a person who has evidence of having acquired the infection within the previous 12 months based on one or more of the following criteria: • Documented seroconversion or fourfold or greater increase in titer of a nontreponemal test during the previous 12 months • A history of symptoms consistent with primary or secondary syphilis during the previous 12 months • A history of sexual exposure to a partner who had confirmed or probable primary or secondary syphilis or probable early latent syphilis (documented independently as duration <1 year) • Reactive nontreponemal and treponemal tests from a person whose only possible exposure occurred within the preceding 12 months Syphilis. Case classification Probable: no clinical signs or symptoms of syphilis and the presence of one of the following: • No past diagnosis of syphilis. and a reactive treponemal test (i. latent syphilis is classified as early latent. latent syphilis is classified as latent syphilis of unknown duration. Syphilis. of unknown duration Clinical description A subcategory of latent syphilis. and the patient is aged 13–35 years and has a nontreponemal titer ≥32 148 Appendix: STD Surveillance Case Definitions STD Surveillance 2010 . Case classification Probable: latent syphilis (see Syphilis. latent Clinical description A stage of infection caused by T. latent. pallidum in which organisms persist in the body of the infected person without causing symptoms or signs. a reactive nontreponemal test (i. When initial infection has occurred within the previous 12 months. latent syphilis is classified as late latent. When the date of initial infection cannot be established as having occurred within the previous year and the patient’s age and titer meet criteria described below.e. FTA-ABS or MHA-TP) • A past history of syphilis therapy and a current nontreponemal test titer demonstrating fourfold or greater increase from the last nontreponemal test titer Syphilis.. When initial infection has occurred >1 year previously.e. early latent Clinical description A subcategory of latent syphilis. early latent) and whose age and titer do not meet the criteria specified for latent syphilis of unknown duration. Latent syphilis is subdivided into early.. late latent Clinical description A subcategory of latent syphilis. latent) that does not meet the criteria for early latent syphilis. and unknown categories based on the duration of infection.

In 2005. and skeletal muscle) may be involved. or other structures with a reactive treponemal test. bone. if the patient has confirmed or probable neurosyphilis. Rarely. the Division of STD Prevention requested that STD control programs discontinue classifying and reporting neurosyphilis as a distinct stage of syphilis. and bone. mouth. in the absence of other known causes of these abnormalities. abdominal organs. a negative VDRL in CSF. between 1996 and 2005. lymph nodes. with clinical manifestations other than neurosyphilis (late benign syphilis and cardiovascular syphilis) Clinical description Clinical manifestations of late syphilis other than neurosyphilis may include inflammatory lesions of the cardiovascular system. it was classified and reported as one of several mutually exclusive stages of syphilis. and without CSF abnormalities and clinical symptoms or signs consistent with neurosyphilis Confirmed: a clinically compatible case that is laboratory confirmed Comment Analysis of CSF for evidence of neurosyphilis is necessary in the evaluation of late syphilis with clinical manifestations.g. STD Surveillance 2010 Appendix: STD Surveillance Case Definitions 149 . Laboratory criteria for diagnosis Demonstration of T. pallidum in late lesions by fluorescent antibody or special stains (although organisms are rarely visualized in late lesions) Case classification Probable: characteristic abnormalities or lesions of the cardiovascular system.Neurosyphilis Note Since neurosyphilis can occur at almost any stage of syphilis. Clinical description Evidence of central nervous system infection with T. skin. late. the upper and lower respiratory tracts. the case should be reported as the appropriate state of syphilis and neurological manifestations should be noted. Late syphilis usually becomes clinically manifest only after a period of 15–30 years of untreated infection. reproductive organs. pallidum Laboratory criteria for diagnosis • A reactive serologic test for syphilis and reactive VDRL in cerebrospinal fluid (CSF) Case classification Case classification Probable: syphilis of any stage. and both of the following: • Elevated CSF protein or leukocyte count in the absence of other known causes of these abnormalities • Clinical symptoms or signs consistent with neurosyphilis without other known causes for these clinical abnormalities Confirmed: syphilis of any stage that meets the laboratory criteria for neurosyphilis Syphilis. other structures (e. Since 2005. eye.. skin.

