Sexually 

Transmitted 

Disease 

Surveillance 

2002 

Division of STD Prevention 

September 2003 

DEPARTMENT OF HEALTH AND HUMAN SERVICES 

Centers for Disease Control and Prevention 

National Center for HIV, STD, and TB Prevention 

Division of STD Prevention 

Atlanta, Georgia 30333 

Centers for Disease Control and 

Prevention........................................Julie Louise Gerberding, M.D., M.P.H. 

Director 

National Center for 

HIV, STD, and TB Prevention..................................Harold W. Jaffe, M.D. 

Director 

Division of STD Prevention ............................John M. Douglas, Jr., M.D. 

Director 

Epidemiology and Surveillance 

Branch ...............................................Stuart M. Berman, M.D., Sc.M. 

Chief 

Surveillance and Special Studies 

Team ......................................Hillard S. Weinstock, M.D., M.P.H. 

Lead 

Statistics and Data Management 

Branch.....................................................................Darien L. Ogburn 

Acting Chief 

Melinda L. Flock, M.S.P.H. 

Team Lead 

Rose Horsley 

Team Lead 

iii 
Copyright Information 

All material contained in this report is in the public domain and may be used and reprinted 

without special permission; citation to source, however, is appreciated. 

Suggested Citation 

Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance, 2002. 

Atlanta, GA: U.S. Department of Health and Human Services, September 2003. 

Copies can be obtained from the National Center for HIV, STD, and TB Prevention, Centers for 

Disease Control and Prevention, 1600 Clifton Road, Mailstop E-07, Atlanta, Georgia 30333. 

Printed copies can also be obtained through the Internet on-line ordering system at the web site 

listed below. 

This report is also available by Internet via the CDC home page at: http://www.cdc.gov/std/stats/ 

iv 
Foreword 

“STDs are hidden epidemics of enormous health and economic consequence in the United 

States. They are hidden because many Americans are reluctant to address sexual health issues in an 

open way and because of the biologic and social characteristics of these diseases. All Americans 

have an interest in STD prevention because all communities are impacted by STDs and all individuals directly or indirectly pay for the costs of these diseases. STDs are public health problems that lack 

easy solutions because they are rooted in human behavior and fundamental societal problems. Indeed, there are many obstacles to effective prevention efforts. The first hurdle will be to confront the 

reluctance of American society to openly confront issues surrounding sexuality and STDs. Despite 

the barriers, there are existing individual- and community-based interventions that are effective and 

can be implemented immediately. That is why a multifaceted approach is necessary to both the 

individual and community levels. 

To successfully prevent STDs, many stakeholders need to redefine their mission, refocus their efforts, modify how they deliver services, and accept new responsibilities. In this process, strong leadership, innovative thinking, partnerships, and adequate resources will be required. The additional 

investment required to effectively prevent STDs may be considerable, but it is negligible when compared with the likely return on the investment. The process of preventing STDs must be a collaborative one. No one agency, organization, or sector can effectively do it alone; all members of the 

community must do their part. A successful national initiative to confront and prevent STDs requires 

widespread public awareness and participation and bold national leadership from the highest 

levels.”1 

1 Concluding statement from the Institute of Medicine’s Summary Report, The Hidden Epidemic: 

Confronting Sexually Transmitted Diseases, National Academy Press, Washington, DC, 1997, p.43. 

v 
Preface 

Sexually Transmitted Disease Surveillance, 2002 presents statistics and trends for sexually transmitted diseases (STDs) in the United States through 2002. This annual publication is intended as a 

reference document for policy makers, program managers, health planners, researchers, and others 

who are concerned with the public health implications of these diseases. The figures and tables in

this edition supersede those in earlier publications of these data. 

The surveillance information in this report is based on the following sources of data: (1) case reports from the STD project areas; (2) prevalence data from the Regional Infertility Prevention Projects, the National Job Training Program (formerly the Job Corps), the Jail STD Prevalence 

Monitoring Projects, the Adolescent Women Reproductive Health Monitoring Project, the Men 

Who Have Sex With Men (MSM) Prevalence Monitoring Project, and the Indian Health Service; (3) 

sentinel surveillance of gonococcal antimicrobial resistance from the Gonococcal Isolate Surveillance Project (GISP); and (4) national sample surveys implemented by federal and private 

organizations. 

The STD surveillance systems operated by state and local STD control programs, which provide 

the case report data, are the sources of many of the figures and all of the statistical tables in this publication. These systems are an integral part of program management at all levels of STD prevention 

and control in the United States. Because of incomplete diagnosis and reporting, the number of 

STD cases reported to CDC is less than the actual number of cases occurring among the United 

States population. 

Sexually Transmitted Disease Surveillance, 2002 consists of four parts. The National Profile 

contains figures that provide an overview of STD morbidity in the United States. The accompanying 

text identifies major findings and trends for selected STDs. The Special Focus Profiles contain 

figures and text describing STDs in selected subgroups and populations that are a focus of national 

and state prevention efforts. The Detailed Tables provide statistical information about STDs at 

the state, county, city, and national levels. The Appendix includes the sources and limitations of the 

data used to produce this report. 

Selected figures and tables in this document identify goals that reflect progress towards some of the 

Healthy People 2010 (HP2010) national health status objectives for STDs.1 Appendix Table A1 displays progress made towards the HP2010 objectives for STDs. These objectives are used as reference 

points throughout this edition of Sexually Transmitted Disease Surveillance, 2002. 

Any comments and suggestions that would improve the usefulness of future publications are appreciated and should be sent to Director, Division of STD Prevention, National Center for HIV, STD, 

and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road, Mailstop E-02, 

Atlanta, Georgia, 30333. 

1 U.S. Department of Health and Human Services. Healthy People 2010. 2nd ed. With Understanding and 

Improving Health and Objectives for Improving Health. 2 vols. Washington, DC: U.S. Government 

Printing Office, November 2000. 

vi 
Acknowledgments 

Publication of this report would not have been possible without the contributions of the State and Territorial 

Health Departments and the Sexually Transmitted Disease Control Programs, the Regional Infertility Prevention 

Projects, the U.S. Department of Labor and the Indian Health Service, which provided surveillance data to the 

Centers for Disease Control and Prevention. 

This report was prepared by the following staff and contractors of the Division of STD Prevention, National 

Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention: Stuart Berman, Susan 

Bradley, Jim Braxton, Sharon Clanton, Susan Conner, Deblina Datta, Darlene Davis, Linda Webster Dicker, 

Melinda Flock, LaZetta Grier, Alesia Harvey, James Heffelfinger, Rose Horsley, Kathleen Hutchins, Richard 

Kahn, Elvin Magee, Catherine McLean, Debra Mosure, Rob Nelson, Lori Newman, Michael Phillips, LuEtta 

Schneider, Maya Sternberg, Katherine Stone, Emmett Swint, Susan Wang, Hillard Weinstock, and Akbar 

Zaidi. 

vii 
Contents 

Foreword . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . v
 

Preface. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vi
 

Acknowledgments. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii
 

Figures in the National Profile . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ix 
 

Additional Figures in the Special Focus Profiles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . x
 

Tables in the National Profile . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xiii
 

Geographic Divisions of the United States . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xvi
 

National Overview of Sexually Transmitted Diseases, 2002 . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
 

National Profile 

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
 

Chlamydia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
 

Gonorrhea . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 
 

Syphilis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
 

Other Sexually Transmitted Diseases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
 

Special Focus Profiles 

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
 

STDs in Women and Infants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
 

STDs in Adolescents and Young Adults . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
 

STDs in Racial and Ethnic Minorities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59
 

STDs in Men Who Have Sex with Men . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67
 

STDs in Persons Entering Corrections Facilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73
 

Tables 

National Summary Tables . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79
 

Chlamydia Tables . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82
 

Gonorrhea Tables . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94
 

Syphilis Tables. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106
 

Chancroid Tables. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 130
 

Appendix 

Sources and Limitations of CDC Surveillance Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133
 

Healthy People 2010 Table A1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139
 

STD Surveillance Case Definitions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141
 

Contributors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 150
 

viii 
Figures in the National Profile 

Chlamydia 

Figure 1. Chlamydia — Number of states that require reporting of Chlamydia
 

trachomatis infections: United States, 1987–2002 . . . . . . . . . . . . . . . . . . . . . . 10
 

Figure 8. Chlamydia — Positivity among 15-24 year old women tested in family
 

Figure 9. Chlamydia — Trends in positivity among 15-44 year old women tested
 

Figure 2. Chlamydia — Rates: United States, 1984–2002. . . . . . . . . . . . . . . . . . . . . . . . 10
 

Figure 3. Chlamydia — Rates by state: United States and outlying areas, 2002 . . . . . . . 11
 

Figure 4. Chlamydia — Rates by county: United States, 2002 . . . . . . . . . . . . . . . . . . . . 11
 

Figure 5. Chlamydia — Rates by region: United States, 1984–2002 . . . . . . . . . . . . . . . . 12
 

Figure 6. Chlamydia — Rates by sex: United States, 1984–2002 . . . . . . . . . . . . . . . . . . 12
 

Figure 7. Chlamydia — Age- and sex-specific rates: United States, 2002 . . . . . . . . . . . . 13
 

planning clinics by state: United States and outlying areas, 2002 . . . . . . . . . . . 13
 

in family planning clinics by HHS regions, 1988–2002. . . . . . . . . . . . . . . . . . . 14
 

Gonorrhea 

Figure 10. Gonorrhea — Rates: United States, 1970–2002 and the Healthy People 

2010 objective . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
 

Figure 11. Gonorrhea — Rates by state: United States and outlying areas, 2002 . . . . . . . 19
 

Figure 12. Gonorrhea — Rates by county: United States, 2002 . . . . . . . . . . . . . . . . . . . . 20
 

Figure 13. Gonorrhea — Rates by region: United States, 1981–2002 and the 

Healthy People 2010 objective. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
 

Figure 14. Gonorrhea — Rates by sex: United States, 1981–2002 and the 

Healthy People 2010 objective. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
 

Figure 15. Gonorrhea — Rates by race and ethnicity: United States, 1981–2002 

and the Healthy People 2010 objective . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
 

Figure 16. Gonorrhea — Age- and sex-specific rates: United States, 2002 . . . . . . . . . . . . 22
 

Figure 17. Gonorrhea — Positivity among 15-24 year old women tested in family 

planning clinics by state: United States and outlying areas, 2002 . . . . . . . . . . . 22
 

Figure 18. Gonococcal Isolate Surveillance Project (GISP) — Location of 

participating clinics and regional laboratories: United States, 2002. . . . . . . . . . 23
 

Figure 19. Gonococcal Isolate Surveillance Project (GISP) — Penicillin and 

tetracycline resistance among GISP isolates, 2002 . . . . . . . . . . . . . . . . . . . . . . 23
 

Figure 20. Gonococcal Isolate Surveillance Project (GISP) — Percent of Neisseria 

gonorrhoeae isolates with resistance or intermediate resistance to 

ciprofloxacin, 1990–2002. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
 

Figure 21. Gonococcal Isolate Surveillance Project (GISP) — Percent of men with 

gonorrhea who had a previous gonorrhea infection, 1991–2002 . . . . . . . . . . . 24
 

Syphilis 

Figure 22. Syphilis — Reported cases by stage of infection: United States, 1941–2002. . . 29
 

Figure 23. Primary and secondary syphilis — Rates: United States, 1970–2002
 

Figure 24. Primary and secondary syphilis — Rates by state: United States and
 

and the Healthy People 2010 objective . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
 

outlying areas, 2002 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
 

Figure 25. Primary and secondary syphilis — Rates by county: United States, 2002. . . . . 30
 

ix 
Figure 26. Primary and secondary syphilis — Rates by region: United States,
 

1981–2002 and the Healthy People 2010 objective. . . . . . . . . . . . . . . . . . . . . 31
 

Figure 27. Primary and secondary syphilis — Rates by sex: United States,
 

Figure 28. Primary and secondary syphilis — Rates by race and ethnicity: United States,
 

Figure 29. Primary and secondary syphilis — Male to female rate ratios: United States,
 

Figure 30. Primary and secondary syphilis — Age- and sex-specific rates: United States,
 

Figure 31. Congenital syphilis — Reported cases for infants <1 year of age and rates of
 

Figure 32. Congenital syphilis — Rates for infants <1 year of age: United States,
 

1981–2002 and the Healthy People 2010 objective. . . . . . . . . . . . . . . . . . . . . 31
 

1981–2002 and the Healthy People 2010 objective. . . . . . . . . . . . . . . . . . . . . 32
 

1981–2002 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
 

2002 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
 

primary and secondary syphilis among women: United States, 1970–2002 . . . 33
 

1981–2002 and the Healthy People 2010 objective. . . . . . . . . . . . . . . . . . . . . 34
 

Other Sexually Transmitted Diseases 

Figure 33. Chancroid — Reported cases: United States, 1981–2002. . . . . . . . . . . . . . . . . 36
 

Figure 34. Genital herpes — Initial visits to physicians’ offices: United States,
 

Figure 35. Herpes simplex virus type 2 infections — Percent seroprevalence
 

Figure 36. Genital warts — Initial visits to physicians’ offices: United States,
 

Figure 37. Trichomoniasis and other vaginal infections — Initial visits to physicians’
 

1966–2002 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
 

according to age in NHANES II (1976-1980) and NHANES III (1988-1994) . . 37
 

1966–2002 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
 

offices: United States, 1966–2002 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
 

Additional Figures in the Special Focus Profiles 

STDs in Women and Infants 

Figure A. Chlamydia — Rates for women by state: United States and outlying
 

areas, 2002 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
 

Figure B. Gonorrhea — Rates for women by state: United States and outlying
 

Figure C. Primary and secondary syphilis — Rates for women by state: United States
 

Figure D. Congenital syphilis — Rates for infants <1 year of age by state: United States
 

Figure E. Congenital syphilis — Cases by prenatal care utilization: United States,
 

Figure F. Chlamydia — Positivity among 15-24 year old women tested in prenatal
 

Figure G. Gonorrhea — Positivity among 15-24 year old women tested in prenatal
 

Figure H. Ectopic pregnancy — Hospitalizations of women 15-44 years of age:
 

areas, 2002 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
 

and outlying areas, 2002 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46
 

and outlying areas, 2002 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46
 

1995-2002. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
 

clinics by state: United States and outlying areas, 2002 . . . . . . . . . . . . . . . . . . 47
 

clinics by state: United States and outlying areas, 2002 . . . . . . . . . . . . . . . . . . 48
 

United States, 1980-2001. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
 

x 
Figure I. Pelvic inflammatory disease — Hospitalizations of women 15-44 years 

of age: United States, 1980–2001 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
 

Figure J. Pelvic inflammatory disease — Initial visits to physicians’ offices by
 

women 15-44 years of age: United States, 1980–2002 . . . . . . . . . . . . . . . . . . 49
 

STDs in Adolescents and Young Adults 

Figure K. Chlamydia — Positivity among women tested in family planning clinics by 

age group: Region X, 1988–2002 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
 

Figure L. Chlamydia — Prevalence among 16-24 year-old women entering the 

National Job Training Program by state of residence: United States and 

outlying areas, 2002. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
 

Figure M. Chlamydia — Adolescent Women Reproductive Health Monitoring Project 

chlamydia positivity by venue and project area, 2002 . . . . . . . . . . . . . . . . . . . 54
 

Figure N. Gonorrhea — Adolescent Women Reproductive Health Monitoring Project 

gonorrhea positivity by venue and project area, 2002 . . . . . . . . . . . . . . . . . . . 54
 

Figure O. Gonorrhea — Prevalence among 16-24 year-old women entering the 

National Job Training Program by state of residence: United States and 

outlying areas, 2002. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
 

Figure P. Gonorrhea — Age-specific rates among women 10-44 years of age: 

United States, 1981–2002 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
 

Figure Q. Gonorrhea — Age-specific rates among men 10-44 years of age: 

United States, 1981–2002 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56
 

Figure R. Primary and secondary syphilis — Age-specific rates among women 

10-44 years of age: United States, 1981–2002. . . . . . . . . . . . . . . . . . . . . . . . . 56
 

Figure S. Primary and secondary syphilis — Age-specific rates among men 

10-44 years of age: United States, 1981–2002. . . . . . . . . . . . . . . . . . . . . . . . . 57
 

STDs in Racial and Ethnic Minorities 

Figure T. Chlamydia — Positivity among women tested in family planning clinics
 

by race and ethnicity: Region X, 1988–2002 . . . . . . . . . . . . . . . . . . . . . . . . . . 62
 

Figure U. Chlamydia — Positivity among 15-30 year old women tested in
 

Figure W. Gonorrhea — Rates for 15-19 year old males by race and ethnicity:
 

Indian Health Service Clinics by IHS areas, 2002. . . . . . . . . . . . . . . . . . . . . . . 62
 

Figure V. Gonorrhea — Rates for 15-19 year old females by race and ethnicity:
 

United States, 1981–2002 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63
 

United States, 1981–2002 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63
 

Figure X. Primary and secondary syphilis — Rates for 15-19 year old females 

by race and ethnicity: United States, 1981–2002 . . . . . . . . . . . . . . . . . . . . . . . 64
 

Figure Y. Primary and secondary syphilis — Rates for 15-19 year old males 

by race and ethnicity: United States, 1981–2002 . . . . . . . . . . . . . . . . . . . . . . . 64
 

Figure Z. Congenital syphilis — Rates for infants <1 year of age by mother’s 

race and ethnicity: United States, 1991–2002 and the Healthy People 

2010 objective . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65
 

STDs in Men Who Have Sex with Men 

Figure AA. MSM Prevalence Monitoring Project — Syphilis serologic reactivity
 

among men who have sex with men, STD clinics, 2002. . . . . . . . . . . . . . . . . . 70
 

Figure BB. MSM Prevalence Monitoring Project — Gonorrhea positivity among
 

men who have sex with men, STD clinics, 2002. . . . . . . . . . . . . . . . . . . . . . . . 70
 

xi 
Figure CC. MSM Prevalence Monitoring Project — Median clinic test positivity for
 

gonorrhea, chlamydia, and HIV among men who have sex with men
 

by race/ethnicity in participating STD clinics, 2002. . . . . . . . . . . . . . . . . . . . . . 71
 

Figure DD. MSM Prevalence Monitoring Project — Median clinic test positivity for
 

gonorrhea and chlamydia among men who have sex with men by HIV
 

status in participating STD clinics, 2002. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
 

Figure EE. Gonococcal Isolate Surveillance Project (GISP) — Percent of gonorrhea
 

cases that occurred among MSM, 1988-2002. . . . . . . . . . . . . . . . . . . . . . . . . . 72
 

Figure FF. Gonococcal Isolate Surveillance Project (GISP) — Percent of Neisseria
 

gonorrhoeae isolates obtained from MSM attending STD clinics in 17 cities,
 

2000, 2001, and 2002 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72
 

STDs in Persons Entering Corrections Facilities 

Figure GG.Syphilis serologic tests — Percent seroreactivity in women entering
 

juvenile and adult corrections facilities, 2002 . . . . . . . . . . . . . . . . . . . . . . . . . . 75
 

Figure HH. Syphilis serologic tests — Percent seroreactivity in men entering juvenile
 

Figure JJ. Chlamydia — Positivity in men entering juvenile and adult corrections
 

Figure KK. Gonorrhea — Positivity in women entering juvenile and adult corrections
 

Figure LL. Gonorrhea — Positivity in men entering juvenile and adult corrections
 

and adult corrections facilities, 2002. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75
 

Figure II. Chlamydia — Positivity in women entering juvenile and adult corrections
 

facilities, 2002 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76
 

facilities, 2002 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76
 

facilities, 2002 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
 

facilities, 2002 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
 

xii 
Tables in the National Profile 

National Summary Tables 

Table 1. Cases of sexually transmitted diseases reported by state health departments
 

and rates per 100,000 civilian population: United States, 1941–2002. . . . . . . 79
 

Table 2. Reported cases of sexually transmitted disease by sex and reporting source:
 

United States, 2002 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81
 

Chlamydia 

Table 3. Chlamydia — Reported cases and rates by state/area, ranked by rates:
 

United States, 2002 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82
 

Table 4. Chlamydia — Reported cases and rates by state/area and region listed in
 

Table 5. Chlamydia — Women – Reported cases and rates by state/area and region
 

Table 6. Chlamydia — Men – Reported cases and rates by state/area and region
 

Table 7. Chlamydia — Reported cases and rates in selected cities of >200,000
 

alphabetical order: United States and outlying areas, 1998–2002 . . . . . . . . . . 83
 

listed in alphabetical order: United States and outlying areas, 1998–2002 . . . . 84
 

listed in alphabetical order: United States and outlying areas, 1998–2002 . . . . 85
 

population, ranked by rates: United States, 2002 . . . . . . . . . . . . . . . . . . . . . . . 86
 

Table 8.	 Chlamydia — Reported cases and rates in selected cities of >200,000
 

population listed in alphabetical order: United States and outlying areas,
 

1998–2002 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87
 

Table 9.	 Chlamydia — Women – Reported cases and rates in selected cities of
 

>200,000 population listed in alphabetical order: United States and
 

outlying areas, 1998–2002. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88
 

Table 10.	 Chlamydia — Men – Reported cases and rates in selected cities of
 

>200,000 population listed in alphabetical order: United States and
 

outlying areas, 1998–2002. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89
 

Table 11. Chlamydia — Reported cases and rates per 100,000 population by age
 

and sex: United States, 1998–2002 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90
 

Table 12A. Chlamydia — Reported cases by age, sex, and race/ethnicity: United States,
 

Table 12B. Chlamydia — Rates per 100,000 population by age, sex, and race/ethnicity:
 

1998–2002 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92
 

United States, 1998–2002 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93
 

Gonorrhea 

Table 13. Gonorrhea — Reported cases and rates by state/area, ranked by rates:
 

United States, 2002 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94
 

Table 14. Gonorrhea — Reported cases and rates by state/area and region listed
 

Table 15. Gonorrhea — Women – Reported cases and rates by state/area and region
 

Table 16. Gonorrhea — Men – Reported cases and rates by state/area and region listed
 

Table 17. Gonorrhea — Reported cases and rates in selected cities of >200,000
 

in alphabetical order: United States and outlying areas, 1998–2002 . . . . . . . . 95
 

listed in alphabetical order: United States and outlying areas, 1998–2002 . . . . 96
 

in alphabetical order: United States and outlying areas, 1998–2002 . . . . . . . . 97
 

population, ranked by rates: United States, 2002 . . . . . . . . . . . . . . . . . . . . . . . 98
 

Table 18.	 Gonorrhea — Reported cases and rates in selected cities of >200,000
 

population listed in alphabetical order: United States and outlying areas,
 

1998–2002 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99
 

xiii 
Table 19. Gonorrhea — Women – Reported cases and rates in selected cities of 

>200,000 population listed in alphabetical order: United States and 

outlying areas, 1998–2002. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100
 

Table 20. Gonorrhea — Men – Reported cases and rates in selected cities of 

>200,000 population listed in alphabetical order: United States and 

outlying areas, 1998–2002. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101
 

Table 21. Gonorrhea — Reported cases and rates per 100,000 population by age 

and sex: United States, 1998–2002 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 102
 

Table 22A. Gonorrhea — Reported cases by age, sex, and race/ethnicity: United States, 

1998–2002 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104
 

Table 22B. Gonorrhea — Rates per 100,000 population by age, sex, and race/ethnicity: 

United States, 1998–2002 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105
 

Syphilis 

Table 23. All stages of syphilis* — Reported cases and rates by state/area and 

region listed in alphabetical order: United States and outlying areas, 

1998–2002 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106
 

Table 24. All stages of syphilis* — Reported cases and rates in selected cities of 

>200,000 population listed in alphabetical order: United States and 

outlying areas, 1998–2002. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107
 

Table 25. Primary and secondary syphilis — Reported cases and rates by state/area, 

ranked by rates: United States, 2002 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 108
 

Table 26. Primary and secondary syphilis — Counties and independent cities ranked * 

by number of reported cases: United States, 2002 . . . . . . . . . . . . . . . . . . . . . 109
 

Table 27. Primary and secondary syphilis — Reported cases and rates by state/area
 

and region listed in alphabetical order: United States and outlying areas,
 

Table 28. Primary and secondary syphilis — Women – Reported cases and rates
 

by state/area and region listed in alphabetical order: United States and
 

Table 29. Primary and secondary syphilis — Men – Reported cases and rates by
 

state/area and region listed in alphabetical order: United States and
 

Table 30. Primary and secondary syphilis — Reported cases and rates in selected
 

Table 31. Primary and secondary syphilis — Reported cases and rates in selected
 

cities of >200,000 population listed in alphabetical order: United States
 

Table 32. Primary and secondary syphilis — Women – Reported cases and rates
 

in selected cities of >200,000 population listed in alphabetical order:
 

Table 33. Primary and secondary syphilis — Men – Reported cases and rates in
 

selected cities of >200,000 population listed in alphabetical order:
 

Table 34. Primary and secondary syphilis — Reported cases and rates per 100,000
 

Table 35A. Primary and secondary syphilis — Reported cases by age, sex, and
 

Table 35B. Primary and secondary syphilis — Rates per 100,000 population by
 

1998–2002 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110
 

outlying areas, 1998–2002. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111
 

outlying areas, 1998–2002. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112
 

cities of >200,000 population, ranked by rates: United States, 2002 . . . . . . . 113
 

and outlying areas, 1998–2002 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 114
 

United States and outlying areas, 1998–2002 . . . . . . . . . . . . . . . . . . . . . . . . 115
 

United States and outlying areas, 1998–2002 . . . . . . . . . . . . . . . . . . . . . . . . 116
 

population by age and sex: United States, 1998–2002. . . . . . . . . . . . . . . . . . 117
 

race/ethnicity: United States, 1998–2002 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 118
 

age, sex, and race/ethnicity: United States, 1998–2002 . . . . . . . . . . . . . . . . . 119
 

xiv 
Table 36. Early latent syphilis — Reported cases and rates by state/area and 

region listed in alphabetical order: United States and outlying areas, 

1998–2002 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 120
 

Table 37. Early latent syphilis — Reported cases and rates in selected cities of 

>200,000 population listed in alphabetical order: United States and 

outlying areas, 1998–2002. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121
 

Table 38. Late and late latent syphilis — Reported cases and rates by state/area 

and region listed in alphabetical order: United States and outlying areas, 

1998–2002 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 122
 

Table 39. Late and late latent syphilis — Reported cases and rates in selected 

cities of >200,000 population listed in alphabetical order: United States 

and outlying areas, 1998–2002 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123
 

Table 40. Congenital syphilis — Reported cases and rates in infants <1 year of age: 

United States (excluding outlying areas), 1963–2002. . . . . . . . . . . . . . . . . . . 124
 

Table 41. Congenital syphilis — Reported cases and rates in infants <1 year of age 

by state/area, ranked by rates: United States, 2002 . . . . . . . . . . . . . . . . . . . . 125
 

Table 42. Congenital syphilis — Reported cases and rates in infants <1 year of 

age by state/area and region listed in alphabetical order: United States 

and outlying areas, 1998–2002 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 126
 

Table 43. Congenital syphilis — Reported cases and rates in infants <1 year of 

age in selected cities of >200,000 population, ranked by rates: 

United States, 2002 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 127
 

Table 44. Congenital syphilis — Reported cases and rates in infants <1 year of 

age in selected cities of >200,000 population listed in alphabetical order: 

United States and outlying areas, 1998–2002 . . . . . . . . . . . . . . . . . . . . . . . . 128
 

Table 45. Congenital syphilis — Reported cases and rates in infants <1 year of 

age by race/ethnicity of mother, 1998–2002 . . . . . . . . . . . . . . . . . . . . . . . . . 129
 

Chancroid 

Table 46. Chancroid — Reported cases and rates by state/area listed in alphabetical 

order: United States and outlying areas, 1998–2002 . . . . . . . . . . . . . . . . . . . 130
 

Table 47. Chancroid — Reported cases and rates in selected cities of >200,000 

population listed in alphabetical order: United States and outlying areas, 

1998–2002 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 131
 

Sources and Limitations of CDC Surveillance Data 

Table A1. Healthy People 2010 Sexually Transmitted Diseases Objective Status . . . . . . 139
 

xv 
Geographic Divisions of the United States 

West Midwest Northeast

South

West Midwest South Northeast 

Alaska Illinois Alabama Connecticut 

Arizona Indiana Arkansas Maine 

California Iowa Delaware Massachusetts 

Colorado Kansas District of Columbia New Hampshire 

Hawaii Michigan Florida New Jersey 

Idaho Minnesota Georgia New York 

Montana Missouri Kentucky Pennsylvania 

Nevada Nebraska Louisiana Rhode Island 

New Mexico North Dakota Maryland Vermont 

Oregon Ohio Mississippi 

Utah South Dakota North Carolina 

Washington Wisconsin Oklahoma 

Wyoming South Carolina 

Tennessee 

Texas 

Virginia 

West Virginia 

xvi 
National Overview of Sexually Transmitted Diseases, 2002 

The logo on the cover of Sexually Transmitted Disease Surveillance, 2002 is a reminder of the 

multifaceted, national dimensions of the morbidity, mortality, and costs that result from sexually 

transmitted diseases (STDs) in the United States. It highlights the central role of STD prevention in 

improving health among women and infants and in promoting HIV prevention. Organized collaboration among interested, committed public and private organizations is the key to reducing STDs 

and their related health burdens in our population. As noted in the report of the Institute of Medicine, The Hidden Epidemic: Confronting Sexually Transmitted Diseases,

1 surveillance is a key component of our efforts to prevent and control these diseases. 

This overview summarizes national surveillance data on the three diseases for which there are 

federally-funded control programs: chlamydia, gonorrhea, and syphilis. Several observations for 

2002 are worthy of note. 

Chlamydia

In 2002, 834,555 cases of genital Chlamydia trachomatisinfection were reported to CDC (Table 1). 

This case count corresponds to a rate of 296.5 cases per 100,000 population, an increase of 6.5% 

compared with the rate of 278.3 in 2001. Rates of reported chlamydial infections among women 

have been increasing annually since the late 1980s when public programs for screening and treatment of women were first established to avert pelvic inflammatory disease and related complications. Chlamydia screening and reporting are likely to expand further in response to the recently 

implemented Health Plan Employer Data and Information Set (HEDIS) measure for chlamydia 

screening of sexually active women 15 to 25 years of age who are provided medical care through 

managed care organizations.2 The increase in chlamydia case reports in 2002 most likely represents 

a continued increase in screening for this infection and also increased use of more sensitive 

chlamydia screening tests than used in prior years. 

In 2002, the overall rate of chlamydial infection in the U.S. among women (455.4 cases per 

100,000 females) was over three times the rate among men (130.1 cases per 100,000 males), reflecting the large number of women screened for this disease (Tables 5 and 6). However, with the increased availability of urine testing, men are increasingly being tested for chlamydial infection. From 

1998 to 2002, the reported chlamydial infection rate in men increased by 54.7% (from 84.1 to 

130.1 cases per 100,000 males) compared with a 19.6% increase in women over this period (from 

380.8 to 455.4 cases per 100,000 females). 

Data from multiple sources on prevalence of chlamydial infection in defined populations have 

been useful in monitoring disease burden and guiding chlamydia screening programs. In 2002, 

the median state-specific chlamydia test positivity among women 15 to 24 years who were 

screened at selected family planning clinics in all states, the District of Columbia, Puerto Rico, and 

the Virgin Islands was 5.6% (range 3.0% to 14.2%) (Figure 8), and at selected prenatal clinics in 

26 states and the Virgin Islands was 7.4% (range 1.5% to 14.4%) (Figure F). For 

STD Surveillance 2002 Overview 1 
economically-disadvantaged women 16 to 24 years of age who entered the National Job Training 

Program in 2002, from 28 states and Puerto Rico, the median state-specific prevalence was 

10.1% (range 4.4% to 16.8%) (Figure L). For women 15 to 30 years of age screened at Indian 

Health Service (IHS) clinics in 3 IHS areas, the prevalence ranged from 7.4% to 9.7% by area 

(Figure U). For adolescent women entering juvenile detention centers, the median chlamydia 

positivity by facility was 16.7% (range 6.3% to 28.3%) (Figure II). It was 13.2% among women attending school-based clinics and 9.7% in female street youth (Figure M). For adolescent men entering juvenile detention centers, the median chlamydia positivity was 6.0% by facility (range 

0.6% to 15.7%) (Figure JJ). Although these data on prevalence are not entirely comparable because of differences in the populations screened, in the performance characteristics of the screening tests, and variations in screening criteria, they provide important information on the 

continuing high burden of disease in the United States. 

In parts of the United States where large scale chlamydia screening programs have been instituted, prevalence of infection has declined. During 1988-2002, among 15-to 44-year-old women 

participating in the screening programs in Health and Human Services (HHS) Region X family 

planning clinics, chlamydia test positivity declined 55.4% (from 13.0% to 5.8%) (Figure 9). After 

adjusting trends in chlamydia positivity to account for changes in laboratory test methods and associated increases in test sensitivity, chlamydia test positivity decreased in 6 of 10 HHS regions from 

2001 to 2002 and increased in 4 regions. Although chlamydia positivity has declined in the past 

year in some regions, most likely due to the effectiveness of screening and treating women, continued expansion of screening programs to populations with higher prevalence of disease may have 

contributed to the increases in positivity seen in other regions. See the Appendix (Sources and 

Limitations of Data) for the composition of the HHS regions. 

Gonorrhea

Following a 73.8% decline in the rate of reported gonorrhea from 1975 (467.7 cases per 100,000 

population) to 1997 (122.4 cases per 100,000 population), overall rates increased in 1998 (131.9 

per 100,000 population) and have been declining slightly since 1999 (Table 1). The gonorrhea rate 

for 2002 (125.0 cases per 100,000 population) was slightly lower than rates in 2001 (128.5 cases 

per 100,000 population) and 2000 (129.0 per 100,000 population) (Table 1). The 2002 rate for 

gonorrhea considerably exceeds the Healthy People 2010 (HP2010) objective of 19 cases per 

100,000 population. 

The gonorrhea rate in the U.S. among women in 2002 was slightly lower than the rate in 2001 

(125.3 and 128.2 cases per 100,000 women, respectively) (Table 15). As in 2001, there were minimal differences between sexes in gonorrhea rates in 2002 (Tables 15 and 16). Since 1998, the rate of 

gonorrhea among 15- to 19-year-olds has decreased by 12.2%. As with chlamydia, rates of gonorrhea in women are particularly high in 15- to 19-year-olds, and in men, are highest in the 20- to 

24-year age group (Table 21). 

In 2002, data on gonorrhea prevalence in defined populations were available from several 

sources. These data showed a continuing high burden of disease in adolescents and young adults in 

some parts of the United States. Among 15- to 24-year-old women attending selected family planning clinics in 35 states, the District of Columbia, Puerto Rico, and the Virgin Islands, the median 

state-specific gonorrhea prevalence was 0.9% (range 0.1% to 2.8%) (Figure 17). For women in this 

age group attending selected prenatal clinics in 20 states and the Virgin Islands, the median prevalence was 0.9% (range 0.0% to 5.7%) (Figure G). However, for 16- to 24-year-old women entering 

2 Overview STD Surveillance 2002 
the National Job Training Program in 21 states in 2002, the median state-specific gonorrhea 

prevalence was 2.9% (range 0.0% to 6.8%) (Figure O). 

Antimicrobial resistance in Neisseria gonorrhoeae remains a continuing concern. In the mid- to 

late 1990s, the prevalence of fluoroquinolone-resistant N. gonorrhoeae infections increased substantially in Asia and the Pacific Islands, including Hawaii; in 2002, increased numbers of 

fluoroquinolone-resistant N. gonorrhoeae infections were identified in California. Nationally in 

2002, 2.2% of N. gonorrhoeae isolates tested through the Gonoccocal Isolate Surveillance Project 

(GISP) demonstrated resistance to ciprofloxacin, compared to 0.7% in 2001 and 0.4% in 2000. 

There is considerable geographic variation in the prevalence of fluoroquinolone-resistance within 

the U.S. Outside of Hawaii and California, 0.4% demonstrated resistance. In Honolulu, the proportion of GISP isolates that were resistant to ciprofloxacin remained high in 2002 at 11.7%, although 

this was lower than in the previous two years (20.3% in 2001 and 14.3% in 2000). Also, in 2002, increased numbers of GISP isolates resistant to ciprofloxacin were identified in all four California 

GISP sites (7.2% in Long Beach, 11.4% in Orange County, 16.5% in San Diego, and 6.7% in San 

Francisco). As a result of these data, the 2002 CDC STD Treatment Guidelines3 recommend that 

fluoroquinolones not be used for treatment of gonorrhea acquired in Asia, the Pacific Islands, including Hawaii, or in other areas with high levels of resistance such as California. See Appendix for 

a further description of GISP. 

Data on characteristics of patients in the GISP sample have been used to describe trends in the 

sexual orientation of male STD clinic patients with gonorrhea. In 2002, there was a marked increase 

in the proportion of GISP isolates from men who have sex with men (MSM), with 21.0% of isolates 

from MSM compared with 17.2% in 2001 and 13.9% in 2000 (Figure EE). In 1988, only 4.0% of 

isolates were from MSM. The proportional increase in MSM in GISP has corresponded to an absolute increase in gonorrhea cases among MSM at STD clinics in several large cities that participate in 

GISP. 

Syphilis

The rate of primary and secondary (P&S) syphilis reported in the United States decreased during 

the 1990s and in 2000 was the lowest since reporting began in 1941. The low rate of syphilis and the 

concentration of the majority of syphilis cases in a small number of geographic areas led to the development of the National Plan to Eliminate Syphilis from the United States, which was announced 

by the Surgeon General in October 1999.4 The rate of P&S syphilis in the United States declined by 

89.2% from 1990 through 2000. However, the rate of P&S syphilis increased slightly in 2001 and 

more substantially in 2002; these increases were observed only in men. 

Despite continued national progress toward syphilis elimination among women and AfricanAmericans, syphilis remains an important problem in the South and, increasingly, in some urban areas with large populations of MSM. Recently, outbreaks of syphilis among MSM have been reported, possibly reflecting increases in risky behavior in this population. 

P&S syphilis cases reported to CDC increased 12.4% from 6,103 in 2001 to 6,862 in 2002. The 

overall rate of P&S syphilis in the United States in 2002 (2.4 cases per 100,000 population) was 

slightly above the rate reported in 2001 (2.2 cases per 100,000), and was considerably higher than 

the Healthy People 2010 (HP2010) objective of 0.2 case per 100,000 population (Figure 23, Table 1). 

The rate of P&S syphilis among women decreased from 1.4 cases per 100,000 population in 2001 

STD Surveillance 2002 Overview 3 
to 1.1 cases per 100,000 population in 2002; among men, the rate increased from 3.0 to 3.8 cases 

per 100,000 population (Tables 28 and 29). 

One factor that may facilitate syphilis elimination efforts is that this disease continues to be primarily reported only in specific areas of the country. In 2002, 2,534 (80.7%) of the 3,139 counties in 

the United States reported no cases of P&S syphilis (see Appendix for details on county coding). 

Half of all the P&S syphilis cases were reported from only 16 counties and 1 city (0.5% of total number of U.S. counties) (Table 26). However, the 2002 P&S syphilis rates were greater than the 

HP2010 objective in 595 counties (19.0% of the total number of U.S. counties). These 595 counties 

accounted for more than 99.9% of all reported P&S syphilis cases. 

Between 2001 and 2002, the national rate of congenital syphilis decreased by 16.4%, from 12.2 

to 10.2 cases per 100,000 live births (Table 42). The continuing reduction in congenital syphilis 

rates, occurring since the early 1990s, reflects the substantial and continuing reduction in the rate of 

P&S syphilis among women over the same period. In 2002, approximately one half of the states 

and outlying areas had a rate of congenital syphilis that was greater than the HP2010 objective of 

1.0 case per 100,000 live births (Table 41). 

Although wide disparities exist in the rates of STDs among racial and ethnic groups, there has been a 

reduction in these differences for syphilis over the past five years. The P&S syphilis rate for 2002 among 

African-Americans was 8 times the rate among whites, reflecting a substantial decline from 1998, when 

the rate among African-Americans was 34 times greater than that among whites (Table 35B). While this 

reflects decreasing rates among African-Americans, in the past two years, it also reflects significant increases among whites. 

While syphilis elimination efforts have successfully focused on heterosexual minority populations 

at risk for syphilis, recent increases in syphilis among MSM highlight the importance of continually 

reassessing and refining surveillance, prevention, and control strategies. 

1 Institute of Medicine. The Hidden Epidemic: Confronting Sexually Transmitted Diseases, Committee on 

Prevention and Control of Sexually Transmitted Diseases, National Academy Press, Washington, DC, 

1997. 

2 National Committee for Quality Assurance (NCQA). HEDIS 2000: Technical Specifications, Washington, 

DC, 1999, pp. 68-70, 285-286. 

3 Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines 2002. 

MMWR 2002;51 (No. RR-6). 

4 Division of STD Prevention. The National Plan to Eliminate Syphilis from the United States. National 

Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, 1999. 

4 Overview STD Surveillance 2002 
NATIONALPROFILE
 

National Profile 

The National Profile section contains figures showing trends and the distribution of sexually 

transmitted diseases (STDs) by age, sex, race/ethnicity, and location for the United States. Where 

relevant, the figures illustrate progress towards specific objectives* for the nation published in U.S. 

Department of Health and Human Services. Healthy People 2010. 2nd ed. With Understanding 

and Improving Health and Objectives for Improving Health. 2 vols. Washington, DC: U.S. Government Printing Office, November 2000. 

* See the Appendix for a listing of the Healthy People 2010 objectives for the diseases addressed in this report. 

STD Surveillance 2002 National Profile 5 

Chlamydia 

Chlamydia trachomatis infections are the most commonly reported notifiable disease in the 

United States. They are among the most prevalent of all STDs and, since 1994, have comprised the 

largest proportion of all STDs reported to CDC (Table 1). In women, chlamydial infections, which 

are usually asymptomatic, may result in pelvic inflammatory disease (PID), which is a major cause 

of infertility, ectopic pregnancy, and chronic pelvic pain. Data from a randomized controlled trial of 

chlamydia screening in a managed care setting suggest that such screening programs can lead to a 

reduction in the incidence of PID by as much as 60%.1 As with other inflammatory STDs, 

chlamydial infection can facilitate the transmission of HIV infection. In addition, pregnant women 

infected with chlamydia can pass the infection to their infants during delivery, potentially resulting in 

neonatal ophthalmia and pneumonia. 

The increase in reported chlamydial infections during the last 10 years reflects the expansion of 

chlamydia screening activities, use of increasingly sensitive diagnostic tests, an increased emphasis 

on case reporting from providers and laboratories, and improvements in the information systems 

for reporting. However, many women who are at risk are still not being tested, reflecting, in part, lack 

of awareness among some health care providers and the limited resources available to support 

screening. Chlamydia screening and reporting are likely to expand further in response to the recently implemented Health Plan Employer Data and Information Set (HEDIS) measure for 

chlamydia screening of sexually active women 15 through 25 years of age who receive medical care 

through managed care organizations.2 To better monitor trends in disease burden in defined populations during the expansion of chlamydia screening activities, data on chlamydia positivity among 

persons screened in a variety of settings are used; in most instances, test positivity serves as a reasonable approximation of prevalence.3 In parts of the United States where large scale chlamydia 

screening programs have been instituted, prevalence of the infection has declined. 

• In 2000, for the first time, all 50 states and the District of Columbia had regulations 

requiring the reporting of chlamydia cases to CDC (Figure 1, Table 4). 

• In 2002, 834,555 chlamydial infections were reported to CDC from 50 states and 

the District of Columbia (Table 1). This case count corresponds to a rate of 296.5 

cases per 100,000 population, an increase of 6.5% compared with the rate of 

278.3 in 2001. The reported number of chlamydial infections was more than 

twice the number of reported cases of gonorrhea (351,852 gonorrhea cases were 

reported in 2002) (Table 1). 

• From 1987 through 2002, the rates of reported chlamydial infection increased 

from 50.8 to 296.5 cases per 100,000 population (Figure 2, Table 1). The 

continuing increase in reported cases likely represents the further expansion of 

screening for this infection, the development and use of more sensitive screening 

tests, and more complete national reporting. 

• For the years 1998-2002, the chlamydia rates in the Southern region of the 

United States were higher than the rates in any other region of the country 

(Figures 3-5, Table 4). Before 1996, chlamydia rates were highest in the West and 

STD Surveillance 2002 National Profile Chlamydia 7 
Midwest, where substantial public resources had been committed for screening 

programs in family planning clinics. Rates have remained lowest in the Northeast. 

• In 2002, the overall rate of reported chlamydial infection among women in the 

U.S. (455.4 cases per 100,000 females) was over 3 times higher than the rate 

among men (130.1 cases per 100,000 males), likely reflecting a greater number 

of women screened for this infection (Figure 6, Tables 5 and 6). The lower rates 

among men suggest that many of the sex partners of women with chlamydia are 

not diagnosed or reported. However, with the advent of highly sensitive nucleic 

acid amplification tests that can be performed on urine, symptomatic and 

asymptomatic men are increasingly being diagnosed with chlamydial infection. 

From 1998 to 2002, the chlamydial infection rate in males increased by 54.7% 

(from 84.1 to 130.1 cases per 100,000 males) compared with a 19.6% increase 

in women over this period (from 380.8 to 455.4 cases per 100,000 females) 

(Tables 5 and 6). 

• For women, the highest age-specific rates of reported chlamydia in 2002 were 

among 15- to 19-year-olds (2,619.1 per 100,000 females) and 20- to 

24-year-olds (2,570.1 per 100,000 females). Age-specific rates among men, 

while substantially lower than the rates in women, were highest in the 20- to 

24-year-olds (Figure 7, Table 11). 

• In 2002, the rate of chlamydia among African-American females in the U.S. was 8 

times higher than the rate among white females (1,638.3 and 202.5 per 100,000, 

respectively) (Table 12B). The chlamydia rate among African-American males 

was 12 times higher than that among white males (573.7 and 48.6 per 100,000 

respectively). 

• Chlamydia screening and prevalence monitoring activities were initiated in 

Health and Human Services (HHS) Region X in 1988 as a CDC-supported 

demonstration project. In 1993, chlamydia screening services for women were 

expanded to three additional HHS regions (III, VII, and VIII) and, in 1995, to the 

remaining HHS regions (I, II, IV, V, VI, and IX). In some regions, federally-funded 

chlamydia screening supplements local- and state-funded screening programs. 

• In 2002, the median state-specific chlamydia test positivity among 15- to 

24-year-old women who were screened during visits to selected family planning 

clinics in all states and outlying areas was 5.6% (range 3.0% to 14.2%) (Figure 8). 

In nearly all states chlamydia positivity was greater than the HP2010 objective of 

3.0%.4 

• The effectiveness of large-scale screening programs in reducing chlamydia 

prevalence in women has been well documented in areas where this intervention 

has been in place for several years. For example, from 1988 to 2002, the 

screening programs in HHS Region X (Alaska, Idaho, Oregon, Washington) 

family planning clinics demonstrated a 55.4% decline in chlamydia positivity 

from 13.0% to 5.8% among 15- to 44-year-old women (Figure 9); chlamydia 

positivity was adjusted for changes in laboratory test methods and associated test 

sensitivity.5,6 See Appendix (Chlamydia, Gonorrhea, and Syphilis Prevalence 

Monitoring) for details. 

• After adjusting trends in chlamydia positivity to account for changes in laboratory 

test methods and associated increases in test sensitivity (see Appendix), 

chlamydia test positivity decreased in 6 of 10 HHS regions from 2001 to 2002, 

8 Chlamydia National Profile STD Surveillance 2002 
and increased in 4 regions (Figure 9). Although chlamydia positivity has declined 

in the past year in some regions due to the effectiveness of screening and 

treatment of women, continued expansion of screening programs to populations 

with higher prevalence of disease may have contributed to increases in positivity 

in other regions. 

• Additional information on chlamydia screening programs for women of 

reproductive age and chlamydia among adolescents and minority populations 

can be found in the Special Focus Profiles. 

1 Scholes D, Stergachis A, Heidrich FE, Andrilla H, Holmes KK, Stamm WE. Prevention of pelvic 

inflammatory disease by screening for cervical chlamydial infection. N Engl J Med 1996;34(21): 1362-66. 

2 National Committee for Quality Assurance (NCQA). HEDIS 2000: Technical Specifications, Washington, 

DC, 1999, pp. 68-70, 285-286. 

3 Dicker LW, Mosure d, Levine W. Chlamydia positivity versus prevalence: what's the difference? Sex 

Transm Dis 1998;25:251-3. 

4 U.S. Department of Health and Human Services. Healthy People 2010. 2nd ed. With Understanding and 

Improving Health and Objectives for Improving Health. 2 vols. Washington, DC: U.S. Government 

Printing Office, November 2000. 

5 Dicker LW, Mosure DJ, Levine WC, et al. Impact of switching laboratory tests on reported trends in 

Chlamydia trachomatis infections. Am J Epidemiol 2000;51:430-5. 

6 Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance 2002 

Supplement: Chlamydia Prevelance Monitoring Project Annual Report 2002. Atlanta, GA: U.S. 

Department of Health and Human Services (in press). 

STD Surveillance 2002 National Profile Chlamydia 9 
Figure 1. Chlamydia — Number of states that require reporting of Chlamydia trachomatis 

infections: United States, 1987–2002 

No. of states

50

40

30

20

10

0

1987 88 89 90 91 92 93 94 95 96 97 98 99 2000 01 02

Figure 2. Chlamydia — Rates: United States, 1984–2002 

Rate (per 100,000 population)

300

240

180

120

60

0

1984 86 88 90 92 94 96 98 2000 02

10 Chlamydia National Profile STD Surveillance 2002 
Figure 3. Chlamydia — Rates by state: United States and outlying areas, 2002 

253.4

274.3 141.6 195.6

204.9 205.4

193.4 293.4 316.9 269.4 VT 156.7 191.2 324.7 NH 126.0

297.1

158.5

279.3 211.7

387.3 281.2 335.0

258.9 MA

RI

CT

171.9

270.1

288.0

325.6 326.1 252.3 289.2 216.6

136.3 261.6 NJ

DE

MD

168.3

338.1

318.9

307.2 282.0 291.8 407.7 313.1 273.5 356.8 Rate per 100,000

Guam 355.3 population

414.8 351.0 415.3

<=150.0 (n= 4) 333.4 150.1-300.0 (n= 29) 607.1 412.7 >300.0 (n= 20) 263.2

373.2

Puerto Rico 78.7

Virgin Is. 190.6

Note: The total rate of chlamydia for the United States and outlying areas (Guam, Puerto Rico and 

Virgin Islands) was 293.6 per 100,000 population. For further information on chlamydia 

reporting, see Appendix (Reporting of Chlamydia Cases). 

Figure 4. Chlamydia — Rates by county: United States, 2002 

STD Surveillance 2002 National Profile Chlamydia 11 
Figure 5. Chlamydia — Rates by region: United States, 1984–2002 

Rate (per 100,000 population)

350

280

210

140

70

0

West

Midwest

Northeast

South

1984 86 88 90 92 94 96 98 2000 02

Figure 6. Chlamydia — Rates by sex: United States, 1984–2002 

Rate (per 100,000 population)
 

500
 

400
 

300
 

200
 

100
 

0
 

Men

Women

1984 86 88 90 92 94 96 98 2000 02

12 Chlamydia National Profile STD Surveillance 2002 
Figure 7.	 Chlamydia — Age- and sex-specific rates: United States, 2002 

Men	 Rate (per 100,000 population)population)population)population)population)population)population)population)population)population)population)population)population)population)population)population)population)population)population)population)population)population) Women

3,000 2,400 1,800 1,200 600 0 Age 0 600 1,200 1,800 2,400 3,000

10.2 10-14 142.1

408.4 15-19 2,619.1

691.5 20-24 2,570.1

331.6 25-29 875.8

163.2 30-34 328.7

82.1 35-39 123.9

46.0 40-44 55.5

19.7 45-54 20.8

6.4 55-64 5.6

2.1 65+ 2.5

130.4 Total 456.5

Note: See Table 11 and Appendix (Reporting of Chlamydia Cases) for more information. 

Figure 8.	 Chlamydia — Positivity among 15-24 year old women tested in family planning 

clinics by state: United States and outlying areas, 2002 

6.7

6.0 3.9 3.2

3.9 4.8

5.4 8.0 4.6	 5.0 VT 4.7

5.4	 5.4 NH 4.3

MA 5.6 4.7 5.6 4.8 RI 7.4 5.5 7.1	 CT 5.3 5.1	 7.6 6.9 NJ 6.0 6.1 4.9	 3.0 6.9 DE 4.4 5.7 6.0 MD 5.6

DC 4.0 3.7

6.3 4.8 6.2	 5.9 6.8	 6.3 7.5 Positivity (%)

7.6 8.3 12.1 <4 (n= 5) 8.2 4.0-4.9 (n= 11) 9.6 5.8 >=5 (n= 37) 5.2

5.5

Puerto Rico 4.3

Virgin Is. 14.2

Note: States reported chlamydia positivity data on at least 500 women aged 15-24 years screened 

during 2002, except for New York State Project Area which submitted chlamydia positivity data 

for January - July 2002 only. 

SOURCE: Regional Infertility Prevention Projects; Office of Population Affairs; Local and State STD Control Programs; Centers 

for Disease Control and Prevention 

STD Surveillance 2002 National Profile	 Chlamydia 13 
Figure 9. Chlamydia — Trends in positivity among 15-44 year old women tested in family 

planning clinics by HHS regions, 1988–2002 

Region VIII Region V Region II Region I 7.9 7.7 7.5 7.3 6.9 7.0 6.4 6.7 6.5 6.5 6.8 7.0

96 97 98 99 00 01 

5.0 4.7 4.3 4.9 5.2 

02 

5.1 

97 98 99 00 01 

5.9 

02 

Region III 

9594 96 97 98 99 00 01

7.8 

6.3 5.5 5.8 6.1 6.5 6.1 5.6 

02 

5.2 

Region IV 

97 98 99 00 01 

9.3 10.6 9.9 9.0 8.9 

02 

8.5 

97 98 99 00 01 

5.9 

02 

Region VI 

8.8 9.410.2 9.2 8.9 8.8 9.2 Region VII 

5.2 5.0 5.6 5.5 5.7 5.6 6.1 

94 95 96 97 98 99 00 01

6.3 5.3 4.9 4.8 5.6 5.8 6.2 

02 

5.6 

Region IX 

96 97 98 99 00 01 

5.3 5.4 6.1 6.5 6.4 6.5 

02 

5.9 

Region X 

94 95939291908988 96 97 98 99 00 01

13.0 

10.0 9.6 

8.1 

6.7 

5.0 4.7 4.1 3.9 3.9 4.6 4.9 5.3 5.3 

02 

5.8 

96 97 98 99 00 01 02 96 97 98 99 00 01 02 

Note: Trends adjusted for changes in laboratory test method and associated increases in test 

sensitivity. See Appendix (Chlamydia, Gonorrhea, and Syphilis Prevalence Monitoring) for 

more information. No data on laboratory test method available for Region VII in 1995 and 

Regions IV and V in 1996. See Appendix for definition of Health and Human Services (HHS) 

regions. 

SOURCE: Regional Infertility Prevention Projects; Office of Population Affairs; Local and State STD Control Programs; Centers for Disease Control and Prevention 

14 Chlamydia National Profile STD Surveillance 2002 
Gonorrhea 

Gonorrhea is the second most commonly reported notifiable disease in the U.S. Infections due to 

Neisseria gonorrhoeae, like those resulting from Chlamydia trachomatis, are a major cause of pelvic 

inflammatory disease (PID) in the United States. PID can lead to serious outcomes such as tubal infertility, ectopic pregnancy, and chronic pelvic pain. In addition, epidemiologic and biologic studies 

provide strong evidence that gonococcal infections facilitate the transmission of HIV infection.1 

From 1975 through 1997, the national gonorrhea rate declined 73.8% following implementation 

of the national gonorrhea control program in the mid-1970s (Table 1). After a small increase in 

1998, the gonorrhea rate has decreased slightly since 1999 (Figure 10 and Table 1). True increases 

or decreases may be masked by changes in screening practices (affected by simultaneous testing for 

chlamydia), use of diagnostic tests with different sensitivities, and changes in reporting practices.2 

For most areas, the number of gonorrhea cases reported to CDC is affected by many factors, in 

addition to the occurrence of the infection within the population. As with reporting of other STDs, 

reporting of gonorrhea cases to CDC is incomplete.3 In addition, reporting practices for gonococcal 

infections may have been biased towards reporting of infections in persons of minority race or ethnicity, who are more likely to attend public STD clinics.2,4 In 2002, 35.2% of gonorrhea cases were 

reported by STD clinics (Table 2). For such reasons, supplemental data on gonorrhea prevalence in 

persons screened in a variety of different settings are useful in assessing disease burden in selected 

populations. 

• In 2002, 351,852 cases of gonorrhea were reported in the United States (Table 1). 

• The rate of reported gonorrhea in the United States was 125.0 cases per 100,000 

population in 2002, which was lower than rates for the previous four years (128.5 in 

2001, 129.0 in 2000, 132.3 in 1999, and 131.9 in 1998 (Tables 1 and 14). 

• As in 2000 and 2001, only 8 states and 1 outlying area had gonorrhea rates below 

the Healthy People 2010 (HP2010) national objective of 19 cases per 100,000 

population5 for 2002 (Figure 11 and Table 13). 

