Appendix B Characteristics of Major STDs in the United States



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--> Appendix B Characteristics of Major STDs in the United States

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--> STD (etiologic agent) Estimated Annual Incidence, 1994a Estimated Prevalence, 1994b Estimated Annual Total Costs (millions of 1994$)c Routes of Transmissiond Frequency of Asymptomatic Infectionse Major Long-Term Health Consequences.f Increases Risk for Acquisition or Transmission of HIV Infection?g Effective Curative Treatment Available/ Vaccine Available?h             Adults Pregnant Women and Infants     Chlamydial infection (Chlamydial trachomatis) 4,000,000 NA 2,013 Vaginal, anal, and oral sex. Mother-to-infant transmission. Women: very common. Men: common. Women: pelvic inflammatory disease, infertility, ectopic pregnancy, chronic pelvic pain. Men: epididymitis, urethral stricture. Women and men: Reiter's syndrome (arthritis), complications of septicemia. Infants: neonatal eye disease, pneumonia. Pregnant women: prematurity and other complications. Yes Yes/No Gonorrhea (Neisseria gonorrhoeae) 800,000 NA 1,051 Vaginal, anal, and oral sex. Mother-to-infant transmission. Women: common. Men: uncommon. Women: pelvic inflammatory disease, infertility, ectopic pregnancy, chronic pelvic pain. Men: epididymitis, urethral stricture. Women and men: complications of septicemia. Infants: eye infections (conjunctivitis), blindness. Pregnant women: prematurity and other complications. Yes Yes (but antibioticresistant strains exist)/No Syphilis (all stages) (Treponema pallidum) 101,000 NA 106 Vaginal, anal, and oral sex. Mother-to-infant transmission. Very rarely by direct nonsexual contact with infectious lesions. Rarely through blood transfusion if donor is in early stages of disease. Women: common. Men: common or less common. Women and men: cardiovascular problems, neurological disorders, damage to other organ systems, often years after the initial infection. Infants: congenital syphilis. Pregnant women: stillborn fetus, premature delivery. Yes Yes/No Human papillomavirus infection (human papillomavirus) 500,000-1,000,000 24,000,000 3,827 Vaginal, anal, and probably oral sex. Occasional mother-to-infant transmission. Women and men: very common. Women: genital cancer (vulvar, cervical, vaginal). Men: penile cancer. Women and men: anal cancer. Infants: wart-like tumors of larynx. No evidence Yes/No Genital herpes (herpes simplex virus types 1 and 2) 200,000-500,000 31,000,000 237 Vaginal, anal, and oral sex. Direct nonsexual contact with infectious lesions. Mother-to-infant transmission. Women and men: common. Women and men: recurrent lesions. Infants: fetal malformations, severe mental retardation, brain damage. Pregnant women: spontaneous abortion, premature delivery. Possible No/No

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--> STD (etiologic agent) Estimated Annual Incidence, 1994a Estimated Prevalence, 1994b Estimated Annual Total Costs (millions of 1994$)c Routes of Transmissiond Frequency of Asymptomatic Infectionse Major Long-Term Health Consequences.f Increases Risk for Acquisition or Transmission of HIV Infection?g Effective Curative Treatment Available/Vaccine Available?h             Adults Pregnant Women and Infants     Hepatitis B virus infection (hepatitis B virus) 53,000 (sexually transmitted cases) NA 156 (sexually transmitted cases) Vaginal, anal, and oral sex. Parenterally, through exposure to infectious blood, especially intravenous drug use. Mother-to-infant transmission. Close direct contact with infectious body fluids, especially in health care settings, including blood, saliva, semen, and vaginal fluids. Women and men common. Women and men: chronic liver disease, cirrhosis, liver cancer, death. Infants: same as adults, chronic infection more likely. No evidence No/Yes Chancroid (Haemophilus ducreyi) 3,500 NA 1 Vaginal and anal sex. Women: common. Men: uncommon. Long-term consequences uncommon. Unknown. Yes Yes/No Trichomoniasis (Trichomonas vaginalis) 3,000,000 NA NA Vaginal sex. Women: common. Men: very common. Women: chronic vaginal discharge. Infants: possible low birth weight. Pregnant women: possible preterm delivery. Possible Yes/No HIV-1 infection (human immunodeficiency virus) NA 630,000-897,000 (estimate for January 1993) 6,683 (sexually transmitted cases) Vaginal, anal, and oral sex. Parenterally, through exposure to infectious blood, especially through intravenous drug use. Mother-to-infant transmission. Women and men: common. Women and men: AIDS. Infants: pediatric AIDS.   No/No NOTE: NA = not available. a CDC, DSTD/HIVP (Division of STD/HIV Prevention). Annual report, 1994. U.S. Department of Health and Human Services, Public Health Service. Atlanta: Centers for Disease Control and Prevention, 1995. CDC, DSTDP (Division of STD Prevention). Sexually transmitted disease surveillance, 1994. U.S. Department of Health and Human Services, Public Health Service. Atlanta: Centers for Disease Control and Prevention, 1995. b CDC, DSTD/HIVP, 1995 (see above). Rosenberg PS. Scope of the AIDS epidemic in the United States. Science 1995;270:1372-5. c IOM Committee on Prevention and Control of STDs, Chapter 2 of this volume. d Benenson AS, ed. Control of communicable disease manual. 16th ed. Washington, D.C.: American Public Health Association, 1995. Wasserheit JN, Aral SO, Holmes KK, Hitchcock PJ, eds. Research issues in human behavior and sexually transmitted diseases in the AIDS era. Washington, D.C.: American Society for Microbiology, 1991. Donovan P. Testing positive: sexually transmitted disease and the public health response. New York: Alan Guttmacher Institute, 1993. e Categories are (a) very common: > 75 percent of infections; (b) common: > 25 to 75 percent of infections; (c) less common: 5 to 25 percent of infections; and (d) uncommon: < 5 percent of infections are asymptomatic. SOURCE: Wasserheit et al., 1991 (see above). f Wasserheit et al., 1991 (see above). Donovan, 1993 (see above). g Wasserheit et al., 1991 (see above). h CDC. 1993 Sexually transmitted diseases treatment guidelines. MMWR 1993;42(No. RR-14).

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