regardless of signs in the infant. or autopsy material Case classification Probable: a condition affecting an infant whose mother had untreated or inadequately treated* syphilis at delivery. or other specific stains in specimens from lesions. rhagades. syphilitic stillbirths should be reported as cases of congenital syphilis. pallidum by darkfield microscopy. saddle nose. as well as IgM antibodies. mulberry molars. nerve deafness. An older child may have stigmata (e. and only severe cases are clinically apparent at birth. the possibility of sexual abuse should be considered as a cause of acquired rather than congenital syphilis.Syphilitic Stillbirth Clinical description A fetal death that occurs after a 20-week gestation or in which the fetus weighs >500 g and the mother had untreated or inadequately treated* syphilis at delivery Comment For reporting purposes. placenta. or edema (nephrotic syndrome and/or malnutrition). umbilical cord. * Inadequate treatment consists of any nonpenicillin therapy or penicillin administered <30 days before delivery. Abnormal values for CSF VDRL. Syphilis. rash. and protein. anemia. A wide spectrum of severity exists. anterior bowing of shins. interstitial keratitis. frontal bossing. Laboratory criteria for diagnosis • Demonstration of T. snuffles. Signs of congenital syphilis may not be obvious. In a young child. or an infant or child who has a reactive treponemal test for syphilis and any one of the following: • Any evidence of congenital syphilis on physical examination • Any evidence of congenital syphilis on radiographs of long bones • A reactive cerebrospinal fluid (CSF) venereal disease research laboratory (VDRL) • An elevated CSF cell count or protein (without other cause) • A reactive fluorescent treponemal antibody absorbed—19S-IgM antibody test or IgM enzyme-linked immunosorbent assay Confirmed: a case that is laboratory confirmed Comment Congenital and acquired syphilis may be difficult to distinguish when a child is seropositive after infancy. cell count. Congenital (Revised 9/96) Clinical description A condition caused by infection in utero with Treponema pallidum. Hutchinson teeth. congenital syphilis includes cases of congenitally acquired syphilis among infants and children as well as syphilitic stillbirths. depending on the clinical picture. may be found in either congenital or acquired syphilis. The decision may ultimately be based on maternal history and clinical judgment. jaundice (nonviral hepatitis). fluorescent antibody. or Clutton joints). For reporting purposes. condyloma lata. 150 Appendix: STD Surveillance Case Definitions STD Surveillance 2010 . and stigmata may not yet have developed..g. An infant or child (aged <2 years) may have signs such as hepatosplenomegaly. Findings on radiographs of long bones may help because radiographic changes in the metaphysis and epiphysis are considered classic signs of congenitally acquired syphilis. pseudoparalysis.

46(No. 1 Centers for Disease Control and Prevention. painful genital or anal lesions Laboratory criteria for diagnosis • Isolation of herpes simplex virus from cervix. urethra.PART 2. or • Demonstration of multinucleated giant cells on a Tzanck smear of scrapings from an anogenital lesion Case classification Probable: a clinically compatible case (in which primary and secondary syphilis have been excluded by appropriate serologic tests and darkfield microscopy. or anogenital lesion. perineum. The first diagnosis for a patient with no previous diagnosis should be reported. exophytic (raised) growths on the internal or external genitalia. MMWR Morb Mortal Wkly Rep. STD Surveillance 2010 Appendix: STD Surveillance Case Definitions 151 . The first diagnosis for a patient with no previous diagnosis should be reported. 1997. or • Demonstration of virus by antigen detection technique in clinical specimens from cervix. RR-10). CASE DEFINITIONS1 FOR NON-NOTIFIABLE INFECTIOUS DISEASES Genital Herpes (Herpes Simplex Virus) (Revised 9/96) Clinical description A condition characterized by visible. 1997. urethra. Case definitions for infectious conditions under public health surveillance. Genital Warts (Revised 9/96) Clinical description An infection characterized by the presence of visible. when available) with either a diagnosis of genital herpes based on clinical presentation (without laboratory confirmation) or a history of one or more previous episodes of similar genital lesions Confirmed: a clinically compatible case that is laboratory confirmed Comment Genital herpes should be reported only once per patient. or anogenital lesion. or perianal region Laboratory criteria for diagnosis • Histopathologic changes characteristic of human papillomavirus infection in specimens obtained by biopsy or exfoliative cytology or • Demonstration of virus by antigen or nucleic acid detection in a lesion biopsy Case classification Probable: a clinically compatible case without histopathologic diagnosis and without microscopic or serologic evidence that the growth is the result of secondary syphilis Confirmed: a clinically compatible case that is laboratory confirmed Comment Genital warts should be reported only once per patient.