• In 2002, 1,376 (43.9%) of 3,139 counties in the United States had gonorrhea 

rates at or below the HP2010 national objective of 19 cases per 100,000 

population. Rates per 100,000 population were between 19 and 100 in 1,029 

counties (32.8%), and greater than 100 in 730 counties (23.3%). The majority of 

counties with greater than 100 cases per 100,000 population were located in the 

South (Figure 12). 

• As in previous years, in 2002 the South had the highest gonorrhea rate among the 

four regions of the country. In 2002, the gonorrhea rate in the South declined by 

6.1% from a rate of 177.6 per 100,000 population in 2001 to 166.8. The gonorrhea 

rate in the Northeast also declined by 3.3% from 97.9 in 2001 to 94.7 in 2002. 

Meanwhile, the gonorrhea rate in the Midwest remained essentially unchanged at 

STD Surveillance 2002 National Profile Gonorrhea 15 
143.9 in 2002. It was 143.4 in 2001. The gonorrhea rate in the West experienced a 

6.0% increase over this time period from 61.5 to 65.2 (Figure 13 and Table 14). 

• Although rates of gonorrhea among men prior to 1997 were higher than rates 

among women, rates among men and women have been similar since 1997 

(Figure 14). In 2002 the gonorrhea rate among women (125.3 cases per 100,000 

females) was similar to the rate among men (124.2 cases per 100,000 males) 

(Tables 15 and 16). 

• The overall gonorrhea rate in selected large cities with populations over 200,000 

persons was 220.2 cases per 100,000 population in 2002. This rate has decreased 

slightly each year since 1998 when it was 241.4 cases per 100,000 population 

(Table 18). All of these cities had rates higher than the HP2010 objective of 19 

cases per 100,000 population. In 2002, 46.1% of gonorrhea cases were reported 

by these selected cities (Table 17). Similar to previous years, in 2002 the total 

gonorrhea rate among males in these selected large cities (231.5) remained 

higher than that among females (208.7) (Tables 19 and 20). 

• When examined by age, in 2002 the gonorrhea rate was highest for 20- to 

24-year-olds (593.0 per 100,000). Among women in 2002, 15- to 19- and 20- to 

24-year-olds had the highest rates of gonorrhea (675.6 and 650.3, per 100,000, 

respectively); among men, 20- to 24-year-olds had the highest rate (538.1 per 

100,000) (Figure 16 and Table 21). Since 1998 there has been a 12.2% decrease 

in the rate of gonorrhea among 15- to 19-year olds, 10.2% among women and 

16.4% among men (Table 21). 

• Changes in gonorrhea rates from 2001 to 2002 differed by racial/ethnic group. 

Gonorrhea rates increased in 2002 for three of the five racial/ethnic groups. The 

rates among American Indian/Alaska Natives (114.4 per 100,000 in 2001 and 

126.8 in 2002), Hispanics (74.2 in 2001 and 76.0 in 2002), and whites (29.4 in 

2001 and 31.1 in 2002) increased by 10.8%, 2.4%, and 5.8%, respectively, 

during this time period. The gonorrhea rate among Asian/Pacific Islanders 

declined 9.7% in 2002 compared to 2001 (from 26.7 down to 24.1). The rate 

among African-Americans declined 5.1% from 782.3 in 2001 to 742.3 in 2002, 

but still remained higher than that among other race/ethnicities (Figure 15 and 

Table 22B). In 2002, the gonorrhea rate among African-Americans was about 24 

times greater than the rate for whites, down from 27 times greater in 2001. The 

2002 gonorrhea rates for all racial/ethnic groups were above the HP2010 

objective of 19 per 100,000 population. 

• Increases in gonorrhea were largest in white men aged 30- to 44-years-old 

between 1998 and 2002. For white men, rates increased 24.1% in 30- to 

34-year-olds, 38.3% in 35- to 39-year-olds and 65.5% in 40- to 44-year-olds 

(Table 22B). 

• As in recent years, the highest rates of gonorrhea were seen among 15- to 

19-year-old African-American women (3,307.7 per 100,000), and 20- to 

24-year-old African American men (3,256.2 per 100,000) (Table 22B). 

• In 2002, the median state-specific gonorrhea test positivity among 15- to 24-yearold women screened in selected family planning clinics in 35 states, Puerto Rico, 

District of Columbia, and the Virgin Islands was 0.9% (range 0.1% to 2.8%) 

(Figure 17). In other settings, gonorrhea test positivity has been much higher. See 

Special Focus Profiles. 

16 Gonorrhea National Profile STD Surveillance 2002 
6,7,8

• Antimicrobial resistance remains an important consideration in the treatment of 

gonorrhea.6-8 Overall, 18.0% of isolates collected in 2002 in 27 STD clinics by the 

Gonococcal Isolate Surveillance Project (GISP) were resistant to penicillin, 

tetracycline, or both (Figures 18 and 19). 

• Resistance to ciprofloxacin was first identified in GISP in 1991. From 1991 to 

1998, fewer than nine ciprofloxacin-resistant isolates were identified each year 

and such isolates were identified in only a few GISP clinics. In 2000, similar to 

1999, 19 (0.4%) ciprofloxacin-resistant GISP isolates were identified in 7 GISP 

clinics. In 2001, 38 (0.7%) ciprofloxacin-resistant GISP isolates were identified 

in 6 clinics and in 2002, 116 (2.2%) such isolates were identified in 13 clinics 

(Figure 20). 

• In Honolulu, the proportion of GISP isolates that were resistant to ciprofloxacin 

remained high in 2002 at 11.7%, although this was lower than in the previous two 

years (20.3% in 2001 and 14.3% in 2000). This high proportion of 

ciprofloxacin-resistant isolates in Hawaii continues to reinforce the 

recommendation made by CDC in 2000 that fluoroquinolones not be used to 

treat gonorrhea acquired in Hawaii.6 

• In California, significant increases in the proportions of GISP isolates resistant to 

ciprofloxacin were identified in all 4 California GISP sites (for Long Beach, 7.2% 

in 2002 compared with 3.0% in 2001; for Orange County, 11.4% in 2002 

compared with 2.3% in 2001; for San Diego, 16.5% in 2002 compared with 

2.1%; for San Francisco, 6.7% in 2002 compared with 3.4% in 2001). In 2002, 

the California STD Program recommended that fluoroquinolones no longer be 

used for gonorrhea treatment in California. 

• The proportion of GISP isolates that were ciprofloxacin-resistant at other GISP 

clinics where such isolates were identified in 2002 were: Anchorage, AL – 3.7%; 

Seattle, WA – 3.0%; Portland, OR – 1.7%; Philadelphia, PA – 1.0%; Minneapolis, 

MN – 0.5%; Cincinnati, OH – 0.4%; Miami, FL – 0.4%; Phoenix, AZ – 0.3%. 

Overall, outside of Hawaii and California, 0.4% of isolates were ciprofloxacinresistant. Additional information on both GISP data and non-GISP antimicrobial 

susceptibility data from health departments may be found in the 2002 GISP 

report7 and the GISP website (http://www.cdc.gov/std/gisp). 

• In 2002, no GISP isolates had decreased susceptibility to cefixime or to ceftriaxone. 

The proportion of GISP isolates demonstrating decreased susceptibility to 

ceftriaxone or cefixime has remained very low over time. To date, cephalosporin 

resistance has not been identified in GISP. In 2001, three GISP isolates with 

decreased susceptibility to cefixime were also found to be resistant to penicillin, 

tetracycline, and ciprofloxacin; such multi-drug resistance in combination with 

decreased susceptibility to cefixime has not previously been identified in the 

United States.9 

• The proportion of GISP isolates demonstrating elevated minimum inhibitory 

concentrations (MICs) to azithromycin has been increasing since GISP began 

monitoring azithromycin susceptibility in 1992. In 1992, 0.9% of GISP isolates 

had azithromycin MIC ≥0.5 μg/ml compared with 3.1% in 2002. In 1992, there 

were no isolates with azithromycin MIC ≥1.0 μg/ml but in 2002, there were 33 

such isolates. 

STD Surveillance 2002 National Profile Gonorrhea 17 
• From GISP data, the percentage of men with gonorrhea who were reported to 

have had a gonorrhea infection in the previous year has remained essentially 

unchanged between 1992 (21.5%) and 2002 (22.5%) (Figure 21). 

• Additional information about gonorrhea in racial and ethnic minority 

populations, adolescents, men who have sex with men, and other at risk 

populations can be found in the Special Focus Profiles. 

1	 Cohen MS, Hoffman IF, Royce RA, et al. Reduction of concentration of HIV-1 in semen after treatment of 

urethritis: implications for prevention of sexual transmission of HIV-1. Lancet 1997;349:1868-73. 

2 Centers for Disease Control and Prevention. Gonorrhea – United States, 1998. MMWR 2000;49:538-42. 

3	 Sexually Transmitted Diseases in America: How Many Cases and At What Cost? Prepared for the Kaiser 

Family Foundation by: American Social Health Association, December 1998, ASHA: Research Triangle 

Park, NC, Kaiser Family Foundation: Menlo Park, CA 94025. 

4	 Fox KK, Whittington W, Levine WC, Moran JS, Zaidi AA, Nakashima AN. Gonorrhea in the United States, 

1981-1996: demographic and geographic trends. Sex Transm Dis 1998;25(7):386-93. 

5	 U.S. Department of Health and Human Services. Healthy People 2010. 2nd ed. With Understanding and 

Improving Health and Objectives for Improving Health. 2 vols. Washington, DC: U.S. Government 

Printing Office, November 2000. 

6	 Centers for Disease Control and Prevention. Fluoroquinolone-resistance in Neisseria gonorrhoeae, 

Hawaii, 1999, and decreased susceptibility to azithromycin in N. gonorrhoeae, Missouri, 1999. MMWR 

2000;49:833-837. 

7	 Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance 2002 

Supplement: Gonococcal Isolate Surveillance Project (GISP) Annual Report 2002. Atlanta, GA: U.S. 

Department of Health and Human Services (in press). 

8	 Centers for Disease Control and Prevention. Increases in fluoroquinolone-resistant Neisseria 

gonorrhoeae–Hawaii and California, 2001 MMWR 2002;51:1041-1044. 

9	 Wang SA, Lee MV, Iverson CJ, O’Connor N, Ohye RG, Hale JA, Knapp JS, Effler PV, Weinstock HS. 

Multi-drug resistant Neisseria gonorrhoeae with decreased susceptibility to cefixime, Hawaii, 2001. 

[Abstract] International Conference on Emerging Infectious Diseases, Atlanta, Georgia, March 25, 2002. 

18 Gonorrhea	 National Profile STD Surveillance 2002 
Figure 10. Gonorrhea — Rates: United States, 1970–2002 and the Healthy People 2010 

objective 

Rate (per 100,000 population) 

500 

Gonorrhea 

2010 Objective 

400 

300 

200 

100 

0 

1970 73 76 79 82 85 88 91 94 97 2000 

Note: The Healthy People 2010 objective for gonorrhea is 19.0 cases per 100,000 population. 

Figure 11. Gonorrhea — Rates by state: United States and outlying areas, 2002 

49.6 

13.6 11.2 11.1 

26.6 62.0 

7.3 34.8 118.2 115.1 VT 16.1 13.2 148.6 NH 9.7 

99.5 

16.7 

91.4 50.6 

193.5 121.6 193.8 

108.2 MA 

RI 

CT 

51.1 

85.9 

95.2 

72.6 81.6 102.1 160.0 93.3 

53.9 147.8 NJ 

DE 

MD 

93.8 

201.1 

176.6 

192.9 164.3 74.0 80.4 135.1 171.5 228.1 Rate per 100,000 

Guam 31.7 population 

241.7 227.5 224.6 

<=19.0 (n= 9) 129.4 19.1-100.0 (n= 20) 102.2 254.8 >100.0 (n= 24) 133.6 

61.1 

Puerto Rico 10.8 

Virgin Is. 45.1 

Note: The total rate of gonorrhea for the United States and outlying areas (Guam, Puerto Rico and 

Virgin Islands) was 123.4 per 100,000 population. The Healthy People 2010 objective is 19.0 

cases per 100,000 population. 

STD Surveillance 2002 National Profile Gonorrhea 19 
Figure 12. Gonorrhea — Rates by county: United States, 2002 

Note: The Healthy People 2010 objective for gonorrhea is 19.0 cases per 100,000 population. 

Figure 13. Gonorrhea — Rates by region: United States, 1981–2002 and the Healthy 

People 2010 objective 

Rate (per 100,000 population) 

600 

West 

Midwest 

480 Northeast 

South 

2010 Objective 

360 

240 

120 

0 

1981 83 85 87 89 91 93 95 97 99 2001 

20 Gonorrhea National Profile STD Surveillance 2002 
Figure 14. Gonorrhea — Rates by sex: United States, 1981–2002 and the Healthy 

People 2010 objective 

Rate (per 100,000 population) 

600 

480 

360 

240 

120 

0 

Male 

Female 

2010 Objective 

1981 83 85 87 89 91 93 95 97 99 2001 

Figure 15. Gonorrhea — Rates by race and ethnicity: United States, 1981–2002 and the 

Healthy People 2010 objective 

Rate (per 100,000 population) 

2,500 

2,000 

1,500 

1,000 

500 

0 

White 

Black 

Hispanic 

Asian/Pac Isl 

Am Ind/AK Nat 

2010 Objective 

1981 83 85 87 89 91 93 95 97 99 2001 

STD Surveillance 2002 National Profile Gonorrhea 21 
Figure 16. Gonorrhea — Age- and sex-specific rates: United States, 2002 

Men Rate (per 100,000 population)population)population)population)population)population)population)population)population)population)population)population)population)population)population)population)population)population)population)population)population)population) Women 

750 600 450 300 150 0 Age 0 150 300 450 600 750 

7.4 10-14 46.6 

287.9 15-19 675.6 

538.1 20-24 650.3 

320.4 25-29 251.4 

199.2 30-34 113.1 

131.4 35-39 57.4 

92.1 40-44 31.3 

48.1 45-54 10.6 

17.3 55-64 2.1 

4.4 65+ 0.8 

124.5 Total 125.5 

Note: See Table 21. 

Figure 17. Gonorrhea — Positivity among 15-24 year old women tested in family planning 

clinics by state: United States and outlying areas, 2002 

0.6 

2.7 VT 0.2 

0.4 1.0 NH 0.1 

0.9 

1.2 

0.2 

0.5 

0.6 0.7 

1.8 1.2 1.5 

2.8 

0.9 MA 

RI 

CT 

NJ 

0.8 

1.3 

0.7 0.9 0.7 

DE 

MD 

DC 1.2 

0.7 0.7 0.7 1.5 1.4 Positivity (%) 

2.8 2.3 2.4 

See * (n= 15) 1.0 <1 (n= 21) 0.6 2.4 1.0-1.9 (n= 10) 0.6 >=2 (n= 7) 0.1 

Puerto Rico 0.2 

Virgin Is. 2.5 

*States reported gonorrhea positivity data on less than 500 women aged 15-24 years during 2002, 

except for Pennsylvania and Puerto Rico which submitted gonorrhea positivity data for April ­

December 2002 only. 

SOURCE: Regional Infertility Prevention Projects; Office of Population Affairs; Local and State STD Control Programs; Centers 

for Disease Control and Prevention 

22 Gonorrhea National Profile STD Surveillance 2002 
Figure 18. Gonococcal Isolate Surveillance Project (GISP) — Location of participating 

clinics and regional laboratories: United States, 2002 

Seattle 

Portland 

Minneapolis 

Cleveland 

Philadelphia
 

Chicago
 

San Francisco
 Cincinnati Baltimore

Denver Las Vegas 

St. Louis
 

Long Beach
 Greensboro Ft. Bragg 

Orange Co. Phoenix Albuquerque
 San Diego
 

Atlanta
 Birmingham
 

Dallas New Orleans 

Anchorage Tripler AMC 

Honolulu STD Clinics 

Laboratories Miami 

Figure 19. Gonococcal Isolate Surveillance Project (GISP) — Penicillin and tetracycline 

resistance among GISP isolates, 2002 

82.0% 

1.2% 

4.3% 

Susceptible 

0.7% PPNG 2.1% TRNG 

PPNG/TRNG 5.5% PenR 

4.2% TetR 

CMRNG 

Note: PPNG=penicillinase-producing N. gonorrhoeae; TRNG=plasmid-mediated tetracycline 

resistant N. gonorrhoeae; PPNG-TRNG=plasmid-mediated penicillin and tetracycline resistant 

N. gonorrhoeae; PenR=chromosomally mediated penicillin resistant N. gonorrhoeae; TetR= 

chromosomally mediated tetracycline resistant N. gonorrhoeae; CMRNG=chromosomally 

mediated penicillin and tetracycline resistant N. gonorrhoeae. 

STD Surveillance 2002 National Profile Gonorrhea 23 
Figure 20. Gonococcal Isolate Surveillance Project (GISP) — Percent of Neisseria 

gonorrhoeae isolates with resistance or intermediate resistance to 

ciprofloxacin, 1990–2002 

Percent 

4.0 

3.2 

2.4 

1.6 

0.8 

0.0 

Resistance 

Intermediate resistance 

1990 91 92 93 94 95 96 97 98 99 2000 01 02 

Note: Resistant isolates have ciprofloxacin MICs ≥ 1 μg/ml. Isolates with intermediate resistance 

have ciprofloxacin MICs of 0.125 - 0.5 μg/ml. Susceptibility to ciprofloxacin was first 

measured in GISP in 1990. 

Figure 21. Gonococcal Isolate Surveillance Project (GISP) — Percent of men with 

gonorrhea who had a previous gonorrhea infection, 1991–2002 

Percent 

Ever* 

Last 12 months** 

0 

12 

24 

36 

48 

60 

1991 92 93 94 95 96 97 98 99 2000 01 02 

*Data first collected in 1991. 

**Data first collected in 1992. 

24 Gonorrhea National Profile STD Surveillance 2002 
4,5,6,7,8,9

Syphilis 

Syphilis, a genital ulcerative disease, facilitates the transmission of HIV and may be important in 

contributing to HIV transmission in those parts of the country where rates of both infections are 

high. Untreated early syphilis in pregnant women results in perinatal death in up to 40% of cases 

and, if acquired during the four years preceding pregnancy, may lead to infection of the fetus in over 

70% of cases.1 

The rate of primary and secondary (P&S) syphilis reported in the United States decreased during 

the 1990s and in 2000 was the lowest since reporting began in 1941 (Figure 22). The low rate of infectious syphilis and the concentration of the majority of syphilis cases in a small number of geographic areas in the United States led to the development of the CDC’s National Plan to Eliminate 

Syphilis, which was announced by Surgeon General David Satcher in October 1999.2 Collaboration with diverse organizations, public health professionals, the private medical community, and 

other partners working in STD and HIV is essential for the successful elimination of syphilis in the 

U.S.3 

Although the rate of P&S syphilis in the United States declined by 89.7% from 1990 to 2000, the 

rate of P&S syphilis increased in 2001 and 2002; these increases were observed only in men. 

Despite national progress toward syphilis elimination, particularly among African-Americans and 

among women, syphilis remains an important problem in the South and in some urban areas in 

other regions of the country. Outbreaks of syphilis occurring among men who have sex with men 

(MSM) have been reported which have been characterized by high rates of HIV co-infection and 

high-risk sexual behavior. 4-9 

• In 2002, P&S syphilis cases reported to CDC increased to 6,862 from 6,103 in 

2001, an increase of 12.4%. The reported rate of P&S syphilis in the United States 

in 2002 (2.4 cases per 100,000 population) was 9.1% higher than the reported 

rate in 2001 (2.2 cases per 100,000 population), and it is significantly greater than 

the Healthy People 2010 (HP2010) objective of 0.2 case per 100,000 population 

(Figure 23, Table 1).10 

• From 2001 to 2002, the number of cases of early latent syphilis reported to CDC 

decreased 3.1% (from 8,701 to 8,429) (Table 36) while the number of cases of 

late and late latent syphilis increased 1.1% (from 16,976 to 17,168) (Table 38). 

The total number of cases of syphilis (P&S, early latent, late and late latent, and 

congenital syphilis) reported to CDC increased 1.9% (from 32,272 to 32,871) 

from 2001 to 2002 (Table 23). 

• Between 2001 and 2002, the rate of P&S syphilis increased 26.7% among men 

(from 3.0 cases to 3.8 cases per 100,000 men) (Figure 27, Table 29). During this 

period, the rate declined 21.4% among women (from 1.4 to 1.1 cases per 

100,000 women) (Figure 27, Table 28). 

STD Surveillance 2002 National Profile Syphilis 25 
• The male-to-female rate ratio for P&S syphilis has risen steadily since 1996 when 

it was 1.1 (Figure 29). The male-to-female rate ratio in 2001 was 2.1 and in 2002, 

the rate ratio was 3.5 suggesting an increase in syphilis among men who have sex 

with men. 

• An increase in the male-to-female rate ratio for P&S syphilis occurred among 

whites, African-Americans, and Hispanics from 2001 to 2002. The 

male-to-female rate ratio for P&S syphilis increased from 6.0 to 11.0 among 

whites, from 1.7 to 2.1 among African-Americans, and from 3.7 to 5.0 among 

Hispanics; the male-to-female rate ratio declined from 10.0 to 8.0 among 

Asian/Pacific Islanders and the rate ratio remained at 1.2 among American 

Indian/Alaska Natives (Table 35B). 

• An increase in the male-to-female rate ratio for P&S syphilis occurred in 25 

(71.9%) of 32 states, the District of Columbia, and 1 outlying area that reported 

25 or more cases in 2002 (Tables 28, 29, 32, and 33). 

• African-Americans accounted for 49.8% of cases of P&S syphilis in 2002 and 

62.5% in 2001. During 2001 to 2002, the rate of P&S syphilis declined 10.9% 

among African-Americans, reflecting a 2.6% decrease in the number of cases 

among men (from 2,286 to 2,226) but a 21.7% decrease among women (from 

1,527 to 1,195). The rate among whites increased 71.4%; cases among men 

increased 85.2% (from 1,138 to 2,108), and cases among women decreased 

12.8% (from 249 to 217). The rate among Hispanics increased 28.6%; cases 

among men increased 35.6% (from 607 to 823), and cases among women 

increased very slightly from 146 to 147. The rate among Asians/Pacific Islanders 

increased 80.0%; cases increased among men (from 51 to 83) and women (from 

4 to 11). The rate among American Indian/Alaska Natives decreased 42.9%; 

cases decreased among men (from 49 to 27) and among women (from 41 to 24). 

(Figure 28, Tables 35A and 35B). 

• In 2002, the rate of P&S syphilis among African-Americans (9.8 cases per 

100,000 population) was eight times greater than the rate among whites (1.2 

cases per 100,000 population). This differential was substantially less than that in 

2001, when the rate of P&S syphilis among African-Americans was 16 times 

greater than the rate among whites. In 1998, the rate among African-Americans 

was 34 times greater than that among whites (Table 35B). The decline in the 

difference in rates between African-Americans and whites is due to significant 

decreases in rates among African-Americans in conjunction with increases in 

rates among whites. 

• The incidence of P&S syphilis was highest among women aged 20-24 years (3.3 

cases per 100,000 population) and among men aged 35-39 (9.9 cases per 

100,000 population) in 2002 (Figure 30, Table 34). 

• The South accounted for 45.8% of P&S syphilis in 2002 down from 56.2% in 

2001. From 2001 to 2002, the rate decreased 8.8% in the South (from 3.4 to 3.1 

cases per 100,000 population) but increased 16.7% in the Midwest (from 1.8 to 

2.1), 54.6% in the Northeast (from 1.1 to 1.7), and 64.3% in the West (from 1.4 to 

2.3). The 2002 rates in all regions were greater than the HP2010 objective of 0.2 

case per 100,000 population (Figure 26, Table 27). 

• In 2002, P&S syphilis rates in seven states were less than or equal to the HP2010 

national objective of 0.2 case per 100,000 population (Figure 24, Table 25). Eight 

26 Syphilis National Profile STD Surveillance 2002 
states and one outlying area reported five or fewer cases of P&S syphilis in 2002 

(Tables 25 and 27). 

• In 2002, 2,534 (80.7%) of 3,139 counties in the United States reported no cases 

of P&S syphilis compared with 2,516 (80.2%) counties reporting no cases in 

2001. For 605 counties reporting at least 1 case of P&S syphilis in 2002, 10 

(1.7%) counties had rates at or below the HP2010 objective of 0.2 case per 

100,000 population. Rates of P&S syphilis were above the HP2010 objective for 

595 counties in 2002 (Figure 25). These 595 counties (19.0% of the total number 

of counties in the U.S.) accounted for 99.9% (6,853) of the 6,862 P&S syphilis 

cases reported in 2002. 

• In 2002, half of the total number of P&S syphilis cases were reported from 16 

counties and the city of Baltimore, MD (Table 26). 

• The overall rate of P&S syphilis in 2002 for selected large U.S. cities with 

populations of at least 200,000 persons (5.8 cases per 100,000 population) was 

higher than the rate in 2001 (4.8 cases per 100,000 population). Rates exceeded 

the HP2010 objective of 0.2 case per 100,000 population in all 63 cities in 2002 

(Tables 30 and 31). 

• Between 2001 and 2002, the overall rate of congenital syphilis decreased by 

16.4% in the U.S., from 12.2 to 10.2 cases per 100,000 live births (Figure 32, 

Table 40). There were 412 cases reported in 2002, down from 492 in 2001. 

Among the 17 states and 1 outlying area with 5 or more reported cases of 

congenital syphilis in 2002, 13 of these areas had rates that decreased from 2001 

to 2002. Eight of these states had rate decreases of 30% or more between 2001 

and 2002 (Table 42). 

• The continuing decline in the rate of congenital syphilis (Figure 32) likely reflects 

the substantial reduction in the rate of P&S syphilis among women that has 

occurred during the last decade (Figure 31).11,12 During 1992-2002, the average 

yearly percentage decrease in the congenital syphilis rate was 19.2% (Table 40). 

The average yearly percentage decrease in the rate of P&S syphilis reported 

among women during 1992-2002 was 21.2%. 

• In 2002, 27 states, the District of Columbia, and 1 outlying area had rates of 

congenital syphilis that exceeded the HP2010 objective of 1.0 case per 100,000 

live births (Tables 41 and 43). 

• Twenty-nine (46.0%) of the 63 selected cities in the U.S. with populations of 

200,000 persons or more had congenital syphilis rates greater than the HP2010 

objective of 1.0 case per 100,000 live births in 2002 (Table 43). All of these cities 

had rates that were more than four times the HP2010 objective. 

• Additional information on syphilis and congenital syphilis can be found in the 

Special Focus Profiles. 

1 Ingraham NR. The value of penicillin alone in the prevention and treatment of congenital syphilis. Acta 

Derm Venereol 31 (suppl 24):60,1951. 

2 Division of STD Prevention. The National Plan to Eliminate Syphilis from the United States. National 

Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, 1999. 

STD Surveillance 2002 National Profile Syphilis 27 
3 Centers for Disease Control and Prevention. Primary and secondary syphilis–United States, 1999. MMWR 

2000;50:113-117. 

4 Centers for Disease Control and Prevention. Resurgent bacterial sexually transmitted disease among men 

who have sex with men–King County, Washington, 1997-1999. MMWR 1999;48:773-777. 

5 Centers for Disease Control and Prevention. Outbreak of syphilis among men who have sex with 

men–Southern California, 2000. MMWR 2001;50(7):117-20. 

6 Bronzan R, Echavarria L, Hermida J, Trepka M, Burns T, Fox, K. Syphilis among men who have sex with 

men (MSM) in Miami–Dade County, Florida [Abstract no. P135]. In: Program and abstracts of the 2002 

National STD Prevention Conference, San Diego, California, March 4-7, 2002. 

7 Centers for Disease Control and Prevention. Primary and secondary syphilis among men who have sex 

with men–New York City, 2001. MMWR 2002;51:853-6. 

8 Chen SY, Gibson S, Katz MH, Klausner JD, Dilley JW, Schwarcz SK, Kellogg TA, McFarland W. 

Continuing increases in sexual risk behavior and sexually transmitted diseases among men who have sex 

with men: San Francisco, California, 1999-2001 [Letter]. Am J Public Health 2002;92:1387-8. 

9 Ciesielski CA, Boghani S. HIV infection among men with infectious syphilis in Chicago, 1998-2000 

[Abstract no. 12]. In: Program and abstracts of the 9th Conference on Retroviruses and Opportunistic 

Infections, Seattle, Washington, February 24-28, 2002. 

10U.S. Department of Health and Human Services. Healthy People 2010. 2nd ed. With Understanding and 

Improving Health and Objectives for Improving Health. 2 vols. Washington, DC: U.S. Government 

Printing Office, November 2000. 

11Centers for Disease Control and Prevention. Congenital syphilis–United States, 2000. MMWR 

2001;50(27):573-7. 

12Centers for Disease Control and Prevention. Primary and secondary syphilis–United States, 2000 – 2001. 

MMWR 2002;51(43):971-3. 

28 Syphilis National Profile STD Surveillance 2002 
Figure 22. Syphilis — Reported cases by stage of infection: United States, 1941–2002 

Cases (in thousands) 

600 

480 

360 

240 

120 

0 

P&S 

Early Latent 

Total Syphilis 

1941 46 51 56 61 66 71 76 81 86 91 96 2001 

Figure 23. Primary and secondary syphilis — Rates: United States, 1970–2002 

and the Healthy People 2010 objective 

Rate (per 100,000 population) 

25 

20 

15 

10 

5 

0 

P&S Syphilis 

2010 Objective 

1970 73 76 79 82 85 88 91 94 97 2000 

Note: The Healthy People 2010 objective for primary and secondary syphilis is 0.2 case per 

100,000 population. 

STD Surveillance 2002 National Profile Syphilis 29 
Figure 24. Primary and secondary syphilis — Rates by state: United States and outlying 

areas, 2002 

1.2 

0.0 0.0 0.2 

0.8 1.2 

0.6 0.0 0.6 2.5 VT 0.3 0.0 4.9 NH 0.6 

0.8 

0.3 

0.4 0.3 

3.9 1.0 1.4 

0.9 MA 

RI 

CT 

1.6 

1.2 

0.8 

3.0 1.5 0.7 0.6 2.2 

0.1 1.0 NJ 

DE 

MD 

2.0 

1.4 

4.3 

3.5 3.0 3.9 2.1 2.1 1.3 3.3 Rate per 100,000 

Guam 3.9 population 

1.7 3.4 5.4 

<=0.2 (n= 7) 2.8 0.21-4.0 (n= 42) 0.0 3.4 >4.0 (n= 4) 3.9 

0.9 

Puerto Rico 7.1 

Virgin Is. 0.9 

Note: The total rate of primary and secondary syphilis for the United States and outlying areas 

(Guam, Puerto Rico and Virgin Islands) was 2.5 per 100,000 population. The Healthy People 

2010 objective is 0.2 case per 100,000 population. 

Figure 25. Primary and secondary syphilis — Rates by county: United States, 2002 

Note: The Healthy People 2010 objective for P&S syphilis is 0.2 case per 100,000 population. 

30 Syphilis National Profile STD Surveillance 2002 
Figure 26. Primary and secondary syphilis — Rates by region: United States, 1981–2002 

and the Healthy People 2010 objective 

Rate (per 100,000 population) 

50 

40 

30 

20 

10 

0 

West 

Midwest 

Northeast 

South 

2010 Objective 

1981 83 85 87 89 91 93 95 97 99 2001 

Figure 27. Primary and secondary syphilis — Rates by sex: United States, 1981–2002 

and the Healthy People 2010 objective 

Rate (per 100,000 population) 

25 

20 

15 

10 

5 

0 

Male 

Female 

2010 Objective 

1981 83 85 87 89 91 93 95 97 99 2001 

STD Surveillance 2002 National Profile Syphilis 31 
Figure 28. Primary and secondary syphilis — Rates by race and ethnicity: United States, 

1981–2002 and the Healthy People 2010 objective 

Rate (per 100,000 population) 

150 

120 

90 

60 

30 

0 

White 

Black 

Hispanic 

Asian/Pac Isl 

Am Ind/AK Nat 

2010 Objective 

1981 83 85 87 89 91 93 95 97 99 2001 

Figure 29. Primary and secondary syphilis — Male to female rate ratios: United States, 

1981–2002 

Male-Female rate ratio 

5:1 

4:1 

3:1 

2:1 

1:1
 

0
 

1981 83 85 87 89 91 93 95 97 99 2001 

32 Syphilis National Profile STD Surveillance 2002 
Figure 30. Primary and secondary syphilis — Age- and sex-specific rates: United States, 

2002 

Men Rate (per 100,000 population)population)population)population)population)population)population)population)population)population)population)population)population)population)population)population)population)population)population)population)population)population) Women 

10.0 8.0 6.0 4.0 2.0 0.0 Age 0.0 2.0 4.0 6.0 8.0 10.0 

0.0 

1.3 

5.5 

6.8 

8.5 

9.9 

7.6 

4.5 

1.7 

0.4 

3.8 

10-14 

15-19 

20-24 

25-29 

30-34 

35-39 

40-44 

45-54 

55-64 

65+ 

Total 

0.1 

2.2 

3.3 

2.4 

2.2 

2.2 

1.6 

0.8 

0.2 

0.0 

1.1 

Note: See Table 34. 

Figure 31. Congenital syphilis — Reported cases for infants <1 year of age and rates of 

primary and secondary syphilis among women: United States, 1970–2002 

P&S rate (per 100,000 population) CS cases (in thousands) 

20 

16 

12 

8 

4 

0 

Kaufman Criteria 

CDC Surveillance 

Definition 

P&S Syphilis 

Congenital 

Syphilis 

7.5 

6.0 

4.5 

3.0 

1.5 

0.0 

1970 75 80 85 90 95 2000 

Note: The surveillance case definition for congenital syphilis changed in 1988. See Appendix 

(Reporting of Congenital Syphilis Cases). Case counts for congenital syphilis shown in this 

graph correspond to those listed in Table 40. 

STD Surveillance 2002 National Profile Syphilis 33 
Figure 32. Congenital syphilis — Rates for infants <1 year of age: United States, 

1981–2002 and the Healthy People 2010 objective 

Rate (per 100,000 live births) 

125
 

100
 

75
 

50
 

25
 

0
 

Cong. Syphilis 

2010 Objective 

1981 83 85 87 89 91 93 95 97 99 2001
 

Note: The Healthy People 2010 objective for congenital syphilis is 1.0 case per 100,000 live 

births. The surveillance case definition for congenital syphilis changed in 1988. See 

Appendix (Reporting of Congenital Syphilis Cases). 

34 Syphilis National Profile STD Surveillance 2002
 
Other Sexually Transmitted Diseases 

Since 1987, reported cases of chancroid have declined steadily until 2001 when 38 cases were reported (Figure 33, Table 1). In 2002, a modest increase occurred with 67 cases of chancroid reported in the United States. Only ten states and one outlying area reported one or more cases of 

chancroid in 2002 and one of these states (South Carolina) accounted for 43 (64.2%) of the 67 reported cases in 2002. South Carolina had the most notable increase in cases between 2001 and 

2002 (15 to 43 cases) (Table 46). Although the overall decline in reported chancroid cases most 

likely reflects a decline in the incidence of this disease, these data should be interpreted with caution 

in view of the fact that Haemophilus ducreyi, the causative organism of chancroid, is difficult to culture and, as a result, this condition may be substantially under diagnosed.1,2 

Case reporting data for genital herpes simplex virus (HSV), genital warts or other human 

papillomavirus infections, and trichomoniasis are not available. Trend data are limited to estimates 

of the office visits in physicians’ office practices provided by the National Disease and Therapeutic 

Index (NDTI) (Figures 34 and 36-37). 

Serious consequences of genital herpes simplex virus infection include lifelong recurrent episodes 

of painful genital lesions, increased likelihood of HIV transmission and acquisition, and, for women 

who acquire genital herpes in pregnancy, potentially fatal neonatal infection.3 Data on herpes simplex virus type 2 (HSV-2) seroprevalence among the non-institutionalized U.S. population are available from the National Health and Nutrition Examination Survey (NHANES). In NHANES III 

(1988-1994), HSV-2 seroprevalence among persons at least 12 years of age was 21.9%, a prevalence which was 30% higher than the age-adjusted HSV-2 seroprevalence from NHANES II 

(1976-1980). Statistically significant increases in seroprevalence were concentrated in 3 of the 

youngest age groups which include persons aged 12 to 39 years (Figure 35).4 Women had a higher 

seroprevalence than men regardless of age or race/ethnicity.5 

For data on Pelvic Inflammatory Disease (PID), see the Special Focus Profile on Women and 

Infants. 

1	 Schulte JM, Martich FA, Schmid GP. Chancroid in the United States, 1981-1990: Evidence for 

underreporting of cases. MMWR 1992;41(no. SS-3):57-61. 

2	 Mertz KJ, Trees D, Levine WC, et al. Etiology of genital ulcers and prevalence of human immunodeficiency 

virus coinfection in 10 US cities. J Infect Dis 1998;178:1795-8. 

3	 Handsfield HH, Stone KM, Wasserheit JN. Prevention agenda for genital herpes. Sex Transm Dis 1999; 

26:228-231. 

4	 Fleming DT, McQuillan GM, Johnson RE, et al. Herpes simplex virus type 2 in the United States, 1976 to 

1994. N Engl J Med 1997;337:1105-11. 

5	 Xu F, Schillinger JA, Sternberg MR, et al. Seroprevalence and coinfection with herpes virus type 1 and type 2 

in the United States, 1988-1994. J Infect Dis 2002;185:1019-24. 

STD Surveillance 2002 National Profile Other Sexually Transmitted Diseases 35 
Figure 33. Chancroid — Reported cases: United States, 1981–2002 

Cases (in thousands)

5

4

3

2

1

0

1981 83 85 87 89 91 93 95 97 99 2001

Figure 34. Genital herpes — Initial visits to physicians’ offices: United States, 1966–2002 

Visits (in thousands)

250

200

150

100

50

0

1966 69 72 75 78 81 84 87 90 93 96 99 2002

Note: See Appendix (Other Data Sources).
 

SOURCE: National Disease and Therapeutic Index (IMS America, Ltd.)
 

36 Other Sexually Transmitted Diseases National Profile STD Surveillance 2002 
Figure 35. Herpes simplex virus type 2 infections — Percent seroprevalence according to 

age in NHANES II (1976-1980) and NHANES III (1988-1994) 

Percent

40

32

24

16

8

0

NHANES II

NHANES III

12-19 20-29 30-39 40-49 50-59 60-69 70+
 

Age Group

Note: Bars indicate 95% confidence intervals.
 

SOURCE: National Health and Nutrition Examination Survey (NHANES)
 

Figure 36. Genital warts — Initial visits to physicians’ offices: United States, 1966–2002 

Visits (in thousands)
 

400
 

320
 

240
 

160
 

80
 

0
 

1966 69 72 75 78 81 84 87 90 93 96 99 2002

Note: See Appendix (Other Data Sources).
 

SOURCE: National Disease and Therapeutic Index (IMS America, Ltd.)
 

STD Surveillance 2002 National Profile Other Sexually Transmitted Diseases 37 
Figure 37. Trichomoniasis and other vaginal infections — Initial visits to physicians’ 

offices: United States, 1966–2002 

Visits (in thousands)

4,500
 

3,600
 

2,700
 

1,800
 

900
 

0
 

Trichomonal

Other Vaginitis

1966 69 72 75 78 81 84 87 90 93 96 99 2002
 

Note: See Appendix (Other Data Sources).
 

SOURCE: National Disease and Therapeutic Index (IMS America, Ltd.)
 

38 Other Sexually Transmitted Diseases National Profile STD Surveillance 2002
 
SPECIALFOCUSPROFILES
 

Special Focus Profiles 

The Special Focus Profiles highlight trends and distribution of sexually transmitted diseases

(STDs) in populations of particular interest for STD and HIV prevention programs in state and local

health departments. These populations are most vulnerable to STDs and their consequences:

women and infants, adolescents and young adults, minorities, men who have sex with men (MSM),

and persons entering corrections facilities. The Special Focus Profiles refer to figures located in

disease-specific sections in the National Profile and additional figures (Figures A-LL) that highlight specific points made in the text.

STD Surveillance 2002 Special Focus Profiles 39 

4,5,6

STDs in Women and Infants
 

Public Health Impact 

Women and infants disproportionately bear the long term consequences of STDs. Women infected 

with Neisseria gonorrhoeae or Chlamydia trachomatis can develop pelvic inflammatory disease 

(PID), which, in turn, may lead to reproductive system morbidity such as ectopic pregnancy and 

tubal factor infertility. If not adequately treated, 20% to 40% of women infected with chlamydia1 

and 10% to 40% of women infected with gonorrhea2 may develop PID. Among women with PID, 

tubal scarring will cause involuntary infertility in 20%, ectopic pregnancy in 9%, and chronic pelvic 

pain in 18%.3 Approximately 70% of chlamydial infections and 50% of gonococcal infections in 

women are asymptomatic. 4-6These infections are detected primarily through screening programs. 

The vague symptoms associated with chlamydial and gonococcal PID cause 85% of women to delay seeking medical care, thereby increasing the risk of infertility and ectopic pregnancy.7 Data from 

a randomized controlled trial of chlamydia screening in a managed care setting suggest that such 

screening programs can reduce the incidence of PID by as much as 60%.8 

Gonorrhea and chlamydia can also result in adverse outcomes of pregnancy, including neonatal 

ophthalmia and, in the case of chlamydia, neonatal pneumonia. Although topical prophylaxis of infants at delivery is effective for prevention of ophthalmia neonatorum, prevention of neonatal pneumonia requires prenatal detection and treatment. 

Human papillomavirus (HPV) infections are highly prevalent, especially among young sexually 

active women. While the great majority of HPV infections in women resolve within one year, they 

are a major concern because persistent infection with specific types (e.g., types 16, 18, 31, 33, 35, 

and 45), are causally related to cervical cancer; these types also cause Pap smear abnormalities. 

Other types (e.g., types 6 and 11) cause genital warts, low grade Pap smear abnormalities and, 

rarely, recurrent respiratory papillomatosis in infants born to infected mothers.9 

Genital infections with herpes simplex virus are extremely common, may cause painful outbreaks, and may have serious consequences for pregnant women including potentially fatal 

neonatal infections.10 

When a woman has a syphilis infection during pregnancy, she may transmit the infection to 

the fetus in utero. This may result in fetal death or an infant born with physical and mental developmental disabilities. Most cases of congenital syphilis are easily preventable if women are 

screened for syphilis and treated early during prenatal care.11 

Observations 

• Between 2001 and 2002, the reported case rate of chlamydial infections in 

women increased from 435.2 to 455.4 per 100,000 females (Figure 6, Table 5). 

STD Surveillance 2002 Special Focus Profiles STDs in Women and Infants 41 
Chlamydia rates exceed gonorrhea rates among women in all states (Figures A 

and B, Tables 5 and 15). 

• In 2002, the median state-specific chlamydia test positivity among 15- to 24­

year-old women screened in selected prenatal clinics in 26 states and the Virgin 

Islands was 7.4% (range 1.5% to 14.4%) (Figure F). 

• In 2002, the median state-specific chlamydia test positivity among 15- to 

24-year-old women who were screened during visits to selected family planning 

clinics in all states and outlying areas was 5.6% (range 3.0% to 14.2%) (Figure 8). 

• Gonorrhea rates among women were higher than the overall HP 2010 objective 

of 19.0 cases per 100,000 population12 in 42 states and two outlying areas in 

2002 (Figure B, Table 15). As in previous years, the highest rates of gonorrhea 

among women in 2002 occurred in the South (Figure B). 

• Like chlamydia, gonorrhea is often asymptomatic in women and can only be 

identified through screening. Large-scale screening programs for gonorrhea in 

women began in the late 1970s. After an initial increase in cases detected through 

screening, gonorrhea rates for both women and men declined steadily throughout 

the 1980s and early 1990s (Figure 14, Tables 15 and 16). The gonorrhea rate for 

women in 2002 (125.3 per 100,000 females) showed a slight decline since 1998. In 

2002, the gonorrhea rate among males declined to 124.2 per 100,000 males, 

similar to the female gonorrhea rate (Figure 14). 

• In 2002, the median state-specific gonorrhea test positivity among 15- to 24-yearold women screened in selected prenatal clinics in 20 states and the Virgin Islands 

was 0.9% (range 0.0% to 5.7%) (Figure G). 

• The HP2010 objective for primary and secondary (P&S) syphilis is 0.2 case per 

100,000 population. In 2002, 32 states, the District of Columbia, and two 

outlying areas had rates of P&S syphilis for women that were greater than 0.2 

case per 100,000 population (Figure C, Table 28). 

• The HP2010 objective for congenital syphilis is 1.0 case per 100,000 live births. In 

2002, 27 states, the District of Columbia, and one outlying area had rates higher 

than this objective (Figure D, Tables 41 and 42). 

• The rate of congenital syphilis closely follows the trend of P&S syphilis among 

women (Figure E). Peaks in congenital syphilis usually occur one year after peaks 

in P&S syphilis among women. The congenital syphilis rate peaked in 1991 at 

107.3 cases per 100,000 live births, and declined by 90.5% to 10.2 cases per 

100,000 live births in 2002 (Figure 32, Table 40). The rate of P&S syphilis among 

women declined 93.6% (from 17.3 to 1.1 cases per 100,000 females) from 1990 

to 2002 (Figure 31). 

• While most cases of congenital syphilis occur among infants whose mothers have 

had some prenatal care (Figure E), late or limited prenatal care has been 

associated with congenital syphilis. Failure of health care providers to adhere to 

maternal syphilis screening recommendations also may contribute to the 

occurrence of congenital syphilis.13 

• Accurate estimates of pelvic inflammatory disease (PID) and tubal factor infertility 

resulting from gonococcal and chlamydial infections are difficult to obtain. 

Definitive diagnosis of these conditions can be complex. Hospitalizations for PID 

have declined steadily throughout the 1980s and early 1990s, but have remained 

42 STDs in Women and Infants Special Focus Profiles STD Surveillance 2002 
relatively constant between 1995 and 2001 (Figure I). These trends may reflect 

changes in the etiology of PID (with increasing proportions of more indolent 

chlamydial infection) as well as changes in the clinical diagnosis and management 

of PID rather than true trends in disease. A greater proportion of women 

diagnosed with PID in the 1990s have been treated in outpatient instead of 

inpatient settings when compared to women diagnosed with PID in the 1980s.14 

• The reported number of initial visits to physicians’ offices for PID through the 

National Disease and Therapeutic Index (NDTI) has generally declined from 

1993 through 2002 (Figure J). In 2000, an estimated 337,053 cases of PID were 

diagnosed in emergency departments among women 15- to 44-years of age 

(National Hospital Ambulatory Medical Care Survey, NCHS). 

• Evidence suggests that health care practices associated with ectopic pregnancy 

changed in the late 1980s and early 1990s. Before that time, treatment of 

ectopic pregnancy usually required admission to a hospital. Hospitalization 

statistics were therefore useful for monitoring trends in ectopic pregnancy. 

Beginning in 1989, hospitalizations for ectopic pregnancy have generally 

declined over time (Figure H). Data suggest that nearly half of all ectopic 

pregnancies are treated on an outpatient basis.15 

1	 Stamm WE, Guinan ME, Johnson C. Effect of treatment regimens for Neisseria gonorrhoeae on 

simultaneous infections with Chlamydia trachomatis. N Engl J Med 1984;310:545-9. 

2	 Platt R, Rice PA, McCormack WM. Risk of acquiring gonorrhea and prevalence of abnormal adnexal 

findings among women recently exposed to gonorrhea. JAMA 1983;250:3205-9. 

3	 Westrom L, Joesoef R, Reynolds G, et al. Pelvic inflammatory disease and fertility: a cohort study of 1,844 

women with laparoscopically verified disease and 657 control women with normal laparoscopy. Sex 

Transm Dis 1992;9:185-92. 

4	 Hook EW III, Handsfield HH. Gonococcal infections in the adult. In: Holmes KK, Mardh PA, Sparling PF, 

et al, eds. Sexually Transmitted Diseases, 2nd edition. New York City: McGraw-Hill, Inc, 1990:149-65. 

5	 Stamm WE, Holmes KK. Chlamydia trachomatis infections in the adult. In: Holmes KK, Mardh PA, 

Sparling PF, et al, eds. Sexually Transmitted Diseases, 2nd edition. New York City: McGraw-Hill, Inc, 

1990:181-93. 

6	 Zimmerman HL, Potterat JJ, Dukes RL, et al. Epidemiologic differences between chlamydia and 

gonorrhea. Am J Public Health 1990;80:1338-42. 

7	 Hillis SD, Joesoef R, Marchbanks PA, et al. Delayed care of pelvic inflammatory disease as a risk factor for 

impaired fertility. Am J Obstet Gynecol 1993;168:1503-9. 

8	 Scholes D, Stergachis A, Heidrich FE, Andrilla H, Holmes KK, Stamm WE. Prevention of pelvic 

inflammatory disease by screening for cervical chlamydial infection. N Engl J Med 1996;34(21):1362-6. 

9	 Division of STD Prevention. Prevention of Genital HPV Infection and Sequelae: Report of an External 

Consultants’ Meeting. National Center for HIV, STD, and TB Prevention, Centers for Disease Control and 

Prevention, Atlanta, December 1999. 

STD Surveillance 2002	 Special Focus Profiles STDs in Women and Infants 43 
10Handsfield HH, Stone KM, Wasserheit JN. Prevention agenda for genital herpes. Sex Transm Dis 

1999;26:228-231. 

11Centers for Disease Control. Guidelines for prevention and control of congenital syphilis. MMWR 

1988;37(No.S-1). 

12U.S. Department of Health and Human Services. Healthy People 2010. 2nd ed. With Understanding and 

Improving Health and Objectives for Improving Health. 2 vols. Washington, DC: U.S. Government 

Printing Office, November 2000. 

13Centers for Disease Control and Prevention. Congenital syphilis–United States, 2000. MMWR 

2001;50:573-77. 

14Rolfs RT, Galaid EI, Zaidi AA. Pelvic inflammatory disease: trends in hospitalization and office visits, 1979 

through 1988. Am J Obstet Gynecol 1992;166:983-90. 

15Centers for Disease Control and Prevention. Ectopic pregnancy in the United States, 1990-1992. MMWR 

1995;44:46-8. 

44 STDs in Women and Infants Special Focus Profiles STD Surveillance 2002 
Figure A. Chlamydia — Rates for women by state: United States and outlying areas, 2002 

371.7

406.4 204.2 256.8

291.8 296.0

288.6 422.8 453.0 419.2 VT 240.3 307.7 496.1 NH 186.0

445.3

223.9

415.8 313.9

538.8 424.5 506.1

370.7 MA

RI

CT

248.5

377.7

440.6

477.8 488.1 415.7 461.0 340.8

223.0 418.7 NJ

DE

MD

281.3

504.6

505.8

496.4 432.5 454.0 640.0 499.4 425.0 604.3 Rate per 100,000

Guam 612.2 population

698.4 608.0 661.0

<=150.0 (n= 1) 547.1 150.1-300.0 (n= 11) 850.7 640.0 >300.0 (n= 41) 414.2

571.4

Puerto Rico 134.9

Virgin Is. 331.3

Note: The total rate of chlamydia for women in the United States and outlying areas (Guam, Puerto 

Rico and Virgin Islands) was 451.1 per 100,000 female population. 

Figure B. Gonorrhea — Rates for women by state: United States and outlying areas, 2002 

40.4

16.6 6.7 12.4

20.7 68.0

7.6 136.9 38.9 113.3 VT 18.0 15.5 157.4 NH 8.1

55.1 MA 48.0 113.4

98.4 104.7 RI 88.9 204.5 13.5 129.0 CT 108.8 193.6

63.9 76.9 61.0 NJ 91.4 151.0 114.4 167.3 DE 212.9 93.7 MD 167.7

184.7 156.4 64.6 146.2 Rate per 100,000 80.0 174.5 211.2

Guam 34.4 population

216.2 223.7 285.6 <=19.0 (n= 9) 134.1 19.1-100.0 (n= 18) 254.2 116.6 >100.0 (n= 26) 126.7

65.4

Puerto Rico 11.6

Virgin Is. 67.0

Note: The total rate of gonorrhea for women in the United States and outlying areas (Guam, Puerto 

Rico and Virgin Islands) was 123.7 per 100,000 female population. 

STD Surveillance 2002 Special Focus Profiles STDs in Women and Infants 45 
Figure C. Primary and secondary syphilis — Rates for women by state: United States and 

outlying areas, 2002 

0.0

0.0 0.0 0.0

0.5 0.2

0.6 0.0 0.2 0.3 VT 0.0 0.0 3.8 NH 0.0

0.1

0.0

0.2 0.3

1.3 0.6 0.5

0.3 MA

RI

CT

0.4

0.4

0.2

0.2 0.1 0.4 0.3 2.1

0.1 0.5 NJ

DE

MD

1.1

1.0

1.9

2.8 2.8 2.9 1.3 1.1 1.3 2.8 Rate per 100,000

Guam 2.6 population

2.1 2.7 2.4

<=0.2 (n= 19) 1.8 0.21-4.0 (n= 33) 0.0 3.3 >4.0 (n= 1) 1.3

0.3

Puerto Rico 6.2

Virgin Is. 0.0

Note: The total rate of primary and secondary syphilis for women in the United States and outlying 

areas (Guam, Puerto Rico and Virgin Islands) was 1.2 per 100,000 female population. 

Figure D. Congenital syphilis — Rates for infants <1 year of age by state: United States and 

outlying areas, 2002 

2.5

0.0 0.0 0.0

0.0 1.5

0.0 0.0 0.0 9.8 VT 0.0 0.0 24.0 NH 0.0

0.0

0.0

0.0 0.0

21.2 8.1 2.0

3.5 MA

RI

CT

1.2

0.0

0.0

10.6 3.0 0.0 1.3 5.5

0.0 1.0 NJ

DE

MD

31.1

0.0

20.5

11.0 2.6 22.2 0.0 4.0 21.6 25.1 Rate per 100,000

Guam 0.0 live births

14.2 9.9 7.5

<=1.0 (n= 25) 20.0 1.1-10.0 (n= 15) 0.0 1.5 >10.0 (n= 13) 13.6

0.0

Puerto Rico 35.8

Virgin Is. 0.0

Note: The total rate of congenital syphilis for infants <1 year of age for the United States and outlying 

areas (Guam, Puerto Rico and Virgin Islands) was 10.6 per 100,000 live births. The Healthy 

People 2010 objective is 1.0 case per 100,000 live births. 

46 STDs in Women and Infants Special Focus Profiles STD Surveillance 2002 
Figure E. Congenital syphilis — Cases by prenatal care utilization: United States,
 

1995-2002
 

Cases

Prenatal

No prenatal

Unknown

0

240

480

720

960

1,200

1995 1996 1997 1998 1999 2000 2001 2002
 

Figure F. Chlamydia — Positivity among 15-24 year old women tested in prenatal
 

clinics by state: United States and outlying areas, 2002
 

Positivity (%)

See *

<5

5.0-9.9

>=10

VT

NH

MA

RI

CT

NJ 7.6

DE 5.3

MD 4.0

DC

Puerto Rico

Virgin Is. 14.4

(n= 26)

(n= 5)

(n= 18)

(n= 4)

7.8

8.0

5.6

8.8 7.2

6.6

7.4 4.1

13.9

11.8

7.7

7.1 1.7

8.1

7.1

6.6

3.9

8.1

7.5

6.4

11.0

8.9 1.5

*States not reporting chlamydia positivity data in prenatal clinics.
 

Note: States reported chlamydia positivity data on at least 100 women aged 15-24 years during 2002.
 

SOURCE: Regional Infertility Prevention Projects; Office of Population Affairs; Local and State STD Control Programs; Centers
 

for Disease Control and Prevention 

STD Surveillance 2002 Special Focus Profiles STDs in Women and Infants 47
 
Figure G. Gonorrhea — Positivity among 15-24 year old women tested in prenatal 

clinics by state: United States and outlying areas, 2002 

VT

NH

MA

0.0 1.0 5.7 RI

0.7 0.6

2.6 0.6

0.5

1.3

CT

NJ

DE

MD

1.5

DC

2.7 0.5 1.1 1.2 0.9 Positivity (%)

2.3 0.8

See * (n= 32) 0.8 <1 (n= 11) 4.3 1.0-1.9 (n= 5) 0.6 >=2 (n= 5)

Puerto Rico

Virgin Is. 0.9

*States not reporting gonorrhea positivity data in prenatal clinics.
 

Note: States reported gonorrhea positivity data on at least 100 women aged 15-24 years during 2002.
 

SOURCE: Regional Infertility Prevention Projects; Office of Population Affairs; Local and State STD Control Programs; Centers
 

for Disease Control and Prevention 

Figure H. Ectopic pregnancy — Hospitalizations of women 15-44 years of age: United 

States, 1980-2001 

Hospitalizations (in thousands)

100

80

60

40

20

0

1980 82 84 86 88 90 92 94 96 98 2000

Note: Some variations in 1981 and 1988 numbers may be due to changes in sampling 

procedures. The relative standard error for these estimates ranges from 8% to 11%. 

SOURCE: National Hospital Discharge Survey (National Center for Health Statistics, CDC) 

48 STDs in Women and Infants Special Focus Profiles STD Surveillance 2002 
Figure I.	 Pelvic inflammatory disease — Hospitalizations of women 15-44 years of age: 

United States, 1980–2001 

Hospitalizations (in thousands)
 

200
 

160
 

120
 

80
 

40
 

0
 

Acute, Unspec.

