Gonorrhea cases more than double in S.D.

Gonorrhea cases in South Dakota more than doubled since 2009, while syphilis has gone from just a handful of cases to dozens.

Chlamydia, the most common sexually transmitted disease, was up 25 percent last year from 2013.

They are among the diseases monitored by the South Dakota Department of Health, which released statistics this week on the prevalence of infectious diseases. They show a steady, and in some cases dramatic, increase in STDs over the years

Not all infectious diseases were up, and some serious ones were down. But preventable diseases – STDs that can be prevented by behavior and some diseases that can be prevented with vaccines – were up.

In 2011, the state recorded zero cases of syphilis. There were 79 last year.

“Now we’ve got one of the highest syphilis rates in the country,” said state epidemiologist Lon Kightlinger.

South Dakota finished 2014 with 847 identified cases of gonorrhea, 63 more than 2013 and 502 more than the state had in 2009. The rate means there are more than 100 cases per 100,000 people. In 2013, Louisiana led the nation with 188.4 cases per 100,000, while New Hampshire had just 9.2, according to the Centers for Disease Control and Prevention.

Kightlinger theorizes that the increase in STDs over the last few years corresponds to social media and the Internet, which has made it easier for people to find anonymous sex partners.

The numbers are disconcerting for public health workers. During the HIV/AIDS epidemic of the 1980s, sexual behavior changed dramatically and there were rapid decreases across the board in STDs. But, nationally, HIV rates have plateaued and other STDs are increasing.

“You saw dramatic change in behavior,” said Dr. Wendell Hoffman, an infectious disease expert at Sanford Health. “However, over time, those behavioral changes were not sustained.”

Public health experts face a challenge about conveying the threats. Abstinence, Hoffman said, might be laughed at in some quarters, but it is the only foolproof way to avoid STDs. For those who are sexually active, they need to understand how to limit their exposure.

The stakes are getting higher as diseases become drug resistant. The Sioux Falls region, Hoffman said, has cases of drug-resistant Gonorrhea.

“We are reaching a time in the world when we may not have any antibiotics to treat those organisms,” Hoffman said.

Jen Aulwes, the spokeswoman for Planned Parenthood in the three-state region of Minnesota, North Dakota and South Dakota, said sex education for youths is a critical component to public health. Sex education, she added, has been criticized by some for encouraging young people to engage earlier in sex, but research shows that education actually delays sex among the young and, when it does occur, encourages safe sex.

“There’s a huge need,” Aulwes said. “Really, the best medicine here is information and education.”

STDs weren’t the only concern for public health officials. An end-of-year measles outbreak in Mitchell – the first in years – was an alarming development, as was an increase in pertussis, or whooping cough.

Both, Hoffman said, can be controlled with vaccines. The whooping cough vaccine wanes over time, but for the highly contagious measles virus, one round of vaccination is typically enough to guarantee a lifetime’s worth of immunity.

Hoffman said it’s sad to see measles return to South Dakota. The disease is among the most contagious viruses known, potentially deadly and easily defended.

“Please believe the science,” he said. “Those vaccines really work, and they are very, very safe.”

For all the downsides, the statistics also registered some triumphs of public health. Once is tuberculosis. The disease used to strike down scores of people. Children would be tested at school with skin tests, Kightlinger said, as well as people at work. Those infected would be placed in sanatoriums.

There were eight reported cases in 2014.

“That represent 50 years of hard work, the way I see it,” Kightlinger said.