St. Mary’s leads the state in gonorrhea increase

Health department can’t explain the spike in number of cases

St. Mary’s County led the state last year in the increased rate of gonorrhea — a sexually transmitted disease — the county commissioners were told Tuesday by the St. Mary’s health officer.

“We’ve had a pretty steep” increase in the number of cases per 100,000 people, Dr. Meena Brewster told the commissioners.

The number has “spiked considerably,” she said, from a rate of 34.2 per 100,000 people in 2015 to 113.6 in 2016 — an increase of more than 230 percent. “The rate of increase in St. Mary’s County is the highest in the state,” she said.

Brewster said the incidence of gonorrhea has “increased across the state to some degree,” but it’s not considered to be an epidemic in St. Mary’s despite the sharp increase.

It’s “definitely a spike we’re delving into deeper,” she said, adding that the health department is looking at what factors contributed to the increase. “We’re very concerned about that,” she said.

In 2016, the rate of gonorrhea in Charles County was 104 per 100,000 people and in Calvert County it was 42 per 100,000, according to the state health department. Both figures were higher than the rates in 2015. In Maryland the 2016 rate was 158.3 per 100,000 people, up from 114.2 the year before.

“Across the nation and in Maryland, there has been an increase in the rate of gonorrhea,” Terry Prochnow, health department division director of public health preparedness and response, said in an email this week. “It is unknown for sure the reason for the increase; however, antibiotic resistance could be contributing factors.”

The health department has been reaching out to local medical offices to make sure that they are using current treatment protocols that were updated in 2015, Brewster said.

The health department is looking to expand community education, testing and treatment for gonorrhea, she said.

“Tell me, as someone who doesn’t have to deal with gonorrhea either, the STDs, don’t they all just go up?” Commissioner Mike Hewitt (R) asked.

“Actually, no,” Brewster said. “We have different ones that tend to pop up. This one is such a striking rise that we’re very concerned about it and looking into it further.”

“Is it relegated to a certain population?” Hewitt asked.

“No. It covers for the most part adolescents through older age groups — males and females, different parts of the county,” Brewster said. “Are we seeing direct clusters? Are we seeing clusters based on different demographics? For the most part, this rise that we’re seeing in St. Mary’s County is being contributed to by various factors.”

The state promotes expedited partner therapy, Brewster said, where if someone comes in to be treated for a sexually transmitted disease, including gonorrhea and chlamydia, a doctor can prescribe antibiotics for that person’s sexual partner as well without being seen by the doctor.

According to the Centers for Disease Control and Prevention, “some men with gonorrhea may have no symptoms at all. However, men who do have symptoms, may have: A burning sensation when urinating; a white, yellow or green discharge from the penis; painful or swollen testicles (although this is less common).

“Most women with gonorrhea do not have any symptoms,” according to the CDC. “Even when a woman has symptoms, they are often mild and can be mistaken for a bladder or vaginal infection. Women with gonorrhea are at risk of developing serious complications from the infection, even if they don’t have any symptoms. Symptoms in women can include: Painful or burning sensation when urinating; increased vaginal discharge; vaginal bleeding between periods.”

Gonorrhea cannot be spread by sharing needles, Prochnow said.