Chronic

1980 82 84 86 88 90 92 94 96 98 2000

Note: The relative standard error for the estimates of the overall total number of PID cases range 

from 6% to 15%. 

SOURCE: National Hospital Discharge Survey (National Center for Health Statistics, CDC) 

Figure J.	 Pelvic inflammatory disease — Initial visits to physicians’ offices by women 

15-44 years of age: United States, 1980–2002 

Visits (in thousands)
 

500
 

400
 

300
 

200
 

100
 

0
 

1980 82 84 86 88 90 92 94 96 98 2000 02

Note: See Appendix (Other Data Sources).
 

SOURCE: National Disease and Therapeutic Index (IMS America, Ltd.)
 

STD Surveillance 2002 Special Focus Profiles STDs in Women and Infants 49 

1,23,

STDs in Adolescents and Young Adults
 

Public Health Impact 

Compared to older adults, adolescents (10- to 19-year-olds) and young adults (20- to 

24-year-olds) are at higher risk for acquiring STDs for a number of reasons. For example, they may 

be more likely to have multiple (sequential or concurrent) sexual partners rather than a single, 

long-term relationship. In addition, for some STDs, for example Chlamydia trachomatis, adolescent 

women may have a physiologically increased susceptibility to infection due to increased cervical 

ectopy. 

The higher prevalence of STDs among adolescents also reflects multiple barriers to quality STD 

prevention services, including lack of insurance or other ability to pay, lack of transportation, 

discomfort with facilities and services designed for adults, and concerns about confidentiality. 

Observations 

• Numerous prevalence studies in various clinic populations have shown that 

sexually active adolescents have high rates of chlamydial infection. 1-3 The 

Regional Infertility Prevention Projects that routinely perform large scale 

screening for detecting chlamydial infections among women attending family 

planning clinics demonstrate that younger women consistently have higher 

positivity than older women, even when prevalence declines. An example is the 

Region X Chlamydia Project, which has screened women in family planning 

clinics since 1988 (Figure K). 

• Among women in 2002, as in previous years, 15- to 24-year-olds had the highest 

rates of gonorrhea compared to women in all other age categories (Figure P and 

Table 21). In addition, 20- to 29-year-old women had the highest rates of primary 

and secondary syphilis in 2002 (Figure R and Table 34). Among men, 20- to 

24-year-olds had the highest rate of gonorrhea and 30- to 39-year-olds had the 

highest rate of primary and secondary syphilis (Figures Q and S and Tables 21 

and 34). 

• Gonorrhea rates among 15- to 19-year-olds have decreased 12.2% from 542.4 

per 100,000 population in 1998 to 476.4 per 100,000 population in 2002. 

• In 15- to 19-year-old women, the 2002 gonorrhea rate of 675.6 cases per 

100,000 females was a 3.9% decrease from the 2001 rate of 703.2. Among 

young women in the 20- to 24-year-old group, the rate of gonorrhea in 2002 was 

650.3, a 2.1% decrease from 664.1 in 2001. Since 1998, the rates in these two 

age groups have been converging (Figure P, Table 21). 

• Rates of gonorrhea among male adolescents generally decreased between the 

years 1991 and 2002 (Figure Q). In the 15- to 19-year-old group, the gonorrhea 

rate declined for the fourth year in a row, from 344.4 cases per 100,000 males in 

STD Surveillance 2002 Special Focus Profiles STDs in Adolescents and Young Adults 51 
1998 to 287.9 cases per 100,000 males in 2002 (a 16.4% decline) among young 

men in the 20- to 24-year-old group. After declining in the early 1990s, the 

gonorrhea rate has remained relatively unchanged since 1997 (537.1 cases per 

100,000 males in 1997 and 538.1 cases per 100,000 males in 2002). 

• Since 1990, approximately 20,000 female National Job Training Program 

entrants have been screened each year for chlamydia. This program, 

administered by the U.S. Department of Labor at more than 100 sites throughout 

the country, is a job training program for economically-disadvantaged youth 

aged 16 through 24 years. 

• Chlamydial infection is widespread geographically and highly prevalent among 

economically-disadvantaged young women in the National Job Training 

Program.3 Among women entering the program from 28 states and Puerto Rico in 

2002, based on their place of residence before program entry, the median 

state-specific chlamydia prevalence was 10.1% (range 4.4% to 16.8%) (Figure L). 

• Data from National Job Training Program centers that submit gonorrhea 

specimens from female students aged 16 to 24 years to a national contract 

laboratory indicate a high prevalence of gonococcal infection in this population. 

Specimens from at least 100 students from each of 21 states were tested by the 

contract laboratory; the median state-specific gonorrhea prevalence was 2.9% 

(range 0.0% to 6.8%) in 2002 (Figure O). 

• The Adolescent Women Reproductive Health Monitoring Project was established 

in 1999 to monitor STD prevalence and reproductive health measures among 

adolescent women (less than 20 years old) in non-traditional venues, including 

school-based clinics, juvenile corrections facilities, drug treatment centers, and 

organizations serving street youth. In 2002, results from this screening project, 

that uses urine-based tests, identified a median site-specific chlamydia positivity 

of 13.2% (range 7.9% to 15.9%) at 19 school-based clinics and 9.7% (range 

5.2% to 39.1%) at 14 organizations serving street youth (Figure M). Median 

site-specific gonorrhea positivity was 4.3% (range 1.6% to 8.5%) at school-based 

clinics and 1.7% (range 0.0% to 13.9%) at organizations serving street youth 

(Figure N). 

• Among adolescent women attending juvenile corrections facilities, data from the 

Adolescent Women Reproductive Health Monitoring Project and the Jail STD 

Prevalence Monitoring Project identified a median chlamydia positivity of 16.7% 

(range 6.3% to 28.3%) (Figure II) and a median gonorrhea positivity of 5.6% 

(range 0.6% to 12.4%) (Figure KK). See Special Focus Profiles (STDs in 

Persons Entering Corrections Facilities). 

1	 Centers for Disease Control and Prevention. Recommendations for the prevention and management of 

Chlamydia trachomatis infections, 1993. MMWR 1993;42(No. RR-12). 

2	 Lossick J, Delisle S, Fine D, Mosure D, Lee V, Smith C. Regional program for widespread screening for 

Chlamydia trachomatis in family planning clinics. In: Bowie WR, Caldwell HD, Jones RP, et al., eds. 

Chlamydial Infections: Proceedings of the Seventh International Symposium of Human Chlamydial 

Infections, Cambridge, Cambridge University Press 1990, pp. 575-9. 

3	 Mertz, KJ, Ransom RL, St. Louis ME, Groseclose SL, Hadgu A, Levine WC, Hayman C. Decline in the 

prevalence of genital chlamydia infection in young women entering a National Job Training Program, 

1990-1997. Am J Pub Health 2001;91(8):1287-1290. 

52 STDs in Adolescents and Young Adults Special Focus Profiles STD Surveillance 2002 
Figure K. Chlamydia — Positivity among women tested in family planning clinics by 

age group: Region X, 1988–2002 

Percent 

15 

<18 Years 

18-19 Years 

12 20-24 Years 

25-29 Years 

30+ Years 

9 

6 

3 

0 

1988 89 90 91 92 93 94 95 96 97 98 99 2000 01 02 

Note: Women who met screening criteria were tested. Trends not adjusted for changes in 

laboratory test method and associated increases in test sensitivity in 1994 and 1999–2002. 

SOURCE: Regional Infertility Prevention Projects: Region X Chlamydia Project 

Figure L. Chlamydia — Prevalence among 16-24 year-old women entering the National Job 

Training Program by state of residence: United States and outlying areas, 2002 

4.8 

4.4 

10.3 VT 

11.6 NH 

MA 10.4 10.1 RI 

8.7 5.6 10.8 10.6 

10.0 8.4 7.9 

8.6 

CT 

NJ 

DE 

16.8 

MD 9.9 

9.2 DC 

9.6 9.4 15.4 9.8 Prevalence (%) 

14.5 14.5 12.3 

See * (n= 25) 12.6 <10 (n= 13) 16.1 10.0-14.9 (n= 12) 12.8 >=15 (n= 3) 

Puerto Rico 7.7 

Virgin Is. 

*Fewer than 100 women residing in these states and entering the National Job Training Program 

were screened for chlamydia in 2002. 

Note: The overall chlamydia prevalence among female students entering the National Job Training 

Program in 2002 was 10.5%. 

SOURCE: U.S. Department of Labor 

STD Surveillance 2002 Special Focus Profiles STDs in Adolescents and Young Adults 53 
Figure M. Chlamydia — Adolescent Women Reproductive Health Monitoring Project 

chlamydia positivity by venue and project area, 2002 

Percent 

Colorado 

Connecticut 

New York City 

Utah 

Wisconsin 

0 

8 

16 

24 

32 

40 

-------- Schools -------- ----- Street Youth ----­

Venues 

Note: Where data are missing for project areas and venues, no testing or fewer than 50 

chlamydia tests were performed at the missing location in 2002. 

Figure N. Gonorrhea — Adolescent Women Reproductive Health Monitoring Project 

gonorrhea positivity by venue and project area, 2002 

Percent 

Colorado 

Connecticut 

New York City 

Utah 

Wisconsin 

0 

3 

6 

9 

12 

15 

-------- Schools -------- ----- Street Youth ----­

Venues 

Note: Where data are missing for project areas and venues, no testing or fewer than 50 

gonorrhea tests were performed in 2002. 

54 STDs in Adolescents and Young Adults Special Focus Profiles STD Surveillance 2002 
0.6 

2.5 VT 

2.5	 NH 

MA 0.5 2.3 RI 5.3 CT 

NJ 4.0 

1.3 1.6 DE 5.7 MD 2.9 

DC 3.7 6.3 3.0 2.4 Prevalence (%) 

3.6 3.3 6.8 See * (n= 32) 0.0 <2 (n= 5) 6.3 2.0-4.9 (n= 11) 2.2 >=5 (n= 5) 

Puerto Rico Virgin Is. 

Rate (per 100,000 population) 

1,500 

10-14 

15-19 

20-24 1,200 25-29 

30-34 

35-39 

40-44 900 

600 

300 

0 

1981 83 85 87 89 91 93 95 97 99 2001 

Figure O. Gonorrhea — Prevalence among 16-24 year-old women entering the National Job 

Training Program by state of residence: United States and outlying areas, 2002 

*Fewer than 100 women residing in these states and entering the National Job Training Program 

were screened for gonorrhea by the national contract laboratory in 2002. 

Note: Many training centers test female students for gonorrhea using local laboratories; these results 

are not available to CDC. For this map, gonorrhea test results for students at centers submitting 

specimens to the national contract laboratory were included if the number of gonorrhea tests 

submitted was greater than 90% of the number of chlamydia tests submitted. The overall 

gonorrhea prevalence among female students entering the National Job Training Program in 

2002 was 2.9%. 

SOURCE: U.S. Department of Labor 

Figure P. Gonorrhea — Age-specific rates among women 10-44 years of age: United 

States, 1981–2002 

STD Surveillance 2002 Special Focus Profiles STDs in Adolescents and Young Adults 55 
Figure Q. Gonorrhea — Age-specific rates among men 10-44 years of age: United States, 

1981–2002 

Rate (per 100,000 population) 

2,000 

1,600 

1,200 

800 

400 

0 

10-14 

15-19 

20-24 

25-29 

30-34 

35-39 

40-44 

1981 83 85 87 89 91 93 95 97 99 2001 

Figure R. Primary and secondary syphilis — Age-specific rates among women 10-44 years of 

age: United States, 1981–2002 

Rate (per 100,000 population) 

75 

60 

45 

30 

15 

0 

10-14 

15-19 

20-24 

25-29 

30-34 

35-39 

40-44 

1981 83 85 87 89 91 93 95 97 99 2001 

56 STDs in Adolescents and Young Adults Special Focus Profiles STD Surveillance 2002 
Figure S. Primary and secondary syphilis — Age-specific rates among men 10-44 years of 

age: United States, 1981–2002 

Rate (per 100,000 population) 

75
 

60
 

45
 

30
 

15
 

0
 

10-14 

15-19 

20-24 

25-29 

30-34 

35-39 

40-44 

1981 83 85 87 89 91 93 95 97 99 2001
 

STD Surveillance 2002 Special Focus Profiles STDs in Adolescents and Young Adults 57
 

STDs in Racial and Ethnic Minorities
 

Public Health Impact 

Surveillance data show higher rates of reported STDs among some minority racial or ethnic 

groups when compared with rates among whites. Race and ethnicity in the United States are risk 

markers that correlate with other more fundamental determinants of health status such as poverty, 

access to quality health care, health care seeking behavior, illicit drug use, and living in communities 

with high prevalence of STDs. Acknowledging the disparity in STD rates by race or ethnicity is one 

of the first steps in empowering affected communities to organize and focus on this problem. 

Surveillance data are based on cases of STDs reported to state and local health departments 

(see Appendix). In many areas, reporting from public sources, for example STD clinics, is more 

complete than reporting from private sources. Since minority populations may utilize public 

clinics more than whites, differences in rates between minorities and whites may be increased by 

this reporting bias. 

Observations 

• Although chlamydia is a widely distributed STD among all racial and ethnic 

groups, trends in positivity in women screened in HHS Region X show 

consistently higher chlamydia positivity among minorities (Figure T). 

• In 2002, chlamydia positivity among sexually active 15- to 30-year-old women 

screened at clinics of the Indian Health Service (IHS) in three IHS areas ranged 

from 7.4% to 9.7% (Figure U). 

• In 2002, 73.3% of the total number of cases of gonorrhea reported to CDC 

occurred among African-Americans (Table 22A). In 2002, the rate of gonorrhea 

among African-Americans was 742.3 cases per 100,000 population, among 

American Indian/Alaska Natives the rate was 126.8, and among Hispanics the 

rate was 76.0 (Table 22B) . These rates are 24, 4, and 2 times higher, 

respectively, than the rate among whites in 2002 of 31.1 cases per 100,000 

population (Figure 15, Table 22B). The reported rate of gonorrhea among 

Asian/Pacific Islanders in 2002 was 24.1 cases per 100,000 population. 

• Gonorrhea rates in 2002 were highest for African-Americans aged 15- to 

24-years among all racial, ethnic, and age categories. In 2002, African-American 

women aged 15- to 19-years had a gonorrhea rate of 3,307.7 cases per 100,000 

females. This rate is 17 times greater than the 2002 rate among white females of 

similar age (196.1). African-American men in the 15- to 19-year-old age category 

had a 2002 gonorrhea rate of 1680.1 cases per 100,000 males, which was 45 

times higher than the rate among 15- to 19-year-old white males of 37.7 (Table 22B). 

Among 20- to 24-year-olds in 2002, the gonorrhea rate among African-Americans 

STD Surveillance 2002 Special Focus Profiles STDs in Racial and Ethnic Minorities 59 
was 21 times greater than that among whites (3,197.6 and 152.0 cases per 

100,000 population, respectively) (Table 22B). 

• Although gonorrhea rates declined for most age and race/ethnic groups during the 

1980s, they did not decline for African-American adolescents. African-American 

females aged 15 to 19 did not show a decline in rates until 1991 (Figure V). Declines 

among African-American males aged 15- to 19-years did not begin until 1992 

(Figure W). From 2001 to 2002 gonorrhea rates among African-Americans 

declined by 5.1% (782.3 and 742.3 cases per 100,000 population, respectively). In 

2002, rates decreased among Asian/Pacific Islanders by 9.7%. During the same 

period, gonorrhea rates increased by 10.8% among American Indian/Alaska 

Natives, 2.4% among Hispanics and 5.4% among whites (Table 22B). 

• The syphilis epidemic in the late 1980s occurred primarily among heterosexual, 

minority populations.1 During the 1990s, the rates of primary and secondary (P&S) 

syphilis declined among all racial and ethnic groups (Figure 28 and Table 35B). 

During 2000 to 2002, the rate continued to decline among African-Americans, but 

the overall rate of P&S syphilis and rates among whites, Hispanics, and 

Asian/Pacific Islanders increased; increases in P&S syphilis occurred only among 

men and the most rapid rate of increase occurred among white men during this 

time. Despite recent changes in the demographics of syphilis infection, the rates of 

P&S syphilis continue to be higher among African-Americans and Hispanics than 

among whites. 

• In 2002, 49.8% of all cases of P&S syphilis reported to CDC occurred among 

African-Americans (Table 35A). Although the rate of P&S syphilis among 

African-Americans declined from 11.0 to 9.8 cases per 100,000 population 

between 2001 and 2002, the 2002 rate was 8 times greater than the rate among 

whites (1.2 cases per 100,000 population) (Table 35B). 

• The incidence of P&S syphilis in African-Americans was highest among women 

aged 20-24 years (17.2 cases per 100,000 population) and highest among men 

aged 35-39 (29.0 cases per 100,000 population) in 2002 (Table 35B). 

• Between 2001 and 2002, P&S syphilis rates for African-Americans aged 15-19 

years declined 13.1%; rates declined 15.0% among African-American females 

and 7.7% among African-American males in this age group (Figures X and Y, 

Table 35B). The P&S syphilis rate among young African-American adults aged 

20- to 24-years declined 3.3% between 2001 and 2002; rates declined 12.7% 

among African-American females but increased 5.6% among African-American 

males in this age group (Table 35B). 

• In 2002, 14.2% of all cases of P&S syphilis reported to CDC occurred among 

Hispanics (Table 35A). The rate of P&S syphilis among Hispanics increased 

28.6% (from 2.1 to 2.7 cases per 100,000 population) between 2001 and 2002. 

The rate among Hispanics in 2002 was more than two times greater than the rate 

among whites (1.2 cases per 100,000 population) (Table 35B). 

• The incidence of P&S syphilis among Hispanics was highest among women aged 

20-24 years (1.9 cases per 100,000 population) and among men aged 35-39 

(12.1 cases per 100,000 population) in 2002 (Table 35B). 

• In 2002, the rate of congenital syphilis (based on the mother’s race/ethnicity) was 

39.8 cases per 100,000 live births among African-Americans and 14.8 cases per 

100,000 live births among Hispanics (Table 45). These rates are 28 and 11 times 

60 STDs in Racial and Ethnic Minorities Special Focus Profiles STD Surveillance 2002 
greater than the 2002 rate among whites (1.4 cases per 100,000 live births), 

(Figure Z, Table 45). During 2001 to 2002, the rate of congenital syphilis 

decreased by 9.3% among African-Americans and 21.7% among Hispanics. 

1 Nakashima AK, Rolfs RT, Flock ML, Kilmarx P, Greenspan JR. Epidemiology of syphilis in the United 

States, 1941 through 1993. Sex Transm Dis 1996;23:16-23. 

STD Surveillance 2002 Special Focus Profiles STDs in Racial and Ethnic Minorities 61 
Figure T. Chlamydia — Positivity among women tested in family planning clinics 

by race and ethnicity: Region X, 1988–2002 

Percent

15
 

12
 

9
 

6
 

3
 

0
 

White

Black

Hispanic

Asian/Pac Isl

Am Ind/AK Nat

1988 89 90 91 92 93 94 95 96 97 98 99 2000 01 02
 

Note: Women who met screening criteria were tested. Trends not adjusted for changes in 

laboratory test method and associated increases in test sensitivity in 1994, and 1999–2002. 

SOURCE: Regional Infertility Prevention Projects: Region X Chlamydia Project 

Figure U. Chlamydia — Positivity among 15-30 year old women tested in Indian Health
 

Service Clinics by IHS areas, 2002
 

*IHS areas not reporting chlamydia positivity data during 2002. See Appendix for definitions of IHS areas. 

SOURCE: Indian Health Service 

62 STDs in Racial and Ethnic Minorities Special Focus Profiles STD Surveillance 2002
 
Figure V. Gonorrhea — Rates for 15-19 year old females by race and ethnicity: 

United States, 1981–2002 

Rate (per 100,000 population)

7,000

5,600

4,200

2,800

1,400

0

White

Black

Hispanic

Asian/Pac Isl

Am Ind/AK Nat

1981 83 85 87 89 91 93 95 97 99 2001

Figure W. Gonorrhea — Rates for 15-19 year old males by race and ethnicity: United 

States, 1981–2002 

Rate (per 100,000 population)
 

7,000
 

5,600
 

4,200
 

2,800
 

1,400
 

0
 

White

Black

Hispanic

Asian/Pac Isl

Am Ind/AK Nat

1981 83 85 87 89 91 93 95 97 99 2001

STD Surveillance 2002 Special Focus Profiles STDs in Racial and Ethnic Minorities 63 
Figure X. Primary and secondary syphilis — Rates for 15-19 year old females by race and 

ethnicity: United States, 1981–2002 

Rate (per 100,000 population)

250

200

150

100

50

0

White

Black

Hispanic

Asian/Pac Isl

Am Ind/AK Nat

1981 83 85 87 89 91 93 95 97 99 2001

Figure Y. Primary and secondary syphilis — Rates for 15-19 year old males by race and 

ethnicity: United States, 1981–2002 

Rate (per 100,000 population)
 

125
 

100
 

75
 

50
 

25
 

0
 

White

Black

Hispanic

Asian/Pac Isl

Am Ind/AK Nat

1981 83 85 87 89 91 93 95 97 99 2001

64 STDs in Racial and Ethnic Minorities Special Focus Profiles STD Surveillance 2002 
Figure Z.	 Congenital syphilis — Rates for infants <1 year of age by mother’s race and 

ethnicity: United States, 1991–2002 and the Healthy People 2010 objective 

Rate (per 100,000 live births)

450
 

360
 

270
 

180
 

90
 

0
 

White

Black

Hispanic

Asian/Pac Isl

Am Ind/AK Nat

2010 Objective

1991 92 93 94 95 96 97 98 99 2000 01 02
 

Note: Less than 5% of cases had missing race/ethnicity information and were excluded. 

STD Surveillance 2002 Special Focus Profiles STDs in Racial and Ethnic Minorities 65
 

1,2,3,4,5

STDs in Men Who Have Sex with Men
 

Public Health Impact 

Data from syphilis surveillance, the Gonococcal Isolate Surveillance Project (GISP), and several 

U.S. cities indicate that since 1993, an increasing number of MSM are acquiring STDs. 1-5 Increases 

in STDs among MSM are consistent with behavioral data suggesting that an increasing number of 

MSM are participating in sexual behavior that places them at risk for STDs and HIV infection.6 Several factors may have contributed to this change, including the availability of highly active 

antiretroviral therapy (HAART).7 Because STDs and the behaviors associated with them increase 

the likelihood of acquiring and transmitting HIV infection,8 the rise in STDs among MSM may signal 

an increase in HIV incidence among MSM. 

Observations 

• National notifiable STD surveillance data reported to CDC does not include 

information regarding sexual behaviors, and, therefore, overall STD trends 

among MSM in the U.S. are not available. Data from special projects and analyses 

are presented to provide information regarding STDs among MSM. 

Monitoring Trends in Prevalence of STDs, Tuberculosis, and HIV Risk Behaviors 

Among Men Who Have Sex with Men (MSM Prevalence Monitoring Project) 

• In 2002, eight U.S. cities (Chicago, Denver, the District of Columbia, Houston, 

Long Beach, Philadelphia, San Francisco, and Seattle) participating in the MSM 

Prevalence Monitoring Project submitted syphilis, gonorrhea, chlamydia, and 

HIV test data to CDC based on 16,336 visits by MSM to STD clinics. The MSM 

Prevalence Monitoring Project includes data collected during routine care and 

reflects testing practices at participating clinics. Medians and city-specific ranges 

were calculated for the proportion of tests done and STD and HIV test positivity. 

• Median positivity among MSM for syphilis nontreponemal serologic testing was 

8.0% (range 3.6-12.1%) (Figure AA). 

• Median positivity among MSM for gonorrhea overall was 17.1% (range 

11.4-23.0%). Median positivity among MSM for urethral gonorrhea was 13.5% 

(range 8.3-36.1%); median positivity for rectal gonorrhea was 5.7% (range 

4.6-10.0%), and median positivity for pharyngeal gonorrhea was 4.2% (range 

0.6-10.4%) (Figure BB). 

• Median positivity for urethral chlamydia among MSM was 7.2% (range 

4.7-11.9%). 

• STD and HIV positivity varied by race and ethnicity, but tended to be highest 

among African-American MSM. Median positivity for HIV, excluding persons 

previously known to be HIV-positive, was 7.4% (range 1.0-17.0%) for 

STD Surveillance 2002 Special Focus Profiles STDs in Men Who Have Sex with Men 67 
African-Americans, 3.9% (range 2.2-6.7%) for Hispanics; and 2.4% (range 

2.0-3.7%) for whites (Figure CC). 

• Median positivity for gonorrhea was higher among MSM who were HIV-positive 

compared with MSM who were HIV-negative or of unknown HIV status. Median 

positivity for urethral gonorrhea was 21.0% for men who were HIV-positive and 

12.5% for men who were HIV-negative or of unknown HIV status. For rectal 

gonorrhea, positivity was 10.3% and 5.5%, respectively, and for pharyngeal 

gonorrhea, 7.7% and 3.9%, respectively. Median positivity for urethral 

chlamydia was 7.7% among HIV-positive MSM and 6.7% among MSM who 

were HIV-negative or of unknown HIV status (Figure DD). 

• Seventy-eight percent (range 63-89%) of MSM attending these STD clinics had a 

nontreponemal serologic test for syphilis (STS) performed, 73% (range 19-95%) 

were tested for urethral gonorrhea, 33% (range 1-61%) were tested for rectal 

gonorrhea, and 59% (range 2-83%) were tested for pharyngeal gonorrhea. 

Among MSM not previously HIV-positive, 60% (range 1-69%) were tested for 

HIV. 

• Median HIV prevalence among MSM, including persons known to be 

HIV-positive, was 18.6% for African-Americans (range 9.9-26.7%), 10.6% 

(range 8.7-18.2%) for Hispanics, and 9.9% (range 7.3-13.4%) for whites. 

Nationally Reported Syphilis Surveillance Data 

• Primary and secondary (P&S) syphilis increased in the U.S. in 2002, and this 

increase occurred only among men. Syphilis male-to-female rate ratios, which 

may reflect trends among MSM, have been increasing in the U.S. during recent 

years (Figure 29). The increase in these ratios has been particularly marked in 

cities with outbreaks of syphilis among MSM. 

• In 2002, the rate of P&S syphilis among men (3.8 cases per 100,000 males) was 

over three times greater than the rate among women (1.1 cases per 100,000 

females) (Tables 28 and 29). The overall male-to-female rate ratio has risen 

steadily since 1996 when it was 1.2. During 2001 to 2002, an increase in the 

male-to-female rate ratio occurred among whites, African-Americans, and 

Hispanics; the male-to-female rate ratio did not change among American 

Indian/Alaska Natives, and it declined among Asian/Pacific Islanders. Additional 

information on syphilis can be found in the Syphilis section. 

Gonococcal Isolate Surveillance Project (GISP) 

• The Gonococcal Isolate Surveillance Project (GISP), a collaborative project 

among selected sexually transmitted disease clinics, was established in 1986 to 

monitor trends in antimicrobial susceptibilities of strains of N. gonorrhoeae in the 

U.S. 

• GISP also reports the percentage of Neisseria gonorrhoeae isolates obtained from 

MSM.9 Overall, the proportion of isolates coming from MSM increased from 4% 

in 1988 to 21% in 2002 in GISP clinics, with most of the increase occurring after 

1993 (Figure EE). The number of GISP clinics having greater than 5% of GISP 

isolates from MSM rose from 7 clinics in 1990 to 17 clinics in 2002. Among the 17 

68 STDs in Men Who Have Sex with Men Special Focus Profiles STD Surveillance 2002 
GISP clinics with greater than 5% of isolates coming from MSM in 2002, the 

percentage of patients who were MSM ranged from 7% to 75%, with a median of 

20% (Figure FF). Additional information on GISP may be found in the 

Gonorrhea section. 

1 Centers for Disease Control and Prevention. Resurgent bacterial sexually transmitted disease among men 

who have sex with men–King County, Washington, 1997-1999. MMWR 1999;48:773-7. 

2 Centers for Disease Control and Prevention. Outbreak of syphilis among men who have sex with 

men–Southern California, 2000. MMWR 2001;50:117-20. 

3 Centers for Disease Control and Prevention. Gonorrhea among men who have sex with men–selected 

sexually transmitted disease clinics, 1993-1996. MMWR 1997;46:889-92. 

4 Fox KK, del Rio C, Holmes K, et. al. Gonorrhea in the HIV era: A reversal in trends among men who have 

sex with men. Am J Public Health 2001;91:959-964. 

5 Centers for Disease Control and Prevention. Primary and secondary syphilis among men who have sex 

with men–New York City, 2001. MMWR 2002;51:853-6. 

6 Stall R, Hays R, Waldo C, Ekstrand M, McFarland W. The gay ‘90s: a review of research in the 1990s on 

sexual behavior and HIV risk among men who have sex with men. AIDS 2000;14:S1-S14. 

7 Scheer S, Chu PL, Klausner JD, Katz MH, Schwarcz SK. Effect of highly active antiretroviral therapy on 

diagnoses of sexually transmitted diseases in people with AIDS. Lancet 2001;357:432-5. 

8 Fleming DT, Wasserheit JN. From epidemiologic synergy to public health policy and practice: the 

contribution of other sexually transmitted diseases to sexual transmission of HIV infection. Sex Transm 

Infect 1999;75:3-17. 

9 Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance 2002 

Supplement: Gonococcal Isolate Surveillance Project (GISP) Annual Report 2002. Atlanta, GA: U.S. 

Department of Health and Human Services (in press). 

STD Surveillance 2002 Special Focus Profiles STDs in Men Who Have Sex with Men 69 
Figure AA. MSM Prevalence Monitoring Project — Syphilis serologic reactivity among men 

who have sex with men, STD clinics, 2002 

Figure BB. MSM Prevalence Monitoring Project — Gonorrhea positivity among men who have 

sex with men, STD clinics, 2002 

70 STDs in Men Who Have Sex with Men Special Focus Profiles STD Surveillance 2002 
Figure CC. MSM Prevalence Monitoring Project — Median clinic test positivity for 

gonorrhea, chlamydia, and HIV among men who have sex with men by 

race/ethnicity in participating STD clinics, 2002 

Median positivity

White

Black

Hispanic

0

5

10

15

20

25

Urethral Rectal Pharyngeal Urethral HIV*

gonorrhea gonorrhea gonorrhea chlamydia

*Excludes persons previously known to be HIV-positive. 

Figure DD.	 MSM Prevalence Monitoring Project — Median clinic test positivity for 

gonorrhea and chlamydia among men who have sex with men by HIV 

status in participating STD clinics, 2002 

Median positivity

HIV-positive

HIV-negative or unknown

0

5

10

15

20

25

Urethral Rectal Pharyngeal Urethral

gonorrhea gonorrhea gonorrhea chlamydia

STD Surveillance 2002 Special Focus Profiles STDs Among Men Who Have Sex with Men 71 
Figure EE. Gonococcal Isolate Surveillance Project (GISP) — Percent of gonorrhea cases 

that occurred among MSM, 1988-2002 

Percent
 

25
 

20
 

15
 

10
 

5
 

0
 

1988 89 90 91 92 93 94 95 96 97 98 99 2000 01 02

Figure FF.	 Gonococcal Isolate Surveillance Project (GISP) — Percent of Neisseria 

gonorrhoeae isolates obtained from MSM attending STD clinics in 17 cities, 

2000, 2001, and 2002 

Percent

2000

2001

2002

0

15

30

45

60

75

ALB ANC ATL CHI DAL DEN HON LBC MIA MIN ORA PHI PHX POR SDG SEA SFO

Cities

Note: In 2002, these 17 clinics reported 96.2% (1,028/1,069) of GISP gonorrhea cases among 

men who have sex with men (MSM). Clinics include: ALB=Albuquerque, NM; 

ANC=Anchorage, AK; ATL=Atlanta, GA; CHI=Chicago, IL; DAL=Dallas, TX; DEN=Denver, 

CO; HON=Honolulu, HI; LBC=Long Beach, CA; MIA=Miami, FL; MIN=Minneapolis, MN; 

ORA=Orange County, CA; PHI=Philadelphia, PA; PHX=Phoenix, AZ; POR=Portland, OR; 

SDG=San Diego, CA; SEA=Seattle, WA; and SFO=San Francisco, CA. 

72 STDs Among Men Who Have Sex with Men Special Focus Profiles STD Surveillance 2002 
1,2,3,4

STDs in Persons Entering Corrections Facilities
 

Public Health Impact 

Multiple studies and surveillance projects have demonstrated a high prevalence of STDs in persons 

entering jails and juvenile corrections facilities. 1-4 Screening for chlamydia, gonorrhea, and syphilis at 

intake offers an opportunity to identify infections, prevent complications, and reduce transmission in 

the community. In cities where routine syphilis screening in jails occurs, a substantial percentage of 

all reported cases is identified in jails.4 Collecting positivity data and analyzing trends in STD prevalence in this population can provide one method for monitoring trends in STD prevalence in the 

community.4 

Observations 

• In 2002, seven states reported syphilis screening data from corrections facilities to 

CDC. Twenty-eight states reported chlamydia screening data and nineteen states 

reported gonorrhea screening data from corrections facilities. These data were 

reported as part of either the Jail STD Prevalence Monitoring Project, the 

Adolescent Women Reproductive Health Monitoring Project, the Syphilis 

Elimination Initiative, the Regional Infertility Prevention Program, or in response 

to CDC’s request for data. 

• The maps shown in this section represent approximately 170,000 syphilis tests in 

men and 31,000 in women; 150,000 chlamydia tests in men and 44,000 in 

women; and 123,000 gonorrhea tests in men and 37,000 in women. 

• The median percentage of reactive syphilis tests by facility was 7.1% (range 0.6% 

to 19.0%) for women entering 10 adult corrections facilities and 1.0% for 

adolescent women entering 1 juvenile corrections facility (Figure GG); it was 

3.4% (range 0.9% to 5.2%) among men at 10 adult corrections facilities and 0.1% 

in men at 1 juvenile facility (Figure HH). The percentage of reactive syphilis tests 

representing cases of syphilis varied from facility to facility. 

• Chlamydia positivity was higher in women screened in juvenile corrections 

facilities than in adult corrections facilities. In adolescent women entering juvenile 

corrections facilities, the median facility positivity for chlamydia was 16.7% 

(range 6.3% to 28.3%); positivity was greater than 10% in 31 of 32 facilities 

reporting data (Figure II). In adult women entering 17 corrections facilities, the 

median positivity for chlamydia was 3.2% (range 0.8% to 14.5%). 

• The median chlamydia positivity in adolescent men entering 42 juvenile 

corrections facilities was 6.0% (range 0.6% to 15.7%) (Figure JJ). In adult men 

entering 6 corrections facilities, the median positivity was 5.3% (range 3.5% to 

8.0%). 

• The median positivity for gonorrhea in women entering 22 juvenile corrections 

facilities was 5.6% (range 0.6% to 12.4%); positivity was greater than 4% in 16 of 

STD Surveillance 2002 Special Focus Profiles STDs in Persons Entering Corrections Facilities 73 
22 juvenile corrections facilities (Figure KK). In adult women entering 14 

corrections facilities, the median positivity for gonorrhea was 2.3% (range 0.2% 

to 6.2%). 

• The median positivity for gonorrhea in adolescent men entering 25 juvenile 

corrections facilities was 1.7% (range 0.3% to 4.5%) (Figure LL). In adult men 

entering six facilities, the median positivity was also 1.7% (range 0.7% to 3.0%). 

1	 Heimberger TS. Chang HG. Birkhead GS. DiFerdinando GD. Greenberg AJ. Gunn R. Morse DL. High 

prevalence of syphilis detected through a jail screening program. A potential public health measure to 

address the syphilis epidemic. Arch Intern Med 1993;153:1799-1804. 

2	 Centers for Disease Control and Prevention. Syphilis screening among women arrestees at the Cook 

County Jail–Chicago, 1996. MMWR 1998;47:432-3. 

3	 Mertz KJ, Schwebke JR, Gaydos CA, Beideinger HA, Tulloch SD, Levine WC. Screening women in jails for 

chlamydial and gonococcal infection using urine tests: Feasibility, acceptability, prevalence and treatment 

rates. Sex Transm Dis 2002;29:271-276. 

4	 Kahn RH, Scholl DT, Shane SM, Lemoine AL, Farley TA. Screening for syphilis in arrestees: Usefulness for 

community-wide syphilis surveillance and control. Sex Transm Dis 2002;29:150-156. 

74 STDs in Persons Entering Corrections Facilities Special Focus Profiles STD Surveillance 2002 
Figure GG. Syphilis serologic tests — Percent seroreactivity in women entering juvenile and 

adult corrections facilities, 2002 

Note: The median positivity is presented from facilities reporting >100 test results. Texas submitted 

data from more than one adult corrections facility. 

SOURCE: Jail STD Prevalence Monitoring Project; Local and State STD Control Programs; Centers for Disease Control and 

Prevention 

Figure HH. Syphilis serologic tests — Percent seroreactivity in men entering juvenile and 

adult corrections facilities, 2002 

Note: The median positivity is presented from facilities reporting >100 test results. Texas submitted 

data from more than one adult corrections facility. 

SOURCE: Jail STD Prevalence Monitoring Project; Local and State STD Control Programs; Centers for Disease Control and 

Prevention 

STD Surveillance 2002 Special Focus Profiles STDs in Persons Entering Corrections Facilities 75 
Figure II. Chlamydia — Positivity in women entering juvenile and adult corrections 

facilities, 2002 

Note: The median positivity is presented from facilities reporting >100 test results. California, Pennsylvania, 

Massachusetts, and Texas submitted data from more than one adult corrections facility. Arizona, 

California, Massachusetts, Texas and Washington submitted data from more than one juvenile 

corrections facility. 

SOURCE: Jail STD Prevalence Monitoring Project; Adolescent Women Reproductive Health Monitoring Project; Regional Infertility Prevention Projects; Local and State STD Control Programs; Centers for Disease Control and Prevention 

Figure JJ.	 Chlamydia — Positivity in men entering juvenile and adult corrections 

facilities, 2002 

Note: The median positivity is presented from facilities reporting >100 test results. Massachusetts 

submitted data from more than one adult corrections facility. Arizona, California, Illinois, 

Maryland, Massachusetts, Texas, Utah, Washington and Wisconsin submitted data from more 

than one juvenile corrections facility. 

SOURCE: Jail STD Prevalence Monitoring Project; Regional Infertility Prevention Projects; Local and State STD Control Programs; Centers for Disease Control and Prevention 

76 STDs in Persons Entering Corrections Facilities Special Focus Profiles STD Surveillance 2002 
Figure KK. Gonorrhea — Positivity in women entering juvenile and adult corrections 

facilities, 2002 

Note: The median positivity is presented from facilities reporting >100 test results. California, 

Pennsylvania, Texas and Wisconsin submitted data from more than one adult corrections facility. 

California and Texas submitted data from more than one juvenile corrections facility. 

SOURCE: Jail STD Prevalence Monitoring Project; Adolescent Women Reproductive Health Monitoring Project; Regional Infertility Prevention Projects; Local and State STD Control Programs; Centers for Disease Control and Prevention 

Figure LL.	 Gonorrhea — Positivity in men entering juvenile and adult corrections 

facilities, 2002 

Note: The median positivity is presented from facilities reporting >100 test results. Wisconsin 

submitted data from more than one adult corrections facility. California, Illinois, Maryland and 

New Jersey submitted data from more than one juvenile corrections facility. 

SOURCE: Jail STD Prevalence Monitoring Project; Regional Infertility Prevention Projects; Local and State STD Control Programs; Centers for Disease Control and Prevention 

STD Surveillance 2002 Special Focus Profiles STDs in Persons Entering Corrections Facilities 77 

TABLES
 

Table 1. Cases of sexually transmitted diseases reported by state health departments and rates per 100,000 

civilian population: United States, 1941–2002 

Syphilis 

Primary Lymphoand Early Late and Granuloma granuloma All Stages Secondary Latent Late Latent Congenital Chlamydia Gonorrhea Chancroid Inguinale Venereum 

Year * Cases Rate Cases Rate Cases Rate Cases Rate Cases Rate† Cases Rate Cases Rate Cases Rate Cases Rate Cases Rate 

1941 485,560 368.2 68,231 51.7 109,018 82.6 202,984 153.9 17,600 13.4 NR . 193,468 146.7 3,384 2.5 639 0.4 1,381 1.0 

1942 479,601 363.4 75,312 57.0 116,245 88.0 202,064 153.1 16,918 12.8 NR . 212,403 160.9 5,477 4.1 1,278 0.9 1,888 1.4 

1943 575,593 447.0 82,204 63.8 149,390 116.0 251,958 195.7 16,164 12.6 NR . 275,070 213.6 8,354 6.4 1,748 1.3 2,593 2.0 

1944 467,755 367.9 78,443 61.6 123,038 96.7 202,848 159.6 13,578 10.7 NR . 300,676 236.5 7,878 6.1 1,759 1.3 2,858 2.2 

1945 359,114 282.3 77,007 60.5 101,719 79.9 142,187 111.8 12,339 9.7 NR . 287,181 225.8 5,515 4.3 1,857 1.4 2,631 2.0 

1946 363,647 271.7 94,957 70.9 107,924 80.6 125,248 93.6 12,106 9.0 NR . 368,020 275.0 7,091 5.2 2,232 1.6 2,603 1.9 

1947 355,592 252.3 93,545 66.4 104,124 73.9 122,089 86.6 12,200 8.7 NR . 380,666 270.0 9,515 6.7 2,330 1.7 2,526 1.8 

1948 314,313 218.2 68,174 47.3 90,598 62.9 123,312 85.6 13,931 9.7 NR . 345,501 239.8 7,661 5.3 2,469 1.7 2,429 1.7 

1949 256,463 175.3 41,942 28.7 75,045 51.3 116,397 79.5 13,952 9.5 NR . 317,950 217.3 6,707 4.6 2,402 1.6 1,925 1.3 

1950 217,558 146.0 23,939 16.7 59,256 39.7 113,569 70.2 13,377 9.0 NR . 286,746 192.5 4,977 3.3 1,783 1.2 1,427 1.0 

1951 174,924 116.1 14,485 9.6 43,316 28.7 98,311 65.2 11,094 7.4 NR . 254,470 168.9 4,233 2.8 1,352 0.9 1,300 0.9 

1952 167,762 110.2 10,449 6.9 36,454 24.0 105,238 69.1 8,553 5.6 NR . 244,957 160.8 3,738 2.5 951 0.6 1,200 0.8 

1953 148,573 95.9 8,637 5.6 28,295 18.3 98,870 63.8 7,675 5.0 NR . 238,340 153.9 3,338 2.2 667 0.4 983 0.6 

1954 130,687 82.9 7,147 4.5 23,861 15.1 89,123 56.5 6,676 4.2 NR . 242,050 153.5 3,003 1.9 618 0.4 875 0.6 

1955 122,392 76.2 6,454 4.0 20,054 12.5 86,526 53.8 5,354 3.3 NR . 236,197 147.0 2,649 1.7 490 0.3 762 0.5 

1956 130,201 78.7 6,392 3.9 19,783 12.0 95,097 57.5 5,491 3.3 NR . 224,346 135.7 2,135 1.3 357 0.2 500 0.3 

1957 123,758 73.5 6,576 3.9 17,796 10.6 91,309 54.2 5,288 3.1 NR . 214,496 127.4 1,637 1.0 348 0.2 448 0.3 

1958 113,884 66.4 7,176 4.2 16,556 9.7 83,027 48.4 4,866 2.8 NR . 232,386 135.6 1,595 0.9 314 0.2 434 0.3 

1959 120,824 69.2 9,799 5.6 17,025 9.8 86,740 49.7 5,130 2.9 NR . 240,254 137.6 1,537 0.9 265 0.2 604 0.3 

1960 122,538 68.8 16,145 9.1 18,017 10.1 81,798 45.9 4,416 2.5 NR . 258,933 145.4 1,680 0.9 296 0.2 835 0.5 

1961 124,658 68.8 19,851 11.0 19,486 10.8 79,304 43.8 4,163 2.3 NR . 264,158 145.8 1,438 0.8 241 0.1 787 0.4 

1962 126,245 68.7 21,067 11.5 19,585 10.7 79,533 43.3 4,070 2.2 NR . 263,714 143.6 1,344 0.7 207 0.1 590 0.3 

1963 124,137 66.6 22,251 11.9 18,235 9.8 78,076 41.9 4,031 2.2 NR . 278,289 149.2 1,220 0.7 173 0.1 586 0.3 

1964 114,325 60.4 22,969 12.1 17,781 9.4 68,629 36.3 3,516 1.9 NR . 300,666 159.0 1,247 0.7 135 0.1 732 0.4 

1965 112,842 58.9 23,338 12.2 17,458 9.1 67,317 35.1 3,564 1.9 NR . 324,925 169.6 982 0.5 155 0.1 878 0.5 

1966 105,159 54.4 21,414 11.1 15,950 8.2 63,541 32.9 3,170 1.6 NR . 351,738 181.9 838 0.4 148 0.1 308 0.2 

1967 102,581 52.5 21,053 10.8 15,554 8.0 61,975 31.7 2,894 1.5 NR . 404,836 207.3 784 0.4 154 0.1 371 0.2 

1968 96,271 48.8 19,019 9.6 15,150 7.7 58,564 29.7 2,381 1.2 NR . 464,543 235.7 845 0.4 156 0.1 485 0.2 

1969 92,162 46.3 19,130 9.6 15,402 7.7 54,587 27.4 2,074 1.0 NR . 534,872 268.6 1,104 0.6 154 0.1 520 0.3 

1970 91,382 45.3 21,982 10.9 16,311 8.1 50,348 24.9 1,953 1.0 NR . 600,072 297.2 1,416 0.7 124 0.1 612 0.3 

1971 95,997 46.9 23,783 11.6 19,417 9.5 49,993 24.4 2,052 1.0 NR . 670,268 327.2 1,320 0.6 89 0.0 692 0.3 

1972 91,149 43.9 24,429 11.8 20,784 10.0 43,456 20.9 1,758 0.8 NR . 767,215 369.7 1,414 0.7 81 0.0 756 0.4 

1973 87,469 41.7 24,825 11.8 23,584 11.3 37,054 17.7 1,527 0.7 NR . 842,621 402.0 1,165 0.6 62 0.0 408 0.2 

1974 83,771 39.6 25,385 12.0 25,124 11.9 31,854 15.1 1,138 0.5 NR . 906,121 428.2 945 0.4 47 0.0 394 0.2 

1975 80,356 37.6 25,561 12.0 26,569 12.4 27,096 12.7 916 0.4 NR . 999,937 467.7 700 0.3 60 0.0 353 0.2 

1976 71,761 33.2 23,731 11.0 25,363 11.7 21,905 10.1 626 0.3 NR . 1001994 464.1 628 0.3 71 0.0 365 0.2 

1977 64,621 29.6 20,399 9.4 21,329 9.8 22,313 10.2 463 0.2 NR . 1002219 459.5 455 0.2 75 0.0 348 0.2 

1978 64,875 29.4 21,656 9.8 19,628 8.9 23,038 10.4 434 0.2 NR . 1013436 459.7 521 0.2 72 0.0 284 0.1 

1979 67,049 30.1 24,874 11.2 20,459 9.2 21,301 9.6 332 0.1 NR . 1004058 450.3 840 0.4 76 0.0 250 0.1 

1980 68,832 30.5 27,204 12.1 20,297 9.0 20,979 9.3 277 0.1 NR . 1004029 445.1 788 0.3 51 0.0 199 0.1 

1981 72,799 32.0 31,266 13.7 21,033 9.2 20,168 8.9 287 0.1 NR . 990,864 435.2 850 0.4 66 0.0 263 0.1 

1982 75,579 32.9 33,613 14.6 21,894 9.5 19,799 8.6 259 0.1 NR . 960,633 417.9 1,392 0.6 17 0.0 235 0.1 

1983 74,637 32.1 32,698 14.1 23,738 10.2 17,896 7.7 239 0.1 NR . 900,435 387.6 847 0.4 24 0.0 335 0.1 

1984 69,872 29.6 28,607 12.1 23,131 9.8 17,829 7.6 305 0.1 7,594 6.5 878,556 372.5 665 0.3 30 0.0 170 0.1 

1985 67,563 28.4 27,131 11.4 21,689 9.1 18,414 7.7 329 0.1 25,848 17.4 911,419 383.0 2,067 0.9 44 0.0 226 0.1 

STD Surveillance 2002 National Summary Tables 79 
Table 1. Cases of sexually transmitted diseases reported by state health departments and rates per 100,000 

civilian population: United States, 1941–2002 (continued) 

Syphilis 

Chlamydia Gonorrhea Chancroid 

Granuloma 

Inguinale 

Lymphogranuloma All Stages Venereum

Primary

and 

Secondary EarlyLatent 

Late and 

Late Latent Congenital 

Year * Cases Rate Cases Rate Cases Rate Cases Rate Cases Rate† Cases Rate Cases Rate Cases Rate Cases Rate Cases Rate 

1986 67,779 28.2 27,667 11.5 21,656 9.0 18,046 7.5 410 0.2 58,001 35.2 892,229 371.5 3,045 1.3 48 0.0 307 0.1 

1987 87,286 36.0 35,585 14.7 28,233 11.7 22,988 9.5 480 0.2 91,913 50.8 787,532 325.0 4,986 2.1 22 0.0 302 0.1 

1988 104,546 42.8 40,474 16.6 35,968 14.7 27,363 11.2 741 0.3 157,854 87.1 738,160 301.9 4,891 2.0 11 0.0 194 0.1 

1989 115,089 46.6 45,826 18.6 45,394 18.4 22,032 8.9 1,837 0.7 200,904 102.5 733,294 297.1 4,697 1.9 7 0.0 182 0.1 

1990 135,590 54.5 50,578 20.3 55,397 22.3 25,750 10.4 3,865 1.6 323,663 160.8 690,042 277.4 4,212 1.7 97 0.0 277 0.1 

1991 128,719 51.1 42,950 17.0 53,855 21.4 27,490 10.9 4,424 1.8 381,228 180.3 621,918 246.7 3,476 1.4 29 0.0 471 0.2 

1992 114,730 45.0 34,009 13.3 49,929 19.6 26,725 10.5 4,067 1.6 409,694 183.4 502,858 197.2 1,906 0.7 6 0.0 299 0.1 

1993 102,612 39.8 26,527 10.3 41,919 16.3 30,746 11.9 3,420 1.3 405,332 179.5 444,649 172.5 1,292 0.5 19 0.0 292 0.1 

1994 82,713 31.8 20,641 7.9 32,017 12.3 27,603 10.6 2,452 0.9 451,785 194.5 424,657 167.7 782 0.3 3 0.0 235 0.1 

1995 69,356 26.4 16,543 6.3 26,657 10.1 24,296 9.2 1,860 0.7 478,577 190.4 392,651 149.4 607 0.2 NR 0.0 188 0.1 

1996 53,238 20.1 11,405 4.3 20,187 7.6 20,366 7.7 1,280 0.5 492,631 193.7 328,169 123.8 386 0.1 10 0.0 72 0.0 

1997 46,713 17.5 8,556 3.2 16,631 6.2 20,447 7.6 1,079 0.4 537,904 209.4 327,665 122.4 246 0.1 8 0.0 114 0.0 

1998 38,286 14.2 7,007 2.6 12,696 4.7 17,743 6.6 840 0.3 614,250 236.7 356,492 131.9 189 0.1 3 0.0 86 0.0 

1999 35,379 13.0 6,617 2.4 11,534 4.2 16,653 6.1 575 0.2 662,647 253.0 360,813 132.3 142 0.1 19 0.0 63 0.0 

2000 31,612 11.2 5,979 2.1 9,465 3.4 15,594 5.5 574 0.2 709,452 252.1 363,136 129.0 78 0.0 4 0.0 42 0.0 

2001 32,272 11.5 6,103 2.2 8,701 3.1 16,976 6.0 492 0.2 783,242 278.3 361,705 128.5 38 0.0 7 0.0 25 0.0 

2002 32,871 11.7 6,862 2.4 8,429 3.0 17,168 6.1 412 0.1 834,555 296.5 351,852 125.0 67 0.0 9 0.0 19 0.0 

*For 1941-1946, data were reported for the federal fiscal year ending June 30 of the year indicated. From 1947 to the present, data were reported for the 

calendar year ending December 31. For 1941-1958, data for Alaska and Hawaii were not included. 

†

For 1941-1994, rates include all cases of congenitally acquired syphilis per 100,000 population. As of 1995, rates of congenital syphilis <1 year of age 

per 100,000 population are reported. For rates of congenital syphilis <1 year of age per 100,000 live births see Tables 40, 41 and 42. As of 1995, 

cases of congenital syphilis <1 year of age are obtained in hardcopy and electronic format based on case reporting form CDC 73.126. 

Note: Adjustments to the number of cases reported from state health departments were made for hardcopy forms and for electronic data submissions 

through May 2, 2003 (see Appendix). The number of cases and the rates shown here supersede those published in previous reports. Cases and rates 

shown in this table exclude the outlying areas of Guam, Puerto Rico and Virgin Islands. 

NR = No report 

80 National Summary Tables STD Surveillance 2002 
Table 2. Reported cases of sexually transmitted disease by sex and reporting source: United States, 2002 

Disease 

Non-STD Clinic STD Clinic * Total

Male Female Total Male Female Total Male Female Total 

Total Chlamydia Trachomatis 111,178 539,393 652,192 68,407 113,465 182,363 179,585 652,858 834,555 

Chlamydial PID† NA 2,688 2,691 NA 324 335 NA 3,012 3,026 

Ophthalmia Neonatorum 126 133 260 18 17 36 144 150 296 

Total Gonorrhea 89,333 138,203 228,047 82,171 41,445 123,805 171,504 179,648 351,852 

Gonococcal PID NA 2,381 2,383 NA 308 313 NA 2,689 2,696 

Ophthalmia Neonatorum 21 15 36 3 5 8 24 20 44 

Total Syphilis NA NA NA NA NA NA 20,534 12,271 32,871 

Primary 861 120 981 920 151 1,071 1,781 271 2,052 

Secondary 2,271 749 3,020 1,215 574 1,790 3,486 1,323 4,810 

Early Latent 3,176 1,760 4,939 2,172 1,316 3,490 5,348 3,076 8,429 

Late and Late Latent§ 6,245 4,879 11,155 3,477 2,525 6,013 9,722 7,404 17,168 

Neurosyphilis¶ 272 84 356 27 4 31 299 88 387 

Congenital <1 year** NR NR NR NR NR NR 197 197 412 

Chancroid 6 7 14 18 35 53 24 42 67 

Granuloma Inguinale 1 0 1 6 2 8 7 2 9 

Lymphogranuloma Venereum 4 1 5 13 1 14 17 2 19 

*Totals include unknown sex and reporting source. 

†

PID = Pelvic inflammatory disease.
 

§

Cases of unknown duration for syphilis are included in late and late latent syphilis.
 

¶

Neurosyphilis cases are not included with Total Syphilis cases but are included in the late and late latent syphilis cases.
 

**Cases of congenital syphilis <1 year of age are obtained using reporting form CDC 73.126. Clinic reporting source is not available from that form.
 

NA = Not applicable
 

NR = No report
 

STD Surveillance 2002 National Summary Tables 81 
5

10

15

20

25

30

35

40

45

50

Table 3. Chlamydia — Reported cases and rates by state/area, ranked by rates: United States, 2002 

Rank* State/Area Cases Rate per 100,000 Population 

1 Alaska 3,806 607.1 

2 Georgia 33,998 415.3 

3 Mississippi 11,800 414.8 

4 Louisiana 18,442 412.7 

New Mexico 7,417 407.7 

6 Illinois 48,101 387.3 

7 Hawaii 4,521 373.2 

8 South Carolina 14,314 356.8 

9 Alabama 15,611 351.0 

Delaware 2,649 338.1 

11 Ohio 38,032 335.0 

12 Texas 69,521 333.4 

13 Colorado 14,028 326.1 

14 California 110,288 325.6 

Michigan 32,272 324.7 

16 Maryland 16,891 318.9 

17 Wisconsin 17,000 316.9 

18 Oklahoma 10,804 313.1 

19 North Carolina 24,726 307.2 

Nevada 5,936 297.1 

U.S. TOTAL† 834,555 296.5 

21 South Dakota 2,215 293.4 

22 Arizona 14,973 291.8 

23 Missouri 16,181 289.2 

24 Connecticut 9,808 288.0 

Tennessee 16,042 282.0 

26 Indiana 17,100 281.2 

27 Nebraska 4,779 279.3 

28 Montana 2,475 274.3 

29 Arkansas 7,312 273.5 

Rhode Island 2,832 270.1 

31 New York 51,123 269.4 

32 Florida 42,058 263.2 

33 Virginia 18,518 261.6 

34 Pennsylvania 31,791 258.9 

Washington 14,934 253.4 

36 Kansas 6,784 252.3 

37 Kentucky 8,756 216.6 

38 Iowa 6,195 211.7 

39 Minnesota 10,107 205.4 

Oregon 7,009 204.9 

41 North Dakota 1,256 195.6 

42 Idaho 2,503 193.4 

43 Wyoming 944 191.2 

44 Massachusetts 10,914 171.9 

New Jersey 14,164 168.3 

46 Utah 3,540 158.5 

47 Vermont 954 156.7 

48 Maine 1,805 141.6 

49 West Virginia 2,464 136.3 

New Hampshire 1,557 126.0 

*

States were ranked in descending order by rate, number of cases, and alphabetically by state. 

