Gonorrhea Sexually Transmitted Disease Surveillance 2006 by bigmekahlo

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									       Gonorrhea
Sexually Transmitted Disease
     Surveillance 2006


    Division of STD Prevention
 Gonorrhea — Rates: United States, 1941–2006 and the Healthy People 2010 target



Rate (per 100,000 population)
   500
                                Gonorrhea
                                2010 Target
   400


   300


   200


   100


     0

           1941     46          51     56     61   66   71   76    81     86     91       96   2001   06



           Note: The Healthy People 2010 target for gonorrhea is 19.0 cases per 100,000
           population.
         Gonorrhea — Rates: Total and by sex: United States, 1987–2006 and the
                             Healthy People 2010 target



Rate (per 100,000 population)
   400
                                                                                     Male
                                                                                     Female
   320                                                                               Total
                                                                                     2010 Target

   240


   160


    80


     0

           1987        89       91    93       95       97       99      2001      03        05



           Note: The Healthy People 2010 target for gonorrhea is 19.0 cases per 100,000
           population.
              Gonorrhea — Rates by region: United States, 1997–2006 and the
                              Healthy People 2010 target



Rate (per 100,000 population)
   300
                                                                                      West
                                                                                      Midwest
   240                                                                                Northeast
                                                                                      South
                                                                                      2010 Target
   180


   120


    60


     0

           1997         98      99      2000       01        02        03        04          05     06



           Note: The Healthy People 2010 target for gonorrhea is 19.0 cases per 100,000
           population.
                 Gonorrhea — Rates by state: United States and outlying areas, 2006


                               67.3
                                                                                                                                                               VT      11.6
                                                    20.7            24.0                                                                           10.4        NH      13.7
                           40.1                                                    64.4
                                                                                                                                                               MA      38.0
                                          14.4                                                    125.1                                                        RI      47.2
                                                                    47.3                                                                90.7
                                                                                                                                                               CT      74.4
                                                           23.6                                              154.9
                                                                                                                                                               NJ      63.0
                                                                                     66.3                                          92.2
                                  115.6                              81.5                                                                                      DE     176.0
                                                                                                                      167.4
                                             36.0                                                   158.2   139.2                                              MD     130.8
                        93.4                                 79.2                                                          52.5 85.6                           DC     342.8
                                                                      80.5                175.9
                                                                                                                    78.5
G u a m 5 8 .1
                                                                                                             162.6
                                                                                                                                   199.4       R a te pe r 1 0 0 ,0 0 0
                                           100.2                           139.5
                                                       89.9                               154.9                                242.5           p o p u l a ti o n
                                                                                                             234.0     216.8
                                                                                                    257.1                                                  <=1 9 .0           (n= 5)
                                                                     133.2
                          94.9                                                              240.6                                                          1 9 .1 -1 0 0 .0   (n= 27)
                                                    69.4
                                                                                                                                134.8                      >1 0 0             (n= 22)


                                                                                                     Puerto Rico 7.7

                                                                                                                               Virgin Is. 31.3




                  Note: The total rate of gonorrhea for the United States and outlying areas
                  (Guam, Puerto Rico and Virgin Islands) was 119.4 per 100,000 population.
                  The Healthy People 2010 target is 19.0 cases per 100,000 population.
            Gonorrhea — Rates by county: United States, 2006




                                                                      Rate per 100,000
                                                                      population

                                                                             <=19.0       (n= 1,234)

                                                                             19.1-100.0   (n= 1,134)
                                                                             >100.0       (n= 772)




Note: The Healthy People 2010 target for gonorrhea is 19.0 cases per 100,000 population.
         Gonorrhea — Cases by reporting source and sex: United States, 1997–2006



Cases (in thousands)
   200
                            non-STD Clinic Male
                            non-STD Clinic Female
                            STD Clinic Male
   160                      STD Clinic Female


   120


    80


    40


     0

           1997        98           99         2000   01   02   03   04   05       06
               Gonorrhea — Rates by race/ethnicity: United States, 1997–2006



Rate (per 100,000 population)
       900


       720


                                A m e rica n In d ia n /A K N a tive
       540
                                A sia n /P a cific Isla n d e r
                                B la ck
                                H isp a n ic
       360                      W h ite



       180


         0

               1997        98          99              2000            01   02   03   04   05   06
      Gonorrhea — Age- and sex-specific rates: United States, 2006



Men                                                        Rate (per 100,000 population)                                           Women

750   600        450          300               150               0    Age        0               150         300          450   600          750


                                                          6 .3        1 0 -1 4           3 5 .1

                          2 7 9 .1                                    1 5 -1 9                                                         6 4 7 .9

            4 5 4 .1                                                  2 0 -2 4                                                     6 0 5 .7

                       3 2 0 .9                                       2 5 -2 9                                  2 9 4 .9

                                     1 8 5 .7                         3 0 -3 4                     1 2 5 .5

                                          1 3 0 .8                    3 5 -3 9               6 5 .7

                                                9 3 .5                4 0 -4 4           3 3 .9

                                                   5 3 .0             4 5 -5 4         1 2 .9

                                                         1 8 .4       5 5 -6 4        2 .9

                                                          4 .2         65+            0 .7

                                           1 1 7 .1                    T o ta l                    1 2 4 .6
             Gonorrhea — Age-specific rates among women 15 to 44 years of age:
                               United States, 1997–2006


Rate (per 100,000 population)
     1,000
                                                          1 5 -1 9             2 0 -2 4
                                                          2 5 -2 9             3 0 -3 4
                                                          3 5 -3 9             4 0 -4 4
       800


