Indiana experienced a continuation in the number of gonorrhea cases in 1997 when compared to 1996. Indiana’s caseload had decreased by 30% from 1996(6,458 cases) from 1995 ( 9,224 cases). Figure 1 shows the gonorrhea case rate by age group for 1997

Persons in the 15-19 year old age group experienced the largest case rate decrease when compared to other age groups. In 1993, persons aged 15-19 had an age-specific gonorrhea case rate of 808 per 100,000 population. The rate decreased to 470 cases per 100,000 by the end of 1997.

Table 1 shows the gonorrhea rate by metropolitan areas for three of the counties with the highest incidence: Allen, Lake and Marion. Although these counties comprise only 28% of the state’s population, they accounted for 68% of the reported cases in 1997.

Very few cases of penicillinase-producing Neisseria gonorrhoeae (PPNG) cases were reported prior to 1989. Gonorrhea-3 illustrates the annual number of gonorrhea cases in the state from 1986 to 1997, and the proportion of isolates tested that were PPNG. In 1990, all public STD clinics in Indiana as well as family planning clinics began to treat gonorrhea with non-penicillin regimens. The decrease in the proportion of PPNG isolates may reflect this change in treatment.

Figure 3 shows the number of early syphilis cases reported from 1992 through 1997. There were 33% fewer early syphilis cases reported in 1997 than in 1996 (317 vs. 472). Intervention methods employed in Ft. Wayne Indianapolis and Lake Counties are likely contributing to the decrease in syphilis cases.

Figure 3.

Figure 4 depicts age-specific rates for early syphilis in 1993-1997. Decreases in morbidity for all age groups is apparent.

Figure 4.

While Chlamydia trachomatis has been known to cause sexually transmitted genital infections for a number of years, only recently have economical and practical diagnostic methods been available to the physician. This enables the clinician to appropriately identify and treat patients, and has led to more accurate reporting of the disease. The medical community now realizes the widespread nature and potentially serious consequences of untreated chlamydia which may lead to pelvic inflammatory disease (PID) and sterility in women. Chlamydia case rates are the result of a combination of factors including more sensitive diagnostic methods, more people being tested in the population, as well as a real increase in disease. As more persons are tested, more cases are discovered.

Figure 5 summaries age-specific rates for chlamlydia infection for 1993-1997. The graph demonstrates the highest rate of chlamydia for the past four years was in the 15-19 and 20-24 year age groups.

Figure 5.

There is a higher prevalence of chlmalydia in females. However, these data must be interpreted with caution, since chlamydia screening programs preferentially test females. Chlamydia infection in males is often diagnosed as non-gonococcal urethritis, which is not reportable. This leads to an underestimation of chlamydia morbidity in males.