†

Total includes cases reported by Washington, D.C., but excludes outlying areas (Guam with 550 cases and rate of 355.3, Puerto Rico with 2,999 

cases and rate of 78.7, and Virgin Islands with 207 cases and rate of 190.6). 

82 Chlamydia Tables STD Surveillance 2002 
Table 4. Chlamydia — Reported cases and rates by state/area and region listed in alphabetical order: United 

States and outlying areas, 1998–2002 

State/Area 

Cases Rates per 100,000 Population 

1998 1999 2000 2001 2002 1998 1999 2000 2001 2002 

Alabama 10,065 12,375 15,323 14,524 15,611 231.3 283.2 344.6 326.6 351.0 

Alaska 1,907 1,886 2,569 2,744 3,806 310.6 304.4 409.8 437.7 607.1 

Arizona 11,489 12,111 12,591 14,346 14,973 246.1 253.5 245.4 279.6 291.8 

Arkansas 4,123 5,865 6,219 7,280 7,312 162.4 229.9 232.6 272.3 273.5 

California 76,519 85,156 95,392 101,944 110,288 234.2 256.9 281.6 301.0 325.6 

Colorado* 9,113 10,848 12,000 13,239 14,028 229.5 267.4 279.0 307.8 326.1 

Connecticut 6,977 7,422 7,604 7,718 9,808 213.1 226.1 223.3 226.6 288.0 

Delaware 2,608 2,761 2,856 2,793 2,649 350.7 366.4 364.5 356.4 338.1 

Florida 24,949 31,410 33,390 37,625 42,058 167.3 207.9 208.9 235.4 263.2 

Georgia 25,250 30,368 29,359 33,840 33,998 330.4 389.9 358.6 413.4 415.3

Hawaii 2,604 3,165 3,547 4,031 4,521 218.3 267.0 292.8 332.7 373.2 

Idaho 2,035 1,778 1,907 2,023 2,503 165.6 142.0 147.4 156.3 193.4 

Illinois 32,861 36,409 40,350 43,716 48,101 272.8 300.2 324.9 352.0 387.3 

Indiana 10,801 11,734 14,063 15,258 17,100 183.1 197.4 231.3 250.9 281.2 

Iowa 5,174 5,511 5,987 5,699 6,195 180.8 192.1 204.6 194.7 211.7 

Kansas 5,587 6,093 6,056 6,050 6,784 212.5 229.6 225.3 225.0 252.3 

Kentucky 6,441 7,378 8,063 8,881 8,756 163.6 186.3 199.5 219.7 216.6 

Louisiana 15,188 16,635 17,846 17,840 18,442 347.6 380.5 399.3 399.2 412.7 

Maine 1,073 1,220 1,474 1,338 1,805 86.2 97.4 115.6 104.9 141.6 

Maryland 13,097 13,568 14,533 15,640 16,891 255.1 262.4 274.4 295.3 318.9

Massachusetts 8,363 8,776 10,967 10,402 10,914 136.0 142.1 172.7 163.8 171.9 

Michigan 22,156 23,107 26,237 31,090 32,272 225.7 234.3 264.0 312.8 324.7

Minnesota 6,970 7,450 8,102 8,323 10,107 147.5 156.0 164.7 169.2 205.4 

Mississippi 10,614 11,545 12,697 11,793 11,800 385.7 417.0 446.3 414.6 414.8

Missouri 12,670 13,355 13,448 13,949 16,181 233.0 244.2 240.3 249.3 289.2 

Montana 1,412 1,584 1,469 1,919 2,475 160.4 179.4 162.8 212.7 274.3 

Nebraska 2,911 3,616 3,791 3,206 4,779 175.1 217.0 221.5 187.3 279.3 

Nevada 3,320 3,086 4,019 4,831 5,936 190.1 170.6 201.1 241.8 297.1 

New Hampshire 960 976 1,130 1,383 1,557 81.0 81.3 91.4 111.9 126.0 

New Jersey 11,686 12,424 10,814 16,312 14,164 144.0 152.6 128.5 193.9 168.3

New Mexico 3,793 5,017 5,204 6,254 7,417 218.4 288.4 286.1 343.8 407.7 

New York† 26,218 26,766 31,494 46,393 51,123 353.3 360.3 166.0 244.5 269.4 

North Carolina 22,197 21,812 21,985 22,101 24,726 294.1 285.1 273.1 274.6 307.2 

North Dakota 1,036 947 909 1,062 1,256 162.3 149.4 141.5 165.4 195.6 

Ohio 27,786 29,398 31,190 37,653 38,032 247.9 261.2 274.7 331.7 335.0 

Oklahoma 9,393 8,195 9,331 10,478 10,804 280.7 244.0 270.4 303.7 313.1 

Oregon 5,855 6,127 7,107 7,454 7,009 178.4 184.8 207.7 217.9 204.9 

Pennsylvania 24,629 27,019 26,475 28,371 31,791 205.2 225.3 215.6 231.0 258.9

Rhode Island 2,307 2,345 2,632 2,912 2,832 233.4 236.7 251.1 277.8 270.1 

South Carolina 18,510 18,499 9,950 15,329 14,314 482.5 476.1 248.0 382.1 356.8 

South Dakota 1,572 1,544 1,834 1,821 2,215 213.0 210.6 243.0 241.2 293.4 

Tennessee 13,717 14,216 15,069 15,560 16,042 252.6 259.2 264.9 273.5 282.0 

Texas 60,436 62,958 68,814 69,752 69,521 305.9 314.1 330.0 334.5 333.4 

Utah 2,209 2,219 2,190 3,004 3,540 105.2 104.2 98.1 134.5 158.5 

Vermont 413 485 526 638 954 69.9 81.7 86.4 104.8 156.7 

Virginia 13,561 13,735 15,352 18,337 18,518 199.7 199.8 216.9 259.1 261.6 

Washington 10,998 11,964 13,066 13,631 14,934 193.3 207.8 221.7 231.3 253.4 

West Virginia 2,791 1,820 2,144 2,346 2,464 154.1 100.7 118.6 129.7 136.3

Wisconsin 13,999 14,462 16,365 16,284 17,000 268.0 275.4 305.1 303.6 316.9 

Wyoming 725 787 807 839 944 150.8 164.1 163.4 169.9 191.2 

U.S. TOTAL§ 614,250 662,647 709,452 783,242 834,555 236.7 253.0 252.1 278.3 296.5 

Northeast 82,626 87,433 93,116 115,467 124,948 201.7 212.9 173.7 215.4 233.1 

Midwest 143,523 153,626 168,332 184,111 200,022 228.2 242.9 261.4 285.9 310.6 

South 256,122 275,860 286,136 307,405 317,211 268.4 286.0 285.5 306.7 316.5 

West 131,979 145,728 161,868 176,259 192,374 219.0 238.3 256.1 278.9 304.4 

Guam 

Puerto Rico 

Virgin Islands 

410 

1,685 

10 

497 

1,445 

136 

525 

2,695 

131 

431 

2,748 

131 

550 

2,999 

207 

256.5 

43.7 

9.1 

303.9 

37.2 

120.5 

339.1 

70.8 

120.6 

278.4 

72.2 

120.6 

355.3 

78.7 

190.6 

OUTLYING AREAS 2,105 2,078 3,351 3,310 3,756 51.0 49.9 82.3 81.3 92.2 

TOTAL 616,355 664,725 712,803 786,552 838,311 233.8 249.8 249.7 275.5 293.6 

*

The number of chlamydia cases occurring in the fourth quarter of 2000 for the State of Colorado was projected based on case counts from the first 

three quarters. 

†

New York City has been reporting chlamydia cases since 1984. The State of New York, with the exception of New York City, initiated chlamydia 

reporting during the year 2000. The number of chlamydia cases reported from 1998-2000 by the state of New York may be incomplete and the rate 

for New York State is underestimated. See Appendix (Reporting of Chlamydia Cases). 

§

Includes cases reported by Washington, D.C., and rates exclude population of states that did not report. 

STD Surveillance 2002 Chlamydia Tables 83 
Table 5. Chlamydia — Women – Reported cases and rates by state/area and region listed in alphabetical 

order: United States and outlying areas, 1998–2002 

State/Area 

Cases Rates per 100,000 Population 

1998 1999 2000 2001 2002 1998 1999 2000 2001 2002 

Alabama 9,197 11,524 13,746 13,375 13,988 406.2 507.1 597.5 581.4 608.0 

Alaska 1,479 1,456 1,863 1,981 2,576 506.9 494.5 615.2 654.2 850.7 

Arizona 9,015 9,497 10,008 11,193 11,665 382.0 393.4 389.5 435.6 454.0 

Arkansas 3,850 4,618 5,015 5,949 5,817 293.4 350.3 366.4 434.6 425.0 

California 59,747 66,334 72,178 76,261 81,218 365.6 400.4 424.7 448.7 477.8 

Colorado* 6,979 8,172 8,748 9,894 10,422 348.5 399.5 409.7 463.4 488.1 

Connecticut 5,828 6,053 6,238 6,260 7,738 345.8 358.3 355.2 356.4 440.6 

Delaware 2,117 2,268 2,271 2,125 2,034 554.2 585.6 563.4 527.2 504.6 

Florida 20,171 25,957 27,562 30,647 33,902 262.7 333.6 336.8 374.4 414.2 

Georgia 21,156 24,685 24,067 27,905 27,494 539.2 617.6 578.6 670.9 661.0

Hawaii 2,209 2,557 2,757 3,053 3,445 371.4 430.9 457.3 506.4 571.4 

Idaho 1,553 1,308 1,435 1,469 1,862 252.3 208.5 222.4 227.6 288.6 

Illinois 26,112 28,758 31,771 33,124 34,154 423.1 462.9 501.2 522.5 538.8 

Indiana 8,823 9,410 10,935 11,668 13,151 291.3 308.4 353.0 376.6 424.5 

Iowa 4,077 4,208 4,480 4,295 4,680 277.6 285.8 300.5 288.1 313.9 

Kansas 4,649 5,034 4,973 4,977 5,653 347.8 373.3 365.7 366.0 415.7 

Kentucky 5,126 5,891 6,466 7,081 7,043 253.0 289.2 312.9 342.7 340.8 

Louisiana 12,169 13,247 14,099 14,416 14,758 536.5 584.0 611.4 625.1 640.0 

Maine 899 991 1,143 1,040 1,337 141.0 154.5 174.6 158.9 204.2 

Maryland 11,093 11,351 12,099 12,863 13,851 420.2 427.0 441.8 469.7 505.8

Massachusetts 6,812 6,959 8,452 7,897 8,177 214.0 217.7 256.9 240.0 248.5 

Michigan 18,769 18,869 20,905 24,550 25,129 372.4 372.6 412.7 484.7 496.1

Minnesota 5,119 5,469 5,856 6,010 7,352 213.5 225.8 235.8 242.0 296.0 

Mississippi 9,185 9,953 11,005 10,258 10,274 640.9 690.3 748.1 697.3 698.4

Missouri 11,063 11,515 11,525 11,854 13,253 394.4 408.5 400.9 412.3 461.0 

Montana 1,131 1,192 1,097 1,466 1,840 255.4 268.5 242.3 323.8 406.4 

Nebraska 2,390 2,903 3,018 2,521 3,609 281.4 341.0 347.7 290.5 415.8 

Nevada 2,820 2,500 3,124 3,586 4,365 328.8 281.5 318.7 365.8 445.3 

New Hampshire 726 769 889 1,042 1,168 120.6 126.0 141.5 165.9 186.0 

New Jersey 10,735 11,123 9,486 14,352 12,183 256.6 265.0 219.0 331.3 281.3

New Mexico 3,204 4,177 4,171 4,891 5,918 363.1 472.6 451.1 528.9 640.0 

New York† 23,449 23,896 26,928 38,297 41,202 596.4 607.9 273.9 389.6 419.2 

North Carolina 18,646 18,416 18,625 18,628 20,384 479.8 467.3 453.5 453.6 496.4 

North Dakota 755 680 663 716 826 235.5 213.5 206.1 222.6 256.8 

Ohio 23,248 23,380 25,105 29,521 29,558 401.4 402.0 429.8 505.4 506.1 

Oklahoma 7,696 6,737 7,715 8,600 8,764 449.4 392.0 439.7 490.1 499.4 

Oregon 4,307 4,462 5,192 5,442 5,033 259.3 265.8 301.0 315.5 291.8 

Pennsylvania 20,878 22,470 21,389 22,521 23,546 335.0 360.8 336.8 354.6 370.7

Rhode Island 1,779 1,769 1,969 2,197 2,057 346.5 343.8 361.5 403.4 377.7 

South Carolina 16,489 16,669 8,721 13,528 12,468 829.7 829.0 422.7 655.7 604.3 

South Dakota 1,171 1,194 1,308 1,311 1,608 312.2 320.4 344.0 344.7 422.8 

Tennessee 10,552 11,084 11,648 12,105 12,625 375.5 390.7 399.0 414.7 432.5 

Texas 49,940 52,071 56,817 57,611 57,438 498.7 512.7 541.2 548.7 547.1 

Utah 1,616 1,618 1,610 2,119 2,494 153.0 151.0 144.5 190.2 223.9 

Vermont 357 414 432 523 746 118.9 137.3 139.1 168.4 240.3 

Virginia 11,567 11,556 12,976 15,177 15,102 332.9 328.8 359.8 420.8 418.7 

Washington 8,377 8,880 9,583 10,159 11,003 292.8 306.8 323.8 343.2 371.7 

West Virginia 2,340 1,585 1,790 1,969 2,072 249.3 169.2 192.6 211.9 223.0

Wisconsin 10,846 11,225 12,352 12,045 12,296 408.2 420.4 455.0 443.7 453.0 

Wyoming 595 649 667 679 755 248.8 271.9 271.8 276.7 307.7 

U.S. TOTAL§ 505,533 539,894 569,658 623,958 652,858 380.8 403.1 397.3 435.2 455.4 

Northeast 71,463 74,444 76,926 94,129 98,154 336.0 349.3 277.7 339.9 354.4 

Midwest 117,022 122,645 132,891 142,592 151,269 362.9 378.3 404.7 434.2 460.7 

South 214,016 230,003 237,408 255,044 260,839 436.5 464.2 463.9 498.3 509.7 

West 103,032 112,802 122,433 132,193 142,596 341.1 368.2 386.8 417.6 450.5 

Guam 

Puerto Rico 

Virgin Islands 

351 

1,327 

10 

432 

1,147 

113 

430 

2,226 

108 

347 

2,313 

116 

463 

2,665 

188 

467.3 

66.1 

17.4 

562.1 

56.7 

219.1 

568.6 

112.7 

190.3 

458.8 

117.1 

204.4 

612.2 

134.9 

331.3 

OUTLYING AREAS 1,688 1,692 2,764 2,776 3,316 78.9 78.7 131.2 131.7 157.3 

TOTAL 507,221 541,586 572,422 626,734 656,174 376.0 398.0 393.5 430.8 451.1 

*The number of chlamydia cases occurring in the fourth quarter of 2000 for the State of Colorado was projected based on case counts from the first 

three quarters. 

†

New York City has been reporting chlamydia cases since 1984. The State of New York, with the exception of New York City, initiated chlamydia 

reporting during the year 2000. The number of chlamydia cases reported from1998-2000 by the state of New York may be incomplete and the rate 

for New York State is underestimated. See Appendix (Reporting of Chlamydia Cases). 

§

Includes cases reported by Washington, D.C., and rates exclude population of states that did not report. Cases reported with unknown sex are not 

included in this table. 

84 Chlamydia Tables STD Surveillance 2002 
Table 6. Chlamydia — Men – Reported cases and rates by state/area and region listed in alphabetical order: 

United States and outlying areas, 1998–2002 

State/Area 

Cases Rates per 100,000 Population 

1998 1999 2000 2001 2002 1998 1999 2000 2001 2002 

Alabama 844 795 1,432 1,124 1,579 40.4 37.9 66.7 52.4 73.6 

Alaska 428 430 706 763 1,230 132.8 132.3 217.8 235.4 379.5 

Arizona 2,474 2,614 2,583 3,153 3,308 107.1 110.6 100.9 123.1 129.2 

Arkansas 267 1,247 1,204 1,325 1,486 21.8 101.1 92.3 101.6 113.9 

California 16,525 18,236 22,759 24,930 28,400 101.2 110.0 134.9 147.7 168.3 

Colorado* 2,115 2,666 3,251 3,328 3,604 107.5 132.6 150.1 153.6 166.4 

Connecticut 1,149 1,369 1,366 1,445 2,070 72.3 85.9 82.8 87.6 125.5 

Delaware 491 493 585 668 615 135.8 134.6 153.7 175.5 161.6 

Florida 4,363 5,341 5,828 6,967 8,156 60.3 72.9 74.7 89.3 104.6 

Georgia 3,932 5,462 5,102 5,926 6,363 105.7 144.1 126.7 147.2 158.0

Hawaii 395 583 777 977 1,076 66.0 98.5 127.7 160.5 176.8 

Idaho 482 446 462 528 641 78.6 71.4 71.2 81.4 98.8 

Illinois 6,749 7,642 8,578 10,588 13,942 114.9 129.2 141.1 174.1 229.3 

Indiana 1,968 2,313 3,093 3,555 3,845 68.6 80.0 103.7 119.2 128.9 

Iowa 1,096 1,302 1,505 1,401 1,505 78.6 93.2 104.8 97.6 104.8 

Kansas 938 1,059 1,083 1,073 1,131 72.6 81.1 81.5 80.8 85.1 

Kentucky 1,093 1,328 1,513 1,779 1,706 57.2 69.0 76.6 90.1 86.4 

Louisiana 3,019 3,388 3,747 3,424 3,525 143.7 161.0 173.2 158.3 163.0 

Maine 174 229 331 297 468 28.7 37.5 53.4 47.9 75.4 

Maryland 1,973 2,196 2,379 2,777 3,029 79.1 87.4 93.0 108.6 118.4 

Massachusetts 1,551 1,817 2,515 2,502 2,724 52.3 61.0 82.2 81.8 89.1 

Michigan 3,387 4,237 5,331 6,540 7,143 70.9 88.3 109.4 134.2 146.6

Minnesota 1,851 1,981 2,246 2,313 2,755 79.5 84.2 92.2 95.0 113.1 

Mississippi 1,355 1,450 1,647 1,535 1,526 102.7 109.3 119.9 111.8 111.1

Missouri 1,607 1,840 1,923 2,095 2,928 61.0 69.4 70.7 77.0 107.6 

Montana 281 392 371 449 625 64.2 89.3 82.5 99.9 139.0 

Nebraska 520 712 769 680 1,128 63.9 87.4 91.2 80.6 133.8 

Nevada 498 586 893 1,239 1,558 56.0 63.6 87.7 121.7 153.0 

New Hampshire 234 207 241 341 389 40.1 35.0 39.7 56.1 64.0 

New Jersey 944 1,281 1,279 1,948 1,962 24.0 32.5 31.3 47.7 48.1 

New Mexico 589 839 1,001 1,237 1,464 68.9 98.0 111.9 138.3 163.7 

New York† 2,669 2,846 4,436 8,042 9,885 76.5 81.4 48.5 87.9 108.1 

North Carolina 3,551 3,396 3,359 3,473 4,340 97.0 91.5 85.2 88.1 110.1 

North Dakota 281 267 246 346 429 88.5 84.7 76.7 107.9 133.8 

Ohio 4,211 5,604 5,819 7,603 7,926 77.7 103.0 105.6 137.9 143.8 

Oklahoma 1,697 1,458 1,616 1,878 2,040 103.8 88.9 95.3 110.7 120.3 

Oregon 1,548 1,665 1,915 2,012 1,976 95.5 101.7 112.9 118.6 116.5 

Pennsylvania 3,751 4,549 5,086 5,850 8,244 65.0 78.9 85.8 98.7 139.0

Rhode Island 528 576 663 715 775 111.1 120.9 131.6 142.0 153.9 

South Carolina 1,837 1,679 1,127 1,731 1,800 99.4 89.5 57.8 88.8 92.4 

South Dakota 400 348 523 510 606 110.2 96.5 139.6 136.2 161.8 

Tennessee 3,165 3,132 3,421 3,455 3,417 120.8 118.3 123.5 124.7 123.3 

Texas 10,301 10,597 11,829 12,033 11,964 105.7 107.2 114.3 116.2 115.6 

Utah 593 601 580 882 1,044 56.8 56.8 51.8 78.8 93.3 

Vermont 56 71 94 115 208 19.3 24.3 31.5 38.5 69.7 

Virginia 1,988 2,177 2,359 3,107 3,416 59.9 64.8 67.9 89.5 98.4 

Washington 2,621 3,084 3,483 3,472 3,931 92.7 107.8 118.7 118.3 134.0 

West Virginia 448 233 350 371 386 51.3 26.8 39.8 42.2 43.9

Wisconsin 3,144 3,212 4,006 4,191 4,669 122.5 124.5 151.2 158.2 176.3 

Wyoming 130 138 140 160 189 53.8 57.3 56.4 64.4 76.1 

U.S. TOTAL§ 106,671 120,430 137,957 157,304 179,585 84.1 94.1 99.9 113.9 130.1 

Northeast 11,056 12,945 16,011 21,255 26,725 56.1 65.5 61.8 82.1 103.2 

Midwest 26,152 30,517 35,122 40,895 48,007 85.3 99.0 111.3 129.6 152.1 

South 40,784 44,688 47,903 52,024 55,807 87.9 95.3 97.6 106.0 113.8 

West 28,679 32,280 38,921 43,130 49,046 95.4 105.8 123.4 136.7 155.5 

Guam 

Puerto Rico 

Virgin Islands 

59

358 

0 

65

298 

23 

95

469 

23 

84

435 

15 

87 

334 

19 

69.7 

19.3 

. 

75.0 

16.0 

37.5 

120.0 

25.6 

44.3 

106.1 

23.7 

28.9 

109.9 

18.2 

36.6 

OUTLYING AREAS 417 386 587 534 440 21.5 19.2 29.9 27.2 22.4 

TOTAL 107,088 120,816 138,544 157,838 180,025 83.2 92.9 98.9 112.7 128.6 

*The number of chlamydia cases occurring in the fourth quarter of 2000 for the State of Colorado was projected based on case counts from the first 

three quarters. 

†

New York City has been reporting chlamydia cases since 1984. The State of New York, with the exception of New York City, initiated chlamydia 

reporting during the year 2000. The number of chlamydia cases reported from1998-2000 by the state of New York may be incomplete and the rate 

for New York State is underestimated. See Appendix (Reporting of Chlamydia Cases). 

§

Includes cases reported by Washington, D.C., and rates exclude population of states that did not report. Cases reported with unknown sex are not 

included in this table. 

STD Surveillance 2002 Chlamydia Tables 85 
Table 7. Chlamydia — Reported cases and rates in selected cities of >200,000 population, ranked by rates: 

United States, 2002 

Rank* City† Cases Rate per 100,000 Population 

1 Detroit, MI 11,374 1,195.7 

2 Richmond, VA 2,108 1,065.8 

3 Baltimore, MD 6,267 962.4 

4 Philadelphia, PA 14,458 952.7 

5 St Louis, MO 3,206 920.8 

6 Milwaukee, WI 8,553 909.7 

7 New Orleans, LA 4,340 895.4 

8 Denver, CO 4,546 819.6 

9 Chicago, IL 24,673 799.4 

10 Indianapolis, IN 6,593 766.2 

11 Minneapolis, MN 2,868 746.9 

12 Kansas City, MO 3,348 740.9 

13 Newark, NJ 2,092 695.5 

14 Buffalo, NY§ 2,217 688.2 

15 Atlanta, GA 5,560 681.4 

16 Rochester, NY§ 1,625 657.7 

17 Albuquerque, NM 3,531 634.3 

18 St Paul, MN 1,798 631.7 

19 Memphis, TN 5,548 618.2 

20 Oklahoma City, OK 2,622 616.5 

21 Washington, DC 3,305 577.7 

22 Norfolk, VA 1,350 575.9 

23 Boston, MA 3,320 555.1 

24 Birmingham, AL 3,650 551.3 

25 Toledo, OH 2,465 541.7 

26 Cincinnati, OH 4,566 540.2 

27 Jacksonville, FL 3,926 504.1 

28 Omaha, NE 2,312 498.7 

29 Tulsa, OK 1,885 478.1 

30 Corpus Christi, TX 1,433 456.9 

31 Austin, TX 3,678 452.8 

32 Portland, OR 2,272 436.0 

33 Honolulu, HI 3,801 433.8 

34 Dallas, TX 9,561 430.9 

35 San Francisco, CA 3,345 430.6 

36 Columbus, OH 4,581 428.5 

37 San Antonio, TX 5,777 414.7 

38 New York City, NY 33,063 412.9 

39 Charlotte, NC 2,778 399.5 

40 Los Angeles, CA 35,544 398.9 

41 Sacramento, CA 4,749 388.1 

42 Nashville, TN 2,157 378.5 

43 San Diego, CA 10,286 365.6 

44 Wichita, KS 1,602 353.7 

45 Cleveland, OH 4,924 353.2 

46 Des Moines, IA 1,322 352.9 

47 Houston, TX 11,768 346.1 

48 Tampa, FL 3,407 341.1 

49 El Paso, TX 2,287 336.5 

50 Pittsburgh, PA 4,145 323.4 

51 Oakland, CA 4,623 320.2 

52 Phoenix, AZ 9,697 315.6 

53 Louisville, KY 2,176 313.7 

54 Dayton, OH 1,723 308.2 

55 Tucson, AZ 2,580 305.8 

56 Jersey City, NJ 678 281.9 

57 Fort Worth, TX 4,005 276.9 

58 San Jose, CA 4,360 259.1 

59 Seattle, WA 4,469 257.3 

60 St Petersburg, FL 2,294 248.9 

61 Akron, OH 1,249 230.1 

62 Yonkers, NY§ 456 229.7 

63 Miami, FL 4,711 209.1 

*Excludes outlying areas (San Juan, PR with 1,058 cases and rate of 103.7). 

†

Cities were ranked in descending order by rate, number of cases, and alphabetically by state.
 

§

New York City has been reporting chlamydia cases since 1984. The State of New York, with the exception of New York City, initiated chlamydia
 

reporting during the year 2000. The number of chlamydia cases reported from 1998-2000 by the state of New York (including the cities of Buffalo,
 

Rochester and Yonkers) may be incomplete and the rate for New York State is underestimated. See Appendix (Reporting of Chlamydia Cases).
 

86 Chlamydia Tables STD Surveillance 2002 
Table 8. Chlamydia — Reported cases and rates in selected cities of >200,000 population listed in 

alphabetical order: United States and outlying areas, 1998–2002 

City 

Cases Rates per 100,000 Population 

1998 1999 2000 2001 2002
 1998 1999 2000 2001 2002 

Akron, OH 

Albuquerque, NM 

Atlanta, GA 

Austin, TX 

Baltimore, MD 

Birmingham, AL 

Boston, MA 

Buffalo, NY* 

Charlotte, NC 

Chicago, IL 

Cincinnati, OH 

Cleveland, OH 

Columbus, OH 

Corpus Christi, TX 

Dallas, TX 

Dayton, OH 

Denver, CO 

Des Moines, IA 

Detroit, MI 

El Paso, TX 

Fort Worth, TX 

Honolulu, HI 

Houston, TX 

Indianapolis, IN 

Jacksonville, FL 

Jersey City, NJ 

Kansas City, MO 

Los Angeles, CA 

Louisville, KY 

Memphis, TN 

Miami, FL 

Milwaukee, WI 

Minneapolis, MN 

Nashville, TN 

New Orleans, LA 

New York City, NY 

Newark, NJ 

Norfolk, VA 

Oakland, CA 

Oklahoma City, OK 

Omaha, NE 

Philadelphia, PA 

Phoenix, AZ 

Pittsburgh, PA 

Portland, OR 

Richmond, VA 

Rochester, NY* 

Sacramento, CA 

San Antonio, TX 

San Diego, CA 

San Francisco, CA 

San Jose, CA 

Seattle, WA 

St Louis, MO 

St Paul, MN 

St Petersburg, FL 

Tampa, FL 

Toledo, OH 

Tucson, AZ 

Tulsa, OK 

Washington, DC 

Wichita, KS 

Yonkers, NY* 

859 

1,715 

5,276 

3,030 

5,663 

2,476 

2,588 

NR 

1,695 

17,023 

4,840 

3,650 

3,854 

1,220 

8,893 

929 

2,834 

743 

7,351 

1,697 

4,089 

2,205 

11,561 

4,584 

1,913 

678 

3,105 

24,160 

1,253 

4,791 

3,486 

7,758 

2,555 

1,981 

3,331 

26,218 

1,725 

954 

3,651 

2,008 

1,410 

11,763 

7,549 

2,980 

2,128 

1,619 

NR 

4,005 

5,909 

7,044 

2,616 

3,349 

3,486 

2,921 

1,233 

1,692 

2,240 

780 

1,610 

1,782 

3,182 

861 

NR 

841 

1,674 

5,572 

2,795 

5,286 

2,209 

2,680 

NR 

1,669 

18,125 

3,801 

3,446 

3,997 

1,158 

9,355 

1,256 

3,371 

922 

7,753 

1,898 

3,752 

2,631 

10,511 

4,641 

2,703 

724 

2,738 

27,614 

1,447 

5,025 

4,010 

7,641 

2,584 

2,202 

3,651 

26,766 

1,881 

920 

4,111 

1,768 

1,808 

12,660 

7,660 

2,879 

2,018 

1,972 

NR 

4,469 

5,731 

7,591 

2,718 

3,428 

3,949 

3,090 

1,349 

1,760 

2,757 

1,043 

1,908 

1,636 

2,720 

1,532 

NR 

990 

2,368 

5,558 

3,113 

5,433 

3,601 

3,229 

722 

1,873 

19,792 

4,715 

3,961 

4,298 

1,525 

9,976 

1,176 

3,164 

1,075 

9,989 

2,225 

4,214 

2,932 

12,213 

5,506 

3,501 

624 

3,128 

31,074 

1,656 

4,967 

3,032 

9,018 

2,652 

2,403 

3,817 

26,170 

1,567 

1,093 

4,975 

2,060 

1,935 

13,584 

7,987 

2,885 

2,306 

2,230 

115 

4,599 

5,871 

8,591 

3,093 

3,908 

4,495 

2,711 

1,639 

1,834 

2,714 

1,646 

1,786 

1,770 

3,205 

1,457 

379 

1,162 

3,139 

6,426 

3,317 

5,405 

2,957 

2,935 

2,379 

1,936 

22,420 

4,594 

4,811 

4,850 

1,458 

10,249 

2,066 

4,186 

1,122 

11,552 

2,356 

4,142 

3,473 

11,289 

6,611 

3,551 

893 

2,747 

32,706 

1,952 

5,418 

3,800 

8,224 

2,614 

2,086 

3,871 

29,649 

2,408 

1,475 

4,682 

2,444 

1,719 

13,628 

8,953 

3,444 

2,355 

2,082 

1,064 

4,442 

5,749 

9,166 

3,030 

4,118 

4,295 

3,195 

1,506 

1,884 

2,535 

2,244 

2,700 

1,720 

3,286 

1,465 

373 

1,249
 

3,531 

5,560
 

3,678
 

6,267
 

3,650 

3,320
 

2,217
 

2,778
 

24,673 

4,566
 

4,924
 

4,581
 

1,433 

9,561 

1,723 

4,546
 

1,322
 

11,374
 

2,287
 

4,005
 

3,801
 

11,768
 

6,593 

3,926 

678 

3,348 

35,544 

2,176 

5,548 

4,711
 

8,553
 

2,868
 

2,157
 

4,340
 

33,063 

2,092
 

1,350
 

4,623
 

2,622 

2,312 

14,458 

9,697 

4,145 

2,272
 

2,108
 

1,625
 

4,749
 

5,777
 

10,286 

3,345
 

4,360
 

4,469
 

3,206
 

1,798
 

2,294 

3,407 

2,465 

2,580 

1,885 

3,305 

1,602 

456 

159.7 

326.1 

713.6 

426.4 

877.2 

375.4 

465.2	 

. 

268.7 

571.5 

571.2 

264.4 

377.4 

385.7 

433.6 

166.4 

567.9 

206.5 

583.3 

241.4 

301.7 

252.7 

360.6 

563.6 

260.0 

308.1 

687.0 

280.2 

186.4 

551.4 

162.0 

850.9 

700.9 

371.0 

715.5 

353.3 

606.6 

443.3 

285.3 

492.6 

317.7 

819.0 

271.1 

234.9 

427.4 

833.8	 

. 

350.0 

436.7 

253.3 

350.8 

204.1 

210.7 

860.8 

455.8 

192.7 

242.1 

173.9 

203.6 

468.4 

608.3 

192.2	 

. 

156.4 

319.8 

748.1 

384.4 

835.5 

336.0 

481.7 

. 

257.4 

608.1 

452.3 

251.2 

388.9 

367.1 

453.7 

222.0 

674.5 

252.8 

618.6 

270.4 

271.4 

304.3 

323.4 

572.3 

366.0 

331.6 

606.3 

316.2 

215.0 

575.6 

184.3 

843.1 

705.7 

415.4 

792.1 

360.3 

664.1 

407.3 

317.7 

431.3 

405.1 

893.1 

267.7 

229.1 

403.9 

1,039.5 

. 

377.3 

417.4 

269.1 

364.0 

208.1 

237.2 

925.3 

498.1 

200.3 

293.1 

233.6 

237.4 

426.3 

524.1 

339.2 

. 

182.4 

425.4 

681.1 

383.2 

834.4 

543.9 

539.9 

224.1 

269.3 

641.3 

557.8 

284.2 

402.1 

486.2 

449.6 

210.4 

570.5 

287.0 

1,050.1 

327.4 

291.4 

334.6 

359.1 

639.9 

449.5 

259.4 

692.2 

348.8 

238.8 

553.4 

134.6 

959.2 

690.7 

421.7 

787.5 

326.8 

521.0 

466.3 

344.6 

484.3 

417.4 

895.1 

260.0 

225.1 

442.5 

1,127.5 

46.5 

375.9 

421.5 

305.3 

398.2 

232.3 

258.8 

778.6 

575.8 

199.0 

271.7 

361.7 

211.7 

448.9 

560.3 

321.7 

190.9 

214.0 

563.9 

787.5 

408.4 

830.1 

446.6 

490.8 

738.5 

278.4 

726.4 

543.5 

345.1 

453.7 

464.9 

461.9 

369.5 

754.7 

299.5 

1,214.4 

346.7 

286.4 

396.4 

332.0 

768.3 

455.9 

371.2 

607.9 

367.1 

281.4 

603.7 

168.6 

874.7 

680.8 

366.0 

798.7 

370.2 

800.6 

629.3 

324.3 

574.6 

370.8 

898.0 

291.4 

268.7 

451.9 

1,052.6 

430.6 

363.1 

412.7 

325.7 

390.1 

244.7 

247.3 

917.6 

529.1 

204.5 

253.8 

493.1 

320.0 

436.2 

574.4 

323.5 

187.9 

230.1 

634.3

681.4 

452.8 

962.4 

551.3

555.1 

688.2 

399.5 

799.4

540.2 

353.2 

428.5 

456.9

430.9 

308.2

819.6 

352.9 

1,195.7 

336.5 

276.9 

433.8 

346.1 

766.2

504.1 

281.9

740.9 

398.9

313.7 

618.2

209.1 

909.7 

746.9 

378.5 

895.4 

412.9

695.5 

575.9 

320.2 

616.5

498.7 

952.7

315.6 

323.4

436.0 

1,065.8 

657.7 

388.1 

414.7 

365.6

430.6 

259.1 

257.3 

920.8 

631.7 

248.9

341.1 

541.7 

305.8 

478.1 

577.7 

353.7 

229.7 

U.S. CITY TOTAL† 258,501 269,806 296,125 318,308 339,607 370.4 384.2 401.8 431.9 460.8 

San Juan, PR 615 501 966 1,076 1,058 58.8 47.6 94.7 105.5 103.7 

TOTAL 259,116 270,307 297,091 319,384 340,665 365.8 379.2 397.6 427.4 455.9 

*New York City has been reporting chlamydia cases since 1984. The State of New York, with the exception of New York City, initiated chlamydia 

reporting during the year 2000. The number of chlamydia cases reported from 1998-2000 by the state of New York (including the cities of Buffalo, 

Rochester and Yonkers) may be incomplete and the rate for New York State is underestimated. See Appendix (Reporting of Chlamydia Cases). †

Rates exclude population of cities that did not report. NR=No report 

STD Surveillance 2002	 Chlamydia Tables 87 
Table 9. Chlamydia — Women – Reported cases and rates in selected cities of >200,000 population listed in 

alphabetical order: United States and outlying areas, 1998–2002 

City 

Cases Rates per 100,000 Population 

1998 1999 2000 2001 2002
 1998 1999 2000 2001 2002 

Akron, OH 

Albuquerque, NM 

Atlanta, GA 

Austin, TX 

Baltimore, MD 

Birmingham, AL 

Boston, MA 

Buffalo, NY* 

Charlotte, NC 

Chicago, IL 

Cincinnati, OH 

Cleveland, OH 

Columbus, OH 

Corpus Christi, TX 

Dallas, TX 

Dayton, OH 

Denver, CO 

Des Moines, IA 

Detroit, MI 

El Paso, TX 

Fort Worth, TX 

Honolulu, HI 

Houston, TX 

Indianapolis, IN 

Jacksonville, FL 

Jersey City, NJ 

Kansas City, MO 

Los Angeles, CA 

Louisville, KY 

Memphis, TN 

Miami, FL 

Milwaukee, WI 

Minneapolis, MN 

Nashville, TN 

New Orleans, LA 

New York City, NY 

Newark, NJ 

Norfolk, VA 

Oakland, CA 

Oklahoma City, OK 

Omaha, NE 

Philadelphia, PA 

Phoenix, AZ 

Pittsburgh, PA 

Portland, OR 

Richmond, VA 

Rochester, NY* 

Sacramento, CA 

San Antonio, TX 

San Diego, CA 

San Francisco, CA 

San Jose, CA 

Seattle, WA 

St Louis, MO 

St Paul, MN 

St Petersburg, FL 

Tampa, FL 

Toledo, OH 

Tucson, AZ 

Tulsa, OK 

Washington, DC 

Wichita, KS 

Yonkers, NY* 

697 

1,437 

4,217 

2,463 

5,066 

2,352 

1,920 

NR 

1,395 

13,424 

4,122 

3,173 

3,027 

1,031 

6,699 

729 

2,146 

581 

6,491 

1,421 

3,278 

1,850 

9,912 

3,472 

1,368 

657 

2,785 

18,930 

985 

3,786 

2,799 

6,219 

1,762 

1,426 

2,574 

23,449 

1,632 

826 

2,942 

1,585 

1,139 

10,182 

5,653 

2,415 

1,453 

1,452 

NR 

3,069 

4,854 

5,394 

1,541 

2,594 

2,430 

2,630 

897 

1,391 

1,851 

630 

1,299 

1,467 

2,722 

665 

NR 

653 

1,401 

4,287 

2,367 

4,700 

2,086 

2,107 

NR 

1,373 

14,377 

3,211 

2,955 

2,907 

999 

7,143 

834 

2,468 

660 

6,343 

1,599 

2,933 

2,102 

8,740 

3,481 

2,091 

681 

2,413 

21,564 

1,136 

4,020 

3,282 

6,076 

1,756 

1,628 

2,794 

23,896 

1,684 

795 

3,212 

1,449 

1,437 

10,479 

5,787 

2,380 

1,379 

1,713 

NR 

3,452 

4,697 

5,839 

1,541 

2,636 

2,654 

2,736 

972 

1,446 

2,380 

815 

1,531 

1,331 

2,391 

1,218 

NR 

769 

1,815 

4,468 

2,432 

4,828 

2,792 

2,360 

528 

1,498 

15,631 

3,938 

3,183 

3,185 

1,292 

7,726 

863 

2,190 

789 

7,716 

1,881 

3,317 

2,239 

10,222 

3,896 

2,809 

605 

2,763 

23,056 

1,301 

3,943 

2,449 

7,077 

1,759 

1,758 

2,772 

22,663 

1,330 

964 

3,851 

1,686 

1,516 

10,724 

6,195 

2,398 

1,597 

1,900 

86 

3,391 

4,767 

6,371 

1,819 

2,948 

3,006 

2,362 

1,154 

1,511 

2,319 

1,348 

1,411 

1,485 

2,786 

1,134 

327 

916 

2,368 

5,152 

2,633 

4,825 

2,524 

2,086 

1,731 

1,484 

16,756 

3,740 

3,635 

3,336 

1,233 

8,083 

1,595 

2,962 

814 

9,137 

1,936 

3,277 

2,574 

9,473 

4,552 

2,865 

818 

2,396 

24,358 

1,511 

4,378 

3,079 

6,308 

1,716 

1,537 

2,958 

25,118 

2,117 

1,251 

3,562 

1,941 

1,346 

10,833 

6,841 

2,798 

1,651 

1,752 

807 

3,279 

4,632 

6,510 

1,723 

3,017 

2,905 

2,787 

1,098 

1,522 

2,112 

1,801 

2,058 

1,406 

2,807 

1,166 

326 

963
 

2,788 

4,349
 

2,923
 

5,490
 

2,833 

2,423
 

1,637
 

2,179
 

16,589 

3,711
 

3,718
 

3,127
 

1,210 

7,529 

1,244 

3,181
 

968
 

8,976
 

1,966
 

3,179
 

2,829
 

9,777
 

4,633 

2,984 

618 

2,773 

25,587 

1,696 

4,546 

3,804
 

6,323
 

1,907
 

1,604
 

3,305
 

27,177 

1,724
 

1,172
 

3,562
 

2,007 

1,738 

10,308 

7,509 

3,204 

1,527
 

1,723
 

1,218
 

3,583
 

4,654
 

7,285 

1,827
 

3,150
 

2,994
 

2,665
 

1,318
 

1,844 

2,774 

1,944 

1,927 

1,561 

2,825 

1,315 

380 

249.1 

532.6 

1,090.7 

689.4 

1,470.5 

668.6 

665.9	 

. 

426.3 

867.6 

923.7 

433.7 

571.6 

634.1 

642.4 

250.2 

837.9 

309.6 

978.8 

387.8 

477.7 

423.8 

612.8 

814.3 

359.9 

577.2 

1,175.9 

435.2 

277.8 

830.3 

248.6 

1,298.3 

938.6 

507.9 

1,029.3 

596.4 

1,090.5 

754.7 

452.9 

747.8 

495.6 

1,321.5 

401.2 

358.2 

571.4 

1,360.3	 

. 

526.0 

692.0 

388.1 

409.3 

318.7 

289.5 

1,430.9 

635.4 

299.0 

389.7 

269.0 

321.3 

744.0 

978.9 

290.5	 

. 

233.1 

521.4 

1,101.3 

647.6 

1,393.0 

595.2 

731.6 

. 

408.0 

928.2 

724.9 

406.3 

545.0 

615.9 

681.6 

282.2 

962.3 

347.1 

961.0 

435.6 

419.6 

484.8 

533.4 

818.2 

546.9 

603.0 

1,020.1 

489.4 

319.8 

877.4 

288.0 

1,271.8 

931.3 

584.4 

1,129.3 

607.9 

1,130.3 

727.4 

490.0 

680.5 

622.2 

1,377.2 

399.9 

356.2 

540.5 

1,643.0 

. 

571.9 

661.0 

417.0 

408.9 

322.6 

314.5 

1,512.5 

687.3 

310.9 

492.8 

349.4 

372.6 

670.1 

866.4 

528.1 

. 

273.2 

637.3 

1,078.5 

613.6 

1,389.5 

797.8 

762.2 

314.1 

423.2 

982.0 

890.3 

432.8 

579.4 

806.7 

695.6 

296.9 

798.0 

409.1 

1,534.0 

534.6 

454.2 

514.0 

598.9 

876.6 

700.3 

494.2 

1,179.7 

511.6 

359.4 

841.0 

210.3 

1,445.5 

902.4 

597.9 

1,076.2 

537.8 

843.4 

841.4 

524.3 

770.0 

640.1 

1,320.0 

403.4 

355.4 

606.7 

1,797.2 

67.2 

542.8 

666.3 

455.5 

476.3 

355.3 

344.5 

1,279.4 

782.6 

313.1 

454.5 

570.5 

327.2 

731.4 

920.4 

495.2 

315.7 

325.5 

831.5 

1,243.6 

664.3 

1,388.6 

721.2 

673.7 

1,029.8 

419.2 

1,052.6 

845.5 

494.2 

606.9 

769.8 

727.7 

548.7 

1,079.3 

422.1 

1,816.6 

550.2 

448.8 

590.9 

555.0 

1,024.2 

714.3 

668.2 

1,023.0 

540.4 

417.4 

933.8 

264.4 

1,288.4 

880.4 

522.7 

1,148.4 

596.1 

1,342.4 

1,091.9 

485.0 

886.4 

568.3 

1,333.4 

445.5 

414.7 

627.3 

1,657.2 

630.4 

524.9 

647.5 

465.4 

451.2 

363.7 

332.9 

1,509.6 

744.6 

315.4 

414.0 

762.2 

477.3 

692.4 

927.3 

509.2 

314.8 

342.2 

979.0 

1,049.8 

737.4 

1,580.0 

809.5

782.5 

973.9 

615.5 

1,042.1

839.0 

505.5 

568.9 

755.5

677.9 

427.9

1,159.1 

501.9 

1,784.6 

558.8 

435.3 

649.4 

572.9 

1,042.4

744.0 

504.8

1,184.0 

567.7

468.5 

969.7

326.7 

1,291.5 

978.3 

545.5 

1,283.1 

644.9

1,093.2 

1,022.9 

485.0 

916.5

733.8 

1,268.8

489.0 

474.9

580.1 

1,629.7 

951.4 

573.6 

650.6 

520.8

478.4 

379.7 

343.1 

1,443.5 

893.8 

382.2

543.7 

822.7 

446.9 

768.8 

933.3 

574.2 

366.9 

U.S. CITY TOTAL† 210,356 217,017 232,899 247,912 258,284 584.0 599.1 616.6 656.3 683.8 

San Juan, PR 445 385 761 901 925 81.8 70.4 143.4 169.8 174.3 

TOTAL 210,801 217,402 233,660 248,813 259,209 576.5 591.2 610.0 649.6 676.7 

*New York City has been reporting chlamydia cases since 1984. The State of New York, with the exception of New York City, initiated chlamydia 

reporting during the year 2000. The number of chlamydia cases reported from 1998-2000 by the state of New York (including the cities of Buffalo, 

Rochester and Yonkers) may be incomplete and the rate for New York State is underestimated. See Appendix (Reporting of Chlamydia Cases). †

Rates exclude population of cities that did not report. Cases reported with unknown sex are not included in this table. NR = No report 

88 Chlamydia Tables	 STD Surveillance 2002 
Table 10. Chlamydia — Men – Reported cases and rates in selected cities of >200,000 population listed in 

alphabetical order: United States and outlying areas, 1998–2002 

City 

Cases Rates per 100,000 Population 

1998 1999 2000 2001 2002
 1998 1999 2000 2001 2002 

Akron, OH 

Albuquerque, NM 

Atlanta, GA 

Austin, TX 

Baltimore, MD 

Birmingham, AL 

Boston, MA 

Buffalo, NY* 

Charlotte, NC 

Chicago, IL 

Cincinnati, OH 

Cleveland, OH 

Columbus, OH 

Corpus Christi, TX 

Dallas, TX 

Dayton, OH 

Denver, CO 

Des Moines, IA 

Detroit, MI 

El Paso, TX 

Fort Worth, TX 

Honolulu, HI 

Houston, TX 

Indianapolis, IN 

Jacksonville, FL 

Jersey City, NJ 

Kansas City, MO 

Los Angeles, CA 

Louisville, KY 

Memphis, TN 

Miami, FL 

Milwaukee, WI 

Minneapolis, MN 

Nashville, TN 

New Orleans, LA 

New York City, NY 

Newark, NJ 

Norfolk, VA 

Oakland, CA 

Oklahoma City, OK 

Omaha, NE 

Philadelphia, PA 

Phoenix, AZ 

Pittsburgh, PA 

Portland, OR 

Richmond, VA 

Rochester, NY* 

Sacramento, CA 

San Antonio, TX 

San Diego, CA 

San Francisco, CA 

San Jose, CA 

Seattle, WA 

St Louis, MO 

St Paul, MN 

St Petersburg, FL 

Tampa, FL 

Toledo, OH 

Tucson, AZ 

Tulsa, OK 

Washington, DC 

Wichita, KS 

Yonkers, NY* 

161 

278 

1,038 

564 

566 

123 

668 

NR 

300 

3,599 

688 

463 

812 

188 

2,156 

198 

676 

162 

860 

273 

763 

355 

1,648 

1,112 

544 

21 

320 

5,230 

260 

1,005 

685 

1,532 

793 

555 

757 

2,669 

93 

128 

698 

423 

270 

1,581 

1,896 

565 

675 

167 

NR 

907 

1,048 

1,583 

1,075 

717 

1,056 

291 

336 

294 

353 

144 

311 

315 

460 

196 

NR 

183 

272 

1,262 

428 

565 

117 

573 

NR 

296 

3,744 

552 

469 

1,053 

158 

2,156 

415 

898 

262 

1,410 

296 

778 

515 

1,634 

1,157 

612 

43 

325 

6,020 

307 

1,005 

717 

1,556 

828 

574 

857 

2,846 

194 

125 

759 

319 

370 

2,181 

1,873 

499 

639 

259 

NR 

987 

1,032 

1,704 

1,177 

761 

1,295 

354 

377 

314 

377 

222 

377 

305 

316 

314 

NR 

216 

521 

1,079 

676 

550 

700 

869 

194 

375 

4,160 

748 

748 

1,071 

233 

2,151 

302 

974 

286 

2,273 

343 

888 

683 

1,971 

1,604 

692 

19 

365 

8,000 

352 

1,024 

583 

1,935 

893 

645 

1,045 

3,377 

234 

129 

1,075 

374 

416 

2,860 

1,792 

487 

709 

329 

29 

1,171 

1,096 

2,072 

1,274 

937 

1,489 

349 

485 

323 

395 

288 

375 

285 

405 

323 

52 

243 

654 

1,273 

683 

580 

433 

849 

648 

452 

5,660 

818 

1,145 

1,434 

225 

2,105 

460 

1,219 

307 

2,415 

420 

858 

898 

1,804 

2,045 

686 

72 

351 

8,307 

439 

1,040 

721 

1,881 

898 

549 

913 

4,477 

291 

222 

1,080 

503 

373 

2,795 

2,112 

646 

704 

329 

257 

1,101 

1,110 

2,232 

1,307 

1,065 

1,390 

408 

408 

362 

423 

430 

642 

314 

451 

299 

47 

271
 

723 

1,185 

751 

777 

815 

896 

580 

599 

8,084 

820
 

1,179
 

1,396
 

223 

2,001 

475 

1,363
 

351
 

2,398
 

320
 

813
 

972
 

1,981
 

1,909 

942 

58 

575 

9,910 

477 

1,002 

907
 

2,210
 

961
 

553
 

972
 

5,850 

366
 

178
 

1,050
 

615 

569 

4,150 

2,188 

941 

745
 

385
 

407
 

1,137
 

1,121
 

2,641 

1,499 

1,155 

1,475 

541 

480 

450 

633 

509 

653 

324 

459 

287 

76 

62.4 

108.5 

294.3 

159.6 

188.0 

40.0 

249.2	 

. 

98.8 

251.4 

171.5 

71.3 

165.2 

122.3 

213.9 

74.1 

278.3 

94.1 

144.0 

81.1 

114.0 

81.4 

103.7 

287.3 

153.0 

19.8 

148.8 

122.4 

81.9 

243.4 

66.7 

354.1 

448.5 

219.2 

351.3 

76.5 

69.0 

121.0 

110.7 

216.2 

126.2 

237.5 

137.9 

95.1 

277.1 

191.0	 

. 

161.7 

160.8 

113.8 

291.1 

86.7 

129.5 

187.1 

259.8 

71.2 

78.4 

67.2 

80.5 

171.8 

187.7 

89.5	 

. 

71.0 

106.8 

354.9 

118.4 

191.3 

38.1 

213.5 

. 

94.9 

261.5 

138.9 

72.8 

213.0 

103.1 

212.6 

153.5 

369.1 

150.1 

237.6 

88.4 

113.8 

119.5 

101.4 

300.1 

171.8 

40.8 

151.1 

139.1 

96.6 

242.3 

69.2 

363.1 

466.2 

228.3 

401.4 

81.4 

144.5 

107.2 

118.9 

161.9 

171.8 

332.1 

132.4 

84.8 

261.4 

303.1 

. 

169.9 

155.8 

119.9 

318.2 

91.6 

157.7 

231.3 

291.3 

76.0 

82.4 

104.1 

96.0 

164.7 

130.0 

142.1 

. 

82.6 

191.6 

268.6 

162.5 

181.1 

224.3 

301.3 

125.9 

109.8 

278.4 

185.6 

113.6 

206.2 

151.8 

194.1 

112.5 

347.6 

157.4 

507.0 

104.6 

124.0 

155.0 

116.4 

385.6 

183.2 

16.1 

167.7 

181.7 

106.2 

238.9 

53.5 

429.5 

472.4 

233.8 

460.2 

89.0 

163.5 

107.7 

151.6 

181.2 

183.5 

405.6 

116.6 

80.2 

274.9 

357.3 

24.4 

195.6 

161.8 

146.4 

322.7 

109.9 

172.2 

213.4 

353.5 

73.6 

80.8 

131.6 

90.9 

149.0 

150.4 

144.3 

54.8 

92.9 

240.5 

316.9 

164.2 

191.0 

138.7 

294.4 

420.7 

132.4 

378.7 

203.0 

173.9 

276.1 

146.6 

189.9 

171.4 

435.0 

168.9 

538.7 

128.1 

119.8 

203.9 

106.5 

491.6 

181.6 

60.9 

161.3 

188.7 

132.4 

242.6 

66.2 

417.5 

475.0 

199.0 

402.0 

118.0 

203.4 

185.3 

152.3 

243.8 

164.5 

396.4 

137.5 

106.4 

273.0 

357.3 

215.9 

183.9 

163.8 

157.7 

331.0 

124.9 

160.8 

249.4 

297.4 

82.5 

86.5 

196.6 

155.6 

164.2 

167.4 

133.6 

49.5 

103.6 

265.9 

295.0 

180.6 

255.9 

261.1 

310.6 

376.5 

175.4 

540.9 

203.5 

179.0 

268.8 

145.3

180.6 

177.0

486.4 

193.1 

534.9 

97.6 

113.5 

220.6 

117.0 

458.9

249.4 

49.1 

264.2 

225.1 

143.8 

233.8 

83.3 

490.5 

508.3 

200.5 

428.0 

154.2

255.8 

148.5 

148.0 

298.0

251.0 

588.6 

142.4 

155.0

288.9 

418.2 

341.9 

189.9 

165.5 

186.6

379.7 

135.4 

170.6 

330.8 

349.9 

102.5 

129.5 

232.7 

158.3 

169.4 

170.4 

128.2 

80.0 

U.S. CITY TOTAL† 47,604 52,013 62,298 69,263 80,333 141.0 153.0 173.4 192.8 223.6 

San Juan, PR 170 116 205 175 133 33.8 23.0 41.9 35.7 27.2 

TOTAL 47,774 52,129 62,503 69,438 80,466 139.4 151.1 171.6 190.7 220.9 

*New York City has been reporting chlamydia cases since 1984. The State of New York, with the exception of New York City, initiated chlamydia 

reporting during the year 2000. The number of chlamydia cases reported from 1998-2000 by the state of New York (including the cities of Buffalo, 

Rochester and Yonkers) may be incomplete and the rate for New York State is underestimated. See Appendix (Reporting of Chlamydia Cases). †

Rates exclude population of cities that did not report. Cases reported with unknown sex are not included in this table. NR = No report 

STD Surveillance 2002	 Chlamydia Tables 89 
Table 11. Chlamydia — Reported cases and rates per 100,000 population by age and sex: United States, 

1998–2002 

Year Age 

Group 

Cases Rates 

Total Male Female Total Male Female 

1998 

10-14 

15-19 

20-24 

25-29 

30-34 

35-39 

40-44 

45-54 

55-64 

14,011 

247,339 

204,567 

79,872 

31,830 

15,622 

6,630 

4,114 

907 

713 

28,545 

37,123 

18,831 

9,131 

5,132 

2,408 

1,654 

396 

13,298 

218,794 

167,444 

61,041 

22,700 

10,490 

4,221 

2,459 

512 

72.8 

1,265.9 

1,157.4 

429.7 

157.7 

69.0 

30.3 

11.9 

4.0 

7.2 

284.2 

412.7 

203.6 

91.2 

45.6 

22.2 

9.8 

3.7 

141.7 

2,304.6 

1,929.5 

653.5 

223.0 

92.3 

38.2 

13.9 

4.3 

65+ 

TOTAL 

1,228 

608,490 

294 

104,912 

935 

503,578 

3.6 

225.1 

2.1 

79.5 

4.6 

364.2 

1999 

10-14 

15-19 

20-24 

25-29 

30-34 

35-39 

40-44 

45-54 

55-64 

65+ 

13,870 

259,742 

228,069 

88,114 

35,248 

17,269 

7,606 

4,661 

1,006 

915 

824 

32,366 

43,011 

21,548 

10,289 

5,957 

2,987 

2,036 

480 

302 

13,046 

227,376 

185,058 

66,566 

24,959 

11,312 

4,619 

2,625 

526 

613 

71.0 

1,315.3 

1,265.3 

483.9 

178.7 

76.6 

34.2 

13.0 

4.3 

2.6 

8.2 

318.8 

468.4 

238.0 

105.3 

53.1 

27.1 

11.6 

4.3 

2.1 

136.8 

2,369.3 

2,092.8 

727.2 

250.7 

99.9 

41.1 

14.3 

4.3 

3.0 

TOTAL 658,711 120,468 538,243 241.6 90.4 386.1 

2000 

10-14 

15-19 

20-24 

25-29 

30-34 

35-39 

40-44 

45-54 

55-64 

65+ 

14,468 

266,583 

249,360 

94,263 

39,509 

18,935 

8,442 

5,601 

1,110 

997 

931 

35,415 

50,103 

24,507 

12,216 

6,791 

3,318 

2,499 

494 

339 

13,537 

231,167 

199,257 

69,756 

27,292 

12,144 

5,123 

3,102 

617 

658 

70.5 

1,318.4 

1,314.9 

486.4 

192.6 

83.4 

37.6 

14.9 

4.6 

2.8 

8.9 

340.8 

517.2 

250.1 

118.4 

60.0 

29.8 

13.5 

4.2 

2.4 

135.3 

2,351.9 

2,148.0 

727.9 

267.9 

106.6 

45.3 

16.2 

4.9 

3.2 

TOTAL 701,339 137,233 564,106 249.2 99.4 393.5 

2001 

10-14 

15-19 

20-24 

25-29 

30-34 

35-39 

40-44 

45-54 

55-64 

65+ 

15,031 

288,333 

285,589 

106,914 

45,255 

21,516 

9,940 

6,415 

1,282 

919 

1,042 

39,064 

58,597 

27,896 

14,493 

7,953 

4,124 

2,943 

638 

313 

13,989 

249,269 

226,992 

79,018 

30,763 

13,563 

5,816 

3,472 

644 

606 

73.2 

1,426.0 

1,506.0 

551.6 

220.6 

94.8 

44.3 

17.0 

5.3 

2.6 

9.9 

375.9 

604.9 

284.7 

140.4 

70.3 

37.1 

15.9 

5.5 

2.2 

139.8 

2,536.1 

2,447.0 

824.6 

301.9 

119.1 

51.4 

18.1 

5.1 

2.9 

TOTAL 783,127 157,623 625,504 278.3 114.2 436.3 

2002 

10-14 

15-19 

20-24 

25-29 

30-34 

35-39 

40-44 

45-54 

55-64 

65+ 

15,294 

299,863 

305,400 

116,422 

50,339 

23,411 

11,405 

7,644 

1,451 

812 

1,076 

42,433 

66,991 

32,497 

16,847 

9,298 

5,122 

3,652 

746 

296 

14,218 

257,429 

238,408 

83,925 

33,492 

14,113 

6,283 

3,992 

705 

516 

74.5 

1,483.0 

1,610.4 

600.7 

245.4 

103.1 

50.8 

20.3 

6.0 

2.3 

10.2 

408.4 

691.5 

331.6 

163.2 

82.1 

46.0 

19.7 

6.4 

2.1 

142.1 

2,619.1 

2,570.1 

875.8 

328.7 

123.9 

55.5 

20.8 

5.6 

2.5 

TOTAL 834,503 180,039 654,464 296.5 130.4 456.5 

NOTE: This table should be used only for age comparisons. If age was not specified, cases were prorated according to the distribution of cases for 

which age was known. Differences between total cases from this table and others in the report are due to different reporting forms and above listed 

exclusions. The 0 to 9 year age group is not shown because some of these may not be due to sexual transmission; however, they are included in the 

totals. 

