Abstract

PIP: Venereal diseases constitute a significant public health problem in the US. Gonorrhea is the most frequently reported communicable disease in the US, and syphilis ranks 3rd among reportable diseases. The incidence of gonorrhea reached a record high of 473 cases per 100,000 in 1975 and has remained close to that level. The incidence of syphilis showed a decline after 1964, reaching 30 per 100,000 in 1978. However, the number of reported cases of all sexually transmitted diseases is believed to be significantly understated, the Center for Disease Control estimating underreporting of gonorrhea by 600,000 to a million cases, and of primary and secondary syphilis by 55 to 60 thousand cases. More than 21,000 cases of syphilis were reported in 1978, with males accounting for more than 3 times the number of cases as females for all ages combined. The ages of highest incidence were 25-29 for males and 20-24 for females. Both males and females had the highest reported incidence of gonorrhea at ages 20-24. Except among the group under 15 and 15-19, the incidence for males was greater than that for females. Nonreportable sexually transmitted diseases have been increasing rapidly, with 2 to 3 million cases annually given as an estimate. The discovery of a new strain of gonococci resistant to standard treatment with penicillin has been a cause for concern, with 508 cases reported between March 1976 and December 1978. Mortality from venereal diseases is relatively low, with 196 deaths from all forms of syphilis and 1 death from gonorrhea reported in 1977. Nearly 50% were attributed to cardiovascular syphilis and about 40% to syphilis of the central nervous system. Morbidity from sexually transmitted diseases is a serious health problem accounting for a significant share of health expenditures. The cost of treating complications relating to gonorrhea in women has been estimated at more than a quarter of a billion dollars, and the outlay for complications among males is also believed to be considerable. Among the complications related to syphilis, treatment of syphilic psychoses alone requires an estimated $60 million annually.