or L3 serovars of Chlamydia trachomatis may result in a disease characterized by genital lesions. L2. or antigen or nucleic acid detection. Laboratory criteria for diagnosis • Demonstration of intracytoplasmic Donovan bodies in Wright or Giemsa-stained smears or biopsies of granulation tissue Case classification Confirmed: a clinically compatible case that is laboratory confirmed Lymphogranuloma Venereum Clinical description Infection with L1. Gram stain. trachomatis complement fixation titer of >64 Confirmed: a clinically compatible case that is laboratory confirmed Mucopurulent Cervicitis (Revised 9/96) Clinical description Cervical inflammation that is not the result of infection with Neisseria gonorrhoeae or Trichomonas vaginalis. serotype L1. trachomatis. The infection is usually sexually transmitted. or L3 from clinical specimen. Laboratory criteria for diagnosis • Isolation of C.Granuloma Inguinale Clinical description A slowly progressive ulcerative disease of the skin and lymphatics of the genital and perianal area caused by infection with Calymmatobacterium granulomatis. or • Positive microimmunofluorescent serologic test for a lymphogranuloma venereum strain of C. cottontipped swab (positive swab test) • Induced endocervical bleeding (bleeding when the first swab is placed in the endocervix) Laboratory criteria for diagnosis • No evidence of N. trachomatis Case classification Probable: a clinically compatible case with one or more tender fluctuant inguinal lymph nodes or characteristic proctogenital lesions with supportive laboratory findings of a single C. Cervical inflammation is defined by the presence of one of the following criteria: • Mucopurulent secretion (from the endocervix) that is yellow or green when viewed on a white. gonorrhoeae by culture. or • Demonstration by immunofluorescence of inclusion bodies in leukocytes of an inguinal lymph node (bubo) aspirate. or hemorrhagic proctitis. suppurative regional lymphadenopathy. L2. and no evidence of T. vaginalis on wet mount 152 Appendix: STD Surveillance Case Definitions STD Surveillance 2010 . A clinically compatible case would have one or more painless or minimally painful granulomatous lesions in the anogenital area.