90 Chlamydia Tables STD Surveillance 2002 
This page intentionally left blank.
 
Table 12A. Chlamydia — Reported cases by age, sex, and race/ethnicity: United States, 1998–2002 

Age 

Group 

Total 

Total Male Female 

White, Non-Hispanic 

Total Male Female 

Black, Non-Hispanic 

Total Male Female Total 

Hispanic 

Male Female 

Asian/Pacific Islander 

Total Male Female 

American Indian/ 

Alaska Native 

Total Male Female 

10-14 11,223 617 10,605 2,967 90 2,878 6,188 376 5,812 1,641 128 1,513 137 11 127 289 13 276 

15-19 199,119 24,352 174,767 63,688 5,206 58,482 97,844 13,952 83,892 30,569 4,380 26,189 3,010 361 2,649 4,008 453 3,555 

20-24 164,920 31,692 133,228 50,696 8,197 42,499 77,651 16,481 61,170 30,193 6,008 24,185 3,107 524 2,583 3,273 483 2,790 

199825-29 

30-34 

35-39 

64,316 15,979 48,337 

25,578 7,711 17,867 

12,564 4,367 8,197 

17,503 3,936 13,567 

6,611 2,025 4,586 

3,370 1,075 2,295 

29,671 8,363 21,308 

11,540 3,961 7,578 

5,784 2,377 3,407 

14,137 

5,964 

2,598 

3,154 10,983 

1,484 4,480 

710 1,888 

1,627 334 1,293 

740 152 588 

433 124 309 

1,378 191 1,187 

723 88 635 

380 81 298 

40-44 5,297 2,029 3,268 1,521 570 952 2,421 1,135 1,286 974 247 727 201 41 160 179 36 143 

45-54 3,172 1,340 1,832 996 430 566 1,405 725 680 534 135 399 111 37 74 126 13 113 

55-64 661 305 356 171 82 89 320 174 147 116 34 82 29 9 20 24 6 18 

65+ 1,032 246 786 299 86 213 550 119 430 147 36 111 22 5 17 15 0 15 

TOTAL 489,760 89,183 400,577 148,314 21,851 126,463 234,279 47,912 186,367 87,276 16,438 70,838 9,448 1,606 7,843 10,443 1,377 9,065 

10-14 12,553 752 11,801 3,180 114 3,066 7,050 449 6,601 1,885 163 1,721 159 12 147 279 13 266 

15-19 232,381 29,730 202,651 72,649 6,302 66,347 116,293 17,281 99,012 35,455 5,184 30,271 3,601 447 3,154 4,382 516 3,867 

20-24 201,730 39,032 162,698 61,460 10,419 51,041 96,754 20,598 76,156 36,102 6,894 29,207 3,879 629 3,250 3,536 492 3,044 

199925-29 

30-34 

35-39 

77,066 19,369 57,697 

30,339 9,169 21,170 

14,823 5,311 9,511 

20,236 4,671 15,565 

7,427 2,256 5,170 

3,926 1,397 2,528 

36,134 10,266 25,868 

13,979 4,832 9,147 

6,773 2,887 3,886 

17,025 

7,316 

3,264 

3,704 13,321 

1,741 5,575 

823 2,441 

2,084 473 1,611 

929 205 724 

470 121 349 

1,587 256 1,331 

688 135 553 

389 83 307 

40-44 6,458 2,683 3,775 1,834 776 1,058 2,917 1,448 1,468 1,262 341 921 246 77 169 200 41 159 

45-54 3,948 1,804 2,144 1,098 517 580 1,746 969 777 787 228 560 171 60 110 146 30 116 

55-64 818 416 402 239 152 87 373 194 179 129 44 85 42 11 31 34 15 20 

65+ 775 264 511 255 98 157 300 104 196 113 24 88 28 15 13 80 23 57 

TOTAL 582,845 109,127 473,718 172,815 26,857 145,958 283,370 59,335 224,035 103,667 19,264 84,403 11,648 2,063 9,585 11,345 1,609 9,736 

10-14 13,081 865 12,216 3,140 110 3,031 7,428 536 6,892 2,044 194 1,850 180 13 167 288 12 276 

15-19 240,404 32,329 208,075 74,657 6,965 67,691 117,722 18,296 99,426 39,526 5,986 33,540 3,865 484 3,381 4,634 597 4,037 

20-24 224,162 45,293 178,869 67,922 12,108 55,814 104,067 22,997 81,070 43,525 8,741 34,785 4,379 820 3,559 4,268 627 3,641 

200025-29 

30-34 

35-39 

83,755 21,967 61,788 

34,614 10,831 23,783 

16,584 6,027 10,557 

21,679 5,274 16,406 

8,389 2,523 5,867 

4,249 1,621 2,628 

37,556 11,151 26,404 

15,044 5,620 9,424 

7,423 3,105 4,318 

20,619 

9,168 

3,782 

4,694 15,925 

2,237 6,931 

1,024 2,758 

2,117 535 1,582 

1,141 270 871 

633 172 461 

1,784 313 1,470 

872 181 690 

497 105 393 

40-44 7,398 2,992 4,407 2,090 862 1,228 3,234 1,512 1,723 1,544 468 1,076 283 93 190 247 57 189 

45-54 4,833 2,235 2,598 1,385 689 696 2,068 1,140 927 968 279 689 231 86 145 183 41 141 

55-64 937 442 495 313 167 146 372 193 178 153 46 107 54 22 32 45 14 31 

65+ 855 307 549 295 114 181 378 131 247 137 39 99 31 21 10 14 2 12 

TOTAL 628,449 123,826 504,623 184,555 30,554 154,001 296,248 64,943 231,306 121,849 23,840 98,009 12,932 2,522 10,410 12,865 1,967 10,898 

10-14 13,028 889 12,139 3,203 122 3,081 7,271 523 6,748 2,176 225 1,951 134 7 127 245 12 233 

15-19 254,176 34,931 219,244 79,923 7,591 72,331 122,896 19,374 103,522 42,630 6,852 35,778 3,907 514 3,393 4,820 601 4,220 

20-24 252,425 52,857 199,568 79,134 14,649 64,485 115,191 26,365 88,827 49,029 10,255 38,774 4,815 905 3,910 4,255 683 3,572 

2001

25-29 

30-34 

35-39 

93,776 25,080 68,696 

39,053 12,830 26,224 

18,453 6,995 11,458 

24,529 6,214 18,315 

9,779 3,137 6,642 

4,814 1,909 2,905 

41,444 12,463 28,981 

16,909 6,553 10,356 

8,034 3,577 4,457 

23,461 

10,347 

4,478 

5,493 17,968 

2,698 7,649 

1,193 3,285 

2,364 536 1,828 

1,140 291 848 

639 213 426 

1,978 373 1,605 

878 150 728 

488 102 385 

40-44 8,531 3,640 4,891 2,369 1,057 1,311 3,795 1,904 1,892 1,833 536 1,297 286 85 202 247 59 189 

45-54 5,479 2,594 2,884 1,631 831 800 2,492 1,352 1,140 962 299 663 209 61 149 184 52 132 

55-64 1,088 569 519 371 191 179 479 291 188 169 62 107 44 17 28 24 8 17 

65+ 748 272 476 199 63 136 371 149 222 143 43 100 29 13 16 6 4 2 

TOTAL 688,385 141,138 547,247 206,348 35,882 170,467 319,667 72,769 246,898 135,617 27,792 107,824 13,590 2,646 10,943 13,164 2,049 11,115 

10-14 14,353 1,013 13,340 3,349 94 3,255 8,245 665 7,580 2,308 234 2,074 160 6 153 291 13 278 

15-19 282,397 40,149 242,248 87,116 8,455 78,660 138,051 22,908 115,143 48,145 7,609 40,536 3,927 479 3,448 5,158 698 4,461 

20-24 288,860 63,745 225,115 91,120 17,951 73,169 130,338 31,430 98,908 56,493 12,380 44,113 5,821 1,137 4,684 5,089 847 4,242 

200225-29 

30-34 

35-39 

110,092 30,848 79,244 

47,628 16,008 31,620 

22,133 8,809 13,324 

29,455 7,780 21,674 

11,867 3,978 7,889 

5,723 2,500 3,223 

47,920 15,117 32,803 

20,437 8,111 12,326 

9,450 4,329 5,121 

27,621 

12,636 

5,554 

6,808 20,813 

3,259 9,377 

1,611 3,943 

2,922 709 2,213 

1,621 446 1,176 

833 224 610 

2,175 434 1,741 

1,067 214 853 

574 146 428 

40-44 10,841 4,868 5,973 2,892 1,422 1,469 4,821 2,503 2,319 2,350 740 1,609 446 114 332 332 89 243 

45-54 7,257 3,477 3,780 2,129 1,165 964 3,142 1,690 1,452 1,404 435 970 384 130 253 198 57 141 

55-64 1,378 712 666 410 282 128 580 309 271 269 88 182 82 23 59 36 10 26 

65+ 773 282 492 226 68 158 376 166 210 141 37 104 20 7 13 10 4 7 

TOTAL 788,067 170,948 617,119 234,839 43,913 190,925 364,513 87,744 276,769 157,458 33,453 124,005 16,276 3,300 12,976 14,981 2,538 12,444 

NOTE: These tables should be used only for race/ethnicity comparisons, not for age, sex, or overall totals. If age or race/ethnicity was not specified, cases 

were prorated according to the distribution of cases for which these variables were specified. For the following years the states listed did not report age 

and/or race/ethnicity for most cases and were excluded: 1998 (CO, DC, MI, NJ, NY, OH, SC); 1999 (CO, DC, MI, NJ, NY); 2000 (CO, DC, MI, NY); 2001 

(CO, DC, MD, NJ, NY); 2002 (MI, NJ). Cases and population denominators have been excluded for these states/areas. Differences between total cases 

from this table and others in the report are due to different reporting forms and above listed exclusions. The 0 to 9 year age group is not shown because 

some of these may not be due to sexual transmission; however, they are included in the totals. 

92 Chlamydia Tables STD Surveillance 2002 
Table 12B. Chlamydia — Rates per 100,000 population by age, sex, and race/ethnicity: United States, 1998–2002 

Age 

Group Total 

Total 

Male Female 

White, Non-Hispanic 

Total Male Female 

Black, Non-Hispanic 

Total Male Female Total 

Hispanic 

Male Female 

Asian/Pacific Islander 

Total Male Female 

American Indian/ 

Alaska Native 

Total Male Female 

10-14 73.0 7.8 141.4 29.2 1.7 58.3 284.6 34.1 542.8 73.0 11.1 137.8 22.3 3.4 42.2 154.4 13.9 299.2 

15-19 1,271.2 302.0 2,299.3 615.8 97.7 1,166.4 4,406.3 1,235.1 7,690.1 1,320.8 362.6 2,366.4 492.1 116.5 877.4 2,284.4 515.9 4,059.1 

20-24 1,163.9 438.0 1,921.5 545.0 172.0 937.0 4,046.3 1,733.8 6,316.1 1,356.8 518.2 2,268.7 534.9 181.4 884.6 2,291.4 673.5 3,921.0 

25-29 

30-34 

35-39 

434.5 

160.1 

70.1 

216.3 651.9 

97.1 222.3 

48.9 91.2 

176.3 79.2 273.5 

60.3 37.0 83.5 

26.1 16.6 35.7 

1,582.1 933.2 2,175.9 

592.2 434.2 731.3 

278.7 244.2 309.1 

654.2 

267.5 

124.5 

279.9 1,062.4 

127.4 420.7 

65.7 187.7 

233.8 103.4 347.2 

104.7 46.2 155.5 

61.0 36.8 83.1 

960.0 260.7 1,690.2 

1998

537.5 131.5 942.7 

270.3 117.5 419.2 

40-44 30.6 23.6 37.5 11.8 8.8 14.8 125.1 125.1 125.2 56.6 28.2 86.1 30.0 13.1 45.1 136.8 56.5 212.0 

45-54 11.6 10.0 13.2 4.7 4.1 5.3 52.9 59.8 47.1 23.7 12.2 34.8 11.2 8.1 13.8 64.9 13.9 111.9 

55-64 3.7 3.6 3.8 1.2 1.2 1.2 20.1 25.1 16.3 9.0 5.6 12.0 5.1 3.5 6.5 21.0 11.3 29.5 

65+ 3.8 2.2 4.9 1.3 0.9 1.6 27.2 15.0 35.1 10.1 5.7 13.3 3.5 1.9 4.7 11.2 0.0 19.4 

TOTAL 228.2 84.8 365.7 96.0 28.9 160.4 948.0 407.8 1,437.4 342.1 127.3 562.3 116.7 41.4 185.9 573.4 153.9 978.8 

10-14 75.1 8.8 144.8 28.8 2.0 57.0 286.7 36.0 545.4 79.8 13.5 149.0 24.7 3.6 47.0 144.3 13.3 279.4 

15-19 1,369.2 340.6 2,458.7 644.2 108.5 1,212.9 4,738.9 1,384.9 8,208.9 1,470.3 412.6 2,620.8 556.8 136.8 986.3 2,406.1 565.6 4,250.4 

20-24 1,302.9 494.0 2,145.9 599.7 198.5 1,020.8 4,490.2 1,933.7 6,989.5 1,548.2 567.3 2,616.0 647.4 211.3 1,077.5 2,378.2 660.2 4,104.4 

25-29 

30-34 

35-39 

495.8 

181.9 

77.7 

250.2 739.6 

110.8 251.8 

55.9 99.3 

194.1 89.5 298.9 

64.8 39.5 89.9 

28.6 20.3 36.9 

1,759.3 1,046.3 2,411.5 

672.1 496.5 826.7 

297.2 270.3 320.9 

768.7 

322.1 

148.9 

324.0 1,243.0 

147.2 512.1 

72.6 230.6 

296.1 144.5 427.7 

126.8 60.5 184.0 

63.5 34.4 89.8 

1,083.2 343.3 1,847.7 

1999

507.6 198.2 820.5 

273.0 117.0 426.7 

40-44 34.2 28.6 39.8 13.1 11.0 15.1 133.7 141.7 126.7 69.0 36.6 102.6 34.9 23.3 45.3 148.0 62.7 228.8 

45-54 13.0 12.2 13.9 4.7 4.4 4.9 56.6 68.9 46.3 32.5 19.1 45.5 15.8 12.1 19.1 71.4 30.6 109.1 

55-64 4.1 4.4 3.9 1.5 2.0 1.1 20.6 24.7 17.5 9.4 6.8 11.6 7.0 4.1 9.6 28.3 25.5 30.7 

65+ 2.6 2.2 3.0 1.0 1.0 1.1 13.3 11.6 14.3 7.3 3.7 10.0 4.3 5.5 3.4 58.8 39.3 73.0 

TOTAL 251.3 96.1 400.1 103.3 32.8 171.0 1,030.7 454.4 1,552.1 387.8 142.6 638.4 137.2 50.8 216.5 605.2 174.6 1,021.4 

10-14 72.2 9.3 138.4 26.9 1.8 53.3 272.9 38.8 514.0 72.3 13.4 133.9 27.0 3.8 51.5 144.2 11.5 282.5 

15-19 1,345.5 352.1 2,395.9 645.6 117.8 1,197.9 4,600.0 1,413.3 7,862.0 1,394.6 396.1 2,535.2 535.2 131.6 954.4 2,465.4 622.6 4,385.4 

20-24 1,340.9 529.5 2,191.0 648.1 228.3 1,078.2 4,563.3 2,067.8 6,938.5 1,432.2 521.0 2,555.1 573.3 214.4 933.4 2,766.8 800.6 4,791.8 

25-29 

30-34 

35-39 

491.6 

192.6 

83.2 

254.6 734.9 

119.6 266.8 

60.6 105.6 

201.1 97.1 306.9 

70.3 42.0 98.9 

30.3 23.1 37.5 

1,713.9 1,066.5 2,304.6 

671.2 527.9 800.9 

305.3 271.1 335.9 

683.4 

330.8 

151.4 

287.4 1,150.6 

150.6 539.0 

78.2 232.1 

233.7 119.9 344.1 

130.9 63.7 194.6 

75.5 42.6 106.1 

1,237.6 434.0 2,043.8 

2000

604.8 252.7 954.0 

310.2 134.0 477.4 

40-44 37.5 30.6 44.4 14.5 12.0 17.0 138.8 137.9 139.6 76.0 44.8 109.0 36.3 25.4 46.0 161.2 77.8 238.2 

45-54 14.6 13.8 15.4 5.5 5.5 5.4 59.2 70.3 49.6 35.4 20.5 50.1 18.2 14.7 21.2 76.7 35.8 115.0 

55-64 4.4 4.3 4.5 1.8 2.0 1.7 18.7 21.6 16.3 10.4 6.6 13.7 7.6 6.6 8.5 33.2 21.8 43.9 

65+ 2.8 2.4 3.0 1.1 1.1 1.2 15.9 14.4 16.8 9.0 6.0 11.3 4.2 6.8 2.2 12.0 4.2 17.8 

TOTAL 253.8 101.8 400.4 105.6 35.7 172.5 991.8 456.3 1,479.2 388.9 147.4 646.5 134.8 54.4 209.8 645.5 199.8 1,080.6 

10-14 72.9 9.7 139.3 27.5 2.0 54.4 276.7 39.2 521.4 79.1 16.0 145.2 21.1 2.0 41.2 120.7 11.5 234.6 

15-19 1,435.5 383.9 2,547.2 689.0 128.0 1,275.9 4,975.3 1,550.2 8,482.9 1,547.1 466.3 2,782.4 567.1 146.4 1,003.3 2,522.4 615.9 4,508.8 

20-24 1,523.6 623.5 2,466.9 751.7 275.0 1,240.0 5,223.1 2,449.3 7,867.6 1,664.4 630.3 2,940.6 658.1 246.7 1,071.9 2,714.0 859.0 4,621.5 

25-29 

30-34 

35-39 

558.1 

221.6 

94.5 

294.4 829.1 

144.3 300.3 

71.7 117.1 

227.9 114.4 343.4 

82.5 52.5 112.9 

34.7 27.5 41.9 

1,959.8 1,233.5 2,624.4 

792.9 645.6 926.7 

349.0 329.4 366.5 

803.9 

387.8 

186.8 

347.6 1,342.9 

188.4 618.8 

94.8 288.4 

274.6 126.4 418.5 

138.8 72.9 201.3 

81.5 56.5 104.7 

1,349.4 508.0 2,193.9 

2001

598.5 204.9 989.3 

299.7 129.1 461.7 

40-44 44.1 37.9 50.2 16.6 14.8 18.3 170.7 181.8 160.9 93.9 53.3 137.0 39.3 24.9 52.1 159.4 78.7 234.1 

45-54 16.8 16.2 17.5 6.5 6.7 6.3 74.6 86.8 64.0 36.6 22.8 50.3 17.6 11.1 23.1 76.1 44.3 106.0 

55-64 5.2 5.6 4.8 2.2 2.3 2.1 25.4 34.3 18.1 12.0 9.3 14.4 6.6 5.4 7.7 17.8 11.5 23.6 

65+ 2.5 2.2 2.7 0.8 0.6 0.9 16.2 16.9 15.7 9.8 6.9 11.9 4.0 4.3 3.8 5.0 7.3 3.3 

TOTAL 282.3 117.8 441.2 118.7 42.2 192.3 1,114.5 531.8 1,646.1 447.4 177.5 735.9 149.9 60.5 233.3 650.8 205.0 1,086.1 

10-14 74.8 10.3 142.6 27.2 1.5 54.4 282.9 44.9 527.8 75.8 15.1 139.4 22.5 1.8 44.5 141.2 12.3 275.8 

15-19 1,488.3 411.7 2,626.4 713.2 135.3 1,318.3 5,032.2 1,651.7 8,488.6 1,578.6 468.6 2,842.7 507.6 121.5 908.9 2,659.6 705.1 4,696.4 

20-24 1,619.2 699.1 2,581.2 819.2 319.0 1,331.4 5,321.1 2,636.3 7,867.0 1,726.2 687.7 2,996.0 697.1 272.3 1,122.2 3,180.9 1,044.3 5,380.3 

25-29 

30-34 

35-39 

605.5 

248.6 

104.4 

335.4 882.1 

165.9 332.5 

83.4 125.4 

257.3 134.9 381.6 

93.7 62.4 125.5 

38.7 33.8 43.6 

2,036.7 1,351.3 2,657.9 

845.5 708.6 968.8 

360.0 350.8 368.2 

850.6 

422.4 

205.7 

388.5 1,392.0 

203.9 673.0 

114.2 305.7 

297.3 146.6 443.2 

172.7 97.6 243.8 

92.5 51.4 130.8 

1,451.3 578.6 2,326.7 

2002

711.0 286.1 1,132.6 

344.1 179.9 500.3 

40-44 51.8 46.9 56.6 19.0 18.7 19.3 192.2 212.4 174.2 106.7 65.7 149.7 53.2 28.8 74.9 209.0 116.3 294.9 

45-54 20.6 20.1 21.1 8.0 8.8 7.1 83.3 96.7 71.6 46.9 29.3 64.1 28.1 20.7 34.5 80.0 47.3 110.6 

55-64 6.1 6.5 5.6 2.3 3.2 1.4 26.6 31.8 22.4 16.5 11.4 21.0 10.7 6.3 14.5 25.6 14.5 36.0 

65+ 2.4 2.1 2.6 0.8 0.6 1.0 14.4 16.8 13.0 8.5 5.3 10.8 2.5 2.2 2.8 8.3 7.0 9.3 

TOTAL 299.6 132.4 460.6 127.2 48.6 202.5 1,132.5 573.7 1,638.3 465.0 192.0 754.3 157.8 66.1 243.7 724.9 248.6 1,190.0 

NOTE: These tables should be used only for race/ethnicity comparisons, not for age, sex, or overall totals. If age or race/ethnicity was not specified, 

cases were prorated according to the distribution of cases for which these variables were specified. For the following years the states listed did not report age and/or race/ethnicity for most cases and were excluded: 1998 (CO, DC, MI, NJ, NY, OH, SC); 1999 (CO, DC, MI, NJ, NY); 2000 (CO, DC, MI, 

NY); 2001 (CO, DC, MD, NJ, NY); 2002 (MI, NJ). Cases and population denominators have been excluded for these states/areas. Differences between 

total rates from this table and others in the report are due to different reporting forms and above listed exclusions. The 0 to 9 year age group is not 

shown because some of these may not be due to sexual transmission; however, they are included in the totals. 

STD Surveillance 2002 Chlamydia Tables 93 
5

10

15

20

25

30

35

40

45

50

Table 13. Gonorrhea — Reported cases and rates by state/area, ranked by rates: United States, 2002 

Rank* State/Area Cases Rate per 100,000 Population 

1 Louisiana 11,387 254.8 

2 Mississippi 6,875 241.7 

3 South Carolina 9,152 228.1 

4 Alabama 10,118 227.5 

Georgia 18,383 224.6 

6 Delaware 1,576 201.1 

7 Ohio 22,008 193.8 

8 Illinois 24,026 193.5 

9 North Carolina 15,531 192.9 

Maryland 9,355 176.6 

11 Arkansas 4,584 171.5 

12 Tennessee 9,348 164.3 

13 Missouri 8,952 160.0 

14 Michigan 14,770 148.6 

Virginia 10,462 147.8 

16 Oklahoma 4,661 135.1 

17 Florida 21,348 133.6 

18 Texas 26,988 129.4 

U.S. TOTAL† 351,852 125.0 

19 Indiana 7,395 121.6 

Wisconsin 6,341 118.2 

21 New York 21,841 115.1 

22 Pennsylvania 13,294 108.2 

23 Alaska 641 102.2 

24 Kansas 2,744 102.1 

Nevada 1,988 99.5 

26 Connecticut 3,241 95.2 

27 New Jersey 7,894 93.8 

28 Kentucky 3,772 93.3 

29 Nebraska 1,564 91.4 

Rhode Island 900 85.9 

31 Colorado 3,511 81.6 

32 New Mexico 1,462 80.4 

33 Arizona 3,795 74.0 

34 California 24,606 72.6 

Minnesota 3,049 62.0 

36 Hawaii 740 61.1 

37 West Virginia 974 53.9 

38 Massachusetts 3,242 51.1 

39 Iowa 1,480 50.6 

Washington 2,925 49.6 

41 South Dakota 263 34.8 

42 Oregon 909 26.6 

YEAR 2010 OBJECTIVE 19.0 

43 Utah 374 16.7 

44 Vermont 98 16.1 

Montana 123 13.6 

46 Wyoming 65 13.2 

47 North Dakota 72 11.2 

48 Maine 142 11.1 

49 New Hampshire 120 9.7 

Idaho 94 7.3 

*States were ranked in descending order by rate, number of cases, and alphabetically by state. 

†

Total includes cases reported by Washington, D.C., but excludes outlying areas (Guam with 49 cases and rate of 31.7, Puerto Rico with 411 cases 

and rate of 10.8, and Virgin Islands with 49 cases and rate of 45.1). 

94 Gonorrhea Tables STD Surveillance 2002 
Table 14. Gonorrhea — Reported cases and rates by state/area and region listed in alphabetical order: United 

States and outlying areas, 1998–2002 

State/Area 

Cases Rates per 100,000 Population 

1998 1999 2000 2001 2002 1998 1999 2000 2001 2002 

Alabama 12,737 10,888 12,063 11,182 10,118 292.7 249.2 271.3 251.4 227.5 

Alaska 331 302 361 457 641 53.9 48.7 57.6 72.9 102.2 

Arizona 4,213 4,293 4,130 3,920 3,795 90.2 89.8 80.5 76.4 74.0 

Arkansas 3,953 3,226 3,642 4,604 4,584 155.7 126.4 136.2 172.2 171.5 

California 19,590 18,672 21,619 23,296 24,606 60.0 56.3 63.8 68.8 72.6 

Colorado 2,033 2,526 3,112 3,190 3,511 51.2 62.3 72.4 74.2 81.6 

Connecticut 3,177 3,321 2,912 2,546 3,241 97.0 101.2 85.5 74.8 95.2 

Delaware 1,556 1,662 1,735 1,733 1,576 209.3 220.6 221.4 221.2 201.1 

Florida 19,080 22,794 22,781 21,531 21,348 127.9 150.8 142.5 134.7 133.6 

Georgia 20,666 21,244 20,265 18,920 18,383 270.4 272.8 247.5 231.1 224.6

Hawaii 506 463 483 604 740 42.4 39.1 39.9 49.9 61.1 

Idaho 182 89 98 76 94 14.8 7.1 7.6 5.9 7.3 

Illinois 22,499 24,136 24,812 24,025 24,026 186.8 199.0 199.8 193.4 193.5 

Indiana 6,307 6,092 6,525 6,972 7,395 106.9 102.5 107.3 114.7 121.6 

Iowa 1,616 1,365 1,392 1,418 1,480 56.5 47.6 47.6 48.5 50.6 

Kansas 2,622 2,665 2,795 2,669 2,744 99.7 100.4 104.0 99.3 102.1 

Kentucky 3,813 3,349 3,502 3,588 3,772 96.9 84.6 86.6 88.8 93.3 

Louisiana 12,499 13,189 13,245 12,253 11,387 286.1 301.7 296.4 274.2 254.8 

Maine 67 83 90 141 142 5.4 6.6 7.1 11.1 11.1 

Maryland 11,254 10,430 9,837 9,427 9,355 219.2 201.7 185.7 178.0 176.6 

Massachusetts 2,258 2,453 3,045 3,214 3,242 36.7 39.7 48.0 50.6 51.1 

Michigan 16,359 15,907 18,182 17,120 14,770 166.6 161.3 182.9 172.3 148.6

Minnesota 2,708 2,830 3,160 2,701 3,049 57.3 59.3 64.2 54.9 62.0 

Mississippi 10,689 10,411 9,217 7,759 6,875 388.4 376.0 324.0 272.8 241.7

Missouri 9,463 8,187 8,883 8,723 8,952 174.0 149.7 158.8 155.9 160.0 

Montana 55 53 60 104 123 6.2 6.0 6.7 11.5 13.6 

Nebraska 1,204 1,471 1,534 1,189 1,564 72.4 88.3 89.6 69.5 91.4 

Nevada 1,445 1,303 1,553 1,756 1,988 82.7 72.0 77.7 87.9 99.5 

New Hampshire 91 115 110 176 120 7.7 9.6 8.9 14.2 9.7 

New Jersey 7,858 7,852 7,232 8,921 7,894 96.8 96.4 85.9 106.0 93.8 

New Mexico 957 974 1,152 1,040 1,462 55.1 56.0 63.3 57.2 80.4 

New York 19,062 19,826 20,114 22,299 21,841 104.9 109.0 106.0 117.5 115.1 

North Carolina 19,230 19,428 17,823 16,583 15,531 254.8 253.9 221.4 206.0 192.9 

North Dakota 80 83 73 56 72 12.5 13.1 11.4 8.7 11.2 

Ohio 18,275 18,141 19,303 21,163 22,008 163.0 161.2 170.0 186.4 193.8 

Oklahoma 5,243 4,021 4,229 4,784 4,661 156.7 119.7 122.6 138.6 135.1 

Oregon 880 903 1,038 1,144 909 26.8 27.2 30.3 33.4 26.6 

Pennsylvania 11,719 13,295 13,607 14,244 13,294 97.6 110.8 110.8 116.0 108.2

Rhode Island 430 601 661 830 900 43.5 60.7 63.1 79.2 85.9 

South Carolina 11,575 15,037 8,383 10,805 9,152 301.7 387.0 208.9 269.3 228.1 

South Dakota 221 192 277 289 263 29.9 26.2 36.7 38.3 34.8 

Tennessee 11,840 11,366 11,876 10,145 9,348 218.0 207.3 208.7 178.3 164.3 

Texas 32,833 32,910 32,919 30,024 26,988 166.2 164.2 157.9 144.0 129.4 

Utah 236 254 231 219 374 11.2 11.9 10.3 9.8 16.7 

Vermont 38 52 65 76 98 6.4 8.8 10.7 12.5 16.1 

Virginia 9,265 9,402 10,175 11,095 10,462 136.4 136.8 143.7 156.7 147.8 

Washington 1,948 2,132 2,418 2,991 2,925 34.2 37.0 41.0 50.7 49.6 

West Virginia 920 584 645 732 974 50.8 32.3 35.7 40.5 53.9

Wisconsin 6,365 6,662 7,013 6,011 6,341 121.9 126.9 130.7 112.1 118.2 

Wyoming 36 43 53 77 65 7.5 9.0 10.7 15.6 13.2 

U.S. TOTAL* 356,492 360,813 363,136 361,705 351,852 131.9 132.3 129.0 128.5 125.0 

Northeast 44,700 47,598 47,836 52,447 50,772 86.4 91.8 89.3 97.9 94.7 

Midwest 87,719 87,731 93,949 92,336 92,664 139.5 138.7 145.9 143.4 143.9 

South 191,661 193,477 185,043 178,048 167,183 200.8 200.6 184.6 177.6 166.8 

West 32,412 32,007 36,308 38,874 41,233 53.8 52.3 57.5 61.5 65.2 

Guam 

Puerto Rico 

Virgin Islands 

72

400 

39 

59

321 

51 

62

527 

24 

48

589 

34 

49 

411 

49 

45.0 

10.4 

35.6 

36.1 

8.3 

45.2 

40.1 

13.8 

22.1 

31.0 

15.5 

31.3 

31.7 

10.8 

45.1 

OUTLYING AREAS 511 431 613 671 509 12.4 10.3 15.1 16.5 12.5 

TOTAL 357,003 361,244 363,749 362,376 352,361 130.1 130.5 127.4 126.9 123.4 

*Includes cases reported by Washington, D.C. 

STD Surveillance 2002 Gonorrhea Tables 95 
Table 15. Gonorrhea — Women – Reported cases and rates by state/area and region listed in alphabetical 

order: United States and outlying areas, 1998–2002 

State/Area 

Cases Rates per 100,000 Population 

1998 1999 2000 2001 2002 1998 1999 2000 2001 2002 

Alabama 6,313 5,460 5,984 5,712 4,974 278.8 240.3 260.1 248.3 216.2 

Alaska 181 153 198 244 353 62.0 52.0 65.4 80.6 116.6 

Arizona 1,730 1,760 1,754 1,700 1,659 73.3 72.9 68.3 66.2 64.6 

Arkansas 1,919 1,576 1,807 2,404 2,388 146.2 119.5 132.0 175.6 174.5 

California 9,345 8,903 9,624 10,448 10,857 57.2 53.7 56.6 61.5 63.9 

Colorado 1,055 1,271 1,544 1,588 1,643 52.7 62.1 72.3 74.4 76.9 

Connecticut 1,714 1,796 1,621 1,411 1,910 101.7 106.3 92.3 80.3 108.8 

Delaware 855 912 987 1,002 858 223.8 235.5 244.9 248.6 212.9 

Florida 8,923 10,960 10,862 10,380 10,373 116.2 140.9 132.7 126.8 126.7 

Georgia 10,056 10,092 9,844 9,590 9,306 256.3 252.5 236.7 230.6 223.7

Hawaii 278 251 240 292 394 46.7 42.3 39.8 48.4 65.4 

Idaho 74 42 51 39 49 12.0 6.7 7.9 6.0 7.6 

Illinois 10,737 11,563 11,829 12,178 12,273 174.0 186.1 186.6 192.1 193.6 

Indiana 3,308 3,254 3,446 3,792 3,996 109.2 106.6 111.2 122.4 129.0 

Iowa 895 759 740 766 821 60.9 51.6 49.6 51.4 55.1 

Kansas 1,454 1,573 1,496 1,468 1,556 108.8 116.6 110.0 107.9 114.4 

Kentucky 1,866 1,626 1,725 1,812 1,936 92.1 79.8 83.5 87.7 93.7 

Louisiana 6,143 6,697 6,471 6,056 5,861 270.8 295.3 280.6 262.6 254.2 

Maine 31 40 29 55 44 4.9 6.2 4.4 8.4 6.7 

Maryland 5,391 4,749 4,577 4,591 4,592 204.2 178.6 167.1 167.6 167.7 

Massachusetts 1,155 1,207 1,568 1,591 1,579 36.3 37.8 47.7 48.4 48.0 

Michigan 8,265 7,771 9,190 9,057 7,974 164.0 153.5 181.4 178.8 157.4

Minnesota 1,443 1,495 1,681 1,461 1,688 60.2 61.7 67.7 58.8 68.0 

Mississippi 5,973 6,137 5,603 4,663 4,201 416.8 425.6 380.9 317.0 285.6

Missouri 4,924 4,459 4,489 4,540 4,810 175.5 158.2 156.1 157.9 167.3 

Montana 33 35 38 57 75 7.5 7.9 8.4 12.6 16.6 

Nebraska 683 814 849 671 909 80.4 95.6 97.8 77.3 104.7 

Nevada 591 480 618 761 965 68.9 54.0 63.0 77.6 98.4 

New Hampshire 47 61 53 96 51 7.8 10.0 8.4 15.3 8.1 

New Jersey 3,763 3,824 3,571 4,522 3,958 89.9 91.1 82.4 104.4 91.4 

New Mexico 530 528 573 472 740 60.1 59.7 62.0 51.0 80.0 

New York 10,586 10,639 10,691 11,873 11,141 112.2 112.9 108.8 120.8 113.3 

North Carolina 9,129 9,089 8,468 7,810 7,585 234.9 230.6 206.2 190.2 184.7 

North Dakota 56 46 36 30 40 17.5 14.4 11.2 9.3 12.4 

Ohio 10,117 9,707 10,311 11,257 11,944 174.7 166.9 176.5 192.7 204.5 

Oklahoma 2,932 2,240 2,433 2,670 2,566 171.2 130.3 138.7 152.2 146.2 

Oregon 430 433 486 448 357 25.9 25.8 28.2 26.0 20.7 

Pennsylvania 6,472 7,356 7,371 7,872 7,200 103.9 118.1 116.1 123.9 113.4 

Rhode Island 258 371 381 488 484 50.3 72.1 69.9 89.6 88.9 

South Carolina 5,730 5,874 4,057 5,126 4,357 288.3 292.1 196.6 248.5 211.2 

South Dakota 124 117 165 166 148 33.1 31.4 43.4 43.7 38.9 

Tennessee 5,263 4,965 5,343 4,808 4,564 187.3 175.0 183.0 164.7 156.4 

Texas 16,704 16,819 16,932 15,599 14,075 166.8 165.6 161.3 148.6 134.1 

Utah 70 100 99 95 150 6.6 9.3 8.9 8.5 13.5 

Vermont 22 22 33 42 56 7.3 7.3 10.6 13.5 18.0 

Virginia 4,543 4,566 4,856 5,485 5,445 130.7 129.9 134.6 152.1 151.0 

Washington 863 1,009 1,078 1,301 1,197 30.2 34.9 36.4 44.0 40.4 

West Virginia 549 357 375 418 567 58.5 38.1 40.4 45.0 61.0

Wisconsin 3,754 3,826 4,189 3,672 3,717 141.3 143.3 154.3 135.3 136.9 

Wyoming 23 26 31 43 38 9.6 10.9 12.6 17.5 15.5 

U.S. TOTAL* 179,204 179,319 181,668 183,863 179,648 129.6 128.6 126.7 128.2 125.3 

Northeast 24,048 25,316 25,318 27,950 26,423 89.8 94.4 91.4 100.9 95.4 

Midwest 45,760 45,384 48,421 49,058 49,876 141.9 140.0 147.5 149.4 151.9 

South 94,193 93,628 91,595 89,367 84,872 192.1 188.9 179.0 174.6 165.8 

West 15,203 14,991 16,334 17,488 18,477 50.3 48.9 51.6 55.2 58.4 

Guam 

Puerto Rico 

Virgin Islands 

25

163 

16 

28

132 

38 

23

238 

14 

22

279 

20 

26 

230 

38 

33.3 

8.1 

27.8 

36.4 

6.5 

73.7 

30.4 

12.1 

24.7 

29.1 

14.1 

35.2 

34.4 

11.6 

67.0 

OUTLYING AREAS 204 198 275 321 294 9.5 9.2 13.0 15.2 14.0 

TOTAL 179,408 179,517 181,943 184,184 179,942 127.8 126.8 125.1 126.6 123.7 

*Includes cases reported by Washington, D.C. 

NOTE: Cases reported with unknown sex are not included in this table. 

96 Gonorrhea Tables STD Surveillance 2002 
Table 16. Gonorrhea — Men – Reported cases and rates by state/area and region listed in alphabetical order: 

United States and outlying areas, 1998–2002 

State/Area 

Cases Rates per 100,000 Population 

1998 1999 2000 2001 2002 1998 1999 2000 2001 2002 

Alabama 6,411 5,399 6,039 5,457 5,131 307.1 257.4 281.3 254.2 239.0 

Alaska 150 149 163 213 288 46.6 45.8 50.3 65.7 88.9 

Arizona 2,483 2,533 2,376 2,220 2,136 107.5 107.1 92.8 86.7 83.4 

Arkansas 2,029 1,650 1,832 2,191 2,194 165.5 133.8 140.4 167.9 168.2 

California 10,192 9,618 11,896 12,701 13,586 62.4 58.0 70.5 75.3 80.5 

Colorado 978 1,255 1,568 1,602 1,868 49.7 62.4 72.4 74.0 86.2 

Connecticut 1,463 1,525 1,291 1,132 1,331 92.1 95.7 78.3 68.6 80.7 

Delaware 701 750 748 731 718 193.9 204.8 196.6 192.1 188.7 

Florida 10,054 11,797 11,919 11,149 10,975 138.9 160.9 152.9 143.0 140.7 

Georgia 10,525 11,039 10,309 9,325 9,013 283.1 291.2 256.0 231.6 223.8

Hawaii 228 211 243 312 346 38.1 35.6 39.9 51.3 56.8 

Idaho 108 46 47 35 45 17.6 7.4 7.2 5.4 6.9 

Illinois 11,761 12,559 12,981 11,845 11,750 200.2 212.3 213.5 194.8 193.2 

Indiana 2,991 2,836 3,069 3,169 3,372 104.2 98.1 102.9 106.3 113.1 

Iowa 721 606 652 652 658 51.7 43.4 45.4 45.4 45.8 

Kansas 1,168 1,092 1,299 1,201 1,188 90.4 83.7 97.8 90.4 89.4 

Kentucky 1,887 1,669 1,751 1,769 1,834 98.8 86.8 88.6 89.6 92.8 

Louisiana 6,356 6,492 6,774 6,197 5,466 302.6 308.6 313.2 286.5 252.7 

Maine 36 43 61 86 98 5.9 7.0 9.8 13.9 15.8 

Maryland 5,846 5,669 5,196 4,836 4,756 234.3 225.6 203.1 189.1 185.9 

Massachusetts 1,103 1,246 1,477 1,622 1,663 37.2 41.8 48.3 53.0 54.4 

Michigan 8,094 8,136 8,992 8,063 6,796 169.5 169.5 184.5 165.5 139.5

Minnesota 1,265 1,335 1,479 1,240 1,361 54.3 56.7 60.7 50.9 55.9 

Mississippi 4,653 4,184 3,586 3,096 2,674 352.8 315.4 261.1 225.4 194.7

Missouri 4,539 3,728 4,394 4,183 4,142 172.4 140.7 161.5 153.8 152.3 

Montana 22 18 22 47 47 5.0 4.1 4.9 10.5 10.5 

Nebraska 520 657 681 516 653 63.9 80.6 80.7 61.2 77.4 

Nevada 854 822 935 993 1,022 96.1 89.2 91.8 97.5 100.4 

New Hampshire 44 54 57 80 69 7.5 9.1 9.4 13.2 11.4 

New Jersey 4,094 4,019 3,654 4,391 3,930 104.2 101.8 89.5 107.5 96.3 

New Mexico 427 445 572 555 716 50.0 52.0 64.0 62.1 80.1 

New York 8,476 9,176 9,378 10,397 10,688 96.9 104.6 102.5 113.7 116.9 

North Carolina 10,101 10,339 9,354 8,772 7,942 276.0 278.7 237.2 222.5 201.4 

North Dakota 24 37 37 26 32 7.6 11.7 11.5 8.1 10.0 

Ohio 8,023 8,245 8,837 9,679 9,819 148.1 151.5 160.3 175.6 178.1 

Oklahoma 2,311 1,781 1,796 2,114 2,095 141.4 108.6 105.9 124.7 123.5 

Oregon 450 470 552 696 552 27.8 28.7 32.5 41.0 32.5 

Pennsylvania 5,247 5,939 6,236 6,372 6,094 90.9 103.0 105.2 107.5 102.8 

Rhode Island 172 230 280 342 416 36.2 48.3 55.6 67.9 82.6 

South Carolina 5,769 9,052 4,256 5,640 4,766 312.1 482.8 218.4 289.4 244.5 

South Dakota 97 75 111 123 115 26.7 20.8 29.6 32.8 30.7 

Tennessee 6,577 6,401 6,533 5,337 4,784 251.0 241.8 235.8 192.7 172.7 

Texas 15,995 15,973 15,919 14,370 12,884 164.1 161.5 153.8 138.8 124.4 

Utah 166 154 132 124 223 15.9 14.5 11.8 11.1 19.9 

Vermont 16 30 32 34 42 5.5 10.3 10.7 11.4 14.1 

Virginia 4,720 4,832 5,307 5,574 5,017 142.3 143.9 152.9 160.5 144.5 

Washington 1,085 1,123 1,340 1,690 1,728 38.4 39.2 45.7 57.6 58.9 

West Virginia 369 227 269 313 406 42.3 26.1 30.6 35.6 46.2

Wisconsin 2,611 2,827 2,817 2,321 2,612 101.7 109.6 106.3 87.6 98.6 

Wyoming 13 17 22 34 27 5.4 7.1 8.9 13.7 10.9 

U.S. TOTAL* 176,529 180,524 180,701 177,194 171,504 133.7 135.5 130.9 128.4 124.2 

Northeast 20,651 22,262 22,466 24,456 24,331 82.8 89.0 86.8 94.4 94.0 

Midwest 41,814 42,133 45,349 43,018 42,498 136.4 136.7 143.7 136.3 134.7 

South 96,908 99,268 93,018 88,498 82,091 208.9 211.6 189.6 180.4 167.3 

West 17,156 16,861 19,868 21,222 22,584 57.1 55.3 63.0 67.3 71.6 

Guam 

Puerto Rico 

Virgin Islands 

47

237 

23 

31

189 

13 

39

289 

10 

26

310 

14 

23 

181 

11 

55.5 

12.8 

43.2 

35.8 

10.1 

21.2 

49.3 

15.8 

19.3 

32.8 

16.9 

27.0 

29.0 

9.9 

21.2 

OUTLYING AREAS 307 233 338 350 215 15.4 11.6 17.2 17.8 10.9 

TOTAL 176,836 180,757 181,039 177,544 171,719 131.9 133.6 129.3 126.8 122.6 

*Includes cases reported by Washington, D.C. 

NOTE: Cases reported with unknown sex are not included in this table. 

STD Surveillance 2002 Gonorrhea Tables 97 
Table 17. Gonorrhea — Reported cases and rates in selected cities of >200,000 population, ranked by rates: 

United States, 2002 

Rank* City† Cases Rate per 100,000 Population 

1 St Louis, MO 2,737 786.1 

2 Richmond, VA 1,507 761.9 

3 Baltimore, MD 4,873 748.4 

4 Detroit, MI 6,845 719.6 

5 Rochester, NY 1,581 639.9 

6 Norfolk, VA 1,463 624.1 

7 Kansas City, MO 2,625 580.9 

8 New Orleans, LA 2,685 554.0 

9 Newark, NJ 1,573 523.0 

10 Buffalo, NY 1,653 513.1 

11 Milwaukee, WI 4,497 478.3 

12 Atlanta, GA 3,810 466.9 

13 Washington, DC 2,669 466.6 

14 Philadelphia, PA 7,006 461.7 

15 Memphis, TN 4,074 453.9 

16 Chicago, IL 13,814 447.6 

17 Indianapolis, IN 3,510 407.9 

18 Cincinnati, OH 3,426 405.3 

19 Birmingham, AL 2,489 376.0 

20 Oklahoma City, OK 1,594 374.8 

21 Jacksonville, FL 2,895 371.7 

22 Minneapolis, MN 1,366 355.8 

23 Toledo, OH 1,519 333.8 

24 Denver, CO 1,812 326.7 

25 Charlotte, NC 2,264 325.5 

26 Cleveland, OH 4,115 295.2 

27 Tulsa, OK 1,123 284.8 

28 San Francisco, CA 2,136 275.0 

29 Dayton, OH 1,505 269.2 

30 Columbus, OH 2,844 266.0 

31 Omaha, NE 1,149 247.9 

32 Nashville, TN 1,409 247.2 

33 Dallas, TX 5,263 237.2 

34 Boston, MA 1,404 234.8 

35 St Paul, MN 584 205.2 

36 Louisville, KY 1,361 196.2 

37 Tampa, FL 1,912 191.4 

38 Wichita, KS 852 188.1 

39 Akron, OH 937 172.6 

40 Austin, TX 1,401 172.5 

41 Pittsburgh, PA 2,133 166.4 

42 St Petersburg, FL 1,527 165.7 

43 New York City, NY 12,727 158.9 

44 Jersey City, NJ 380 158.0 

45 Houston, TX 5,235 153.9 

46 Corpus Christi, TX 466 148.6 

47 Albuquerque, NM 805 144.6 

48 San Antonio, TX 1,944 139.6 

49 Fort Worth, TX 1,967 136.0 

50 Oakland, CA 1,949 135.0 

51 Sacramento, CA 1,442 117.9 

52 Portland, OR 546 104.8 

53 Phoenix, AZ 2,991 97.4 

54 Des Moines, IA 359 95.8 

55 Miami, FL 2,047 90.8 

56 Los Angeles, CA 7,765 87.1 

57 Seattle, WA 1,462 84.2 

58 Yonkers, NY 160 80.6 

59 Honolulu, HI 685 78.2 

60 San Diego, CA 2,132 75.8 

61 Tucson, AZ 458 54.3 

62 El Paso, TX 336 49.4 

63 San Jose, CA 502 29.8 

YEAR 2010 OBJECTIVE 19.0 

*Cities were ranked in descending order by rate, number of cases, and alphabetically by state. 

†

Excludes outlying areas (San Juan, PR, with 194 cases and rate of 19.0). 