       600


       400


       200


         0

               1997        98   99   2000    01     02        03     04   05              06
             Gonorrhea — Age-specific rates among men 15 to 44 years of age:
                              United States, 1997–2006


Rate (per 100,000 population)
       750
                                                         1 5 -1 9              2 0 -2 4
                                                         2 5 -2 9              3 0 -3 4
                                                         3 5 -3 9              4 0 -4 4
       600


       450


       300


       150


         0

               1997        98   99   2000   01     02        03     04    05              06
Gonorrhea — Positivity among 15- to 24-year-old women tested in family planning
            clinics by state: United States and outlying areas, 2006

                        0.5
                                                                                                                                                 VT      0.0
                                            1.7                                                                                     0.1          NH      0.3
                                                                      0.6
                                                                                                                                                 MA
                                0.3                                               4.8                                                            RI
                                                                                                                         0.4
                                                                                                                                                 CT      0.5
                                                  0.2                                      2.6
                                                                                                                                                 NJ      1.2
                                                                        0.7                                        0.8
                          0.6                             0.6                                                                                    DE      1.7
                                                                                                   2.0
                                      1.0                                           1.3   1.4                                                    MD
                1.4                                 0.6                                                            1.2                           DC      2.3
                                                            0.7             1.4
                                                                                                 0.8
                                                                                                                   1.6
                                                                                           1.0
                                 0.9                            1.0
                                                  1.3                       1.8                              2.2               P o s i ti v i ty (% )

                                                                                          3.9          2.9
                                                                                    3.3                                                     S ee*              (n= 7)
                                                          2.2
                  0.3                                                         2.1                                                           <1 .0              (n= 20)
                                            0.7
                                                                                                              1.3                           1 .0 -1 .9         (n= 16)

                                                                                                                                            >=2 .0             (n= 10)
                                                                                    Puerto Rico 0.1

                                                                                                             Virgin Is. 1.9



       *States/areas not meeting minimum inclusion criteria.
       Note: Includes states and outlying areas that reported positivity data on at least 500 women
       aged 15-24 years screened during 2006.

       SOURCE: Regional Infertility Prevention Projects; Office of Population Affairs; Local and State STD Control Programs; Centers for
       Disease Control and Prevention
Gonococcal Isolate Surveillance Project (GISP) — Prevalence of ciprofloxacin
         resistant Neisseria gonorrhoeae by GISP site, 2003-2006


                    SEA



           PO R
                                                                            M IN
                                                                                           DTR
                                                                                                                      NY C
                                                                                     CHI
                                                                                                 CLE
             S FO
                                                             DE N
                                                                                             CIN         BAL
                                 LV G
                                                                                                                        P HI
                          LA X                                                                          G RB
                  LB C                                                                                                       QRNG Prevalence
                                                      A LB          O KC
      O RA                                                                                                                     50%
                                        P HX                                                     A TL
                                                                                          B HM
                                                                     DA L
                                                                                                                               25%


    S DG
                                   TRP                                                                                          0%
                                                                                                                                     ' 03 ' 04 ' 05 ' 06
                                                                                   NO R

                                                                                                               M IA
                                               HO N


    Note: Not all clinics participated in GISP for the last 4 years. Clinics include: ALB=Albuquerque, NM; ATL=Atlanta,
    GA; BAL=Baltimore, MD; BHM=Birmingham, AL; CHI=Chicago, IL; CIN=Cincinnati, OH; CLE=Cleveland, OH;
    DAL=Dallas, TX; DEN=Denver, CO; DTR=Detroit, MI; HON=Honolulu, HI; LAX=Los Angeles, CA; LBC=Long
    Beach, CA; LVG=Las Vegas, NV; MIA=Miami, FL; MIN=Minneapolis, MN; GRB=Greensboro, NC; NOR=New
    Orleans, LA; NYC=New York City, NY; OKC=Oklahoma City, OK; ORA=Orange County, CA; PHI=Philadelphia,
    PA; PHX=Phoenix, AZ; POR=Portland, OR; SDG=San Diego, CA; SEA=Seattle, WA; SFO=San Francisco, CA; and
    TRP=Tripler Army Medical Center, HI.
Gonococcal Isolate Surveillance Project (GISP) — Penicillin, tetracycline, and
            ciprofloxacin resistance among GISP isolates, 2006




    Note: PenR=penicillinase producing N. gonorrhoeae and chromosomally mediated
    penicillin-resistant N. gonorrhoeae; TetR=chromosomally and plasmid mediated
    tetracycline-resistant N. gonorrhoeae; QRNG=ciprofloxacin resistant N. gonorrhoeae.
      Gonococcal Isolate Surveillance Project (GISP) — Percent of Neisseria
   gonorrhoeae isolates with resistance or intermediate resistance to ciprofloxacin,
                                     1990–2006


Percent
   16.0
                  Resistant
                  Intermediate resistance
   12.0




    8.0




    4.0




    0.0
          1990   91    92     93   94       95   96   97   98   99   2000   01   02   03   04   05   06



             Note: Resistant isolates have ciprofloxacin MICs ≥ 1 µg/ml. Isolates with
             intermediate resistance have ciprofloxacin MICs of 0.125 - 0.5 µg/ml.
             Susceptibility to ciprofloxacin was first measured in GISP in 1990.
          Gonococcal Isolate Surveillance Project (GISP) — Percent of Neisseria
         gonorrhoeae isolates with resistance to ciprofloxacin by sexual behavior,
                                        2001–2006


Percent Ciprofloxacin Resistant
 40


                Heterosexual men
 32
                Men who have sex with men (MSM)

 24



 16



  8



  0
             2001                 2002            2003   2004    2005         2006

								
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