and • Adnexal tenderness STD Surveillance 2010 Appendix: STD Surveillance Case Definitions 153 . Nongonococcal Urethritis (Revised 9/96) Clinical description Urethral inflammation that is not the result of infection with Neisseria gonorrhoeae. urogenital anatomic anomaly. Genital Infections). The syndrome may result from infection with any of several agents (see Chlamydia trachomatis. Gram stain. gonorrhoeae infection by culture. ectopic pregnancy. Urethral inflammation may be diagnosed by the presence of one of the following criteria: • A visible abnormal urethral discharge.. trichomoniasis. trachomatis infection should be classified as chlamydia. a clinically compatible illness should be classified as MPC. or • Microscopic evidence of urethritis (≥5 white blood cells per high-power field) on a Gram stain of a urethral smear Laboratory criteria for diagnosis • No evidence of N. If gonorrhea and chlamydia are excluded. or antigen or nucleic acid detection Comment Nongonococcal urethritis (NGU) is a clinical diagnosis of exclusion. Gram stain. and • Tenderness with motion of the cervix. In a female who has lower abdominal pain and who has not been diagnosed as having an established cause other than pelvic inflammatory disease (PID) (e. Genital Infection). If gonorrhea. An illness in a female that meets the case definition of MPC and C. all the following clinical criteria must be present: • Lower abdominal tenderness. or antigen or nucleic acid detection Case classification Confirmed: a clinically compatible case in a male in whom gonorrhea is not found. fallopian tubes. acute appendicitis.Case classification Confirmed: a clinically compatible case in a female who does not have either gonorrhea or trichomoniasis Comment Mucopurulent cervicitis (MPC) is a clinical diagnosis of exclusion. either by culture. a clinically compatible illness should be classified as NGU. An illness in a male that meets the case definition of NGU and C. or recent urinary tract instrumentation. Pelvic Inflammatory Disease (Revised 9/96) Clinical case definition A clinical syndrome resulting from the ascending spread of microorganisms from the vagina and endocervix to the endometrium. prostate enlargement. The syndrome may result from infection with any of several agents (see Chlamydia trachomatis.g. and/or contiguous structures. and chlamydia are excluded. and functional pain). or • A positive leukocyte esterase test from a male aged <60 years who does not have a history of kidney disease or bladder infection. trachomatis infection should be classified as chlamydia.

In addition to the preceding criteria.000 white blood cells/mm3 • Purulent material in the peritoneal cavity obtained by culdocentesis or laparoscopy • Pelvic abscess or inflammatory complex detected by bimanual examination or by sonography • Patient is a sexual contact of a person known to have gonorrhea.4 F (>38. or nongonococcal urethritis Case classification Confirmed: a case that meets the clinical case definition Comment For reporting purposes.0 C) • Leukocytosis >10. a clinician’s report of PID should be counted as a case. 154 Appendix: STD Surveillance Case Definitions STD Surveillance 2010 . chlamydia. at least one of the following findings must also be present: • Meets the surveillance case definition of C. trachomatis infection or gonorrhea • Temperature >100.

state and territorial epidemiologists.I. and laboratory directors. Shahied Kerry Buchs Ewa King Arthur Wozniak Michael Smith David Smalley Grace Kubin Barbara Jepson Mary Celotti James Pearson Romesh Gautom Andrea Labik Charles Brokopp Richard Harris Utoofili Mago Paul Lalita Kevin Villagomez Josie O’Mallan Maritza Muniz Francis Permeteet Joseph Mark 155 . Dee Brown Christine Bean Dennis Flynn David Mills Lawrence Sturman Sara Beatrice Leslie Wolf Myra Kosse Rosemarie Gearhart Robin Botchlet Michael Skeels S. The persons listed were in the positions shown as of September 8. 