98 Gonorrhea Tables STD Surveillance 2002 
Table 18. Gonorrhea — Reported cases and rates in selected cities of >200,000 population listed in 

alphabetical order: United States and outlying areas, 1998–2002 

City 

Cases Rates per 100,000 Population 

1998 1999 2000 2001 2002
 1998 1999 2000 2001 2002 

Akron, OH 823 848 913 962 937
 153.1 157.7 168.2 177.2 172.6 

Albuquerque, NM 570 472 697 647 805 108.4 90.2 125.2 116.2 144.6 

Atlanta, GA 5,599 5,631 3,456 4,621 3,810
 757.3 756.0 423.5 566.3 466.9 

Austin, TX 1,803 1,562 1,518 1,536 1,401
 253.7 214.8 186.9 189.1 172.5 

Baltimore, MD 6,989 6,124 5,603 5,014 4,873
 1,082.6 967.9 860.5 770.0 748.4 

Birmingham, AL 3,172 2,492 3,018 2,600 2,489 481.0 379.1 455.9 392.7 376.0

Boston, MA 982 900 1,229 1,332 1,404
 176.5 161.8 205.5 222.7 234.8 

Buffalo, NY 1,108 1,233 1,572 2,194 1,653
 349.8 392.8 488.0 681.1 513.1 

Charlotte, NC 1,911 1,908 1,758 2,014 2,264
 302.9 294.3 252.8 289.6 325.5 

Chicago, IL 14,143 15,169 14,872 14,326 13,814 474.8 509.0 481.9 464.2 447.6

Cincinnati, OH 3,583 2,814 3,227 3,178 3,426
 422.8 334.8 381.8 376.0 405.3 

Cleveland, OH 3,030 3,391 3,497 3,854 4,115
 219.5 247.2 250.9 276.5 295.2 

Columbus, OH 3,082 3,120 3,386 3,349 2,844
 301.8 303.6 316.8 313.3 266.0 

Corpus Christi, TX 449 524 775 667 466 141.9 166.1 247.1 212.7 148.6

Dallas, TX 7,421 7,476 7,315 6,166 5,263 361.8 362.5 329.7 277.9 237.2 

Dayton, OH 1,092 932 1,015 1,428 1,505 195.5 164.7 181.6 255.4 269.2

Denver, CO 973 1,157 1,594 1,618 1,812
 195.0 231.5 287.4 291.7 326.7 

Des Moines, IA 371 333 380 270 359
 103.1 91.3 101.4 72.1 95.8 

Detroit, MI 8,459 7,900 9,610 8,220 6,845
 671.2 630.3 1,010.2 864.1 719.6 

El Paso, TX 252 156 209 291 336
 35.8 22.2 30.8 42.8 49.4 

Fort Worth, TX 3,310 2,847 2,787 2,291 1,967
 244.2 205.9 192.7 158.4 136.0 

Honolulu, HI 481 430 433 557 685
 55.1 49.7 49.4 63.6 78.2 

Houston, TX 7,226 5,939 5,918 5,489 5,235
 225.4 182.7 174.0 161.4 153.9 

Indianapolis, IN 3,071 3,045 3,206 3,383 3,510 377.5 375.5 372.6 393.2 407.9

Jacksonville, FL 2,463 2,972 3,640 2,731 2,895 334.8 402.4 467.3 350.6 371.7 

Jersey City, NJ 491 490 465 489 380 223.1 224.4 193.3 203.3 158.0

Kansas City, MO 2,538 1,956 2,688 2,161 2,625 561.6 433.1 594.9 478.2 580.9 

Los Angeles, CA 5,986 6,054 7,307 7,747 7,765 69.4 69.3 82.0 86.9 87.1

Louisville, KY 1,462 1,195 1,200 1,436 1,361 217.5 177.6 173.0 207.0 196.2 

Memphis, TN 5,235 5,038 4,941 4,420 4,074 602.5 577.1 550.5 492.5 453.9

Miami, FL 2,573 2,775 1,995 1,964 2,047
 119.5 127.5 88.5 87.2 90.8 

Milwaukee, WI 4,856 4,884 5,146 4,150 4,497
 532.6 538.9 547.4 441.4 478.3 

Minneapolis, MN 1,562 1,558 1,577 1,295 1,366
 428.5 425.5 410.7 337.3 355.8 

Nashville, TN 1,777 1,785 2,404 1,625 1,409
 332.8 336.8 421.8 285.1 247.2 

New Orleans, LA 2,691 2,687 3,015 3,160 2,685
 578.0 583.0 622.1 652.0 554.0 

New York City, NY 12,097 12,210 11,669 12,614 12,727 163.0 164.4 145.7 157.5 158.9

Newark, NJ 1,781 1,741 1,558 1,798 1,573
 626.3 614.7 518.0 597.8 523.0 

Norfolk, VA 1,415 1,291 1,490 1,450 1,463
 657.5 571.6 635.7 618.6 624.1 

Oakland, CA 1,742 1,700 1,793 2,039 1,949
 136.1 131.4 124.2 141.2 135.0 

Oklahoma City, OK 1,571 1,351 1,434 1,617 1,594 385.4 329.6 337.2 380.2 374.8

Omaha, NE 871 1,000 1,161 934 1,149 196.3 224.1 250.4 201.5 247.9 

Philadelphia, PA 7,271 7,775 8,198 8,096 7,006 506.2 548.5 540.2 533.5 461.7

Phoenix, AZ 3,543 3,586 3,195 2,826 2,991 127.3 125.3 104.0 92.0 97.4 

Pittsburgh, PA 1,351 1,573 1,494 1,916 2,133 106.5 125.2 116.6 149.5 166.4

Portland, OR 527 540 681 743 546
 105.8 108.1 130.7 142.6 104.8 

Richmond, VA 1,527 1,827 1,752 2,109 1,507
 786.4 963.1 885.8 1,066.3 761.9 

Rochester, NY 1,992 2,037 2,142 1,769 1,581
 827.9 851.0 866.9 716.0 639.9 

Sacramento, CA 1,546 1,236 1,295 1,171 1,442
 135.1 104.3 105.8 95.7 117.9 

San Antonio, TX 1,862 2,087 2,298 2,140 1,944
 137.6 152.0 165.0 153.6 139.6 

San Diego, CA 1,595 1,561 1,798 1,878 2,132 57.4 55.3 63.9 66.7 75.8

San Francisco, CA 1,858 1,606 2,161 2,053 2,136 249.1 215.1 278.2 264.3 275.0 

San Jose, CA 453 418 446 547 502 27.6 25.4 26.5 32.5 29.8 

Seattle, WA 975 922 1,221 1,556 1,462 58.9 55.4 70.3 89.6 84.2 

St Louis, MO 3,652 2,876 2,879 3,185 2,737 1,076.3 861.2 826.8 914.7 786.1 

St Paul, MN 519 545 703 560 584 191.9 201.2 247.0 196.7 205.2 

St Petersburg, FL 1,468 1,835 1,542 1,391 1,527 167.2 208.9 167.3 151.0 165.7 

Tampa, FL 1,696 1,783 1,653 1,517 1,912 183.3 189.6 165.5 151.9 191.4 

Toledo, OH 655 624 864 1,187 1,519 146.0 139.8 189.9 260.8 333.8 

Tucson, AZ 403 415 591 748 458 51.0 51.6 70.0 88.7 54.3 

Tulsa, OK 1,308 964 892 1,014 1,123 343.8 251.2 226.2 257.2 284.8 

Washington, DC 4,508 3,536 2,706 2,883 2,669 861.7 681.3 473.0 504.0 466.6 

Wichita, KS 466 771 675 837 852 104.0 170.7 149.0 184.8 188.1 

Yonkers, NY 105 102 109 143 160 54.4 52.4 54.9 72.0 80.6 

U.S. CITY TOTAL 170,291 165,709 170,766 167,906 162,300 241.4 233.5 231.7 227.8 220.2 

San Juan, PR 227 179 270 281 194 21.7 17.0 26.5 27.5 19.0 

TOTAL 170,518 165,888 171,036 168,187 162,494 238.2 230.3 228.9 225.1 217.5 

STD Surveillance 2002 Gonorrhea Tables 99 
Table 19. Gonorrhea — Women – Reported cases and rates in selected cities of >200,000 population listed in 

alphabetical order: United States and outlying areas, 1998–2002 

City 

Cases Rates per 100,000 Population 

1998 1999 2000 2001 2002
 1998 1999 2000 2001 2002 

Akron, OH 435 413 463 484 493
 155.4 147.5 164.5 172.0 175.2 

Albuquerque, NM 308 234 323 254 375 114.2 87.1 113.4 89.2 131.7 

Atlanta, GA 2,462 2,443 1,543 2,110 1,679
 636.8 627.6 372.5 509.3 405.3 

Austin, TX 894 768 712 722 670
 250.2 210.1 179.6 182.1 169.0 

Baltimore, MD 3,258 2,702 2,578 2,423 2,374
 945.7 800.8 741.9 697.3 683.2 

Birmingham, AL 1,555 1,229 1,552 1,420 1,231 442.0 350.6 443.5 405.8 351.8

Boston, MA 477 410 618 623 664 165.4 142.4 199.6 201.2 214.4 

Buffalo, NY 682 725 914 1,212 872 412.8 443.9 543.7 721.0 518.8 

Charlotte, NC 830 754 748 830 980 253.7 224.0 211.3 234.5 276.8 

Chicago, IL 6,345 6,821 6,525 6,924 6,604 410.1 440.4 409.9 435.0 414.9 

Cincinnati, OH 2,044 1,600 1,868 1,743 1,882
 458.0 361.2 422.3 394.0 425.5 

Cleveland, OH 1,672 1,779 1,697 1,816 1,976
 228.6 244.6 230.7 246.9 268.7 

Columbus, OH 1,584 1,575 1,798 1,696 1,505
 299.1 295.3 327.1 308.5 273.8 

Corpus Christi, TX 181 224 355 349 229 111.3 138.1 221.7 217.9 143.0

Dallas, TX 3,591 3,616 3,494 3,103 2,610 344.4 345.1 314.6 279.4 235.0 

Dayton, OH 490 393 430 722 757 168.2 133.0 147.9 248.4 260.4

Denver, CO 463 515 714 717 756
 180.8 200.8 260.2 261.3 275.5 

Des Moines, IA 189 161 200 144 205
 100.7 84.7 103.7 74.7 106.3 

Detroit, MI 4,147 3,706 4,737 4,336 3,618
 625.4 561.5 941.8 862.1 719.3 

El Paso, TX 123 78 96 148 167
 33.6 21.2 27.3 42.1 47.5 

Fort Worth, TX 1,743 1,405 1,346 1,153 1,025
 254.0 201.0 184.3 157.9 140.4 

Honolulu, HI 262 231 217 269 365
 60.0 53.3 49.8 61.7 83.8 

Houston, TX 3,285 2,699 2,986 2,674 2,526
 203.1 164.7 175.0 156.7 148.0 

Indianapolis, IN 1,532 1,601 1,516 1,751 1,776 359.3 376.3 341.1 394.0 399.6

Jacksonville, FL 898 1,238 1,599 1,200 1,316 236.3 323.8 398.7 299.2 328.1 

Jersey City, NJ 231 228 211 234 176 202.9 201.9 172.4 191.2 143.8

Kansas City, MO 1,382 1,045 1,242 1,039 1,283 583.5 441.8 530.3 443.6 547.8 

Los Angeles, CA 2,792 2,835 3,072 3,469 3,401 64.2 64.3 68.2 77.0 75.5

Louisville, KY 624 494 510 640 632 176.0 139.1 140.9 176.8 174.6 

Memphis, TN 2,259 2,163 2,225 2,070 1,963 495.4 472.1 474.6 441.5 418.7 

Miami, FL 1,053 1,152 750 775 855
 93.5 101.1 64.4 66.6 73.4 

Milwaukee, WI 2,862 2,783 3,057 2,540 2,612
 597.5 582.5 624.4 518.8 533.5 

Minneapolis, MN 806 781 725 625 662
 429.4 414.2 371.9 320.6 339.6 

Nashville, TN 718 736 1,016 752 621
 255.8 264.2 345.5 255.8 211.2 

New Orleans, LA 1,158 1,198 1,325 1,310 1,211
 463.1 484.2 514.4 508.6 470.1 

New York City, NY 6,791 6,402 6,051 6,671 6,418 172.7 162.9 143.6 158.3 152.3

Newark, NJ 794 806 692 881 716
 530.5 541.0 438.8 558.6 454.0 

Norfolk, VA 593 542 646 662 670
 541.8 495.9 563.8 577.8 584.8 

Oakland, CA 987 950 992 1,062 999
 151.9 144.9 135.1 144.6 136.0 

Oklahoma City, OK 839 721 839 909 861 395.8 338.6 383.2 415.1 393.2

Omaha, NE 494 546 626 518 672 215.0 236.4 264.3 218.7 283.7 

Philadelphia, PA 3,938 4,179 4,288 4,421 3,609 511.1 549.2 527.8 544.2 444.2 

Phoenix, AZ 1,415 1,434 1,325 1,169 1,261 100.4 99.1 86.3 76.1 82.1 

Pittsburgh, PA 788 920 826 1,045 1,243 116.9 137.7 122.4 154.9 184.2

Portland, OR 246 250 303 268 184
 96.7 98.0 115.1 101.8 69.9 

Richmond, VA 752 956 783 1,016 895
 704.5 916.9 740.6 961.0 846.6 

Rochester, NY 1,031 1,047 1,102 947 802
 827.4 845.9 860.8 739.7 626.5 

Sacramento, CA 869 692 702 619 777
 148.9 114.6 112.4 99.1 124.4 

San Antonio, TX 1,012 1,113 1,187 1,124 1,009
 144.3 156.6 165.9 157.1 141.0 

San Diego, CA 688 653 702 685 718 49.5 46.6 50.2 49.0 51.3

San Francisco, CA 402 381 412 360 374 106.8 101.1 107.9 94.3 97.9 

San Jose, CA 224 190 174 198 189 27.5 23.3 21.0 23.9 22.8 

Seattle, WA 324 331 448 572 438 38.6 39.2 51.3 65.6 50.2 

St Louis, MO 1,685 1,510 1,426 1,620 1,415 916.7 834.8 772.4 877.5 766.4 

St Paul, MN 278 276 411 335 343 196.9 195.2 278.7 227.2 232.6 

St Petersburg, FL 738 942 739 651 782 158.7 202.5 153.2 134.9 162.1 

Tampa, FL 886 942 823 758 859 186.5 195.1 161.3 148.6 168.4 

Toledo, OH 350 388 487 713 899 149.5 166.3 206.1 301.7 380.5 

Tucson, AZ 175 179 257 346 204 43.3 43.6 59.6 80.2 47.3 

Tulsa, OK 728 527 494 503 588 369.2 265.3 243.3 247.7 289.6 

Washington, DC 1,904 1,509 1,271 1,241 1,224 684.7 546.8 419.9 410.0 404.4 

Wichita, KS 243 452 358 473 508 106.1 196.0 156.3 206.6 221.8 

Yonkers, NY 55 73 64 81 90 54.3 71.7 61.8 78.2 86.9 

U.S. CITY TOTAL* 82,564 79,646 81,590 82,125 78,818 226.8 217.5 216.0 217.4 208.7 

San Juan, PR 85 73 105 114 89 15.6 13.3 19.8 21.5 16.8 

TOTAL 82,649 79,719 81,695 82,239 78,907 223.7 214.5 213.3 214.7 206.0 

*Cases reported with unknown sex are not included in this table. 

100 Gonorrhea Tables STD Surveillance 2002 
Table 20. Gonorrhea — Men – Reported cases and rates in selected cities of >200,000 population listed in 

alphabetical order: United States and outlying areas, 1998–2002 

City 

Cases Rates per 100,000 Population 

1998 1999 2000 2001 2002
 1998 1999 2000 2001 2002 

Akron, OH 380 429 446 474 435
 147.4 166.4 170.6 181.3 166.4 

Albuquerque, NM 262 237 367 380 427 102.3 93.0 135.0 139.8 157.0 

Atlanta, GA 3,118 3,172 1,910 2,510 2,126
 884.0 892.2 475.4 624.8 529.2 

Austin, TX 905 792 804 814 731
 256.1 219.1 193.3 195.7 175.8 

Baltimore, MD 3,714 3,410 2,961 2,591 2,499
 1,233.5 1,154.8 975.0 853.2 822.9 

Birmingham, AL 1,614 1,258 1,439 1,177 1,257 524.5 409.9 461.1 377.1 402.8

Boston, MA 505 490 611 709 740
 188.4 182.6 211.8 245.8 256.6 

Buffalo, NY 426 508 658 982 781
 281.1 337.4 427.1 637.5 507.0 

Charlotte, NC 1,081 1,154 1,010 1,184 1,283
 356.0 370.0 295.8 346.7 375.7 

Chicago, IL 7,797 8,338 8,346 7,400 7,208 544.6 582.5 558.5 495.2 482.3

Cincinnati, OH 1,518 1,193 1,343 1,417 1,514
 378.4 300.1 333.3 351.6 375.7 

Cleveland, OH 1,347 1,589 1,777 2,019 2,109
 207.5 246.6 269.9 306.6 320.3 

Columbus, OH 1,488 1,523 1,561 1,618 1,317
 302.6 308.1 300.6 311.6 253.6 

Corpus Christi, TX 268 300 420 318 237 174.3 195.7 273.6 207.2 154.4

Dallas, TX 3,814 3,834 3,775 3,028 2,642 378.3 378.1 340.6 273.2 238.4 

Dayton, OH 601 539 578 699 743 225.1 199.4 215.4 260.5 276.9

Denver, CO 510 642 880 901 1,056
 209.9 263.9 314.1 321.5 376.9 

Des Moines, IA 182 172 180 126 153
 105.7 98.6 99.0 69.3 84.2 

Detroit, MI 4,312 4,194 4,873 3,884 3,227
 722.1 706.8 1,087.0 866.4 719.9 

El Paso, TX 129 78 113 143 169
 38.3 23.3 34.5 43.6 51.6 

Fort Worth, TX 1,537 1,425 1,433 1,133 939
 229.7 208.5 200.1 158.2 131.1 

Honolulu, HI 219 199 216 288 320
 50.2 46.2 49.0 65.4 72.6 

Houston, TX 3,937 3,193 2,928 2,809 2,705
 247.8 198.1 172.9 165.8 159.7 

Indianapolis, IN 1,539 1,443 1,687 1,630 1,720 397.7 374.3 405.5 391.8 413.5

Jacksonville, FL 1,564 1,734 2,041 1,531 1,579 439.7 486.8 540.3 405.3 418.0 

Jersey City, NJ 260 262 254 255 203 244.7 248.5 215.0 215.9 171.8

Kansas City, MO 1,156 911 1,446 1,122 1,342 537.4 423.6 664.4 515.5 616.6 

Los Angeles, CA 3,194 3,218 4,228 4,264 4,350 74.7 74.4 96.0 96.8 98.8

Louisville, KY 831 699 688 793 728 261.7 220.0 207.5 239.1 219.5 

Memphis, TN 2,976 2,875 2,716 2,350 2,111 720.8 693.0 633.6 548.2 492.5 

Miami, FL 1,518 1,618 1,245 1,189 1,192
 147.9 156.2 114.3 109.2 109.5 

Milwaukee, WI 1,994 2,098 2,084 1,596 1,877
 460.8 489.6 462.5 354.2 416.6 

Minneapolis, MN 756 777 852 670 704
 427.6 437.5 450.7 354.4 372.4 

Nashville, TN 1,059 1,049 1,388 873 788
 418.2 417.2 503.1 316.5 285.6 

New Orleans, LA 1,533 1,489 1,690 1,850 1,463
 711.5 697.4 744.2 814.6 644.2 

New York City, NY 5,306 5,797 5,573 5,914 6,297 152.1 165.8 146.9 155.9 166.0

Newark, NJ 987 935 866 917 857 732.8 696.4 605.2 640.9 598.9 

Norfolk, VA 822 749 841 783 793 777.2 642.5 701.8 653.4 661.8 

Oakland, CA 749 667 783 960 945 118.8 104.5 110.4 135.3 133.2 

Oklahoma City, OK 732 630 595 708 733 374.1 319.8 288.3 343.1 355.2 

Omaha, NE 376 454 531 415 475 175.7 210.8 234.2 183.0 209.5 

Philadelphia, PA 3,333 3,596 3,910 3,675 3,397 500.6 547.6 554.5 521.2 481.8 

Phoenix, AZ 2,128 2,152 1,870 1,657 1,730 154.8 152.2 121.7 107.8 112.6 

Pittsburgh, PA 563 653 668 871 890 94.7 110.9 110.0 143.5 146.6

Portland, OR 281 290 378 475 362
 115.3 118.6 146.6 184.2 140.4 

Richmond, VA 775 870 968 1,083 612
 886.4 1,018.3 1,051.4 1,176.3 664.7 

Rochester, NY 961 990 1,040 822 779
 828.5 856.4 873.6 690.4 654.3 

Sacramento, CA 673 534 581 543 660
 120.0 91.9 97.0 90.7 110.2 

San Antonio, TX 846 974 1,110 1,015 935
 129.8 147.1 163.8 149.8 138.0 

San Diego, CA 883 896 1,066 1,109 1,336 63.5 63.1 75.3 78.4 94.4

San Francisco, CA 1,456 1,225 1,749 1,693 1,749 394.3 331.2 443.0 428.8 443.0 

San Jose, CA 227 224 270 349 303 27.4 27.0 31.7 40.9 35.5 

Seattle, WA 651 591 773 984 1,024 79.8 72.0 89.4 113.8 118.5 

St Louis, MO 1,967 1,366 1,453 1,565 1,322 1,264.8 892.4 888.3 956.8 808.2 

St Paul, MN 241 269 292 225 241 186.4 207.8 212.9 164.0 175.7 

St Petersburg, FL 728 893 803 740 745 176.2 216.0 182.9 168.6 169.7 

Tampa, FL 800 841 830 759 1,053 177.7 183.8 169.8 155.3 215.4 

Toledo, OH 305 235 370 466 613 142.3 110.2 169.1 213.0 280.2 

Tucson, AZ 228 236 334 402 254 59.0 60.1 81.0 97.4 61.6 

Tulsa, OK 580 437 398 511 535 316.4 236.0 208.1 267.2 279.7 

Washington, DC 2,604 2,014 1,430 1,627 1,436 1,062.7 828.7 530.9 604.0 533.1 

Wichita, KS 223 319 317 364 344 101.8 144.3 141.6 162.6 153.7 

Yonkers, NY 50 29 45 62 70 54.4 31.2 47.4 65.3 73.7 

U.S. CITY TOTAL* 87,519 85,708 88,792 85,421 83,165 256.5 249.4 247.1 237.8 231.5 

San Juan, PR 142 106 165 167 105 28.3 21.0 33.7 34.1 21.4 

TOTAL 87,661 85,814 88,957 85,588 83,270 253.1 246.1 244.3 235.0 228.6 

*Cases reported with unknown sex are not included in this table. 

STD Surveillance 2002 Gonorrhea Tables 101 
Table 21. Gonorrhea — Reported cases and rates per 100,000 population by age and sex: United States, 

1998–2002 

Year Age 

Group 

Cases Rates 

Total Male Female Total Male Female 

1998 

10-14 

15-19 

20-24 

25-29 

30-34 

35-39 

40-44 

45-54 

55-64 

65+ 

TOTAL 

6,143 

105,987 

105,999 

55,908 

32,307 

22,874 

13,067 

9,294 

2,177 

1,211 

356,107 

823 

34,595 

51,501 

32,206 

20,301 

15,578 

9,864 

7,774 

1,938 

872 

175,847 

5,320 

71,392 

54,498 

23,702 

12,006 

7,296 

3,203 

1,520 

238 

339 

180,260 

31.9 

542.4 

599.7 

300.8 

160.0 

101.1 

59.7 

26.9 

9.6 

3.5 

131.7 

8.4 

344.4 

572.5 

348.3 

202.9 

138.4 

91.0 

46.0 

17.9 

6.1 

133.2 

56.7 

752.0 

628.0 

253.7 

117.9 

64.2 

29.0 

8.6 

2.0 

1.7 

130.4 

1999 

10-14 

15-19 

20-24 

25-29 

30-34 

35-39 

40-44 

45-54 

55-64 

65+ 

5,954 

104,426 

108,741 

56,120 

32,344 

23,441 

14,007 

10,338 

2,356 

905 

825 

34,295 

52,735 

32,604 

20,690 

16,217 

10,652 

8,657 

2,122 

722 

5,129 

70,131 

56,007 

23,516 

11,654 

7,224 

3,355 

1,681 

233 

183 

30.5 

528.8 

603.3 

308.2 

164.0 

104.0 

62.9 

28.9 

10.1 

2.6 

8.2 

337.9 

574.3 

360.1 

211.7 

144.6 

96.5 

49.5 

19.0 

5.0 

53.8 

730.8 

633.4 

256.9 

117.1 

63.8 

29.9 

9.2 

1.9 

0.9 

TOTAL 359,716 179,913 179,803 131.9 135.0 129.0 

2000 

10-14 

15-19 

20-24 

25-29 

30-34 

35-39 

40-44 

45-54 

55-64 

65+ 

5,925 

102,043 

112,313 

55,929 

31,814 

22,605 

13,526 

10,344 

2,299 

897 

830 

33,312 

54,195 

32,831 

20,603 

15,765 

10,234 

8,669 

2,077 

722 

5,094 

68,731 

58,119 

23,098 

11,211 

6,840 

3,292 

1,676 

222 

175 

28.9 

504.7 

592.2 

288.6 

155.1 

99.6 

60.3 

27.5 

9.5 

2.6 

7.9 

320.6 

559.4 

335.0 

199.6 

139.3 

92.0 

46.9 

17.8 

5.0 

50.9 

699.3 

626.5 

241.0 

110.0 

60.1 

29.1 

8.7 

1.8 

0.9 

TOTAL 358,779 179,651 179,128 127.5 130.1 124.9 

2001 

10-14 

15-19 

20-24 

25-29 

30-34 

35-39 

40-44 

45-54 

55-64 

65+ 

6,041 

101,065 

116,207 

56,083 

32,537 

21,799 

13,605 

10,458 

2,255 

843 

862 

31,952 

54,604 

32,181 

21,050 

15,216 

10,072 

8,655 

2,003 

651 

5,179 

69,113 

61,603 

23,902 

11,487 

6,583 

3,533 

1,803 

252 

192 

29.4 

499.8 

612.8 

289.4 

158.6 

96.0 

60.6 

27.8 

9.3 

2.4 

8.2 

307.5 

563.6 

328.4 

203.9 

134.4 

90.5 

46.8 

17.2 

4.5 

51.8 

703.2 

664.1 

249.4 

112.7 

57.8 

31.2 

9.4 

2.0 

0.9 

TOTAL 361,758 177,531 184,227 128.5 128.6 128.5 

2002 

10-14 

15-19 

20-24 

25-29 

30-34 

35-39 

40-44 

45-54 

55-64 

65+ 

5,449 

96,325 

112,449 

55,480 

32,081 

21,419 

13,791 

10,927 

2,284 

791 

784 

29,921 

52,130 

31,391 

20,560 

14,878 

10,254 

8,891 

2,019 

631 

4,665 

66,404 

60,318 

24,089 

11,521 

6,541 

3,536 

2,036 

266 

159 

26.5 

476.4 

593.0 

286.3 

156.4 

94.3 

61.5 

29.0 

9.4 

2.3 

7.4 

287.9 

538.1 

320.4 

199.2 

131.4 

92.1 

48.1 

17.3 

4.4 

46.6 

675.6 

650.3 

251.4 

113.1 

57.4 

31.3 

10.6 

2.1 

0.8 

TOTAL 351,836 171,839 179,997 125.0 124.5 125.5 

NOTE: This table should be used only for age comparisons. If age was not specified, cases were prorated according to the distribution of cases for 

which age was known. Differences between total cases from this table and others in the report are due to different reporting forms. The 0 to 9 year 

age group is not shown because some of these may not be due to sexual transmission; however, they are included in the totals. 

102 Gonorrhea Tables STD Surveillance 2002 
This page intentionally left blank.
 
Table 22A. Gonorrhea — Reported cases by age, sex, and race/ethnicity: United States, 1998–2002 

Age Total White, Non-Hispanic Black, Non-Hispanic Hispanic Asian/Pacific Islander 

American Indian/ 

Alaska Native 

Group Total Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total Male Female 

10-14 6,017 802 5,216 835 54 781 4,780 689 4,091 329 52 277 23 3 20 51 4 46 

15-19 103,540 33,772 69,768 15,555 2,522 13,033 81,131 29,076 52,055 5,661 1,959 3,702 458 81 377 735 134 601 

20-24 103,675 50,288 53,387 13,889 4,105 9,784 82,325 42,676 39,649 6,253 3,122 3,131 572 196 376 636 190 446 

1998 25-29 

30-34 

35-39 

54,561 

31,570 

22,405 

31,385 

19,797 

15,241 

23,176 

11,772 

7,163 

7,660 

5,298 

3,915 

3,296 

2,866 

2,395 

4,364 

2,432 

1,520 

42,657 25,788 16,869 

23,838 15,438 8,399 

16,938 11,865 5,074 

3,517 

2,043 

1,259 

2,029 

1,315 

837 

1,488 

729 

422 

355 

195 

140 

159 

95 

82 

197 

100 

58 

371 

196 

152 

113 

83 

63 

259 

113 

89 

40-44 12,805 9,651 3,153 2,105 1,394 711 9,915 7,731 2,184 627 432 195 75 48 27 82 47 35 

45-54 9,080 7,589 1,490 1,535 1,177 358 7,005 6,038 967 437 312 125 45 23 23 58 41 17 

55-64 2,127 1,891 236 396 344 53 1,598 1,450 148 107 82 25 11 6 4 16 10 6 

65+ 1,186 854 333 231 159 73 854 633 220 77 57 20 9 3 6 15 2 14 

TOTAL 348,069 171,650 176,419 51,581 18,354 33,227 271,884 141,684 130,199 20,390 10,219 10,170 1,892 698 1,194 2,322 694 1,628 

10-14 5,952 824 5,128 842 55 787 4,666 705 3,961 368 60 308 35 1 34 41 3 39 

15-19 104,430 34,295 70,135 14,882 2,437 12,445 81,913 29,452 52,460 6,359 2,151 4,208 562 133 429 714 121 592 

20-24 108,768 52,757 56,011 14,408 4,288 10,120 86,318 44,709 41,609 6,704 3,278 3,426 673 291 382 665 190 475 

1999 25-29 

30-34 

35-39 

56,119 32,608 23,511 

32,330 20,680 11,650 

23,436 16,212 7,224 

7,859 

5,364 

4,319 

3,397 

2,864 

2,563 

4,462 

2,499 

1,756 

43,874 26,821 17,053 

24,390 16,279 8,110 

17,559 12,685 4,875 

3,773 

2,131 

1,272 

2,114 

1,306 

815 

1,659 

825 

457 

316 

240 

146 

173 

138 

91 

142 

102 

55 

298 

206 

139 

103 

93 

57 

195 

113 

82 

40-44 14,005 10,652 3,353 2,395 1,671 725 10,832 8,492 2,340 638 410 228 69 38 32 70 41 29 

45-54 10,336 8,656 1,680 1,817 1,387 430 7,954 6,877 1,076 432 310 122 63 43 20 69 39 31 

55-64 2,354 2,121 233 503 432 71 1,718 1,587 131 109 83 26 14 11 3 11 8 3 

65+ 903 721 183 193 151 42 634 517 116 62 48 15 6 1 4 9 3 6 

TOTAL 359,716 179,919 179,797 52,733 19,295 33,438 280,707 148,437 132,270 21,920 10,602 11,318 2,130 925 1,205 2,226 660 1,566 

10-14 5,923 830 5,093 769 50 719 4,649 689 3,960 419 82 336 38 1 37 48 7 41 

15-19 102,044 33,310 68,734 14,608 2,576 12,032 79,244 28,108 51,137 6,877 2,315 4,563 670 180 489 644 131 514 

20-24 112,328 54,207 58,121 15,597 4,831 10,766 87,435 44,977 42,459 7,757 3,762 3,995 884 431 454 655 207 448 

2000 25-29 

30-34 

35-39 

55,930 32,836 23,094 

31,809 20,601 11,207 

22,602 15,763 6,838 

7,898 

5,802 

4,689 

3,373 

3,190 

2,969 

4,524 

2,612 

1,720 

42,931 26,572 16,359 

23,063 15,542 7,521 

16,039 11,591 4,448 

4,175 

2,347 

1,445 

2,417 

1,482 

933 

1,758 

865 

512 

565 

378 

251 

351 

274 

181 

214 

104 

70 

361 

219 

178 

123 

114 

89 

238 

105 

89 

40-44 13,524 10,234 3,290 2,724 1,840 884 9,909 7,796 2,114 668 449 219 126 96 30 96 52 44 

45-54 10,342 8,669 1,674 2,038 1,572 465 7,576 6,567 1,009 560 414 146 103 73 29 66 41 25 

55-64 2,298 2,077 222 495 436 59 1,636 1,513 123 115 91 24 30 19 11 22 17 5 

65+ 896 722 175 190 144 46 641 527 114 51 45 6 2 0 2 13 6

TOTAL 358,779 179,662 179,117 54,964 21,039 33,925 273,928 144,191 129,737 24,512 12,030 12,481 3,056 1,609 1,447 2,319 793 1,526 

10-14 6,040 861 5,179 855 57 798 4,646 715 3,932 440 80 360 53 6 47 46 3 43 

15-19 101,065 31,949 69,116 14,961 2,611 12,351 77,554 26,692 50,862 7,095 2,312 4,783 763 205 559 692 130 562 

20-24 116,226 54,619 61,607 16,997 5,390 11,607 89,154 44,621 44,533 8,416 4,024 4,393 881 354 526 778 231 547 

2001 25-29 

30-34 

35-39 

56,084 32,186 23,899 

32,531 21,049 11,482 

21,794 15,213 6,581 

8,535 

6,106 

4,720 

3,610 

3,461 

3,026 

4,924 

2,645 

1,694 

42,275 25,705 16,570 

23,242 15,644 7,597 

15,136 10,957 4,178 

4,418 

2,636 

1,630 

2,464 

1,646 

1,055 

1,954 

990 

575 

512 

327 

160 

281 

205 

116 

231 

122 

44 

344 

220 

149 

124 

93 

59 

219 

127 

90 

40-44 13,603 10,072 3,531 2,882 1,924 958 9,749 7,496 2,253 759 513 246 111 92 19 101 46 55 

45-54 10,455 8,654 1,801 2,364 1,796 568 7,386 6,356 1,030 542 398 144 84 60 25 79 45 34 

55-64 2,254 2,003 251 583 510 73 1,510 1,374 136 124 90 33 23 16 7 14 12 2 

65+ 842 650 192 207 163 44 554 443 111 57 29 28 17 11 6 7 3

TOTAL 361,758 177,541 184,217 58,323 22,585 35,738 271,871 140,235 131,636 26,190 12,624 13,566 2,935 1,348 1,588 2,439 751 1,689 

10-14 5,448 783 4,665 786 50 736 4,181 665 3,516 412 57 355 28 4 24 41 7 34 

15-19 96,326 29,920 66,406 15,055 2,521 12,534 73,130 24,995 48,134 6,809 2,111 4,699 547 122 425 785 170 615 

20-24 112,467 52,141 60,325 18,044 5,714 12,330 84,159 41,703 42,456 8,648 4,176 4,473 772 304 468 843 244 599 

2002 25-29 

30-34 

35-39 

55,483 31,399 24,084 

32,076 20,560 11,516 

21,414 14,875 6,538 

9,168 

6,450 

5,067 

3,917 

3,628 

3,336 

5,251 

2,822 

1,731 

40,777 24,593 16,184 

22,223 14,951 7,271 

14,263 10,190 4,073 

4,647 

2,820 

1,695 

2,470 

1,656 

1,132 

2,177 

1,164 

562 

501 

322 

214 

263 

207 

130 

238 

115 

84 

390 

260 

175 

157 

117 

87 

233 

143 

88 

40-44 13,787 10,253 3,535 3,386 2,393 993 9,226 7,098 2,128 957 637 320 109 66 44 109 58 51 

45-54 10,924 8,890 2,034 2,706 2,089 617 7,460 6,268 1,192 573 408 165 105 74 31 80 51 29 

55-64 2,283 2,018 265 664 574 90 1,467 1,336 132 125 95 29 23 10 13 4 3 2 

65+ 790 631 159 196 155 41 523 428 95 50 35 15 18 11 7 3 3

TOTAL 351,836 171,849 179,987 61,671 24,429 37,243 257,986 132,498 125,488 26,829 12,822 14,007 2,646 1,196 1,450 2,704 905 1,800 

 7 

4 

0 

NOTE: These tables should be used only for race/ethnicity comparisons, not for age, sex, or overall totals. If age or race/ethnicity was not specified, cases 

were prorated according to the distribution of cases for which these variables were specified. For 1998, ID and NJ did not report age and/or race/ethnicity 

for most cases and were excluded. Cases and population denominators have been excluded for these states/areas. Differences between total cases from 

this table and others in the report are due to different reporting forms and above listed exclusions. The 0 to 9 year age group is not shown because some 

of these may not be due to sexual transmission; however, they are included in the totals. 

104 Gonorrhea Tables STD Surveillance 2002 
Table 22B. Gonorrhea — Rates per 100,000 population by age, sex, and race/ethnicity: United States, 1998–2002 

Age 

Group Total 

Total 

Male Female 

White, Non-Hispanic 

Total Male Female 

Black, Non-Hispanic 

Total Male Female Total 

Hispanic 

Male Female 

Asian/Pacific Islander 

Total Male Female 

American Indian/ 

Alaska Native 

Total Male Female 

10-14 32.4 8.4 57.5 6.7 0.8 13.0 173.7 49.3 301.8 12.9 4.0 22.2 3.3 0.8 5.9 25.2 4.2 46.9 

15-19 547.5 347.4 759.4 123.3 38.8 213.0 2,909.7 2,053.7 3,792.6 216.6 144.0 295.5 64.8 22.5 108.1 389.8 142.0 638.9 

20-24 605.9 577.4 635.4 122.4 70.7 176.4 3,401.1 3,574.4 3,232.3 249.4 240.2 259.3 84.1 58.2 109.5 411.4 244.4 579.9 

25-29 

30-34 

35-39 

303.0 

162.1 

102.8 

350.4 

205.0 

140.5 

256.1 

119.9 

65.4 

62.9 54.2 71.6 

39.3 42.7 36.0 

24.8 30.3 19.3 

1,774.1 2,251.2 1,340.0 

960.1 1,332.4 634.3 

641.8 962.3 360.8 

143.5 

80.6 

52.7 

159.7 

99.9 

68.1 

126.2 

59.8 

36.5 

43.6 42.0 44.9 

23.5 24.6 22.5 

16.8 20.7 13.3 

236.8 140.8 337.4 

1998

133.1 112.8 153.3 

98.8 82.8 114.5 

40-44 60.6 92.3 29.6 13.4 17.7 9.0 401.9 672.8 165.8 31.7 43.2 20.0 9.6 12.9 6.6 57.6 67.7 48.1 

45-54 27.2 46.6 8.7 5.9 9.2 2.7 202.7 386.2 51.1 16.6 24.3 9.3 3.9 4.2 3.6 27.1 39.6 15.5 

55-64 9.7 18.2 2.1 2.3 4.1 0.6 76.0 159.4 12.4 7.0 11.5 3.0 1.6 2.1 1.2 12.7 16.4 9.3 

65+ 3.6 6.2 1.7 0.8 1.4 0.4 31.9 60.6 13.6 4.5 8.0 2.0 1.3 1.0 1.4 10.9 2.6 17.0 

TOTAL 133.4 134.6 132.2 27.3 19.9 34.5 859.4 946.2 781.4 69.9 69.6 70.3 20.0 15.4 24.3 117.7 71.6 162.4 

10-14 30.4 8.2 53.8 6.5 0.8 12.5 159.5 47.4 275.1 13.4 4.3 23.0 4.6 0.4 9.0 20.0 2.6 38.0 

15-19 528.8 337.8 730.8 113.5 36.1 195.5 2,833.8 2,004.8 3,690.4 228.7 148.9 315.2 73.5 34.5 113.4 365.4 123.9 607.7 

20-24 603.4 574.5 633.4 121.1 70.4 174.1 3,377.4 3,540.9 3,217.8 249.2 235.0 264.5 93.8 82.2 105.2 414.3 236.2 593.4 

25-29 

30-34 

35-39 

308.2 

163.9 

104.0 

360.1 

211.7 

144.5 

256.8 

117.0 

63.8 

64.6 55.9 73.4 

39.7 42.6 36.9 

26.7 31.7 21.8 

1,772.7 2,269.6 1,318.7 

967.1 1,380.7 604.0 

639.0 986.0 333.6 

146.8 

80.1 

49.2 

160.3 

95.0 

61.4 

132.6 

64.2 

36.4 

37.3 44.3 31.3 

27.0 33.5 21.4 

16.2 21.3 11.7 

186.5 127.1 248.0 

1999

139.1 124.8 153.6 

89.3 74.2 104.2 

40-44 62.9 96.5 29.9 14.5 20.3 8.8 413.7 695.3 167.5 29.5 37.5 21.3 8.1 9.3 7.1 47.6 57.4 38.3 

45-54 28.9 49.5 9.2 6.6 10.2 3.1 211.7 404.6 52.3 14.8 21.8 8.2 4.9 7.1 2.9 31.0 36.2 26.3 

55-64 10.1 19.0 1.9 2.7 4.8 0.7 76.4 163.4 10.2 6.5 10.7 2.8 1.9 3.1 0.8 8.2 12.7 4.3 

65+ 2.6 5.0 0.9 0.7 1.3 0.2 22.7 47.3 6.9 3.4 6.2 1.4 0.7 0.4 0.9 6.2 4.6 7.3 

TOTAL 131.9 135.0 129.0 26.9 20.1 33.4 848.3 947.0 759.4 70.0 67.3 72.7 20.9 18.9 22.7 109.9 66.3 152.0 

10-14 28.9 7.9 50.9 5.8 0.7 11.2 147.9 43.2 255.8 13.2 5.1 21.7 5.1 0.4 10.0 22.6 6.4 39.5 

15-19 504.7 320.6 699.3 111.6 38.5 188.3 2,692.7 1,889.3 3,514.0 216.8 137.1 307.6 81.8 43.2 121.8 322.7 128.2 525.5 

20-24 592.3 559.5 626.6 131.4 80.4 183.5 3,322.1 3,511.8 3,142.4 227.5 200.6 260.4 100.0 97.5 102.6 397.5 247.8 551.6 

25-29 

30-34 

35-39 

288.6 

155.1 

99.5 

335.1 

199.6 

139.3 

241.0 

110.0 

60.0 

64.5 54.7 74.5 

42.6 46.6 38.6 

29.5 37.3 21.6 

1,685.0 2,194.7 1,223.5 

881.4 1,255.0 545.8 

567.3 872.5 296.7 

123.3 

75.1 

51.1 

132.4 

88.9 

63.3 

112.7 

59.4 

37.9 

53.7 67.9 40.1 

37.5 55.7 20.2 

25.9 38.6 14.0 

233.5 158.6 308.9 

2000

140.8 147.1 134.5 

103.3 105.9 100.9 

40-44 60.3 92.0 29.1 16.6 22.5 10.8 366.5 614.6 147.3 29.0 38.1 19.4 14.0 22.6 6.3 58.6 66.2 51.6 

45-54 27.4 46.9 8.7 7.1 11.0 3.2 185.6 348.1 46.0 17.9 26.7 9.2 7.1 10.9 3.7 25.7 33.3 18.5 

55-64 9.5 17.8 1.8 2.6 4.7 0.6 69.1 143.4 9.4 6.7 11.3 2.6 3.7 4.9 2.6 15.4 25.0 6.4 

65+ 2.6 5.0 0.8 0.6 1.2 0.3 22.8 49.2 6.5 2.9 6.3 0.5 0.2 0.0 0.4 10.4 10.8 10.1 

TOTAL 127.5 130.1 124.9 27.7 21.7 33.5 788.2 873.5 711.0 69.4 66.2 72.8 27.8 30.2 25.5 108.7 75.2 141.4 

10-14 29.4 8.2 51.7 6.4 0.8 12.4 147.8 44.8 253.9 13.9 5.0 23.3 7.0 1.6 12.7 21.6 2.7 41.3 

15-19 499.8 307.5 703.2 114.3 39.0 193.2 2,635.3 1,794.1 3,495.2 223.7 136.9 322.5 93.2 49.0 139.1 346.3 127.5 574.6 

20-24 612.9 563.8 664.1 143.1 89.7 197.8 3,387.4 3,484.0 3,295.9 246.9 214.6 286.3 99.7 80.2 119.1 472.2 276.6 673.5 

25-29 

30-34 

35-39 

289.4 

158.6 

96.0 

328.5 

203.9 

134.4 

249.4 

112.7 

57.8 

69.7 58.5 81.1 

44.9 50.6 39.1 

29.7 38.0 21.3 

1,659.3 2,123.2 1,239.3 

888.2 1,263.2 551.3 

535.3 824.8 278.7 

130.5 

84.4 

57.7 

134.9 

98.7 

71.5 

125.3 

68.0 

42.6 

48.7 54.4 43.2 

32.4 41.8 23.5 

16.6 24.8 8.9 

222.1 160.3 284.3 

2001

141.6 119.5 163.5 

86.4 70.5 101.4 

40-44 60.6 90.5 31.2 17.6 23.5 11.7 360.6 591.0 157.0 33.0 43.6 21.8 12.4 21.8 4.0 61.5 58.1 64.7 

45-54 27.7 46.8 9.4 8.2 12.6 3.9 181.0 336.9 46.9 17.3 25.7 9.1 5.8 8.9 3.2 30.8 36.4 25.5 

55-64 9.3 17.2 2.0 3.0 5.5 0.7 63.8 130.2 10.4 7.2 11.3 3.7 2.8 4.2 1.6 9.6 17.4 2.3 

65+ 2.4 4.5 0.9 0.7 1.3 0.3 19.7 41.4 6.3 3.3 4.0 2.7 2.0 3.2 1.2 5.5 6.0 5.1 

TOTAL 128.5 128.6 128.5 29.4 23.3 35.3 782.3 849.6 721.4 74.2 69.5 79.1 26.7 25.3 28.0 114.4 71.2 156.5 

10-14 26.5 7.4 46.6 5.9 0.7 11.4 133.0 41.7 227.1 13.0 3.5 22.9 3.8 1.1 6.6 19.1 6.4 32.4 

15-19 476.4 287.9 675.6 115.0 37.7 196.1 2,484.9 1,680.1 3,307.7 214.7 125.0 316.8 66.8 29.2 105.9 393.1 167.2 628.7 

20-24 593.1 538.2 650.3 152.0 95.1 210.1 3,197.6 3,256.2 3,142.1 253.7 222.7 291.5 87.4 68.9 105.9 511.6 292.3 737.4 

25-29 

30-34 

35-39 

286.3 

156.4 

94.3 

320.4 

199.2 

131.4 

251.3 

113.0 

57.4 

74.9 63.5 86.4 

47.4 53.0 41.8 

31.8 41.9 21.8 

1,600.5 2,031.3 1,210.4 

849.3 1,207.3 527.6 

504.4 767.0 271.7 

137.3 

90.2 

60.0 

135.2 

99.3 

76.8 

139.6 

79.9 

41.6 

47.7 50.8 44.6 

31.9 42.2 22.2 

22.1 27.8 16.9 

251.9 201.8 302.3 

2002

167.7 151.3 184.0 

101.5 103.3 99.9 

40-44 61.4 92.1 31.2 20.7 29.3 12.1 341.3 559.6 148.2 41.5 54.1 28.4 12.2 15.5 9.3 66.1 73.6 59.2 

45-54 29.0 48.1 10.6 9.4 14.6 4.3 182.8 332.2 54.3 18.3 26.3 10.4 7.3 11.1 4.0 31.3 41.2 22.1 

55-64 9.4 17.3 2.1 3.5 6.2 0.9 62.0 126.6 10.0 7.3 11.9 3.2 2.8 2.5 3.0 3.0 4.0 2.2 

65+ 2.3 4.4 0.8 0.7 1.3 0.2 18.6 39.9 5.5 2.9 4.8 1.5 2.2 3.0 1.6 2.4 5.6 0.0 

TOTAL 125.0 124.5 125.5 31.1 25.2 36.8 742.3 802.7 687.7 76.0 70.6 81.7 24.1 22.5 25.6 126.8 85.9 166.8 

NOTE: These tables should be used only for race/ethnicity comparisons, not for age, sex, or overall totals. If age or race/ethnicity was not specified, cases 

were prorated according to the distribution of cases for which these variables were specified. For 1998, ID and NJ did not report age and/or race/ethnicity for 

most cases and were excluded. Cases and population denominators have been excluded for these states/areas. Differences between total cases from this 

table and others in the report are due to different reporting forms and above listed exclusions. The 0 to 9 year age group is not shown because some of these 

may not be due to sexual transmission; however, they are included in the totals. 

STD Surveillance 2002 Gonorrhea Tables 105 
Table 23. All stages of syphilis* — Reported cases and rates by state/area and region listed in alphabetical 

order: United States and outlying areas, 1998–2002 

State/Area 

Cases Rates per 100,000 Population 

1998 1999 2000 2001 2002 1998 1999 2000 2001 2002 

Alabama 1,139 1,019 753 724 700 26.2 23.3 16.9 16.3 15.7 

Alaska 13 13 6 9 9 2.1 2.1 1.0 1.4 1.4 

Arizona 697 833 848 1,147 1,085 14.9 17.4 16.5 22.4 21.1 

Arkansas 506 364 366 239 217 19.9 14.3 13.7 8.9 8.1 

California 2,869 2,859 3,354 3,053 3,912 8.8 8.6 9.9 9.0 11.5 

Colorado 122 91 63 149 174 3.1 2.2 1.5 3.5 4.0 

Connecticut 177 126 151 165 188 5.4 3.8 4.4 4.8 5.5 

Delaware 114 72 45 79 62 15.3 9.6 5.7 10.1 7.9 

Florida 2,540 2,690 2,770 2,915 3,280 17.0 17.8 17.3 18.2 20.5 

Georgia 1,836 1,974 1,640 1,988 1,893 24.0 25.3 20.0 24.3 23.1

Hawaii 18 11 22 41 59 1.5 0.9 1.8 3.4 4.9 

Idaho 15 13 11 11 23 1.2 1.0 0.9 0.9 1.8 

Illinois 1,946 1,966 1,638 1,546 1,592 16.2 16.2 13.2 12.4 12.8 

Indiana 509 802 751 529 318 8.6 13.5 12.4 8.7 5.2 

Iowa 48 37 55 44 54 1.7 1.3 1.9 1.5 1.8 

Kansas 116 95 67 88 77 4.4 3.6 2.5 3.3 2.9 

Kentucky 339 302 253 191 212 8.6 7.6 6.3 4.7 5.2 

Louisiana 1,651 1,423 973 793 775 37.8 32.5 21.8 17.7 17.3 

Maine 4 1 7 16 9 0.3 0.1 0.5 1.3 0.7 

Maryland 2,156 1,385 1,172 938 839 42.0 26.8 22.1 17.7 15.8 

Massachusetts 568 385 448 446 541 9.2 6.2 7.1 7.0 8.5 

Michigan 692 780 1,001 1,169 1,181 7.0 7.9 10.1 11.8 11.9 

Minnesota 75 71 77 132 148 1.6 1.5 1.6 2.7 3.0 

Mississippi 1,161 906 685 654 451 42.2 32.7 24.1 23.0 15.9 

Missouri 379 396 299 174 204 7.0 7.2 5.3 3.1 3.6 

Montana 0 3 0 0 4 0.0 0.3 0.0 0.0

Nebraska 35 24 7 16 25 2.1 1.4 0.4 0.9 1.5 

Nevada 139 92 52 62 113 8.0 5.1 2.6 3.1 5.7 

New Hampshire 14 17 19 20 24 1.2 1.4 1.5 1.6 1.9 

New Jersey 836 803 802 1,040 1,062 10.3 9.9 9.5 12.4 12.6 

New Mexico 76 80 98 73 110 4.4 4.6 5.4 4.0 6.0 

New York 5,148 4,094 2,947 3,609 3,879 28.3 22.5 15.5 19.0 20.4 

North Carolina 2,133 1,713 1,495 1,422 1,049 28.3 22.4 18.6 17.7 13.0 

North Dakota 0 0 1 2 0 0.0 0.0 0.2 0.3

Ohio 474 364 282 297 351 4.2 3.2 2.5 2.6 3.1 

Oklahoma 369 539 327 288 287 11.0 16.1 9.5 8.3 8.3 

Oregon 32 37 49 48 75 1.0 1.1 1.4 1.4 2.2 

Pennsylvania 910 932 685 726 689 7.6 7.8 5.6 5.9 5.6 

Rhode Island 55 55 38 39 67 5.6 5.6 3.6 3.7 6.4 

South Carolina 876 929 860 916 619 22.8 23.9 21.4 22.8 15.4 

South Dakota 3 3 1 1 0 0.4 0.4 0.1 0.1

Tennessee 1,754 1,737 1,709 1,478 1,074 32.3 31.7 30.0 26.0 18.9 

Texas 3,967 3,699 3,298 3,662 4,110 20.1 18.5 15.8 17.6 19.7 

Utah 58 49 59 25 71 2.8 2.3 2.6 1.1 3.2 

Vermont 6 3 0 8 2 1.0 0.5 0.0 1.3

Virginia 719 722 539 525 528 10.6 10.5 7.6 7.4 7.5 

Washington 143 205 171 174 158 2.5 3.6 2.9 3.0 2.7 

West Virginia 11 15 13 7 5 0.6 0.8 0.7 0.4 0.3 

Wisconsin 257 192 184 131 134 4.9 3.7 3.4 2.4 2.5 

Wyoming 2 0 5 4 1 0.4 0.0 1.0 0.8

U.S. TOTAL† 38,286 35,379 31,612 32,272 32,871 14.2 13.0 11.2 11.5 11.7 

Northeast 7,718 6,416 5,097 6,069 6,461 14.9 12.4 9.5 11.3 12.1 

Midwest 4,534 4,730 4,363 4,129 4,084 7.2 7.5 6.8 6.4 6.3 

South 21,850 19,947 17,414 17,278 16,532 22.9 20.7 17.4 17.2 16.5 

West 4,184 4,286 4,738 4,796 5,794 6.9 7.0 7.5 7.6 9.2 

Guam 

Puerto Rico 

Virgin Islands 

3

1,461 

35 

12 

1,463 

13 

9

1,340 

11 

30

1,268 

9 

18 

1,390 

4 

1.9 

37.8 

31.9 

7.3 

37.6 

11.5 

5.8 

35.2 

10.1 

19.4 

33.3 

8.3 

11.6 

36.5 

3.7 

OUTLYING AREAS 1,499 1,488 1,360 1,307 1,412 36.3 35.7 33.4 32.1 34.7 

TOTAL 39,785 36,867 32,972 33,579 34,283 14.5 13.3 11.5 11.8 12.0 

0.4 

0.0 

0.0 

0.3 

0.2 

*See Appendix (Reporting of Syphilis Cases) for definition. 

†

Includes cases reported by Washington, D.C. 

106 Syphilis Tables STD Surveillance 2002 
Table 24. All stages of syphilis* — Reported cases and rates in selected cities of >200,000 population listed in 

alphabetical order: United States and outlying areas, 1998–2002 

City 

Cases Rates per 100,000 Population 

1998 1999 2000 2001 2002
 1998 1999 2000 2001 2002 

Akron, OH 7 6 2 4 5
 1.3 1.1 0.4 0.7

Albuquerque, NM 45 50 63 42 60 8.6 9.6 11.3 7.5 10.8 

Atlanta, GA 591 580 384 799 827
 79.9 77.9 47.1 97.9 101.3 

Austin, TX 56 62 59 115 101
 7.9 8.5 7.3 14.2 12.4 

Baltimore, MD 1,472 941 728 477 398
 228.0 148.7 111.8 73.3 61.1 

Birmingham, AL 246 278 212 151 127 37.3 42.3 32.0 22.8 19.2

Boston, MA 240 164 160 157 231 43.1 29.5 26.8 26.3 38.6 

Buffalo, NY 12 6 10 12 10 3.8 1.9 3.1 3.7 3.1 

Charlotte, NC 211 194 151 130 102 33.4 29.9 21.7 18.7 14.7 

Chicago, IL 1,371 1,322 1,090 1,094 1,148 46.0 44.4 35.3 35.4 37.2 

Cincinnati, OH 32 12 14 16 21 3.8 1.4 1.7 1.9 2.5 

Cleveland, OH 151 88 42 39 26 10.9 6.4 3.0 2.8 1.9 

Columbus, OH 115 109 90 140 189 11.3 10.6 8.4 13.1 17.7 

Corpus Christi, TX 27 20 10 10 12 8.5 6.3 3.2 3.2 3.8 

Dallas, TX 736 695 587 702 1,044 35.9 33.7 26.5 31.6 47.1 

Dayton, OH 39 16 17 18 9 7.0 2.8 3.0 3.2 1.6

Denver, CO 35 46 23 64 89
 7.0 9.2 4.1 11.5 16.0 

Des Moines, IA 20 7 18 15 19
 5.6 1.9 4.8 4.0 5.1 

Detroit, MI 477 569 771 924 878
 37.8 45.4 81.0 97.1 92.3 

El Paso, TX 81 79 92 106 119
 11.5 11.3 13.5 15.6 17.5 

Fort Worth, TX 175 177 191 267 374
 12.9 12.8 13.2 18.5 25.9 

Honolulu, HI 18 8 15 30 52
 2.1 0.9 1.7 3.4 5.9 

Houston, TX 1,401 1,111 850 922 1,035
 43.7 34.2 25.0 27.1 30.4 

Indianapolis, IN 239 553 521 306 134 29.4 68.2 60.5 35.6 15.6

Jacksonville, FL 154 74 125 139 69 20.9 10.0 16.0 17.8 8.9 

Jersey City, NJ 34 42 27 39 59 15.4 19.2 11.2 16.2 24.5 

Kansas City, MO 14 66 46 30 37 3.1 14.6 10.2 6.6 8.2 

Los Angeles, CA 1,264 1,189 1,857 1,339 1,625 14.7 13.6 20.8 15.0 18.2 

Louisville, KY 213 174 149 100 141 31.7 25.9 21.5 14.4 20.3 

Memphis, TN 1,036 927 882 896 538 119.2 106.2 98.3 99.8 59.9 

Miami, FL 773 795 829 1,044 1,297 35.9 36.5 36.8 46.3 57.6 

Milwaukee, WI 233 166 151 98 88 25.6 18.3 16.1 10.4 9.4 

Minneapolis, MN 34 28 34 63 79 9.3 7.6 8.9 16.4 20.6 

Nashville, TN 416 505 523 379 289 77.9 95.3 91.8 66.5 50.7 

New Orleans, LA 348 228 124 101 101 74.8 49.5 25.6 20.8 20.8 

New York City, NY 4,652 3,736 2,712 3,304 3,483 62.7 50.3 33.9 41.3 43.5 

Newark, NJ 191 172 265 377 343 67.2 60.7 88.1 125.3 114.0 

Norfolk, VA 108 84 85 83 47 50.2 37.2 36.3 35.4 20.1 

Oakland, CA 129 127 91 109 175 10.1 9.8 6.3 7.5 12.1 

Oklahoma City, OK 181 300 193 160 170 44.4 73.2 45.4 37.6 40.0 

Omaha, NE 26 10 6 3 15 5.9 2.2 1.3 0.6 3.2 

Philadelphia, PA 804 825 618 646 566 56.0 58.2 40.7 42.6 37.3 

Phoenix, AZ 572 722 737 957 855 20.5 25.2 24.0 31.2 27.8 

Pittsburgh, PA 12 7 7 15 26 0.9 0.6 0.5 1.2 2.0 

Portland, OR 17 19 30 29 48 3.4 3.8 5.8 5.6 9.2 

Richmond, VA 81 64 40 58 25 41.7 33.7 20.2 29.3 12.6 

Rochester, NY 39 16 7 4 13 16.2 6.7 2.8 1.6 5.3 

Sacramento, CA 31 20 25 33 38 2.7 1.7 2.0 2.7 3.1 

San Antonio, TX 237 228 287 364 306 17.5 16.6 20.6 26.1 22.0 

San Diego, CA 187 251 232 151 159 6.7 8.9 8.2 5.4 5.7 

San Francisco, CA 129 128 163 301 604 17.3 17.1 21.0 38.8 77.8 

San Jose, CA 62 56 43 92 92 3.8 3.4 2.6 5.5 5.5 

Seattle, WA 69 123 116 110 96 4.2 7.4 6.7 6.3 5.5 

St Louis, MO 170 165 115 63 80 50.1 49.4 33.0 18.1 23.0 

St Paul, MN 10 6 9 16 16 3.7 2.2 3.2 5.6 5.6 

St Petersburg, FL 56 38 64 40 81 6.4 4.3 6.9 4.3 8.8 

Tampa, FL 177 111 132 148 222 19.1 11.8 13.2 14.8 22.2 

Toledo, OH 23 21 18 3 18 5.1 4.7 4.0 0.7 4.0 

Tucson, AZ 36 42 36 72 91 4.6 5.2 4.3 8.5 10.8 

Tulsa, OK 75 109 32 22 30 19.7 28.4 8.1 5.6 7.6 

Washington, DC 579 458 516 459 431 110.7 88.2 90.2 80.2 75.3 

Wichita, KS 21 34 10 15 13 4.7 7.5 2.2 3.3 2.9 

Yonkers, NY 22 12 10 13 27 11.4 6.2 5.0 6.5 13.6 

U.S. CITY TOTAL 21,012 19,171 17,446 18,415 19,403 29.8 27.0 23.7 25.0 26.3 

San Juan, PR 673 682 545 483 442 64.3 64.8 53.4 47.3 43.3 

TOTAL 21,685 19,853 17,991 18,898 19,845 30.3 27.6 24.1 25.3 26.6 

0.9 

*See Appendix (Reporting of Syphilis Cases) for definition.
 

