Major STDs in the United States

• Chlamydia bacterium

• Genital Herpes
• Genital Warts
• Gonorrhea bacterium
• Hepatitis B virus infection
• Human Papillomavirus (HPV) Vaccine Fact Sheet
• Syphilis (all stages) bacterium
• Trichomoniasis Protozoan infection
   

Syphilis (all stages) bacterium (Treponema pallidum)
Estimated Annual Incidence, 1996:	70,000
Routes of Transmission:	Vaginal, anal and oral sex. Mother-to-infant. Very rarely by direct nonsexual contact with sores. Rarely through blood transfusion if donor is in early stages of disease.
Frequency of Asymptomatic Infection:	Women: common. Men: common or less common.
Major Long-Term Health Consequences
Adults:	Women and Men: heart, nerve, brain damage, damage to other organ systems, often years after the first infection.
Pregnant Women and Infants:	Infants: congenital syphilis. Pregnant women: stillborn fetus, premature delivery.
Increases Risk for Acquisition or Transmission of HIV infection?	Yes
Effective Curative Treatment Available/Vaccine Available?	Yes/No

Gonorrhea Bacterium (Neisseria gonorrhoeae)
Estimated Annual Incidence, 1996:	650,000
Estimated Annual Total Costs  (millions of $ - 1995):	1,051
Routes of Transmission:	Vaginal, anal and oral sex. Mother-to-infant.
Frequency of Asymptomatic Infection:	Women: very common. Men: uncommon.
Major Long-Term Health Consequences
Adults:	Women: pelvic inflammatory disease, infertility, ectopic pregnancy, chronic (long term) pelvic pain. Men: epididymitis, urethral stricture. Women and Men: can spread to blood stream.
Pregnant Women and Infants:	Infants: eye infections (conjunctiveitis), blindness. Pregnant women: prematurity and other complications.
Increases Risk for Acquisition or Transmission of HIV infection?	Yes
Effective Curative Treatment Available/Vaccine Available?	Yes, but antibiotic-resistant strains exist/No

Genital Warts (human papillomavirus - HPV)
Estimated Annual Incidence, 1996:	5.5 million
Estimated Annual Total Costs  (millions of $ - 1994):	3,827
Routes of Transmission:	Vaginal, anal and probably oral sex. Direct contact with site of infection. Occasional mother-to-infant transmission.
Frequency of Asymptomatic Infection:	Women and Men: very common.
Major Long-Term Health Consequences
Adults:	Women: Genital cancer association. Men: penile cancer association. Women and Men: anal cancer association.
Pregnant Women and Infants:	Infants: rarely warts inside throat.
Increases Risk for Acquisition or Transmission of HIV infection?	No evidence
Effective Curative Treatment Available/Vaccine Available?	Yes for warts, no for virus/No

Genital herpes  (herpes simplex virus types 1 and 2-HSV1 and HSV2)
Estimated Annual Incidence, 1996:	1,000,000
Estimated Annual Total Costs  (millions of $ - 1994):	237
Routes of Transmission:	Vaginal, anal and probably oral sex. Direct contact with site of infection. Occasional mother-to-infant transmission.
Frequency of Asymptomatic Infection:	Women and men: common.
Major Long-Term Health Consequences
Adults:	Women and men: repeated outbreaks.
Pregnant Women and Infants:	Infants: birth defects, severe mental retardation, brain damage. Pregnant women: spontaneous abortion, premature delivery. First time infection during pregnancy, especially near delivery, is the cause of most severe outcomes.
Increases Risk for Acquisition or Transmission of HIV infection?	Yes
Effective Curative Treatment Available/Vaccine Available?	Yes/No

Hepatitis B virus infection (hepatitis B virus-HBV)
Estimated Annual Incidence, 1996:	120,000 (sexually transmitted cases)
Estimated Annual Total Costs  (millions of $ - 1994):	156 (sexually transmitted cases)
Routes of Transmission:	Close direct contact with infected body fluids, including blood, semen, vaginal fluids and saliva. Vaginal, anal and oral sex. Exposure to infected blood, especially intravenous drug use. Also in health care settings. Mother-to-infant transmission.
Frequency of Asymptomatic Infection:	Women and men: very common.
Major Long-Term Health Consequences
Adults:	Women and Men: chronic (long term) liver disease, cirrhosis, liver cancer, death.
Pregnant Women and Infants:	Infants: same as adults, long term (chronic) infection much more likely.
Increases Risk for Acquisition or Transmission of HIV infection?	No evidence.
Effective Curative Treatment Available/Vaccine Available?	No/Yes

Trichomoniasis Protozoan infection (Trichomonas vaginalis)
Estimated Annual Incidence, 1996:	5,000,000
Routes of Transmission:	Vaginal sex.
Frequency of Asymptomatic Infection:	Women: common. Men: very common.
Major Long-Term Health Consequences
Adults:	Women: chronic (long term) vaginal discharge.
Pregnant Women and Infants:	Infants: possible low birth weight. Pregnant women: possible preterm delivery.
Increases Risk for Acquisition or Transmission of HIV infection?	Increasing evidence for risk.
Effective Curative Treatment Available/Vaccine Available?	Yes/No

This material appeared in the STD Focus: STD 101 for Outreach Workers section of the July/August 1997 edition of Washington State Responds, a public information project of the Washington State Department of Health. It was adapted from the Institute of Medicine’s "The Hidden Epidemic: Confronting Sexually Transmitted Diseases."