2011. State/City/Outlying Area Alabama Alaska Arizona Arkansas California Los Angeles San Francisco Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Chicago Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Baltimore Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York New York City North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Philadelphia Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming American Samoa Federated States of Micronesia Government of the Marshall Islands Northern Marianas (CNMI) Guam Puerto Rico Republic of Palau Virgin Islands STD Surveillance 2010 STD Project Directors STD Program Managers Vacant Susan Jones Judy Norton Tina Long Jacqueline Mincks Peter Kerndt Susan Philip Ralph Wilmoth Matthew Cartter Catherine Mosley Gregory Pappas Stacy Shiver Anil Mangla Peter Whiticar Kathy Cohen Richard Zimmerman Chris Brown Larry Harris Randy Mayer Brenda Walker Robert Brawley DeAnn Gruber James Markiewicz Barbara Conrad Vacant Brenda Cole Kristine Judd Christine Jones Nicholas Mosca Michael Herbert Laurie Kops Sandy Klocke Richard Whitley Christine Adamski Gary Ludwig Daniel Burke Bob Reed Susan Blank Pete Moore Vacant Bill Tiedemann Jan Fox Vada Latin Beth Butler Caroline Johnson Utpala Bandy Dennis Murphy Vacant Jeanece Seals Ann Robbins Emily Holmes Daniel Daltry Kathryn Hafford Mark Aubin Loretta Haddy Diane Christen Brownen Anderson Elizabeth Ponausuia Vita Skilling Richard Trinidad Joseph Villagomz Josie O’Mallan Greduvel Duran-Guzman Victor Yano Darlene Carty Jane Cheeks Donna Cecere Roxanne Ereth Mark Morehead Romni Neiman Yolanda Cavalier Wendy Wolf Rebecca Jordan Heidi Jenkins Catherine Mosley Kim Seechuk Daniel George Michelle Allen Venie Lee Annabeth Elliott Richard Zimmerman John Paffel Andrea Allen Randy Mayer Derek Coppedge Chang Lee Dee Cordova James Markiewicz Glen Oltoff Victoria Stovall Brenda Cole Kristine Judd Peter Carr Vacant Michael Herbert Vacant Jeri Weberg-Bryce Sandra Noffsinger Lindsay Pierce Patricia Mason Carmelita Garcia Vacant Vacant Jacqueline Clymore Julie Wagendorf Jen Keagy Kristen Eberly Doug Harger Steve Kowalewski Melinda Salmon Michael Gosciminski Janice Tapp Amanda Gill Lauarie Anderson Jim Lee Lynn Meinor Daniel Daltry Theresa Henry Mark Aubin Loretta Haddy Anthony Wade Canyon Hardesty Fara Utu Mayleen Ekiek Justina Langidrik John Dax Moreno Bernadette Schumann Trinidad Garcia Johana Ngiruchelbad Gritell Martinez Appendix: Contributors State Epidemiologists Laboratory Directors Kelly Stevens Joe McLaughlin Kenneth Komatsu Nathaniel Smith Gilberto Chavez Gilberto Chavez Gilberto Chavez Ken Gershman Matthew Cartter Marjorie Shannon John Davies-Cole Richard Hopkins Cherie Drenzek Sarah Park Christine Hahn Craig Conover Craig Conover Pamela Pontones Patricia Quinlisk Charles Hunt Kraig Humbaugh Raoult Ratard Stephen Sears David Blythe David Blythe Alfred DeMaria Corrine Miller Ruth Lynfield Paul Byers George Turabelidze Carol Ballew Thomas Safranek Ishan Azzam Sharon Alroy-Preis Christina Tan C. Christian Whelen Christopher Ball Tom Johnson Susan Gerber Judith Lovchik Christopher Atchison Leo Henning Stephanie Gibson Stephen Martin Kenneth Pote Robert Myers Jack DeBoy Linda Han) Frances Downes Joanne Bartkus Daphne Ware Bill Whitmar Susanne Zanto Steve Hinrichs L. Mack Sewell Millicent Eidson (Acting) Perry Smith Megan Davies Kirby Kruger Mary DiOrio (Acting) Kristy Bradley Katrina Hedberg Maria Moll (Acting) Maria Moll (Acting) Utpala Bandy James Gibson Lon Kightlinger Tim Jones Thomas Erlinger Robert Rolfs Patsy Kelso Keri Hall Juliet Van Eenwyk Loretta Haddy Jeffrey Davis Tracy Murphy Sharmain Mageo Vita Skilling James Hosfschneider Josephine O’Mallan John Rullan Julie Erb-Alvarez Eugene Tull Sharon Massingale Bernard Jilly Victor Waddell Glen Baker Paul Kimsey Mary Beth Duke (Acting) Sally Liska David Butcher John Fontana Christina Pleasanton Maurice Knuckles Max Salfinger Elizabeth Franko A.Contributors We gratefully acknowledge the contributions of state STD project directors. STD program managers.

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