Chancroid

Since 1987, reported cases of chancroid had declined steadily until 2001 when 38 cases were reported (Figure 38, Table 1). In 2004, 30 cases of chancroid were reported in the United States. Only 16 states and one outlying area reported one or more cases of chancroid in 2004 (Table 45). Although the overall decline in reported chancroid cases most likely reflects a decline in the incidence of this disease, these data should be interpreted with caution in view of the fact that Haemophilus ducreyi, the causative organism of chancroid, is difficult to culture and, as a result, this condition may be substantially under diagnosed.^1,2

Human Papillomavirus

Sentinel surveillance for cervical infection with high-risk human papillomavirus (HR-HPV types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) is being conducted in 29 STD, family planning and primary care clinics in six locations (Boston, MA; Baltimore, MD; New Orleans, LA; Denver, CO; Seattle, WA; and Los Angeles, CA) as part of an effort to estimate national burden of disease and inform prevention efforts in the U.S. Testing was performed using a commercially available test for HR-HPV testing (Digene Hybrid Capture 2, Gaithersburg, MD). Interim results from 2003-2004 document an overall HR-HPV prevalence of 22.5%. Prevalence in STD clinics was 28%, 24% in Family Planning clinics, and 16% in Primary Care clinics. Prevalence by age group was: 14-19 years 35%; 20-29 years 29%; 30-39 years 14%; 40-49 years 12%; and 50-65 years 6%.³

Lymphogranuloma Venereum

Lymphogranuloma venereum (LGV) is a systemic, sexually transmitted disease caused by a type of Chlamydia trachomatis. Prevalent in developing countries, LGV has been relatively rare in industrialized countries. However, beginning in late 2003 and continuing to the present time, outbreaks of LGV proctitis among men who have sex with men (MSM), the majority of whom were HIV infected, have been reported in Europe.^4,5 There is no national surveillance for LGV in the United States. In 1995, LGV was removed from the list of nationally notifiable diseases. However, reporting is mandated in 24 states, and some of these states continue to report cases of LGV to the CDC. In 2004, 27 cases of LGV were reported to the CDC. Studies are underway to identify LGV throughout the United States through genotypic confirmation.⁶ Additional information can be found here.

Pelvic Inflammatory Disease

For data on Pelvic Inflammatory Disease (PID), see the Special Focus Profile on Women and Infants.

Other Sexually Transmitted Diseases

Case reporting data for genital herpes simplex virus (HSV), genital warts or other human papillomavirus infections, and trichomoniasis are not available. Trend data are limited to estimates of the office visits in physicians' office practices provided by the National Disease and Therapeutic Index (NDTI) (Figures 39-41 and Table 47).

¹ Schulte JM, Martich FA, Schmid GP. Chancroid in the United States, 1981-1990: Evidence for underreporting of cases. MMWR 1992;41(no. SS-3):57-61.

² Mertz KJ, Trees D, Levine WC, et al. Etiology of genital ulcers and prevalence of human immunodeficiency virus coinfection in 10 US cities. J Infect Dis 1998;178:1795-8.

³ Datta SD, Koutsky L, Douglas J, et al. Sentinel surveillance for human papillomavirus among women in the United States, 2003-2004. Program and abstracts of the 16th Biennial Meeting of the International Society for Sexually Transmitted Diseases Research; July 10-13, 2005; Amsterdam, The Netherlands. Abstract MO-306.

⁴ Centers for Disease Control and Prevention. Lymphogranuloma venereum among men who have sex with men - Netherlands, 2003-2004. MMWR 2004; 53:985-988.

⁵ Nieuwenhuis RF, Ossewaarde JM, Götz HM, Dees J, Thio HB, Thomeer MG, et al. Resurgence of lymphogranuloma venereum in Western Europe: an outbreak of Chlamydia trachomatis serovar L2 proctitis in the Netherlands among men who have sex with men. Clin Infect Dis 2004;39:996-1003.

⁶ McLean C, Lindstrom H, Wendt A, et al. Lymphogranuloma venereum in the United States, November 2004 through March 2005. Program and abstracts of the 16th Biennial Meeting of the International Society for Sexually Transmitted Diseases Research; July 10-13, 2005; Amsterdam, The Netherlands. Poster MP-138.