STD Surveillance 2002 Syphilis Tables 107
 
Table 25. Primary and secondary syphilis — Reported cases and rates by state/area, ranked by rates: United 

States, 2002 

Rank* State/Area Cases Rate per 100,000 Population 

1 Georgia 439 5.4 

2 Michigan 486 4.9 

3 Maryland 228 4.3 

4 Florida 617 3.9 

5 Illinois 479 3.9 

6 Arizona 200 3.9 

7 North Carolina 279 3.5 

8 Louisiana 152 3.4 

9 Alabama 149 3.4 

10 South Carolina 134 3.3 

11 California 1,033 3.0 

12 Tennessee 168 3.0 

13 Texas 589 2.8 

14 New York 478 2.5 

U.S. TOTAL† 6,862 2.4 

15 Kentucky 88 2.2 

16 Oklahoma 72 2.1 

17 New Mexico 39 2.1 

18 New Jersey 169 2.0 

19 Mississippi 49 1.7 

20 Massachusetts 99 1.6 

21 Colorado 64 1.5 

22 Ohio 159 1.4 

23 Delaware 11 1.4 

24 Arkansas 34 1.3 

25 Washington 70 1.2 

26 Minnesota 59 1.2 

27 Rhode Island 13 1.2 

28 Virginia 71 1.0 

29 Indiana 62 1.0 

30 Pennsylvania 105 0.9 

31 Hawaii 11 0.9 

32 Connecticut 28 0.8 

33 Oregon 28 0.8 

34 Nevada 15 0.8 

35 Kansas 20 0.7 

36 Missouri 34 0.6 

37 Wisconsin 30 0.6 

38 Idaho 8 0.6 

39 New Hampshire 8 0.6 

40 Nebraska 6 0.4 

41 Iowa 8 0.3 

42 Utah 7 0.3 

43 Vermont 2 0.3 

YEAR 2010 OBJECTIVE 0.2 

44 Maine 2 0.2 

45 West Virginia 2 0.1 

Alaska 0 0.0 

Montana 0 0.0 

North Dakota 0 0.0 

South Dakota 0 0.0 

Wyoming 0 0.0 

*States were ranked in descending order by rate, number of cases, and alphabetically by state. States with no cases were not ranked. †

Total includes cases reported by Washington, D.C., but excludes outlying areas (Guam with 6 cases and rate of 3.9, Puerto Rico with 270 cases and 

rate of 7.1, and Virgin Islands with 1 case and rate of 0.9). 

108 Syphilis Tables STD Surveillance 2002 
Table 26. Primary and secondary syphilis — Counties and independent cities* ranked by number of reported 

cases: United States, 2002 

† Rank County/Independent City Cases Rate per 100,000 Population Cumulative Percent 

1 Wayne County, MI 438 21.3 6 

2 Cook County, IL 408 7.6 12 

3 Los Angeles County, CA 403 4.2 18 

4 San Francisco County, CA 315 40.6 22 

5 Fulton County, GA 257 31.5 26 

6 New York County, NY 248 16.1 30 

7 Dade County, FL 231 10.3 33 

8 Dallas County, TX 191 8.6 36 

9 Maricopa County, AZ 155 5.0 38 

10 Broward County, FL 133 8.2 40 

11 Baltimore (City), MD 121 18.6 42 

12 Harris County, TX 112 3.3 43 

13 Tarrant County, TX 106 7.3 45 

14 Franklin County, OH 102 9.5 46 

15 Montgomery County, AL 96 43.0 48 

16 Shelby County, TN 89 9.9 49 

17 Essex County, NJ 86 10.8 50 

*Accounting for 50% of reported primary and secondary syphilis cases. 

†

Counties were ranked in descending order by number of cases, rate, and alphabetically by state. 

STD Surveillance 2002 Syphilis Tables 109 
Table 27. Primary and secondary syphilis — Reported cases and rates by state/area and region listed in 

alphabetical order: United States and outlying areas, 1998–2002 

State/Area 

Cases Rates per 100,000 Population 

1998 1999 2000 2001 2002 1998 1999 2000 2001 2002 

Alabama 274 202 123 142 149 6.3 4.6 2.8 3.2 3.4 

Alaska 1 1 0 0 0 0.2 0.2 0.0 0.0

Arizona 185 212 189 180 200 4.0 4.4 3.7 3.5 3.9 

Arkansas 108 87 104 49 34 4.3 3.4 3.9 1.8 1.3 

California 327 283 325 545 1,033 1.0 0.9 1.0 1.6 3.0 

Colorado 10 8 11 23 64 0.3 0.2 0.3 0.5 1.5 

Connecticut 26 16 16 12 28 0.8 0.5 0.5 0.4 0.8 

Delaware 21 10 9 14 11 2.8 1.3 1.1 1.8 1.4 

Florida 294 343 413 484 617 2.0 2.3 2.6 3.0 3.9 

Georgia 333 430 402 414 439 4.4 5.5 4.9 5.1 5.4 

Hawaii 4 3 2 12 11 0.3 0.3 0.2 1.0 0.9 

Idaho 2 1 1 1 8 0.2 0.1 0.1 0.1

Illinois 396 422 412 409 479 3.3 3.5 3.3 3.3 3.9 

Indiana 215 450 351 151 62 3.6 7.6 5.8 2.5 1.0 

Iowa 5 9 11 5 8 0.2 0.3 0.4 0.2 0.3 

Kansas 14 14 6 25 20 0.5 0.5 0.2 0.9 0.7 

Kentucky 106 101 85 48 88 2.7 2.5 2.1 1.2 2.2 

Louisiana 430 306 209 173 152 9.8 7.0 4.7 3.9 3.4 

Maine 1 0 1 1 2 0.1 0.0 0.1 0.1

Maryland 648 343 300 266 228 12.6 6.6 5.7 5.0 4.3 

Massachusetts 46 37 68 46 99 0.7 0.6 1.1 0.7 1.6 

Michigan 211 249 330 428 486 2.1 2.5 3.3 4.3 4.9 

Minnesota 9 10 16 33 59 0.2 0.2 0.3 0.7 1.2 

Mississippi 261 194 137 140 49 9.5 7.0 4.8 4.9 1.7 

Missouri 109 96 29 26 34 2.0 1.8 0.5 0.5 0.6 

Montana 0 1 0 0 0 0.0 0.1 0.0 0.0

Nebraska 8 6 2 10 6 0.5 0.4 0.1 0.6 0.4 

Nevada 15 5 5 8 15 0.9 0.3 0.3 0.4 0.8 

New Hampshire 2 1 2 1 8 0.2 0.1 0.2 0.1

New Jersey 107 68 71 137 169 1.3 0.8 0.8 1.6 2.0 

New Mexico 14 12 16 19 39 0.8 0.7 0.9 1.0 2.1 

New York 119 150 132 304 478 0.7 0.8 0.7 1.6 2.5 

North Carolina 723 464 483 445 279 9.6 6.1 6.0 5.5 3.5 

North Dakota 0 0 0 0 0 0.0 0.0 0.0 0.0

Ohio 134 92 69 81 159 1.2 0.8 0.6 0.7 1.4 

Oklahoma 98 187 116 60 72 2.9 5.6 3.4 1.7 2.1 

Oregon 6 8 12 13 28 0.2 0.2 0.4 0.4 0.8 

Pennsylvania 98 84 77 100 105 0.8 0.7 0.6 0.8 0.9 

Rhode Island 1 3 4 9 13 0.1 0.3 0.4 0.9

South Carolina 271 269 229 235 134 7.1 6.9 5.7 5.9 3.3 

South Dakota 1 0 0 1 0 0.1 0.0 0.0 0.1

Tennessee 567 641 532 331 168 10.4 11.7 9.4 5.8 3.0 

Texas 443 473 396 478 589 2.2 2.4 1.9 2.3 2.8 

Utah 4 2 2 11 7 0.2 0.1 0.1 0.5 0.3 

Vermont 4 3 0 3 2 0.7 0.5 0.0 0.5

Virginia 149 153 126 102 71 2.2 2.2 1.8 1.4 1.0 

Washington 44 77 66 57 70 0.8 1.3 1.1 1.0 1.2 

West Virginia 3 5 3 5 2 0.2 0.3 0.2 0.3

Wisconsin 78 41 48 22 30 1.5 0.8 0.9 0.4 0.6 

Wyoming 1 0 1 1 0 0.2 0.0 0.2 0.2

U.S. TOTAL* 7,007 6,617 5,979 6,103 6,862 2.6 2.4 2.1 2.2 2.4 

Northeast 404 362 371 613 904 0.8 0.7 0.7 1.1 1.7 

Midwest 1,180 1,389 1,274 1,191 1,343 1.9 2.2 2.0 1.8 2.1 

South 4,810 4,253 3,704 3,429 3,140 5.0 4.4 3.7 3.4 3.1 

West 613 613 630 870 1,475 1.0 1.0 1.0 1.4 2.3 

Guam 

Puerto Rico 

Virgin Islands 

0

177 

7 

2

146 

1 

1

175 

3 

12

244 

0 

6 

270 

1 

0.0 

4.6 

6.4 

1.2 

3.8 

0.9 

0.6 

4.6 

2.8 

7.8 

6.4 

0.0

3.9 

7.1 

OUTLYING AREAS 184 149 179 256 277 4.5 3.6 4.4 6.3 6.8 

TOTAL 7,191 6,766 6,158 6,359 7,139 2.6 2.4 2.2 2.2 2.5 

0.0 

0.6 

0.2 

0.0 

0.6 

0.0 

1.2 

0.0 

0.3 

0.1 

0.0 

0.9 

*Includes cases reported by Washington, D.C. 

110 Syphilis Tables STD Surveillance 2002 
Table 28. Primary and secondary syphilis — Women – Reported cases and rates by state/area and region 

listed in alphabetical order: United States and outlying areas, 1998–2002 

State/Area 

Cases Rates per 100,000 Population 

1998 1999 2000 2001 2002 1998 1999 2000 2001 2002 

Alabama 133 102 63 67 63 5.9 4.5 2.7 2.9 2.7 

Alaska 0 0 0 0 0 0.0 0.0 0.0 0.0

Arizona 67 65 80 50 74 2.8 2.7 3.1 1.9 2.9 

Arkansas 59 44 58 27 18 4.5 3.3 4.2 2.0 1.3 

California 132 76 51 42 39 0.8 0.5 0.3 0.2 0.2 

Colorado 3 6 1 5 2 0.1 0.3 0.0 0.2

Connecticut 16 6 7 2 3 0.9 0.4 0.4 0.1

Delaware 11 1 1 5 4 2.9 0.3 0.2 1.2

Florida 116 143 163 135 108 1.5 1.8 2.0 1.6 1.3 

Georgia 130 160 159 129 98 3.3 4.0 3.8 3.1 2.4 

Hawaii 0 2 1 0 2 0.0 0.3 0.2 0.0

Idaho 0 0 0 0 4 0.0 0.0 0.0 0.0

Illinois 158 180 181 91 81 2.6 2.9 2.9 1.4 1.3 

Indiana 113 225 196 71 18 3.7 7.4 6.3 2.3 0.6 

Iowa 0 6 6 1 4 0.0 0.4 0.4 0.1

Kansas 6 8 1 11 6 0.4 0.6 0.1 0.8 0.4 

Kentucky 49 45 42 17 43 2.4 2.2 2.0 0.8 2.1 

Louisiana 196 153 97 83 76 8.6 6.7 4.2 3.6 3.3 

Maine 0 0 0 0 0 0.0 0.0 0.0 0.0

Maryland 302 164 115 113 53 11.4 6.2 4.2 4.1 1.9 

Massachusetts 15 15 19 4 12 0.5 0.5 0.6 0.1 0.4 

Michigan 86 95 141 161 192 1.7 1.9 2.8 3.2 3.8 

Minnesota 4 5 5 16 4 0.2 0.2 0.2 0.6 0.2 

Mississippi 128 93 70 69 31 8.9 6.4 4.8 4.7 2.1 

Missouri 50 49 11 8 10 1.8 1.7 0.4 0.3 0.3 

Montana 0 0 0 0 0 0.0 0.0 0.0 0.0

Nebraska 3 3 1 8 2 0.4 0.4 0.1 0.9

Nevada 3 3 2 1 1 0.3 0.3 0.2 0.1

New Hampshire 1 1 0 0 0 0.2 0.2 0.0 0.0

New Jersey 37 32 23 44 48 0.9 0.8 0.5 1.0 1.1 

New Mexico 8 3 5 6 12 0.9 0.3 0.5 0.6

New York 28 34 12 23 26 0.3 0.4 0.1 0.2 0.3 

North Carolina 347 202 234 191 115 8.9 5.1 5.7 4.7 2.8 

North Dakota 0 0 0 0 0 0.0 0.0 0.0 0.0

Ohio 72 43 26 26 27 1.2 0.7 0.4 0.4 0.5 

Oklahoma 45 77 54 28 20 2.6 4.5 3.1 1.6 1.1 

Oregon 2 5 4 2 8 0.1 0.3 0.2 0.1

Pennsylvania 31 27 30 28 22 0.5 0.4 0.5 0.4 0.3 

Rhode Island 1 1 2 0 2 0.2 0.2 0.4 0.0

South Carolina 131 117 96 101 58 6.6 5.8 4.7 4.9 2.8 

South Dakota 1 0 0 0 0 0.3 0.0 0.0 0.0

Tennessee 284 283 247 158 82 10.1 10.0 8.5 5.4 2.8 

Texas 183 182 152 169 192 1.8 1.8 1.4 1.6 1.8 

Utah 0 0 1 2 0 0.0 0.0 0.1 0.2

Vermont 1 2 0 0 0 0.3 0.7 0.0 0.0

Virginia 61 71 44 43 17 1.8 2.0 1.2 1.2 0.5 

Washington 7 3 8 7 1 0.2 0.1 0.3 0.2

West Virginia 2 3 1 1 1 0.2 0.3 0.1 0.1

Wisconsin 40 18 24 13 6 1.5 0.7 0.9 0.5 0.2 

Wyoming 0 0 1 1 0 0.0 0.0 0.4 0.4

U.S. TOTAL* 3,096 2,777 2,445 1,967 1,594 2.2 2.0 1.7 1.4 1.1 

Northeast 130 118 93 101 113 0.5 0.4 0.3 0.4 0.4 

Midwest 533 632 592 406 350 1.7 1.9 1.8 1.2 1.1 

South 2,211 1,864 1,606 1,344 988 4.5 3.8 3.1 2.6 1.9 

West 222 163 154 116 143 0.7 0.5 0.5 0.4 0.5 

Guam 

Puerto Rico 

Virgin Islands 

0

81 

1 

0

73 

1 

0

76 

2 

5

130 

0 

2 

123 

0 

0.0 

4.0 

1.7 

0.0 

3.6 

1.9 

0.0 

3.8 

3.5 

6.6

6.6 

0.0

6.2 

OUTLYING AREAS 82 74 78 135 125 3.8 3.4 3.7 6.4 5.9 

TOTAL 3,178 2,851 2,523 2,102 1,719 2.3 2.0 1.7 1.4 1.2 

0.0 

0.1 

0.2 

1.0 

0.3 

0.6 

0.3 

0.0 

0.0 

0.2 

0.1 

0.0 

1.3 

0.0 

0.5 

0.4 

0.0 

0.0 

0.0 

0.0 

0.1 

0.0 

2.6 

0.0 

*Includes cases reported by Washington, D.C. 

NOTE: Cases reported with unknown sex are not included in this table. 

STD Surveillance 2002 Syphilis Tables 111 
Table 29. Primary and secondary syphilis — Men – Reported cases and rates by state/area and region listed 

in alphabetical order: United States and outlying areas, 1998–2002 

State/Area 

Cases Rates per 100,000 Population 

1998 1999 2000 2001 2002 1998 1999 2000 2001 2002 

Alabama 141 100 60 75 86 6.8 4.8 2.8 3.5 4.0 

Alaska 1 1 0 0 0 0.3 0.3 0.0 0.0

Arizona 118 147 109 130 126 5.1 6.2 4.3 5.1 4.9 

Arkansas 49 43 46 22 16 4.0 3.5 3.5 1.7 1.2 

California 195 206 272 501 994 1.2 1.2 1.6 3.0 5.9 

Colorado 7 2 10 18 62 0.4 0.1 0.5 0.8 2.9 

Connecticut 10 10 9 10 25 0.6 0.6 0.5 0.6 1.5 

Delaware 10 9 8 9 7 2.8 2.5 2.1 2.4

Florida 178 199 250 349 509 2.5 2.7 3.2 4.5 6.5 

Georgia 203 269 243 285 340 5.5 7.1 6.0 7.1 8.4 

Hawaii 4 1 1 12 9 0.7 0.2 0.2 2.0 1.5 

Idaho 2 1 1 1 4 0.3 0.2 0.2 0.2

Illinois 238 242 231 318 398 4.1 4.1 3.8 5.2 6.5 

Indiana 102 225 155 80 44 3.6 7.8 5.2 2.7 1.5 

Iowa 5 3 5 4 4 0.4 0.2 0.3 0.3

Kansas 8 6 5 14 14 0.6 0.5 0.4 1.1 1.1 

Kentucky 57 56 43 31 45 3.0 2.9 2.2 1.6 2.3 

Louisiana 234 153 112 90 76 11.1 7.3 5.2 4.2 3.5 

Maine 1 0 1 1 2 0.2 0.0 0.2 0.2

Maryland 346 179 185 153 175 13.9 7.1 7.2 6.0 6.8 

Massachusetts 31 22 49 42 87 1.0 0.7 1.6 1.4 2.8 

Michigan 125 154 189 267 294 2.6 3.2 3.9 5.5 6.0 

Minnesota 5 5 11 17 55 0.2 0.2 0.5 0.7 2.3 

Mississippi 131 101 67 71 18 9.9 7.6 4.9 5.2 1.3 

Missouri 59 47 18 18 24 2.2 1.8 0.7 0.7 0.9 

Montana 0 1 0 0 0 0.0 0.2 0.0 0.0

Nebraska 5 3 1 2 4 0.6 0.4 0.1 0.2

Nevada 12 2 3 7 14 1.3 0.2 0.3 0.7 1.4 

New Hampshire 1 0 2 1 8 0.2 0.0 0.3 0.2

New Jersey 70 36 48 93 121 1.8 0.9 1.2 2.3 3.0 

New Mexico 6 9 11 13 27 0.7 1.1 1.2 1.5 3.0 

New York 91 116 120 281 452 1.0 1.3 1.3 3.1 4.9 

North Carolina 376 262 249 254 164 10.3 7.1 6.3 6.4 4.2 

North Dakota 0 0 0 0 0 0.0 0.0 0.0 0.0

Ohio 62 49 43 55 132 1.1 0.9 0.8 1.0 2.4 

Oklahoma 53 110 62 32 52 3.2 6.7 3.7 1.9 3.1 

Oregon 4 3 8 11 20 0.2 0.2 0.5 0.6 1.2 

Pennsylvania 67 57 47 72 83 1.2 1.0 0.8 1.2 1.4 

Rhode Island 0 2 2 9 11 0.0 0.4 0.4 1.8

South Carolina 140 152 133 134 76 7.6 8.1 6.8 6.9 3.9 

South Dakota 0 0 0 1 0 0.0 0.0 0.0 0.3

Tennessee 283 358 285 173 86 10.8 13.5 10.3 6.2 3.1 

Texas 260 289 244 309 397 2.7 2.9 2.4 3.0 3.8 

Utah 4 2 1 9 7 0.4 0.2 0.1 0.8

Vermont 3 1 0 3 2 1.0 0.3 0.0 1.0

Virginia 88 82 82 59 54 2.7 2.4 2.4 1.7 1.6 

Washington 37 74 58 50 69 1.3 2.6 2.0 1.7 2.4 

West Virginia 1 2 2 4 1 0.1 0.2 0.2 0.5

Wisconsin 38 23 24 9 24 1.5 0.9 0.9 0.3 0.9 

Wyoming 1 0 0 0 0 0.4 0.0 0.0 0.0

U.S. TOTAL* 3,909 3,835 3,532 4,134 5,267 3.0 2.9 2.6 3.0 3.8 

Northeast 274 244 278 512 791 1.1 1.0 1.1 2.0 3.1 

Midwest 647 757 682 785 993 2.1 2.5 2.2 2.5 3.1 

South 2,597 2,385 2,098 2,085 2,151 5.6 5.1 4.3 4.3 4.4 

West 391 449 474 752 1,332 1.3 1.5 1.5 2.4 4.2 

Guam 

Puerto Rico 

Virgin Islands 

0

96 

6 

2

73 

0 

1

99 

1 

7

114 

0 

4 

147 

1 

0.0 

5.2 

11.3 

2.3 

3.9 

0.0 

1.3 

5.4 

1.9 

8.8

6.2 

0.0 

8.0 

1.9 

OUTLYING AREAS 102 75 101 121 152 5.1 3.7 5.1 6.2 7.7 

TOTAL 4,011 3,910 3,633 4,255 5,419 3.0 2.9 2.6 3.0 3.9 

0.0 

1.8 

0.6 

0.3 

0.3 

0.0 

0.5 

1.3 

0.0 

2.2 

0.0 

0.6 

0.7 

0.1 

0.0 

5.1 

*Includes cases reported by Washington, D.C. 

NOTE: Cases reported with unknown sex are not included in this table. 

112 Syphilis Tables STD Surveillance 2002 
Table 30. Primary and secondary syphilis — Reported cases and rates in selected cities of >200,000 

population, ranked by rates: United States, 2002 

Rank* † City Cases Rate per 100,000 Population 

1 San Francisco, CA 315 40.6 

2 Detroit, MI 384 40.4 

3 Atlanta, GA 257 31.5 

4 Newark, NJ 63 20.9 

5 Baltimore, MD 121 18.6 

6 Oklahoma City, OK 52 12.2 

7 Chicago, IL 353 11.4 

8 Louisville, KY 77 11.1 

9 Miami, FL 231 10.3 

10 Washington, DC 58 10.1 

11 Memphis, TN 89 9.9 

12 Minneapolis, MN 37 9.6 

13 Columbus, OH 96 9.0 

14 Dallas, TX 191 8.6 

15 Boston, MA 48 8.0 

16 Denver, CO 41 7.4 

17 Fort Worth, TX 106 7.3 

18 Jersey City, NJ 16 6.7 

19 Norfolk, VA 13 5.5 

20 New York City, NY 435 5.4 

21 Phoenix, AZ 155 5.0 

22 Nashville, TN 26 4.6 

23 Philadelphia, PA 67 4.4 

24 Indianapolis, IN 36 4.2 

25 Los Angeles, CA 359 4.0 

26 Charlotte, NC 28 4.0 

27 Albuquerque, NM 21 3.8 

28 Portland, OR 20 3.8 

29 St Louis, MO 13 3.7 

30 Oakland, CA 49 3.4 

31 Houston, TX 112 3.3 

32 Tampa, FL 33 3.3 

33 Tucson, AZ 28 3.3 

34 San Antonio, TX 45 3.2 

35 Seattle, WA 50 2.9 

36 Austin, TX 22 2.7 

37 Toledo, OH 12 2.6 

38 St Petersburg, FL 22 2.4 

39 Jacksonville, FL 16 2.1 

40 New Orleans, LA 9 1.9 

41 San Jose, CA 30 1.8 

42 El Paso, TX 12 1.8 

43 Kansas City, MO 8 1.8 

44 Tulsa, OK 7 1.8 

45 St Paul, MN 5 1.8 

46 Milwaukee, WI 16 1.7 

47 Rochester, NY 4 1.6 

48 Richmond, VA 3 1.5 

49 Birmingham, AL 9 1.4 

50 San Diego, CA 37 1.3 

51 Des Moines, IA 5 1.3 

52 Honolulu, HI 10 1.1 

53 Yonkers, NY 2 1.0 

54 Sacramento, CA 11 0.9 

55 Buffalo, NY 3 0.9 

56 Cincinnati, OH 6 0.7 

57 Dayton, OH 4 0.7 

58 Wichita, KS 3 0.7 

59 Cleveland, OH 9 0.6 

60 Corpus Christi, TX 2 0.6 

61 Pittsburgh, PA 7 0.5 

62 Omaha, NE 2 0.4 

63 Akron, OH 2 0.4 

YEAR 2010 OBJECTIVE 0.2 

*Cities were ranked in descending order by rate, number of cases, and alphabetically by state. 

†

Excludes outlying areas (San Juan, PR, with 78 cases and rate of 7.6). 

STD Surveillance 2002 Syphilis Tables 113 
Table 31. Primary and secondary syphilis — Reported cases and rates in selected cities of >200,000 

population listed in alphabetical order: United States and outlying areas, 1998–2002 

City 

Cases Rates per 100,000 Population 

1998 1999 2000 2001 2002
 1998 1999 2000 2001 2002 

Akron, OH 3 0 0 1 2
 0.6 0.0 0.0 0.2

Albuquerque, NM 11 11 11 8 21 2.1 2.1 2.0 1.4 3.8 

Atlanta, GA 163 213 116 224 257 22.0 28.6 14.2 27.5 31.5 

Austin, TX 15 19 8 17 22 2.1 2.6 1.0 2.1 2.7 

Baltimore, MD 466 246 218 161 121 72.2 38.9 33.5 24.7 18.6 

Birmingham, AL 36 24 24 12 9 5.5 3.7 3.6 1.8 1.4 

Boston, MA 23 16 25 18 48 4.1 2.9 4.2 3.0 8.0 

Buffalo, NY 4 1 1 4 3 1.3 0.3 0.3 1.2

Charlotte, NC 69 53 45 29 28 10.9 8.2 6.5 4.2 4.0 

Chicago, IL 310 282 292 317 353 10.4 9.5 9.5 10.3 11.4 

Cincinnati, OH 12 1 0 2 6 1.4 0.1 0.0 0.2

Cleveland, OH 30 12 4 3 9 2.2 0.9 0.3 0.2 0.6 

Columbus, OH 55 43 40 54 96 5.4 4.2 3.7 5.1 9.0 

Corpus Christi, TX 0 1 1 1 2 0.0 0.3 0.3 0.3

Dallas, TX 126 151 100 121 191 6.1 7.3 4.5 5.5 8.6 

Dayton, OH 6 2 5 2 4 1.1 0.4 0.9 0.4

Denver, CO 3 4 4 15 41 0.6 0.8 0.7 2.7 7.4 

Des Moines, IA 3 0 1 1 5 0.8 0.0 0.3 0.3

Detroit, MI 152 189 274 351 384 12.1 15.1 28.8 36.9 40.4 

El Paso, TX 2 9 6 12 12 0.3 1.3 0.9 1.8 1.8 

Fort Worth, TX 26 22 22 40 106 1.9 1.6 1.5 2.8 7.3 

Honolulu, HI 4 3 1 10 10 0.5 0.3 0.1 1.1 1.1 

Houston, TX 99 77 70 103 112 3.1 2.4 2.1 3.0 3.3 

Indianapolis, IN 165 407 301 128 36 20.3 50.2 35.0 14.9 4.2 

Jacksonville, FL 16 7 24 38 16 2.2 0.9 3.1 4.9 2.1 

Jersey City, NJ 1 3 1 5 16 0.5 1.4 0.4 2.1

Kansas City, MO 6 8 1 5 8 1.3 1.8 0.2 1.1

Los Angeles, CA 120 83 133 186 359 1.4 1.0 1.5 2.1 4.0 

Louisville, KY 91 67 57 19 77 13.5 10.0 8.2 2.7 11.1 

Memphis, TN 260 258 246 208 89 29.9 29.6 27.4 23.2 9.9 

Miami, FL 31 82 126 185 231 1.4 3.8 5.6 8.2 10.3 

Milwaukee, WI 71 39 43 18 16 7.8 4.3 4.6 1.9 1.7 

Minneapolis, MN 4 6 9 23 37 1.1 1.6 2.3 6.0 9.6 

Nashville, TN 210 250 200 76 26 39.3 47.2 35.1 13.3 4.6 

New Orleans, LA 105 51 22 24 9 22.6 11.1 4.5 5.0 1.9 

New York City, NY 81 130 117 282 435 1.1 1.8 1.5 3.5 5.4 

Newark, NJ 27 22 28 58 63 9.5 7.8 9.3 19.3 20.9 

Norfolk, VA 33 20 37 35 13 15.3 8.9 15.8 14.9 5.5 

Oakland, CA 11 10 11 23 49 0.9 0.8 0.8 1.6 3.4 

Oklahoma City, OK 61 114 82 35 52 15.0 27.8 19.3 8.2 12.2 

Omaha, NE 4 5 2 3 2 0.9 1.1 0.4 0.6

Philadelphia, PA 89 69 67 79 67 6.2 4.9 4.4 5.2 4.4 

Phoenix, AZ 173 195 172 148 155 6.2 6.8 5.6 4.8 5.0 

Pittsburgh, PA 0 2 3 7 7 0.0 0.2 0.2 0.5

Portland, OR 4 5 11 9 20 0.8 1.0 2.1 1.7 3.8 

Richmond, VA 22 13 5 9 3 11.3 6.9 2.5 4.6 1.5 

Rochester, NY 7 0 1 2 4 2.9 0.0 0.4 0.8

Sacramento, CA 1 2 1 4 11 0.1 0.2 0.1 0.3

San Antonio, TX 26 31 67 71 45 1.9 2.3 4.8 5.1 3.2 

San Diego, CA 24 25 27 27 37 0.9 0.9 1.0 1.0 1.3 

San Francisco, CA 25 29 53 139 315 3.4 3.9 6.8 17.9 40.6 

San Jose, CA 3 3 2 10 30 0.2 0.2 0.1 0.6 1.8 

Seattle, WA 33 65 50 41 50 2.0 3.9 2.9 2.4 2.9 

St Louis, MO 58 51 11 15 13 17.1 15.3 3.2 4.3 3.7 

St Paul, MN 3 2 2 5 5 1.1 0.7 0.7 1.8

St Petersburg, FL 8 4 7 11 22 0.9 0.5 0.8 1.2 2.4 

Tampa, FL 32 15 20 15 33 3.5 1.6 2.0 1.5 3.3 

Toledo, OH 8 6 2 1 12 1.8 1.3 0.4 0.2

Tucson, AZ 7 8 8 22 28 0.9 1.0 0.9 2.6 3.3 

Tulsa, OK 14 45 8 5 7 3.7 11.7 2.0 1.3 1.8 

Washington, DC 81 45 37 43 58 15.5 8.7 6.5 7.5 10.1 

Wichita, KS 3 7 2 4 3 0.7 1.5 0.4 0.9

Yonkers, NY 1 1 1 1 2 0.5 0.5 0.5 0.5

U.S. CITY TOTAL 3,537 3,564 3,265 3,525 4,303 5.0 5.0 4.4 4.8 5.8 

San Juan, PR 79 61 68 68 78 7.5 5.8 6.7 6.7 7.6 

TOTAL 3,616 3,625 3,333 3,593 4,381 5.1 5.0 4.5 4.8 5.9 

0.6 

0.7 

6.7 

0.5 

0.4 

0.9 

0.7 

1.3 

1.8 

0.4 

1.6 

0.9 

1.8 

2.6 

0.7 

1.0 

114 Syphilis Tables STD Surveillance 2002 
Table 32. Primary and secondary syphilis — Women – Reported cases and rates in selected cities of >200,000 

population listed in alphabetical order: United States and outlying areas, 1998–2002 

City 

Cases Rates per 100,000 Population 

1998 1999 2000 2001 2002
 1998 1999 2000 2001 2002 

Akron, OH 1 0 0 0 0
 0.4 0.0 0.0 0.0

Albuquerque, NM 6 3 3 1 6 2.2 1.1 1.1 0.4

Atlanta, GA 62 85 37 67 57 16.0 21.8 8.9 16.2 13.8 

Austin, TX 6 2 2 3 3 1.7 0.5 0.5 0.8

Baltimore, MD 222 112 92 77 33 64.4 33.2 26.5 22.2 9.5 

Birmingham, AL 15 10 15 8 4 4.3 2.9 4.3 2.3 1.1 

Boston, MA 5 5 5 1 6 1.7 1.7 1.6 0.3

Buffalo, NY 1 0 1 0 0 0.6 0.0 0.6 0.0

Charlotte, NC 36 18 24 12 13 11.0 5.3 6.8 3.4 3.7 

Chicago, IL 119 116 129 61 43 7.7 7.5 8.1 3.8 2.7 

Cincinnati, OH 8 0 0 2 2 1.8 0.0 0.0 0.5

Cleveland, OH 15 3 2 2 3 2.1 0.4 0.3 0.3

Columbus, OH 32 21 14 17 10 6.0 3.9 2.5 3.1 1.8 

Corpus Christi, TX 0 1 1 1 1 0.0 0.6 0.6 0.6

Dallas, TX 46 57 36 49 76 4.4 5.4 3.2 4.4 6.8 

Dayton, OH 3 0 1 1 0 1.0 0.0 0.3 0.3

Denver, CO 2 3 0 2 0 0.8 1.2 0.0 0.7

Des Moines, IA 0 0 1 0 2 0.0 0.0 0.5 0.0

Detroit, MI 67 74 121 136 168 10.1 11.2 24.1 27.0 33.4 

El Paso, TX 0 2 1 2 4 0.0 0.5 0.3 0.6

Fort Worth, TX 9 4 7 16 45 1.3 0.6 1.0 2.2 6.2 

Honolulu, HI 0 2 0 0 1 0.0 0.5 0.0 0.0

Houston, TX 44 30 27 28 16 2.7 1.8 1.6 1.6 0.9 

Indianapolis, IN 87 204 170 60 10 20.4 48.0 38.2 13.5 2.2 

Jacksonville, FL 8 3 11 18 8 2.1 0.8 2.7 4.5 2.0 

Jersey City, NJ 0 0 1 2 1 0.0 0.0 0.8 1.6

Kansas City, MO 2 5 0 2 1 0.8 2.1 0.0 0.9

Los Angeles, CA 50 25 19 9 18 1.1 0.6 0.4 0.2 0.4 

Louisville, KY 45 30 26 9 39 12.7 8.4 7.2 2.5 10.8 

Memphis, TN 134 126 123 106 51 29.4 27.5 26.2 22.6 10.9 

Miami, FL 11 24 40 40 33 1.0 2.1 3.4 3.4 2.8 

Milwaukee, WI 35 17 21 12 4 7.3 3.6 4.3 2.5 0.8 

Minneapolis, MN 2 3 3 12 2 1.1 1.6 1.5 6.2 1.0 

Nashville, TN 93 102 83 29 10 33.1 36.6 28.2 9.9 3.4 

New Orleans, LA 41 24 8 11 3 16.4 9.7 3.1 4.3 1.2 

New York City, NY 18 28 10 19 18 0.5 0.7 0.2 0.5 0.4 

Newark, NJ 14 10 9 21 26 9.4 6.7 5.7 13.3 16.5 

Norfolk, VA 13 7 14 20 4 11.9 6.4 12.2 17.5 3.5 

Oakland, CA 5 2 3 1 0 0.8 0.3 0.4 0.1

Oklahoma City, OK 26 42 39 18 10 12.3 19.7 17.8 8.2 4.6 

Omaha, NE 1 2 1 1 1 0.4 0.9 0.4 0.4

Philadelphia, PA 30 21 25 24 14 3.9 2.8 3.1 3.0 1.7 

Phoenix, AZ 64 62 75 39 59 4.5 4.3 4.9 2.5 3.8 

Pittsburgh, PA 0 0 2 1 2 0.0 0.0 0.3 0.1

Portland, OR 1 3 4 1 5 0.4 1.2 1.5 0.4

Richmond, VA 8 7 2 3 1 7.5 6.7 1.9 2.8

Rochester, NY 4 0 0 1 1 3.2 0.0 0.0 0.8

Sacramento, CA 0 1 1 1 0 0.0 0.2 0.2 0.2

San Antonio, TX 8 10 23 24 12 1.1 1.4 3.2 3.4 1.7 

San Diego, CA 7 6 6 6 6 0.5 0.4 0.4 0.4

San Francisco, CA 4 1 5 2 4 1.1 0.3 1.3 0.5

San Jose, CA 1 0 0 1 1 0.1 0.0 0.0 0.1

Seattle, WA 1 2 4 1 0 0.1 0.2 0.5 0.1

St Louis, MO 25 28 3 6 4 13.6 15.5 1.6 3.2 2.2 

St Paul, MN 2 1 1 1 0 1.4 0.7 0.7 0.7

St Petersburg, FL 4 2 3 2 2 0.9 0.4 0.6 0.4

Tampa, FL 20 7 10 6 8 4.2 1.4 2.0 1.2 1.6 

Toledo, OH 4 5 0 0 4 1.7 2.1 0.0 0.0

Tucson, AZ 1 1 2 5 7 0.2 0.2 0.5 1.2

Tulsa, OK 6 22 4 1 5 3.0 11.1 2.0 0.5 2.5 

Washington, DC 34 24 10 8 9 12.2 8.7 3.3 2.6 3.0 

Wichita, KS 1 4 1 1 1 0.4 1.7 0.4 0.4

Yonkers, NY 1 0 0 0 1 1.0 0.0 0.0 0.0

U.S. CITY TOTAL* 1,510 1,409 1,281 1,010 878 4.1 3.8 3.4 2.7 2.3 

San Juan, PR 38 34 32 38 31 7.0 6.2 6.0 7.2 5.8 

TOTAL 1,548 1,443 1,313 1,048 909 4.2 3.9 3.4 2.7 2.4 

2.1 

0.6 

0.0 

0.8 

0.3 

0.4 

0.4 

0.0 

0.8 

1.9 

0.0 

0.5 

0.4 

0.0 

1.0 

1.1 

0.2 

0.4 

0.0 

0.4 

1.9 

0.9 

0.8 

0.0 

1.0 

0.1 

0.0 

0.0 

1.7 

1.6 

0.4 

1.0 

*Cases reported with unknown sex are not included in this table. 

STD Surveillance 2002 Syphilis Tables 115 
Table 33. Primary and secondary syphilis — Men – Reported cases and rates in selected cities of >200,000 

population listed in alphabetical order: United States and outlying areas, 1998–2002 

City 

Cases Rates per 100,000 Population 

1998 1999 2000 2001 2002
 1998 1999 2000 2001 2002 

Akron, OH 2 0 0 1 2
 0.8 0.0 0.0 0.4

Albuquerque, NM 5 8 8 7 15 2.0 3.1 2.9 2.6

Atlanta, GA 101 128 79 157 199 28.6 36.0 19.7 39.1 49.5 

Austin, TX 9 16 6 14 19 2.5 4.4 1.4 3.4 4.6 

Baltimore, MD 244 134 126 84 88 81.0 45.4 41.5 27.7 29.0 

Birmingham, AL 21 14 9 4 5 6.8 4.6 2.9 1.3 1.6 

Boston, MA 18 11 20 17 42 6.7 4.1 6.9 5.9 14.6 

Buffalo, NY 3 1 0 4 3 2.0 0.7 0.0 2.6

Charlotte, NC 33 35 21 17 15 10.9 11.2 6.2 5.0 4.4 

Chicago, IL 191 166 163 256 310 13.3 11.6 10.9 17.1 20.7 

Cincinnati, OH 4 1 0 0 4 1.0 0.3 0.0 0.0

Cleveland, OH 15 9 2 1 6 2.3 1.4 0.3 0.2

Columbus, OH 23 22 26 37 86 4.7 4.4 5.0 7.1 16.6 

Corpus Christi, TX 0 0 0 0 1 0.0 0.0 0.0 0.0

Dallas, TX 80 94 64 72 115 7.9 9.3 5.8 6.5 10.4 

Dayton, OH 3 2 4 1 4 1.1 0.7 1.5 0.4

Denver, CO 1 1 4 13 41 0.4 0.4 1.4 4.6 14.6 

Des Moines, IA 3 0 0 1 3 1.7 0.0 0.0 0.6

Detroit, MI 85 115 153 215 216 14.2 19.4 34.1 48.0 48.2 

El Paso, TX 2 7 5 10 8 0.6 2.1 1.5 3.1 2.4 

Fort Worth, TX 17 18 15 24 61 2.5 2.6 2.1 3.4 8.5 

Honolulu, HI 4 1 1 10 9 0.9 0.2 0.2 2.3 2.0 

Houston, TX 55 47 43 75 96 3.5 2.9 2.5 4.4 5.7 

Indianapolis, IN 78 203 131 68 26 20.2 52.7 31.5 16.3 6.3 

Jacksonville, FL 8 4 13 20 8 2.2 1.1 3.4 5.3 2.1 

Jersey City, NJ 1 3 0 3 15 0.9 2.8 0.0 2.5 12.7 

Kansas City, MO 4 3 1 3 7 1.9 1.4 0.5 1.4

Los Angeles, CA 70 57 112 175 341 1.6 1.3 2.5 4.0 7.7 

Louisville, KY 46 37 31 10 38 14.5 11.6 9.3 3.0 11.5 

Memphis, TN 126 132 123 102 38 30.5 31.8 28.7 23.8 8.9 

Miami, FL 20 58 86 145 198 1.9 5.6 7.9 13.3 18.2 

Milwaukee, WI 36 22 22 6 12 8.3 5.1 4.9 1.3 2.7 

Minneapolis, MN 2 3 6 11 35 1.1 1.7 3.2 5.8 18.5 

Nashville, TN 117 148 117 47 16 46.2 58.9 42.4 17.0 5.8 

New Orleans, LA 64 27 14 13 6 29.7 12.6 6.2 5.7 2.6 

New York City, NY 63 102 107 263 417 1.8 2.9 2.8 6.9 11.0 

Newark, NJ 13 12 19 37 37 9.7 8.9 13.3 25.9 25.9 

Norfolk, VA 20 13 23 15 9 18.9 11.2 19.2 12.5 7.5 

Oakland, CA 6 8 8 22 49 1.0 1.3 1.1 3.1 6.9 

Oklahoma City, OK 35 72 43 17 42 17.9 36.6 20.8 8.2 20.4 

Omaha, NE 3 3 1 2 1 1.4 1.4 0.4 0.9

Philadelphia, PA 59 48 42 55 53 8.9 7.3 6.0 7.8 7.5 

Phoenix, AZ 109 133 97 109 96 7.9 9.4 6.3 7.1 6.2 

Pittsburgh, PA 0 2 1 6 5 0.0 0.3 0.2 1.0

Portland, OR 3 2 7 8 15 1.2 0.8 2.7 3.1

Richmond, VA 14 6 3 6 2 16.0 7.0 3.3 6.5 2.2 

Rochester, NY 3 0 1 1 3 2.6 0.0 0.8 0.8

Sacramento, CA 1 1 0 3 11 0.2 0.2 0.0 0.5

San Antonio, TX 18 20 44 47 33 2.8 3.0 6.5 6.9 4.9 

San Diego, CA 17 19 21 21 31 1.2 1.3 1.5 1.5 2.2 

San Francisco, CA 21 28 48 137 311 5.7 7.6 12.2 34.7 78.8 

San Jose, CA 2 3 2 9 29 0.2 0.4 0.2 1.1

Seattle, WA 32 63 46 40 50 3.9 7.7 5.3 4.6 5.8 

St Louis, MO 33 23 8 9 9 21.2 15.0 4.9 5.5 5.5 

St Paul, MN 1 1 1 4 5 0.8 0.8 0.7 2.9

St Petersburg, FL 4 2 4 9 20 1.0 0.5 0.9 2.1

Tampa, FL 12 8 10 9 25 2.7 1.7 2.0 1.8 5.1 

Toledo, OH 4 1 2 1 8 1.9 0.5 0.9 0.5

Tucson, AZ 6 7 6 17 21 1.6 1.8 1.5 4.1 5.1 

Tulsa, OK 8 23 4 4 2 4.4 12.4 2.1 2.1 1.0 

Washington, DC 47 21 27 35 49 19.2 8.6 10.0 13.0 18.2 

Wichita, KS 2 3 1 3 2 0.9 1.4 0.4 1.3

Yonkers, NY 0 1 1 1 1 0.0 1.1 1.1 1.1

U.S. CITY TOTAL* 2,027 2,152 1,982 2,513 3,424 5.9 6.3 5.5 7.0 9.5 

San Juan, PR 41 27 36 30 47 8.2 5.3 7.4 6.1 9.6 

TOTAL 2,068 2,179 2,018 2,543 3,471 6.0 6.2 5.5 7.0 9.5 

5.5 

0.7 

1.5 

0.8 

4.6 

0.8 

1.9 

1.0 

0.9 

1.7 

3.2 

0.4 

5.8 

2.5 

1.8 

3.4 

3.6 

3.7 

0.9 

1.1 

*Cases reported with unknown sex are not included in this table. 

116 Syphilis Tables STD Surveillance 2002 
Table 34. Primary and secondary syphilis — Reported cases and rates per 100,000 population by age and sex: 

United States, 1998–2002 

Year Age 

Group 

Cases Rates 

Total Male Female Total Male Female 

10-14 39 5 34 0.2 0.1 0.4 

15-19 612 193 418 3.1 1.9 4.4 

1998 

20-24 

25-29 

30-34 

35-39 

40-44 

1,030 

1,029 

1,179 

1,178 

831 

509 

508 

626 

683 

533 

521 

521 

553 

494 

298 

5.8 

5.5 

5.8 

5.2 

3.8 

5.7 

5.5 

6.3 

6.1 

4.9 

6.0 

5.6 

5.4 

4.3 

2.7 

45-54 780 577 203 2.3 3.4 1.1 

55-64 232 194 37 1.0 1.8 0.3 

65+ 102 86 16 0.3 0.6 0.1 

TOTAL 7,018 3,918 3,100 2.6 3.0 2.2 

10-14 25 2 23 0.1 0.0 0.2 

15-19 522 183 340 2.6 1.8 3.5 

20-24 963 510 452 5.3 5.6 5.1 

25-29 992 508 483 5.4 5.6 5.3 

1999 

30-34 

35-39 

40-44 

1,084 

1,153 

808 

589 

676 

537 

495 

477 

271 

5.5 

5.1 

3.6 

6.0 

6.0 

4.9 

5.0 

4.2 

2.4 

45-54 753 572 181 2.1 3.3 1.0 

55-64 228 188 40 1.0 1.7 0.3 

65+ 74 65 9 0.2 0.5 0.0 

TOTAL 6,613 3,833 2,780 2.4 2.9 2.0 

10-14 23 4 19 0.1 0.0 0.2 

15-19 457 162 295 2.3 1.6 3.0 

20-24 881 419 462 4.6 4.3 5.0 

25-29 902 527 376 4.7 5.4 3.9 

30-34 957 553 404 4.7 5.4 4.0 

2000 35-39 

40-44 

1,006 

782 

606 

502 

400 

280 

4.4 

3.5 

5.3 

4.5 

3.5 

2.5 

45-54 706 528 178 1.9 2.9 0.9 

55-64 179 157 22 0.7 1.3 0.2 

65+ 76 68 8 0.2 0.5 0.0 

TOTAL 5,973 3,528 2,445 2.1 2.6 1.7 

10-14 19 2 17 0.1 0.0 0.2 

15-19 387 142 245 1.9 1.4 2.5 

20-24 836 482 354 4.4 5.0 3.8 

25-29 876 583 293 4.5 5.9 3.1 

30-34 964 660 304 4.7 6.4 3.0 

2001 35-39 

40-44 

1,146 

808 

818 

587 

328 

221 

5.0 

3.6 

7.2 

5.3 

2.9 

2.0 

45-54 805 632 173 2.1 3.4 0.9 

55-64 193 167 26 0.8 1.4 0.2 

65+ 64 57 7 0.2 0.4 0.0 

TOTAL 6,100 4,132 1,968 2.2 3.0 1.4 

10-14 15 4 11 0.1 0.0 0.1 

15-19 351 135 216 1.7 1.3 2.2 

20-24 842 533 309 4.4 5.5 3.3 

25-29 895 668 227 4.6 6.8 2.4 

2002 

30-34 

35-39 

40-44 

45-54 

1,097 

1,367 

1,023 

982 

877 

1,121 

845 

825 

220 

246 

178 

157 

5.4 

6.0 

4.6 

2.6 

8.5 

9.9 

7.6 

4.5 

2.2 

2.2 

1.6 

0.8 

55-64 217 196 21 0.9 1.7 0.2 

65+ 67 59 8 0.2 0.4 0.0 

TOTAL 6,862 5,268 1,594 2.4 3.8 1.1 

NOTE: This table should be used only for age comparisons. If age was not specified, cases were prorated according to the distribution of cases for 

which age was known. Differences between total cases from this table and others in the report are due to different reporting forms. The 0 to 9 year 

age group is not shown because some of these may not be due to sexual transmission; however, they are included in the totals. 

STD Surveillance 2002 Syphilis Tables 117 
Table 35A. Primary and secondary syphilis — Reported cases by age, sex, and race/ethnicity: United States, 

1998–2002 

Age 

Group Total 

Total 

Male Female 

White, Non-Hispanic 

Total Male Female 

Black, Non-Hispanic 

Total Male Female Total 

Hispanic 

Male Female 

Asian/Pacific Islander 

Total Male Female 

American Indian/ 

Alaska Native 

Total Male Female 

10-14 39 5 34 4 0 4 34 5 29 1 0 1 0 0 0 0 0 0 

15-19 612 193 418 54 11 43 504 163 342 43 16 27 3 0 3 7 3 4 

20-24 1,029 509 521 105 30 75 835 418 417 73 52 21 5 3 2 11 6 5 

199825-29 

30-34 

35-39 

1,028 

1,179 

1,178 

508 

626 

683 

520 

553 

494 

130 50 79 

146 77 69 

172 104 68 

782 383 398 

949 484 465 

927 523 404 

100 

65 

65 

65 

54 

46 

35 

11 

18 

5 4 1 

9 7 2 

7 6 1 

12 5 7 

9 4 5 

7 4 3 

40-44 831 533 298 129 95 35 653 404 250 40 30 10 3 2 1 5 3 2 

45-54 780 577 203 123 102 20 610 439 171 45 35 10 1 1 0 1 0 1 

55-64 232 194 37 51 48 3 161 129 32 16 14 2 2 2 0 2 2 0 

65+ 102 86 16 21 18 3 71 60 11 9 7 2 0 0 0 1 1 0 

TOTAL 7,018 3,918 3,100 936 536 400 5,534 3,009 2,524 457 319 138 36 26 10 56 29 28 

10-14 25 2 23 3 1 2 21 1 20 1 0 1 0 0 0 0 0 0 

15-19 522 182 340 49 16 32 421 139 282 44 24 19 1 1 0 8 2 6 

20-24 963 510 452 120 46 74 717 381 336 110 75 35 5 3 2 10 5 5 

199925-29 

30-34 

35-39 

991 

1,084 

1,153 

508 

589 

677 

482 

496 

476 

137 67 70 

168 98 70 

189 112 77 

741 364 376 

801 411 390 

883 501 382 

94 

97 

69 

67 

73 

56 

26 

24 

12 

7 7 0 

12 6 6 

4 4 0 

11 2 9 

6 1 5 

8 3 5 

40-44 808 538 271 142 98 44 601 390 211 56 46 9 8 3 4 2 0 2 

45-54 753 572 181 139 96 43 561 430 130 42 36 6 5 5 0 6 4 2 

55-64 228 188 40 53 41 12 151 129 22 22 16 5 1 0 1 1 1 0 

65+ 74 65 9 24 22 2 46 39 7 4 4 0 0 0 0 0 0 0 

TOTAL 6,612 3,833 2,779 1,026 598 428 4,950 2,788 2,163 538 399 139 43 30 13 54 18 36 

10-14 23 4 19 2 0 2 20 4 16 0 0 0 0 0 0 1 0 1 

15-19 457 162 295 47 11 35 365 129 236 41 21 19 1 0 1 4 1 3 

20-24 881 419 462 110 40 70 653 310 344 101 66 35 4 1 3 13 3 10 

200025-29 

30-34 

35-39 

902 

957 

1,006 

527 

553 

606 

376 

404 

400 

146 93 53 

182 119 62 

216 143 72 

631 338 293 

665 350 314 

664 374 291 

108 

94 

113 

82 

72 

81 

27 

22 

32 

8 7 1 

12 10 2 

5 4 1 

9 7 2 

5 2 3 

7 3 4 

40-44 782 502 280 173 118 55 550 341 209 51 38 13 2 2 0 5 3 2 

45-54 706 528 178 145 114 31 511 375 136 43 32 11 4 4 0 4 4 0 

55-64 179 157 22 42 40 2 124 106 18 11 10 1 0 0 0 2 1 1 

65+ 76 68 8 21 19 2 50 44 6 3 3 0 1 1 0 1 1 0 

TOTAL 5,972 3,527 2,445 1,083 698 385 4,233 2,369 1,864 567 405 162 37 29 8 52 26 26 

10-14 19 2 17 0 0 0 17 1 16 2 1 1 0 0 0 0 0 0 

15-19 387 142 245 32 13 19 290 97 193 59 29 29 2 1 1 4 2 2 

20-24 836 482 354 114 72 42 562 296 266 138 105 34 6 5 1 15 4 11 

2001

25-29 

30-34 

35-39 

876 

964 

1,146 

583 

660 

818 

293 

304 

328 

152 121 31 

236 192 44 

332 281 51 

554 323 231 

563 330 233 

653 397 255 

140 

137 

134 

115 

117 

120 

26 

20 

13 

13 13 0 

12 12 0 

15 14 1 

18 11 6 

17 9 7 

13 5 7 

40-44 808 587 221 227 193 34 505 335 170 59 48 11 2 2 0 15 10 5 

45-54 805 632 173 220 196 24 513 377 137 61 52 9 4 3 1 6 4 2 

55-64 193 167 26 51 48 3 121 100 21 18 16 2 2 2 0 2 2 0 

65+ 64 57 7 23 22 1 36 30 6 4 4 0 0 0 0 1 1 0 

TOTAL 6,100 4,132 1,968 1,387 1,138 249 3,813 2,286 1,527 754 607 146 55 51 4 90 49 41 

10-14 15 4 11 2 1 1 10 2 8 2 1 1 1 0 1 0 0 0 

15-19 351 135 216 33 9 24 253 89 164 62 37 25 2 0 2 1 0 1 

20-24 842 533 309 129 89 40 546 313 233 146 117 29 13 9 4 8 5 3 

200225-29 

30-34 

35-39 

895 

1,097 

1,367 

668 

877 

1,121 

227 

220 

246 

224 189 36 

404 373 31 

576 541 35 

485 323 163 

476 310 166 

568 385 183 

165 

192 

200 

138 

172 

178 

26 

20 

22 

17 16 1 

22 21 1 

15 14 1 

4 3 1 

3 1 2 

8 3 5 

40-44 1,023 845 178 452 429 23 448 305 142 102 93 8 15 14 1 7 4 3 

45-54 982 825 157 393 370 23 482 370 112 83 69 15 8 8 0 16 8 7 

55-64 217 196 21 95 91 4 110 94 16 10 10 0 0 0 0 2 1 1 

65+ 67 59 8 15 15 0 42 35 7 9 8 1 0 0 0 1 1 0 

TOTAL 6,862 5,268 1,594 2,325 2,108 217 3,421 2,226 1,195 971 823 147 94 83 11 51 27 24 

NOTE: These tables should be used only for race/ethnicity comparisons, not for age, sex, or overall totals. If age or race/ethnicity was not specified, cases 

were prorated according to the distribution of cases for which these variables were specified. For 1998, ID and NJ did not report age and/or race/ethnicity 

for most cases and were excluded. Cases and population denominators have been excluded for these states/areas. Differences between total cases from 

this table and others in the report are due to different reporting forms and above listed exclusions. The 0 to 9 year age group is not shown because some 

of these may not be due to sexual transmission; however, they are included in the totals. 

