The Hidden Epidemic: Confronting Sexually Transmitted Diseases (1997)
Chapter: APPENDIX B
|
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 |
| Complete Table on previous page. |
|
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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