STD Outbreak Status

Sangamon County
Board of Health
Data Review
March 25th
Why STDs are Difficult to Control
- Many times there are no symptoms present – 80% of chlamydia cases
- Symptoms can go away, but the STD does not
- If left untreated can lead to severe complications
- STDs are easier for young women to become infected than men
- Rectal intercourse both men and women and lack of testing GC in throat and anus
- Youth access to sexual health clinics

- Dating Apps
- Anonymous Sex partners
- Sex Parties
- Substance Use
- Stigma/Shame about STDs
- Lack of openness and mixed messages regarding sexuality
- Lack of Sexual Health Education
- Expedited partner therapy (EPT) not provided, if so, several doses involved
 Sangamon County
STD Rates (2015 – 2019)
• Chlamydia
• Gonorrhea
• Syphilis
 Gonorrhea
Rates/100,000 2019 2018 2017 2016 2015
1 Macon 618
2 Alexander 510
3 Peoria 472
4 St.Clair 407
5 Jackson 362
6 Cook 350
7 Marion 302
8 Champaign 299
8 Winnebago 291
10 Jefferson 281
11 Sangamon 273 243 287 263 190
ILLINOIS 228 198 186 165 134
Syphilis - Primary & Secondary
Rates/100,000 2019 2018 2017 2016 2015
1 Alexander 24
2 Cook 19
3 Edwards 15
4 Brown 14
5 Schuyler 13
6 McLean 13
7 Rock Island 12
8 St. Clair 12
8 Knox 11
10 Champaign 9
11 Winnebago 9
12 McDonough 9
13 Lee 8
14 Sangamon 7 11 3 5 5
ILLINOIS 11 11 10 10 9
Syphilis - Early
Rates/100,000 2019 2018 2017 2016 2015
26 Sangamon 11 15 7 9 7
ILLINOIS 21 22 19 19 15

Sangamon County is 13th highest in total # of early syphilis cases - 22

 IDPH Health Alert Notice for Gonorrhea Outbreak in
Sangamon County
The reason why Sangamon county is in outbreak status is because the total number of cases reported year-to-date
is 50% greater than the previous year for the same time period and there is at least a 10 case increase.
Gonorrhea – Cumulative Monthly Cases 2019 & 2020
 IDPH Health Alert Notice for Early Syphilis Outbreak in
Sangamon County
The reason why Sangamon county is in outbreak status is because the total number of cases reported for one
month is 110% greater than the monthly average for the previous three months. Your county was also in outbreak
status in May for the same reason.
Early Syphilis – Cumulative Monthly Cases 2019 & 2020
 Recent Observations in SCDPH Adult Clinic
Syphilis:
- This past Monday, working 8 cases. Another case came in on Tuesday – a 16 y/o also
diagnosed with TRICH and Gonorrhea as well as 2 couples (4 people – 2 who were
16 & 17 y/o) and an additional 17 y/o.
- Most cases are in men who have sex with men.
- Seeing an uptick in the number of young (mostly black) women of child bearing age.
- Clients come to our clinic who were previously misdiagnosed and have ongoing
symptoms/rash.
- Providers are not aware of emergent levels of syphilis to be on the lookout for it.
Gonorrhea:
- Increased number of people coming in with complaints of discharge (men & women).
- New treatment of Ceftriaxone 500 mg IM x1 – double the previous dose.
- Expedited Partner Therapy (EPT) is a single oral 800 mg Cefixime dose plus oral doxycycline.
100 mg twice daily for 7 days. This is not ideal.
 IDPH Recommended Next Steps
Broad Scale Steps
- Notify the medical community of the outbreak.
- Discuss with the LHD administration whether a press release is indicated.
- Increase STD screening practices in any STD clinics.
- Inform all appropriate programs within the LHD of the outbreak, request their support in educating clients
about the outbreak, and the possible need for clients to be tested – WIC, family case management, prenatal
programs, etc.
- Contact appropriate community-based organizations that work with the vulnerable populations in the
community to gain support in educating the public.

Syphilis
- Test all early syphilis cases for HIV as there is a high-co-infection rate of these two diseases.

Gonorrhea
- Ask laboratories & physicians to send report of positive STD results to the LHD within 24 hours.
- Treat infected person and their sex partners promptly.
- Promote use of Expedited Partner Therapy (EPT).
Discussion