Sexually Transmitted Diseases, 2001

STDs on this page:
Chlamydia
Gonorrhea
Syphilis
Chancroid

Laboratory-confirmed cases of chlamydia, gonorrhea, syphilis, and chancroid are monitored by MDH through a passive, physician- and laboratory-based surveillance system. Other common sexually transmitted diseases (STDs) caused by viral pathogens, such as herpes simplex virus and human papillomavirus, are not reportable.

Chlamydia

Chlamydia trachomatis infection is the most commonly reported STD in Minnesota. In 2001, 8,323 cases (169 per 100,000 population) were reported. This incidence rate represents a 1% decrease from 2000 and the first time since 1997 that chlamydia rates have not increased (Figure 6, Table 3).

Adolescents and young adults are most at risk for acquiring chlamydia infection (Table 4). The chlamydia rate is highest among 20-24-year-olds (963 per 100,000 population), with the next highest rate among 15-19-year-olds (763 per 100,000 population). The incidence of chlamydia among adults 25-29 years of age (387 per 100,000 population) is markedly less, and rates among older age groups are even lower. The incidence of chlamydia infection among women (242 per 100,000 population) is more than twice the rate among men (95 per 100,000 population); however, this difference primarily is due to more frequent screening among women.

The incidence of chlamydia infection is highest in communities of color (Table 4). The rate among blacks (1,268 per 100,000 population) is approximately 17 times higher than the rate among whites (75 per 100,000 population). Although blacks comprise approximately 3.5% of Minnesota's population, 31% of chlamydia cases occur among blacks. The incidence among American Indians (428 per 100,000 population) and Hispanics (527 per 100,000 population) are six to seven times higher than the rate among whites, and the rate among Asians (240 per 100,000 population) is three times higher than among whites.

Chlamydia infections occur throughout the state, with the highest rates in Minneapolis (687 per 100,000 population) and St. Paul (533 per 100,000 population). The incidence in the suburban Twin Cities metropolitan area (104 per 100,000 population) is similar to that in greater Minnesota (93 per 100,000 population).

Gonorrhea

Gonorrhea, caused by Neisseria gonorrhoeae, is the second most commonly reported STD in Minnesota. In 2001, 2,701 cases (55 per 100,000 population) were reported, reversing a trend of increasing rates that began in 1997 (Figure 6, Table 3).

Adolescents and young adults are at greatest risk for gonorrhea (Table 4), with incidence rates of 209 per 100,000 population among 15-19-year-olds, 259 per 100,000 population among 20-24-years olds, and 140 per 100,000 population among 25-29-year-olds. Gonorrhea rates for men (51 per 100,000 population) and women (59 per 100,000 population) are comparable. Communities of color are disproportionately affected by gonorrhea, with 54% of cases among blacks. The incidence of gonorrhea among blacks (719 per 100,000 population) is 48 times higher than the rate among whites (15 per 100,000 population). Similarly, rates among American Indians (86 per 100,000 population) and Hispanics (79 per 100,000 population) are five to six times higher than among whites. The incidence among Asians (32 per 100,000 population) is more than twice the rate among whites.

Cases of gonorrhea are concentrated in core urban populations of Minneapolis and St. Paul (Table 4). The incidence in Minneapolis (341 per 100,000 population) is 1.7 times higher than the rate in St. Paul (197 per 100,000 population), 13 times higher than the rate in the suburban Twin Cities metropolitan area (27 per 100,000 population), and 26 times higher than the rate in greater Minnesota (13 per 100,000 population).

Syphilis

Syphilis is caused by the spirochete Treponema pallidum. Surveillance data for primary and secondary syphilis typically are used to monitor morbidity trends, because they represent recently acquired infections. Trends in the occurrence of syphilis are difficult to assess due to the generally low numbers of cases.

Primary and Secondary Syphilis

The incidence of primary/secondary syphilis in Minnesota is lower than that for chlamydia or gonorrhea (Figure 6, Table 3). Thirty-three cases of primary/secondary syphilis (0.7 per 100,000 population) were reported in 2001; the incidence rate increased 133% from 2000 to 2001. The rate of early latent syphilis decreased 25% during this time.

The highest rates of primary/secondary syphilis occurred among 25-29-year-olds (Table 4). Men and women had similar rates of primary/secondary syphilis (0.7 and 0.6 per 100,000 population, respectively). The primary/secondary syphilis rate among blacks (11.8 per 100,000 population) was nearly 60 times higher than the rate among whites (0.2 per 100,000 population). Twenty-four (73%) cases of primary/secondary syphilis occurred among blacks, and seven (21%) occurred among whites.

Syphilis primarily is an urban disease (Table 4). No cases of primary/secondary syphilis were reported from greater Minnesota. The majority (70%) of cases occurred in Minneapolis (23 cases, 6.0 per 100,000 population), with the remaining cases evenly distributed between St. Paul (5 cases, 1.7 per 100,000 population) and the suburban Twin Cities metropolitan area (5 cases, 0.3 per 100,000 population).

Congenital Syphilis

Two cases of congenital syphilis (3.0 per 100,000 live births) were reported in Minnesota during 2001.

Chancroid

Chancroid continues to be very rare in Minnesota; no cases were reported in 2001.

Although overall incidence rates for STDs in Minnesota are lower than those in many other areas of the U.S., certain population subgroups in Minnesota have very high STD rates. Specifically, STDs disproportionately affect adolescents, young adults, and persons of color.

• For up to date information see>> Sexually Transmitted Diseases (STDs)
• Full issue>> Annual Summary of Communicable Diseases Reported to the Minnesota Department of Health, 2001