118 Syphilis Tables STD Surveillance 2002 
Table 35B. Primary and secondary syphilis — Rates per 100,000 population by age, sex, and race/ethnicity: United 

States, 1998–2002 

Age 

Group Total 

Total 

Male Female 

White, Non-Hispanic 

Total Male Female 

Black, Non-Hispanic 

Total Male Female Total 

Hispanic 

Male Female 

Asian/Pacific Islander 

Total Male Female 

American Indian/ 

Alaska Native 

Total Male Female 

10-14 0.2 0.1 0.4 0.0 0.0 0.1 1.2 0.3 2.1 0.0 0.0 0.1 0.0 0.0 0.0 0.0 0.0 0.0 

15-19 3.1 1.9 4.4 0.4 0.2 0.7 17.5 11.2 24.1 1.6 1.2 2.0 0.4 0.0 0.8 3.7 3.2 4.3 

20-24 5.8 5.7 6.0 0.9 0.5 1.3 33.4 33.9 33.0 2.8 3.8 1.7 0.7 0.9 0.6 7.1 7.7 6.5 

25-29 

30-34 

35-39 

5.5 

5.8 

5.2 

5.5 

6.3 

6.1 

5.6 

5.4 

4.3 

1.0 0.8 1.3 

1.0 1.1 1.0 

1.1 1.3 0.8 

31.4 32.3 30.6 

36.9 40.3 33.9 

33.9 40.9 27.7 

3.9 

2.5 

2.6 

5.0 

3.9 

3.6 

2.8 

0.9 

1.5 

0.6 1.0 0.2 

1.1 1.8 0.4 

0.8 1.5 0.2 

7.7 6.3 9.1 

1998

6.2 5.5 6.9 

4.6 5.3 3.9 

40-44 3.8 4.9 2.7 0.8 1.2 0.4 25.6 34.0 18.3 1.9 2.9 1.0 0.4 0.5 0.2 3.5 4.4 2.7 

45-54 2.3 3.4 1.1 0.5 0.8 0.2 17.0 27.2 8.7 1.6 2.6 0.7 0.1 0.2 0.0 0.5 0.0 0.9 

55-64 1.0 1.8 0.3 0.3 0.5 0.0 7.3 13.6 2.6 1.0 1.9 0.2 0.3 0.6 0.0 1.6 3.3 0.0 

65+ 0.3 0.6 0.1 0.1 0.1 0.0 2.6 5.6 0.7 0.5 1.0 0.2 0.0 0.0 0.0 0.7 1.7 0.0 

TOTAL 2.6 3.0 2.2 0.5 0.6 0.4 16.9 19.4 14.6 1.5 2.1 0.9 0.4 0.5 0.2 2.8 2.9 2.7 

10-14 0.1 0.0 0.2 0.0 0.0 0.0 0.7 0.1 1.4 0.0 0.0 0.1 0.0 0.0 0.0 0.0 0.0 0.0 

15-19 2.7 1.8 3.6 0.4 0.2 0.5 14.6 9.4 19.8 1.6 1.7 1.4 0.1 0.3 0.0 4.2 2.1 6.4 

20-24 5.4 5.6 5.1 1.0 0.8 1.3 28.0 30.2 26.0 4.1 5.4 2.7 0.7 0.9 0.6 6.5 6.4 6.6 

25-29 

30-34 

35-39 

5.5 

5.5 

5.1 

5.6 

6.1 

6.1 

5.3 

5.0 

4.2 

1.1 1.1 1.2 

1.2 1.5 1.0 

1.2 1.4 1.0 

29.9 30.9 29.1 

31.8 34.9 29.1 

32.2 39.0 26.1 

3.6 

3.6 

2.7 

5.1 

5.3 

4.2 

2.1 

1.9 

1.0 

0.9 1.9 0.0 

1.3 1.5 1.2 

0.5 1.0 0.0 

7.2 2.5 12.0 

1999

4.3 1.4 7.1 

5.3 4.0 6.7 

40-44 3.6 4.9 2.4 0.9 1.2 0.5 23.0 31.9 15.1 2.6 4.2 0.9 0.9 0.8 1.0 1.4 0.0 2.8 

45-54 2.1 3.3 1.0 0.5 0.7 0.3 14.9 25.3 6.3 1.4 2.5 0.4 0.4 0.8 0.0 2.8 3.8 1.8 

55-64 1.0 1.7 0.3 0.3 0.5 0.1 6.7 13.3 1.7 1.3 2.1 0.6 0.2 0.0 0.3 0.8 1.6 0.0 

65+ 0.2 0.5 0.0 0.1 0.2 0.0 1.7 3.6 0.4 0.2 0.5 0.0 0.0 0.0 0.0 0.0 0.0 0.0 

TOTAL 2.4 2.9 2.0 0.5 0.6 0.4 15.0 17.8 12.4 1.7 2.5 0.9 0.4 0.6 0.3 2.7 1.9 3.5 

10-14 0.1 0.0 0.2 0.0 0.0 0.0 0.6 0.3 1.0 0.0 0.0 0.0 0.0 0.0 0.0 0.5 0.0 1.0 

15-19 2.3 1.6 3.0 0.4 0.2 0.6 12.4 8.7 16.2 1.3 1.3 1.3 0.1 0.0 0.3 2.0 1.0 3.1 

20-24 4.6 4.3 5.0 0.9 0.7 1.2 24.8 24.2 25.4 3.0 3.5 2.3 0.5 0.2 0.7 8.0 3.7 12.4 

25-29 

30-34 

35-39 

4.7 

4.7 

4.4 

5.4 

5.4 

5.3 

3.9 

4.0 

3.5 

1.2 1.5 0.9 

1.3 1.7 0.9 

1.4 1.8 0.9 

24.8 27.9 21.9 

25.4 28.3 22.8 

23.5 28.1 19.4 

3.2 

3.0 

4.0 

4.5 

4.3 

5.5 

1.7 

1.5 

2.3 

0.8 1.4 0.2 

1.1 1.9 0.4 

0.5 0.9 0.2 

6.0 9.3 2.6 

2000

3.3 2.7 3.9 

4.2 3.7 4.6 

40-44 3.5 4.5 2.5 1.1 1.4 0.7 20.4 26.9 14.6 2.2 3.2 1.2 0.2 0.5 0.0 3.1 3.9 2.4 

45-54 1.9 2.9 0.9 0.5 0.8 0.2 12.5 19.9 6.2 1.4 2.1 0.7 0.3 0.6 0.0 1.6 3.3 0.0 

55-64 0.7 1.3 0.2 0.2 0.4 0.0 5.2 10.0 1.4 0.6 1.3 0.1 0.0 0.0 0.0 1.4 1.4 1.3 

65+ 0.2 0.5 0.0 0.1 0.2 0.0 1.8 4.1 0.3 0.2 0.4 0.0 0.1 0.3 0.0 0.8 1.9 0.0 

TOTAL 2.1 2.6 1.7 0.5 0.7 0.4 12.2 14.4 10.2 1.6 2.2 0.9 0.3 0.5 0.1 2.4 2.4 2.4 

10-14 0.1 0.0 0.2 0.0 0.0 0.0 0.5 0.1 1.0 0.1 0.1 0.1 0.0 0.0 0.0 0.0 0.0 0.0 

15-19 1.9 1.4 2.5 0.2 0.2 0.3 9.9 6.5 13.3 1.8 1.7 2.0 0.3 0.3 0.3 2.1 2.1 2.1 

20-24 4.4 5.0 3.8 1.0 1.2 0.7 21.4 23.1 19.7 4.1 5.6 2.2 0.7 1.1 0.2 9.3 4.9 13.9 

25-29 

30-34 

35-39 

4.5 

4.7 

5.0 

5.9 

6.4 

7.2 

3.1 

3.0 

2.9 

1.2 2.0 0.5 

1.7 2.8 0.6 

2.1 3.5 0.6 

21.7 26.7 17.3 

21.5 26.6 16.9 

23.1 29.9 17.0 

4.1 

4.4 

4.7 

6.3 

7.0 

8.2 

1.6 

1.4 

1.0 

1.2 2.4 0.0 

1.1 2.4 0.0 

1.5 3.0 0.2 

11.4 14.8 8.0 

2001

10.7 12.2 9.2 

7.3 6.3 8.1 

40-44 3.6 5.3 2.0 1.4 2.4 0.4 18.7 26.4 11.9 2.6 4.0 1.0 0.2 0.5 0.0 8.9 12.0 6.1 

45-54 2.1 3.4 0.9 0.8 1.4 0.2 12.6 20.0 6.2 2.0 3.3 0.6 0.3 0.5 0.1 2.4 3.4 1.6 

55-64 0.8 1.4 0.2 0.3 0.5 0.0 5.1 9.4 1.6 1.0 1.9 0.2 0.3 0.5 0.0 1.4 3.0 0.0 

65+ 0.2 0.4 0.0 0.1 0.2 0.0 1.3 2.8 0.3 0.2 0.6 0.0 0.0 0.0 0.0 0.8 1.8 0.0 

TOTAL 2.2 3.0 1.4 0.7 1.2 0.2 11.0 13.8 8.4 2.1 3.3 0.9 0.5 1.0 0.1 4.2 4.7 3.8 

10-14 0.1 0.0 0.1 0.0 0.0 0.0 0.3 0.1 0.5 0.1 0.1 0.1 0.1 0.0 0.3 0.0 0.0 0.0 

15-19 1.7 1.3 2.2 0.3 0.1 0.4 8.6 6.0 11.3 1.9 2.2 1.7 0.2 0.0 0.5 0.5 0.0 1.0 

20-24 4.4 5.5 3.3 1.1 1.5 0.7 20.7 24.4 17.2 4.3 6.2 1.9 1.5 2.1 0.9 5.0 6.2 3.8 

25-29 

30-34 

35-39 

4.6 

5.4 

6.0 

6.8 

8.5 

9.9 

2.4 

2.2 

2.2 

1.8 3.1 0.6 

3.0 5.5 0.5 

3.6 6.8 0.4 

19.1 26.6 12.2 

18.2 25.0 12.0 

20.1 29.0 12.2 

4.9 

6.1 

7.1 

7.6 

10.3 

12.1 

1.7 

1.4 

1.7 

1.6 3.1 0.2 

2.2 4.2 0.2 

1.6 3.0 0.2 

2.7 4.1 1.3 

2002

2.0 1.4 2.7 

4.8 3.9 5.8 

40-44 4.6 7.6 1.6 2.8 5.2 0.3 16.6 24.1 9.9 4.4 7.9 0.7 1.6 3.2 0.2 4.5 5.3 3.7 

45-54 2.6 4.5 0.8 1.4 2.6 0.2 11.8 19.6 5.1 2.7 4.4 0.9 0.6 1.3 0.0 6.1 6.8 5.5 

55-64 0.9 1.7 0.2 0.5 1.0 0.0 4.6 8.9 1.2 0.6 1.3 0.0 0.0 0.0 0.0 1.4 1.5 1.3 

65+ 0.2 0.4 0.0 0.1 0.1 0.0 1.5 3.2 0.4 0.5 1.2 0.1 0.0 0.0 0.0 0.8 1.9 0.0 

TOTAL 2.4 3.8 1.1 1.2 2.2 0.2 9.8 13.5 6.5 2.7 4.5 0.9 0.9 1.6 0.2 2.4 2.6 2.2 

NOTE: These tables should be used only for race/ethnicity comparisons, not for age, sex, or overall totals. If age or race/ethnicity was not specified, cases 

were prorated according to the distribution of cases for which these variables were specified. For 1998, ID and NJ did not report age and/or race/ethnicity 

for most cases and were excluded. Cases and population denominators have been excluded for these states/areas. Differences between total rates from 

this table and others in the report are due to different reporting forms and above listed exclusions. The 0 to 9 year age group is not shown because some 

of these may not be due to sexual transmission; however, they are included in the totals. 

STD Surveillance 2002 Syphilis Tables 119 
Table 36. Early latent syphilis — Reported cases and rates by state/area and region listed in alphabetical 

order: United States and outlying areas, 1998–2002 

State/Area 

Cases Rates per 100,000 Population 

1998 1999 2000 2001 2002 1998 1999 2000 2001 2002 

Alabama 440 367 219 192 211 10.1 8.4 4.9 4.3 4.7 

Alaska 0 1 1 0 1 0.0 0.2 0.2 0.0

Arizona 206 290 248 266 200 4.4 6.1 4.8 5.2 3.9 

Arkansas 185 123 117 60 51 7.3 4.8 4.4 2.2 1.9 

California 783 591 353 408 716 2.4 1.8 1.0 1.2 2.1 

Colorado 10 6 7 14 22 0.3 0.1 0.2 0.3 0.5 

Connecticut 37 12 9 20 13 1.1 0.4 0.3 0.6 0.4 

Delaware 44 16 10 18 9 5.9 2.1 1.3 2.3 1.1 

Florida 1,092 1,085 1,165 947 949 7.3 7.2 7.3 5.9 5.9 

Georgia 740 729 521 703 701 9.7 9.4 6.4 8.6 8.6

Hawaii 0 1 3 7 21 0.0 0.1 0.2 0.6

Idaho 0 1 0 0 4 0.0 0.1 0.0 0.0

Illinois 596 639 382 386 528 4.9 5.3 3.1 3.1 4.3 

Indiana 121 172 184 120 53 2.1 2.9 3.0 2.0 0.9 

Iowa 20 4 8 6 8 0.7 0.1 0.3 0.2

Kansas 39 19 9 18 13 1.5 0.7 0.3 0.7 0.5 

Kentucky 101 81 62 38 49 2.6 2.0 1.5 0.9 1.2 

Louisiana 446 404 231 194 183 10.2 9.2 5.2 4.3 4.1 

Maine 0 0 0 3 1 0.0 0.0 0.0 0.2

Maryland 848 610 518 362 181 16.5 11.8 9.8 6.8 3.4 

Massachusetts 104 65 83 64 95 1.7 1.1 1.3 1.0 1.5 

Michigan 261 302 406 368 255 2.7 3.1 4.1 3.7 2.6 

Minnesota 8 9 18 16 23 0.2 0.2 0.4 0.3 0.5 

Mississippi 650 553 409 329 149 23.6 20.0 14.4 11.6 5.2 

Missouri 165 99 52 33 51 3.0 1.8 0.9 0.6 0.9 

Montana 0 2 0 0 0 0.0 0.2 0.0 0.0

Nebraska 3 6 1 1 0 0.2 0.4 0.1 0.1

Nevada 38 28 9 7 12 2.2 1.5 0.5 0.4 0.6 

New Hampshire 1 1 0 2 1 0.1 0.1 0.0 0.2

New Jersey 231 99 109 234 220 2.8 1.2 1.3 2.8 2.6 

New Mexico 8 2 25 18 23 0.5 0.1 1.4 1.0 1.3 

New York 679 700 467 566 756 3.7 3.8 2.5 3.0 4.0 

North Carolina 846 740 618 483 333 11.2 9.7 7.7 6.0 4.1 

North Dakota 0 0 1 0 0 0.0 0.0 0.2 0.0

Ohio 227 168 119 100 84 2.0 1.5 1.0 0.9 0.7 

Oklahoma 158 249 128 121 124 4.7 7.4 3.7 3.5 3.6 

Oregon 7 6 19 9 18 0.2 0.2 0.6 0.3 0.5 

Pennsylvania 424 414 278 260 237 3.5 3.5 2.3 2.1 1.9 

Rhode Island 0 1 1 1 9 0.0 0.1 0.1 0.1

South Carolina 383 407 394 394 202 10.0 10.5 9.8 9.8 5.0 

South Dakota 0 1 0 0 0 0.0 0.1 0.0 0.0

Tennessee 659 647 627 553 390 12.1 11.8 11.0 9.7 6.9 

Texas 1,480 1,273 1,171 964 1,149 7.5 6.4 5.6 4.6 5.5 

Utah 3 5 10 0 8 0.1 0.2 0.4 0.0 0.4 

Vermont 2 0 0 1 0 0.3 0.0 0.0 0.2

Virginia 230 212 140 133 94 3.4 3.1 2.0 1.9 1.3 

Washington 16 17 20 19 23 0.3 0.3 0.3 0.3 0.4 

West Virginia 2 3 3 1 1 0.1 0.2 0.2 0.1

Wisconsin 115 90 72 43 66 2.2 1.7 1.3 0.8 1.2 

Wyoming 0 0 0 0 0 0.0 0.0 0.0 0.0

U.S. TOTAL* 12,696 11,534 9,465 8,701 8,429 4.7 4.2 3.4 3.1 3.0 

Northeast 1,478 1,292 947 1,151 1,332 2.9 2.5 1.8 2.1 2.5 

Midwest 1,555 1,509 1,252 1,091 1,081 2.5 2.4 1.9 1.7 1.7 

South 8,592 7,783 6,571 5,711 4,968 9.0 8.1 6.6 5.7 5.0 

West 1,071 950 695 748 1,048 1.8 1.6 1.1 1.2 1.7 

Guam 

Puerto Rico 

Virgin Islands 

0

659 

28 

0

680 

12 

1

663 

5 

2

600 

8 

3 

702 

1 

0.0 

17.1 

25.5 

0.0 

17.5 

10.6 

0.6 

17.4 

4.6 

1.3

15.8 

7.4 

18.4 

0.9 

OUTLYING AREAS 687 692 669 610 706 16.6 16.6 16.4 15.0 17.3 

TOTAL 13,383 12,226 10,134 9,311 9,135 4.9 4.4 3.5 3.3 3.2 

0.2 

1.7 

0.3 

0.3 

0.1 

0.0 

0.0 

0.1 

0.0 

0.9 

0.0 

0.0 

0.1 

0.0 

1.9 

*Includes cases reported by Washington, D.C. 

120 Syphilis Tables STD Surveillance 2002 
Table 37. Early latent syphilis — Reported cases and rates in selected cities of >200,000 population listed in 

alphabetical order: United States and outlying areas, 1998–2002 

City 

Cases Rates per 100,000 Population 

1998 1999 2000 2001 2002
 1998 1999 2000 2001 2002 

Akron, OH 4 6 1 2 1
 0.7 1.1 0.2 0.4

Albuquerque, NM 5 2 19 8 10 1.0 0.4 3.4 1.4 1.8 

Atlanta, GA 303 241 173 398 406 41.0 32.4 21.2 48.8 49.8 

Austin, TX 19 23 27 31 23 2.7 3.2 3.3 3.8 2.8 

Baltimore, MD 646 472 384 257 124 100.1 74.6 59.0 39.5 19.0 

Birmingham, AL 95 103 62 35 27 14.4 15.7 9.4 5.3 4.1 

Boston, MA 60 41 29 26 50 10.8 7.4 4.8 4.3 8.4 

Buffalo, NY 2 1 1 0 2 0.6 0.3 0.3 0.0

Charlotte, NC 97 99 63 69 40 15.4 15.3 9.1 9.9 5.8 

Chicago, IL 518 521 292 298 439 17.4 17.5 9.5 9.7 14.2 

Cincinnati, OH 11 5 2 2 0 1.3 0.6 0.2 0.2

Cleveland, OH 98 63 29 31 10 7.1 4.6 2.1 2.2 0.7 

Columbus, OH 42 34 32 33 48 4.1 3.3 3.0 3.1 4.5 

Corpus Christi, TX 13 9 3 1 1 4.1 2.9 1.0 0.3

Dallas, TX 405 384 361 247 351 19.7 18.6 16.3 11.1 15.8 

Dayton, OH 5 5 2 4 1 0.9 0.9 0.4 0.7

Denver, CO 7 4 1 4 12 1.4 0.8 0.2 0.7

Des Moines, IA 11 2 6 4 5 3.1 0.5 1.6 1.1

Detroit, MI 180 223 328 293 172 14.3 17.8 34.5 30.8 18.1 

El Paso, TX 14 9 11 14 32 2.0 1.3 1.6 2.1 4.7 

Fort Worth, TX 121 66 80 60 115 8.9 4.8 5.5 4.1 8.0 

Honolulu, HI 0 1 1 4 16 0.0 0.1 0.1 0.5

Houston, TX 367 248 134 137 136 11.4 7.6 3.9 4.0 4.0 

Indianapolis, IN 44 102 125 82 30 5.4 12.6 14.5 9.5 3.5 

Jacksonville, FL 69 37 46 54 25 9.4 5.0 5.9 6.9 3.2 

Jersey City, NJ 2 1 1 6 15 0.9 0.5 0.4 2.5

Kansas City, MO 6 16 4 1 5 1.3 3.5 0.9 0.2 1.1 

Los Angeles, CA 525 330 187 203 349 6.1 3.8 2.1 2.3 3.9 

Louisville, KY 64 38 40 20 33 9.5 5.6 5.8 2.9 4.8 

Memphis, TN 382 338 325 356 202 44.0 38.7 36.2 39.7 22.5 

Miami, FL 242 294 329 221 295 11.2 13.5 14.6 9.8 13.1 

Milwaukee, WI 94 84 55 35 51 10.3 9.3 5.9 3.7 5.4 

Minneapolis, MN 5 7 11 8 17 1.4 1.9 2.9 2.1 4.4 

Nashville, TN 148 201 173 137 109 27.7 37.9 30.4 24.0 19.1 

New Orleans, LA 84 65 32 31 39 18.0 14.1 6.6 6.4 8.0 

New York City, NY 645 659 447 548 726 8.7 8.9 5.6 6.8 9.1 

Newark, NJ 56 23 58 74 74 19.7 8.1 19.3 24.6 24.6 

Norfolk, VA 50 34 23 25 14 23.2 15.1 9.8 10.7 6.0 

Oakland, CA 25 22 4 12 12 2.0 1.7 0.3 0.8 0.8 

Oklahoma City, OK 70 147 86 73 74 17.2 35.9 20.2 17.2 17.4 

Omaha, NE 3 2 1 0 0 0.7 0.4 0.2 0.0

Philadelphia, PA 407 394 261 248 214 28.3 27.8 17.2 16.3 14.1 

Phoenix, AZ 193 266 220 243 150 6.9 9.3 7.2 7.9 4.9 

Pittsburgh, PA 1 1 1 4 6 0.1 0.1 0.1 0.3

Portland, OR 5 5 12 7 17 1.0 1.0 2.3 1.3 3.3 

Richmond, VA 36 34 18 28 11 18.5 17.9 9.1 14.2 5.6 

Rochester, NY 9 2 0 1 2 3.7 0.8 0.0 0.4

Sacramento, CA 12 3 2 5 8 1.0 0.3 0.2 0.4

San Antonio, TX 63 72 102 120 105 4.7 5.2 7.3 8.6 7.5 

San Diego, CA 21 23 10 16 34 0.8 0.8 0.4 0.6 1.2 

San Francisco, CA 15 14 18 47 173 2.0 1.9 2.3 6.1 22.3 

San Jose, CA 5 11 4 12 11 0.3 0.7 0.2 0.7 0.7 

Seattle, WA 8 6 16 14 10 0.5 0.4 0.9 0.8 0.6 

St Louis, MO 63 40 21 15 23 18.6 12.0 6.0 4.3 6.6 

St Paul, MN 1 1 1 4 2 0.4 0.4 0.4 1.4

St Petersburg, FL 19 15 23 6 19 2.2 1.7 2.5 0.7 2.1 

Tampa, FL 76 51 56 51 57 8.2 5.4 5.6 5.1 5.7 

Toledo, OH 5 5 3 1 3 1.1 1.1 0.7 0.2

Tucson, AZ 6 14 14 8 29 0.8 1.7 1.7 0.9 3.4 

Tulsa, OK 44 40 8 5 16 11.6 10.4 2.0 1.3 4.1 

Washington, DC 288 284 238 219 192 55.1 54.7 41.6 38.3 33.6 

Wichita, KS 13 11 1 7 3 2.9 2.4 0.2 1.5 0.7 

Yonkers, NY 2 2 0 0 1 1.0 1.0 0.0 0.0

U.S. CITY TOTAL 6,829 6,256 5,017 4,905 5,177 9.7 8.8 6.8 6.7 7.0 

San Juan, PR 300 296 250 232 210 28.7 28.1 24.5 22.7 20.6 

TOTAL 7,129 6,552 5,267 5,137 5,387 10.0 9.1 7.0 6.9 7.2 

0.3 

0.2 

6.2 

0.5 

0.2 

0.6 

0.0 

2.2 

1.3 

1.8 

0.0 

0.8 

0.7 

0.7 

0.7 

0.5 

STD Surveillance 2002 Syphilis Tables 121 
0.1 

Table 38. Late and late latent syphilis — Reported cases and rates by state/area and region listed in 

alphabetical order: United States and outlying areas, 1998–2002 

0.4 

0.0 

0.0 

0.0 

0.2 

1.8 

State/Area 

Cases Rates per 100,000 Population 

1998 1999 2000 2001 2002 1998 1999 2000 2001 2002 

Alabama 413 443 403 380 334 9.5 10.1 9.1 8.5 7.5 

Alaska 12 11 5 9 8 2.0 1.8 0.8 1.4 1.3 

Arizona 281 307 385 672 666 6.0 6.4 7.5 13.1 13.0 

Arkansas 183 140 130 124 124 7.2 5.5 4.9 4.6 4.6 

California 1,637 1,897 2,590 2,038 2,107 5.0 5.7 7.6 6.0 6.2 

Colorado 100 76 45 111 86 2.5 1.9 1.0 2.6 2.0 

Connecticut 114 97 125 131 147 3.5 3.0 3.7 3.8 4.3 

Delaware 49 46 26 47 42 6.6 6.1 3.3 6.0 5.4 

Florida 1,082 1,231 1,150 1,446 1,686 7.3 8.1 7.2 9.0 10.5 

Georgia 749 799 695 850 743 9.8 10.3 8.5 10.4 9.1 

Hawaii 14 7 17 22 27 1.2 0.6 1.4 1.8 2.2 

Idaho 13 11 10 10 11 1.1 0.9 0.8 0.8 0.9 

Illinois 883 851 794 706 546 7.3 7.0 6.4 5.7 4.4 

Indiana 173 173 212 245 196 2.9 2.9 3.5 4.0 3.2 

Iowa 23 24 36 33 38 0.8 0.8 1.2 1.1 1.3 

Kansas 63 62 50 43 44 2.4 2.3 1.9 1.6 1.6 

Kentucky 127 120 103 104 72 3.2 3.0 2.5 2.6 1.8 

Louisiana 767 701 526 426 439 17.6 16.0 11.8 9.5 9.8 

Maine 3 1 6 12 6 0.2 0.1 0.5 0.9 0.5 

Maryland 616 405 338 305 415 12.0 7.8 6.4 5.8 7.8 

Massachusetts 416 283 296 334 346 6.8 4.6 4.7 5.3 5.4 

Michigan 202 207 232 347 408 2.1 2.1 2.3 3.5 4.1 

Minnesota 58 52 43 83 65 1.2 1.1 0.9 1.7 1.3 

Mississippi 235 147 125 175 247 8.5 5.3 4.4 6.2 8.7 

Missouri 90 191 215 110 118 1.7 3.5 3.8 2.0 2.1 

Montana 0 0 0 0 4 0.0 0.0 0.0 0.0

Nebraska 24 12 4 5 19 1.4 0.7 0.2 0.3 1.1 

Nevada 86 59 38 47 86 4.9 3.3 1.9 2.4 4.3 

New Hampshire 11 14 17 17 15 0.9 1.2 1.4 1.4 1.2 

New Jersey 411 587 599 637 637 5.1 7.2 7.1 7.6 7.6 

New Mexico 54 66 57 36 48 3.1 3.8 3.1 2.0 2.6 

New York 4,291 3,201 2,308 2,701 2,620 23.6 17.6 12.2 14.2 13.8 

North Carolina 540 490 375 475 424 7.2 6.4 4.7 5.9 5.3 

North Dakota 0 0 0 2 0 0.0 0.0 0.0 0.3

Ohio 109 98 89 115 105 1.0 0.9 0.8 1.0 0.9 

Oklahoma 97 94 82 102 89 2.9 2.8 2.4 3.0 2.6 

Oregon 19 23 18 26 29 0.6 0.7 0.5 0.8 0.8 

Pennsylvania 367 427 321 362 342 3.1 3.6 2.6 2.9 2.8 

Rhode Island 54 51 33 29 45 5.5 5.1 3.1 2.8 4.3 

South Carolina 198 230 206 268 269 5.2 5.9 5.1 6.7 6.7 

South Dakota 1 1 1 0 0 0.1 0.1 0.1 0.0

Tennessee 515 439 525 580 514 9.5 8.0 9.2 10.2 9.0 

Texas 1,930 1,885 1,659 2,145 2,299 9.8 9.4 8.0 10.3 11.0 

Utah 50 42 46 14 56 2.4 2.0 2.1 0.6 2.5 

Vermont 0 0 0 4 0 0.0 0.0 0.0 0.7

Virginia 334 354 266 287 362 4.9 5.2 3.8 4.1 5.1 

Washington 82 110 85 98 63 1.4 1.9 1.4 1.7 1.1 

West Virginia 6 7 7 1 2 0.3 0.4 0.4 0.1

Wisconsin 58 52 60 64 38 1.1 1.0 1.1 1.2 0.7 

Wyoming 1 0 4 3 1 0.2 0.0 0.8 0.6

U.S. TOTAL* 17,743 16,653 15,594 16,976 17,168 6.6 6.1 5.5 6.0 6.1 

Northeast 5,667 4,661 3,705 4,227 4,158 11.0 9.0 6.9 7.9 7.8 

Midwest 1,684 1,723 1,736 1,753 1,577 2.7 2.7 2.7 2.7 2.4 

South 8,043 7,660 6,853 7,910 8,241 8.4 7.9 6.8 7.9 8.2 

West 2,349 2,609 3,300 3,086 3,192 3.9 4.3 5.2 4.9 5.1 

Guam 

Puerto Rico 

Virgin Islands 

3 

597 

0 

10 

614 

0 

7 

485 

3 

15 

402 

0 

9 

398 

2 

1.9 

15.5 

0.0 

6.1 

15.8 

0.0 

4.5 

12.7 

2.8 

9.7 

10.6 

0.0

5.8 

10.5 

OUTLYING AREAS 600 624 495 417 409 14.5 15.0 12.2 10.2 10.0 

TOTAL 18,343 17,277 16,089 17,393 17,577 6.7 6.2 5.6 6.1 6.2 

*Includes cases reported by Washington, D.C. 

122 Syphilis Tables STD Surveillance 2002 
Table 39. Late and late latent syphilis — Reported cases and rates in selected cities of >200,000 population 

listed in alphabetical order: United States and outlying areas, 1998–2002 

City 

Cases Rates per 100,000 Population 

1998 1999 2000 2001 2002
 1998 1999 2000 2001 2002 

Akron, OH 0 0 1 1 2
 0.0 0.0 0.2 0.2

Albuquerque, NM 29 37 33 26 29 5.5 7.1 5.9 4.7 5.2 

Atlanta, GA 120 119 88 168 159 16.2 16.0 10.8 20.6 19.5 

Austin, TX 22 20 24 64 52 3.1 2.8 3.0 7.9 6.4 

Baltimore, MD 331 202 111 57 145 51.3 31.9 17.0 8.8 22.3 

Birmingham, AL 110 149 124 101 89 16.7 22.7 18.7 15.3 13.4 

Boston, MA 155 107 106 113 133 27.9 19.2 17.7 18.9 22.2 

Buffalo, NY 6 4 8 7 5 1.9 1.3 2.5 2.2

Charlotte, NC 44 39 40 31 33 7.0 6.0 5.8 4.5 4.7 

Chicago, IL 494 475 468 444 325 16.6 15.9 15.2 14.4 10.5 

Cincinnati, OH 9 6 12 12 15 1.1 0.7 1.4 1.4 1.8 

Cleveland, OH 20 11 7 5 5 1.4 0.8 0.5 0.4 0.4 

Columbus, OH 17 30 18 52 45 1.7 2.9 1.7 4.9 4.2 

Corpus Christi, TX 13 10 6 8 9 4.1 3.2 1.9 2.6 2.9 

Dallas, TX 187 156 120 326 493 9.1 7.6 5.4 14.7 22.2 

Dayton, OH 28 9 10 12 4 5.0 1.6 1.8 2.1 0.7 

Denver, CO 24 37 18 45 36 4.8 7.4 3.2 8.1 6.5 

Des Moines, IA 6 5 11 10 9 1.7 1.4 2.9 2.7 2.4 

Detroit, MI 131 136 145 257 294 10.4 10.9 15.2 27.0 30.9 

El Paso, TX 65 60 73 78 74 9.2 8.5 10.7 11.5 10.9 

Fort Worth, TX 27 87 85 159 149 2.0 6.3 5.9 11.0 10.3 

Honolulu, HI 14 4 13 16 26 1.6 0.5 1.5 1.8 3.0 

Houston, TX 879 755 614 661 748 27.4 23.2 18.1 19.4 22.0 

Indianapolis, IN 30 38 92 87 65 3.7 4.7 10.7 10.1 7.6 

Jacksonville, FL 69 30 53 47 28 9.4 4.1 6.8 6.0 3.6 

Jersey City, NJ 28 38 22 26 26 12.7 17.4 9.1 10.8 10.8 

Kansas City, MO 2 41 39 24 24 0.4 9.1 8.6 5.3 5.3 

Los Angeles, CA 557 740 1,496 923 890 6.5 8.5 16.8 10.4 10.0 

Louisville, KY 54 69 51 61 31 8.0 10.3 7.4 8.8 4.5 

Memphis, TN 383 321 297 324 247 44.1 36.8 33.1 36.1 27.5 

Miami, FL 463 409 356 628 766 21.5 18.8 15.8 27.9 34.0 

Milwaukee, WI 62 36 49 43 21 6.8 4.0 5.2 4.6 2.2 

Minneapolis, MN 25 15 14 32 24 6.9 4.1 3.6 8.3 6.3 

Nashville, TN 58 54 145 162 154 10.9 10.2 25.4 28.4 27.0 

New Orleans, LA 157 108 70 46 53 33.7 23.4 14.4 9.5 10.9 

New York City, NY 3,881 2,907 2,115 2,442 2,300 52.3 39.1 26.4 30.5 28.7 

Newark, NJ 82 115 170 237 194 28.8 40.6 56.5 78.8 64.5 

Norfolk, VA 25 30 22 22 20 11.6 13.3 9.4 9.4 8.5 

Oakland, CA 91 92 75 71 114 7.1 7.1 5.2 4.9 7.9 

Oklahoma City, OK 39 34 25 50 43 9.6 8.3 5.9 11.8 10.1 

Omaha, NE 19 3 3 0 13 4.3 0.7 0.6 0.0 2.8 

Philadelphia, PA 287 355 281 315 280 20.0 25.0 18.5 20.8 18.5 

Phoenix, AZ 187 245 324 546 536 6.7 8.6 10.5 17.8 17.4 

Pittsburgh, PA 11 4 3 4 13 0.9 0.3 0.2 0.3 1.0 

Portland, OR 8 9 7 13 11 1.6 1.8 1.3 2.5 2.1 

Richmond, VA 20 17 17 20 11 10.3 9.0 8.6 10.1 5.6 

Rochester, NY 21 13 6 1 7 8.7 5.4 2.4 0.4 2.8 

Sacramento, CA 16 13 20 24 19 1.4 1.1 1.6 2.0 1.6 

San Antonio, TX 143 121 113 167 155 10.6 8.8 8.1 12.0 11.1 

San Diego, CA 135 196 195 103 87 4.9 6.9 6.9 3.7 3.1 

San Francisco, CA 88 84 91 114 116 11.8 11.2 11.7 14.7 14.9 

San Jose, CA 54 40 36 68 47 3.3 2.4 2.1 4.0 2.8 

Seattle, WA 28 51 50 55 36 1.7 3.1 2.9 3.2 2.1 

St Louis, MO 46 69 82 30 44 13.6 20.7 23.6 8.6 12.6 

St Paul, MN 6 3 6 7 9 2.2 1.1 2.1 2.5

St Petersburg, FL 29 18 34 23 40 3.3 2.0 3.7 2.5 4.3 

Tampa, FL 65 41 55 76 130 7.0 4.4 5.5 7.6 13.0 

Toledo, OH 10 10 13 1 3 2.2 2.2 2.9 0.2 0.7 

Tucson, AZ 23 20 14 42 34 2.9 2.5 1.7 5.0 4.0 

Tulsa, OK 14 23 16 12 6 3.7 6.0 4.1 3.0 1.5 

Washington, DC 202 129 237 195 180 38.6 24.9 41.4 34.1 31.5 

Wichita, KS 5 16 7 4 7 1.1 3.5 1.5 0.9 1.5 

Yonkers, NY 17 9 9 12 23 8.8 4.6 4.5 6.0 11.6 

U.S. CITY TOTAL 10,171 9,024 8,845 9,710 9,686 14.4 12.7 12.0 13.2 13.1 

San Juan, PR 293 322 222 178 152 28.0 30.6 21.8 17.4 14.9 

TOTAL 10,464 9,346 9,067 9,888 9,838 14.6 13.0 12.1 13.2 13.2 

0.4 

1.6 

3.2 

STD Surveillance 2002 Syphilis Tables 123 
Table 40. Congenital syphilis — Reported cases and rates in infants <1 year of age: United States (excluding 

outlying areas), 1963–2002 

Year Cases Rate per 100,000 Live Births 

1963* 367 9.2 

1964* 336 8.7 

1965* 335 8.9 

1966* 333 8.8 

1967 156 4.1 

1968 274 7.3 

1969 264 7.0 

1970 323 8.6 

1971 422 11.9 

1972 360 11.0 

1973 295 9.4 

1974 250 7.9 

1975 169 5.3 

1976 160 5.1 

1977 134 4.0 

1978 104 3.0 

1979 123 3.5 

1980 107 3.0 

1981 160 4.4 

1982 159 4.3 

1983 158 4.3 

1984 247 6.7 

1985 266 7.1 

1986 357 9.5 

1987 444 11.7 

1988 658 16.8 

1989 1,807 44.7 

1990 3,816 91.8 

1991 4,410 107.3 

1992 4,024 99.0 

1993 3,395 84.9 

1994 2,435 61.6 

1995 1,860 47.7 

1996 1,280 32.9 

1997 1,079 27.8 

1998 840 21.3 

1999 575 14.5 

2000 574 14.1 

2001 492 12.2 

2002 412 10.2 

*For 1963 to 1966 data were reported for the federal fiscal year ending June 30 of the year indicated.
 

NOTE: The surveillance case definition for congenital syphilis changed in 1988. As of 1995, cases of congenital syphilis <1 year of age are obtained
 

using case reporting form CDC 73.126. Yearly case counts in this table correspond to confirmed diagnoses of congenital syphilis among those
 

known to be less than one year of age. As a result, the case counts in this table are a subset of those listed in Table 1 for the years prior to 1995.
 

124 Syphilis Tables STD Surveillance 2002 
Table 41. Congenital syphilis — Reported cases and rates in infants <1 year of age by state/area, ranked 

by rates: United States, 2002 

Rank	* † State/Area Cases Rate per 100,000 Live Births 

1 New Jersey 36 31.1 

2 South Carolina 14 25.1 

3 Michigan 32 24.0 

4 Arizona 19 22.2 

5 Arkansas 8 21.6 

6 Illinois 39 21.2 

7 Maryland 15 20.5 

8 Texas 73 20.0 

9 Mississippi 6 14.2 

10 Florida 28 13.6 

11 North Carolina 13 11.0 

12 California 56 10.6 

U.S. TOTAL§ 412	 10.2 

13 Alabama 6 9.9 

14 New York 25 9.8 

15 Indiana 7 8.1 

16 Georgia 10 7.5 

17 Kentucky 3 5.5 

18 Oklahoma 2 4.0 

19 Pennsylvania 5 3.5 

20 Colorado 2 3.0 

21 Tennessee 2 2.6 

22 Washington 2 2.5 

23 Ohio 3 2.0 

24 Louisiana 1 1.5 

25 Minnesota 1 1.5 

26 Missouri 1 1.3 

27 Massachusetts 1 1.2 

YEAR 2010 OBJECTIVE	 1.0 

28	 Virginia 1 1.0 

Alaska 0 0.0 

Connecticut 0 0.0 

Delaware 0 0.0 

Hawaii 0 0.0 

Idaho 0 0.0 

Iowa 0 0.0 

Kansas 0 0.0 

Maine 0 0.0 

Montana 0 0.0 

Nebraska 0 0.0 

Nevada 0 0.0 

New Hampshire 0 0.0 

New Mexico 0 0.0 

North Dakota 0 0.0 

Oregon 0 0.0 

Rhode Island 0 0.0 

South Dakota 0 0.0 

Utah 0 0.0 

Vermont 0 0.0 

West Virginia 0 0.0 

Wisconsin 0 0.0 

Wyoming 0 0.0 

*States were ranked in descending order by rate, number of cases, and alphabetically by state. States with no cases were not ranked. †

Mother’s state of residence used to assign case. 

§

Total includes cases reported by Washington, D.C. but excludes outlying areas (Guam with 0 cases and rate of 0.0, Puerto Rico with 20 cases and 

rate of 35.8, and Virgin Islands with 0 cases and rate of 0.0). 

STD Surveillance 2002	 Syphilis Tables 125 
Table 42. Congenital syphilis — Reported cases and rates in infants <1 year of age by state/area and region 

listed in alphabetical order: United States and outlying areas, 1998–2002 

State/Area* 

Cases Rates per 100,000 Live Births 

1998 1999 2000 2001 2002 1998 1999 2000 2001 2002 

Alabama 12 7 8 10 6 19.3 11.3 12.6 16.5 9.9 

Alaska 0 0 0 0 0 0.0 0.0 0.0 0.0

Arizona 25 24 26 29 19 32.0 29.6 30.5 33.9 22.2 

Arkansas 30 14 15 6 8 81.4 38.1 39.7 16.2 21.6 

California 122 88 86 62 56 23.4 17.0 16.2 11.7 10.6 

Colorado 2 1 0 1 2 3.4 1.6 0.0 1.5

Connecticut 0 1 1 2 0 0.0 2.3 2.3 4.7

Delaware 0 0 0 0 0 0.0 0.0 0.0 0.0

Florida 72 31 42 38 28 36.8 15.7 20.6 18.5 13.6 

Georgia 14 16 22 21 10 11.4 12.6 16.6 15.7 7.5 

Hawaii 0 0 0 0 0 0.0 0.0 0.0 0.0

Idaho 0 0 0 0 0 0.0 0.0 0.0 0.0

Illinois 71 54 50 45 39 38.9 29.7 27.0 24.4 21.2 

Indiana 0 7 4 13 7 0.0 8.1 4.6 15.0 8.1 

Iowa 0 0 0 0 0 0.0 0.0 0.0 0.0

Kansas 0 0 2 2 0 0.0 0.0 5.0 5.1

Kentucky 5 0 3 1 3 9.2 0.0 5.4 1.8

Louisiana 8 12 7 0 1 12.0 17.9 10.3 0.0 1.5 

Maine 0 0 0 0 0 0.0 0.0 0.0 0.0

Maryland 44 27 16 5 15 61.1 37.5 21.5 6.8 20.5 

Massachusetts 2 0 1 2 1 2.5 0.0 1.2 2.5

Michigan 18 22 33 26 32 13.5 16.5 24.2 19.5 24.0 

Minnesota 0 0 0 0 1 0.0 0.0 0.0 0.0

Mississippi 15 12 14 10 6 34.9 28.1 31.8 23.7 14.2 

Missouri 15 10 3 5 1 19.9 13.3 3.9 6.6 1.3 

Montana 0 0 0 0 0 0.0 0.0 0.0 0.0

Nebraska 0 0 0 0 0 0.0 0.0 0.0 0.0

Nevada 0 0 0 0 0 0.0 0.0 0.0 0.0

New Hampshire 0 1 0 0 0 0.0 7.1 0.0 0.0

New Jersey 87 49 23 32 36 75.9 42.9 19.9 27.6 31.1 

New Mexico 0 0 0 0 0 0.0 0.0 0.0 0.0

New York 59 43 40 38 25 22.8 16.8 15.5 15.0 9.8 

North Carolina 24 19 19 19 13 21.5 16.7 15.8 16.1 11.0 

North Dakota 0 0 0 0 0 0.0 0.0 0.0 0.0

Ohio 4 6 5 1 3 2.6 3.9 3.2 0.7

Oklahoma 16 9 1 5 2 32.3 18.4 2.0 10.0 4.0 

Oregon 0 0 0 0 0 0.0 0.0 0.0 0.0

Pennsylvania 21 7 9 4 5 14.4 4.8 6.2 2.8 3.5 

Rhode Island 0 0 0 0 0 0.0 0.0 0.0 0.0

South Carolina 24 23 31 19 14 44.5 41.9 55.2 34.1 25.1 

South Dakota 1 1 0 0 0 9.7 9.5 0.0 0.0

Tennessee 13 10 25 14 2 16.8 12.9 31.4 17.9 2.6 

Texas 114 68 72 75 73 33.3 19.5 19.8 20.5 20.0 

Utah 1 0 1 0 0 2.2 0.0 2.1 0.0

Vermont 0 0 0 0 0 0.0 0.0 0.0 0.0

Virginia 6 3 7 3 1 6.4 3.1 7.1 3.0

Washington 1 1 0 0 2 1.3 1.3 0.0 0.0

West Virginia 0 0 0 0 0 0.0 0.0 0.0 0.0

Wisconsin 6 9 4 2 0 8.9 13.2 5.8 2.9 0.0 

Wyoming 0 0 0 0 0 0.0 0.0 0.0 0.0

U.S. TOTAL† 840 575 574 492 412 21.3 14.5 14.1 12.2 10.2 

Northeast 169 101 74 78 67 24.4 14.7 10.7 11.4 9.8 

Midwest 115 109 101 94 83 13.1 12.4 11.2 10.6 9.4 

South 405 251 286 228 183 28.5 17.5 19.2 15.4 12.4 

West 151 114 113 92 79 15.9 12.0 11.5 9.4 8.1 

Guam 

Puerto Rico 

Virgin Islands 

0

28 

0 

0

23 

0 

0

17 

0 

1

22 

1 

0 

20 

0 

0.0 

46.3 

0.0 

0.0 

38.6 

0.0 

0.0 

28.7 

0.0 

28.1 

39.4 

59.9 

0.0 

35.8 

0.0 

OUTLYING AREAS 28 23 17 24 20 42.1 35.2 26.3 39.3 32.7 

TOTAL 868 598 591 516 432 21.7 14.9 14.3 12.6 10.6 

0.0 

3.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

5.5 

0.0 

1.2 

1.5 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

2.0 

0.0 

0.0 

0.0 

0.0 

0.0 

1.0 

2.5 

0.0 

0.0 

*Mother’s state of residence used to assign case. 

†

Includes cases reported by Washington, D.C. 

126 Syphilis Tables STD Surveillance 2002 
Table 43. Congenital syphilis — Reported cases and rates in infants <1 year of age in selected cities of 

>200,000 population, ranked by rates: United States, 2002 

Rank	* † City Cases Rate per 100,000 Live Births 

1 Newark, NJ 12 242.7 

2 Detroit, MI 28 182.8 

3 Houston, TX 39 88.2 

4 Baltimore, MD 8 81.5 

5 Chicago, IL 31 62.6 

6 Phoenix, AZ 14 55.5 

7 Atlanta, GA 5 53.6 

8 Jersey City, NJ 2 51.6 

9 Birmingham, AL 2 46.5 

10 Los Angeles, CA 27 41.8 

11 Miami, FL 5 36.8 

12 Yonkers, NY 1 35.8 

13 Dallas, TX 9 35.7 

14 Fort Worth, TX 4 35.3 

15 Austin, TX 4 31.1 

16 Cleveland, OH 2 24.6 

17 San Jose, CA 4 24.3 

18 Tampa, FL 2 24.2 

19 Philadelphia, PA 5 23.6 

20 Indianapolis, IN 3 21.5 

21 New York City, NY 22 18.4 

22 Minneapolis, MN 1 15.2 

23 Tulsa, OK 1 15.1 

24 Washington, DC 1 13.1 

25 Oklahoma City, OK 1 12.5 

26 Charlotte, NC 1 9.6 

27 El Paso, TX 1 7.7 

28 San Diego, CA 1 5.4 

29	 San Antonio, TX 1 4.5 

YEAR 2010 OBJECTIVE 1.0 

Tucson, AZ 0 0.0 

Oakland, CA 0 0.0 

Sacramento, CA 0 0.0 

San Francisco, CA 0 0.0 

Denver, CO 0 0.0 

Jacksonville, FL 0 0.0 

St Petersburg, FL 0 0.0 

Honolulu, HI 0 0.0 

Des Moines, IA 0 0.0 

Wichita, KS 0 0.0 

Louisville, KY 0 0.0 

New Orleans, LA 0 0.0 

Boston, MA 0 0.0 

St Paul, MN 0 0.0 

Kansas City, MO 0 0.0 

St Louis, MO 0 0.0 

Omaha, NE 0 0.0 

Albuquerque, NM 0 0.0 

Buffalo, NY 0 0.0 

Rochester, NY 0 0.0 

Akron, OH 0 0.0 

Cincinnati, OH 0 0.0 

Columbus, OH 0 0.0 

Dayton, OH 0 0.0 

Toledo, OH 0 0.0 

Portland, OR 0 0.0 

Pittsburgh, PA 0 0.0 

Memphis, TN 0 0.0 

Nashville, TN 0 0.0 

Corpus Christi, TX 0 0.0 

Norfolk, VA 0 0.0 

Richmond, VA 0 0.0 

Seattle, WA 0 0.0 

Milwaukee, WI 0 0.0 

*Cities were ranked in descending order by rate, number of cases, and alphabetically by state. Cities with no cases were not ranked. Excludes 

outlying areas (San Juan, PR, with 2 cases and rate of 32.2). 

†

Mother's city of residence used to assign case. 

STD Surveillance 2002 Syphilis Tables 127 
Table 44. Congenital syphilis — Reported cases and rates in infants <1 year of age in selected cities of 

>200,000 population listed in alphabetical order: United States and outlying areas, 1998–2002 

City* 

Cases Rates per 100,000 Live Births 

1998 1999 2000 2001 2002
 1998 1999 2000 2001 2002 

Akron, OH 0 0 0 0 0
 0.0 0.0 0.0 0.0

Albuquerque, NM 0 0 0 0 0 0.0 0.0 0.0 0.0

Atlanta, GA 5 7 7 9 5 57.2 78.2 73.9 96.5 53.6 

Austin, TX 0 0 0 3 4 0.0 0.0 0.0 23.3 31.1 

Baltimore, MD 29 21 15 2 8 295.6 203.9 146.9 20.4 81.5 

Birmingham, AL 5 2 2 3 2 112.6 44.6 43.9 69.7 46.5 

Boston, MA 2 0 0 0 0 25.4 0.0 0.0 0.0 0.0 

Buffalo, NY 0 0 0 1 0 0.0 0.0 0.0 22.8 0.0 

Charlotte, NC 1 3 3 1 1 10.8 31.0 28.1 9.6 9.6 

Chicago, IL 49 44 38 35 31 95.2 87.1 74.8 70.6 62.6 

Cincinnati, OH 0 0 0 0 0 0.0 0.0 0.0 0.0

Cleveland, OH 3 2 2 0 2 33.5 23.4 23.2 0.0 24.6 

Columbus, OH 1 2 0 1 0 8.9 18.7 0.0 9.4 0.0 

Corpus Christi, TX 1 0 0 0 0 21.6 0.0 0.0 0.0 0.0 

Dallas, TX 18 4 6 8 9 77.4 16.8 24.5 31.7 35.7 

Dayton, OH 0 0 0 0 0 0.0 0.0 0.0 0.0

Denver, CO 1 1 0 0 0 10.2 9.8 0.0 0.0 0.0 

Des Moines, IA 0 0 0 0 0 0.0 0.0 0.0 0.0

Detroit, MI 14 21 24 23 28 85.2 132.9 151.1 150.1 182.8 

El Paso, TX 0 1 2 2 1 0.0 7.9 15.4 15.4 7.7 

Fort Worth, TX 1 2 4 8 4 10.1 19.2 36.8 70.6 35.3 

Honolulu, HI 0 0 0 0 0 0.0 0.0 0.0 0.0

Houston, TX 56 31 32 21 39 133.2 72.0 71.4 47.5 88.2 

Indianapolis, IN 0 6 3 9 3 0.0 43.6 21.1 64.4 21.5 

Jacksonville, FL 0 0 2 0 0 0.0 0.0 17.5 0.0 0.0 

Jersey City, NJ 3 0 3 2 2 76.4 0.0 75.6 51.6 51.6 

Kansas City, MO 0 1 2 0 0 0.0 13.7 27.2 0.0 0.0 

Los Angeles, CA 62 36 41 27 27 94.2 55.5 62.7 41.8 41.8 

Louisville, KY 4 0 1 0 0 58.5 0.0 14.1 0.0 0.0 

Memphis, TN 11 10 14 8 0 96.6 87.7 122.9 71.3 0.0 

Miami, FL 37 10 18 10 5 278.7 76.5 131.7 73.7 36.8 

Milwaukee, WI 6 7 4 2 0 54.5 62.2 35.9 17.9 0.0 

Minneapolis, MN 0 0 0 0 1 0.0 0.0 0.0 0.0 15.2 

Nashville, TN 0 0 5 4 0 0.0 0.0 56.9 46.5 0.0 

New Orleans, LA 2 4 0 0 0 26.4 52.1 0.0 0.0 0.0 

New York City, NY 45 40 33 32 22 37.5 33.5 27.3 26.8 18.4 

Newark, NJ 26 12 9 8 12 536.7 245.7 183.0 161.8 242.7 

Norfolk, VA 0 0 3 1 0 0.0 0.0 75.0 24.8 0.0 

Oakland, CA 2 3 1 3 0 31.4 47.5 14.8 44.4 0.0 

Oklahoma City, OK 11 5 0 2 1 142.8 66.3 0.0 25.1 12.5 

Omaha, NE 0 0 0 0 0 0.0 0.0 0.0 0.0

Philadelphia, PA 21 7 9 4 5 95.0 32.2 41.1 18.9 23.6 

Phoenix, AZ 19 16 21 20 14 82.0 66.4 83.6 79.3 55.5 

Pittsburgh, PA 0 0 0 0 0 0.0 0.0 0.0 0.0

Portland, OR 0 0 0 0 0 0.0 0.0 0.0 0.0

Richmond, VA 3 0 0 1 0 105.2 0.0 0.0 31.9 0.0 

Rochester, NY 2 1 0 0 0 46.3 25.8 0.0 0.0 0.0 

Sacramento, CA 2 2 2 0 0 18.8 18.9 18.3 0.0 0.0 

San Antonio, TX 5 4 5 6 1 22.9 18.3 22.6 27.2 4.5 

San Diego, CA 7 7 0 5 1 37.8 37.8 0.0 26.9 5.4 

San Francisco, CA 1 1 1 1 0 12.3 12.3 11.5 12.1 0.0 

San Jose, CA 0 2 1 2 4 0.0 12.5 5.9 12.1 24.3 

Seattle, WA 0 1 0 0 0 0.0 13.6 0.0 0.0 0.0 

St Louis, MO 3 5 1 3 0 53.4 90.5 18.4 56.6 0.0 

St Paul, MN 0 0 0 0 0 0.0 0.0 0.0 0.0

St Petersburg, FL 0 1 0 0 0 0.0 29.5 0.0 0.0 0.0 

Tampa, FL 4 4 1 6 2 50.8 47.5 11.8 72.5 24.2 

Toledo, OH 0 0 0 0 0 0.0 0.0 0.0 0.0

Tucson, AZ 0 0 0 0 0 0.0 0.0 0.0 0.0

Tulsa, OK 3 1 0 0 1 45.1 15.2 0.0 0.0 15.1 

Washington, DC 8 0 4 2 1 104.1 0.0 52.2 26.2 13.1 

Wichita, KS 0 0 0 0 0 0.0 0.0 0.0 0.0

Yonkers, NY 2 0 0 0 1 74.3 0.0 0.0 0.0 35.8 

U.S. CITY TOTAL 475 327 319 275 237 59.4 40.9 39.0 34.0 29.3 

San Juan, PR 1 3 5 5 2 15.3 43.2 77.3 80.4 32.2 

TOTAL 476 330 324 280 239 59.1 40.9 39.3 34.4 29.3 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

*Mother’s city of residence used to assign case. 

128 Syphilis Tables STD Surveillance 2002 
Table 45. Congenital syphilis — Reported cases and rates in infants <1 year of age by race/ethnicity of 

mother, 1998–2002 

Year of Birth Race/Ethnicity Cases Rate per 100,000 Live Births 

1998 

White/Non-Hispanic 

Black/Non-Hispanic 

Hispanic 

Asian/Pacific Islander 

Native American/Alaskan Native 

Other 

76 

529 

204 

8

5 

8 

3.2 

88.6 

27.8 

4.7 

13.2 

NA 

Unknown 10 NA 

Total 840 21.3 

1999 

White/Non-Hispanic 

Black/Non-Hispanic 

Hispanic 

Asian/Pacific Islander 

Native American/Alaskan Native 

Other 

47 

350 

148 

8 

6 

4 

2.0 

59.1 

19.4 

4.5

15.9 

NA 

Unknown 12 NA 

Total 575 14.5 

2000 

White/Non-Hispanic 

Black/Non-Hispanic 

Hispanic 

Asian/Pacific Islander 

Native American/Alaskan Native 

Other 

37 

330 

169 

11 

5 

3 

1.5 

54.3 

20.7 

5.6

12.9 

NA 

Unknown 19 NA 

Total 574 14.1 

2001 

White/Non-Hispanic 

Black/Non-Hispanic 

Hispanic 

Asian/Pacific Islander 

Native American/Alaskan Native 

Other 

48 

260 

161 

4 

5 

2 

2.0 

43.9 

18.9 

2.0

12.8 

NA 

Unknown 12 NA 

Total 492 12.2 

2002 

White/Non-Hispanic 

Black/Non-Hispanic 

Hispanic 

Asian/Pacific Islander 

Native American/Alaskan Native 

Other 

33 

236 

126 

8 

3 

1 

1.4 

39.8 

14.8 

4.1

7.7 

NA 

Unknown 5 NA 

Total 412 10.2 

NA = Not applicable 

STD Surveillance 2002 Syphilis Tables 129 
Table 46. Chancroid — Reported cases and rates by state/area listed in alphabetical order: United States and 

outlying areas, 1998–2002 

State/Area 

Cases Rates per 100,000 Population 

1998 1999 2000 2001 2002 1998 1999 2000 2001 2002 

Alabama 1 1 1 0 0 0.0 0.0 0.0 0.0

Alaska 0 0 0 0 0 0.0 0.0 0.0 0.0

Arizona 2 0 0 0 0 0.0 0.0 0.0 0.0

Arkansas 7 0 0 0 0 0.3 0.0 0.0 0.0

California 7 7 3 2 2 0.0 0.0 0.0 0.0

Colorado 0 0 1 0 0 0.0 0.0 0.0 0.0

Connecticut 2 0 0 0 0 0.1 0.0 0.0 0.0

Delaware 0 0 0 0 0 0.0 0.0 0.0 0.0

Florida 3 2 0 2 7 0.0 0.0 0.0 0.0

Georgia 2 1 0 0 0 0.0 0.0 0.0 0.0

Hawaii 0 0 0 0 0 0.0 0.0 0.0 0.0

Idaho 0 0 0 0 0 0.0 0.0 0.0 0.0

Illinois 0 0 0 0 0 0.0 0.0 0.0 0.0

Indiana 1 0 0 0 0 0.0 0.0 0.0 0.0

Iowa 0 0 0 0 0 0.0 0.0 0.0 0.0

Kansas 1 0 0 0 0 0.0 0.0 0.0 0.0

Kentucky 0 0 0 0 0 0.0 0.0 0.0 0.0

Louisiana 1 9 6 0 2 0.0 0.2 0.1 0.0

Maine 0 0 0 0 0 0.0 0.0 0.0 0.0

Maryland 0 0 0 0 0 0.0 0.0 0.0 0.0

Massachusetts 0 1 2 2 3 0.0 0.0 0.0 0.0

Michigan 0 0 0 0 0 0.0 0.0 0.0 0.0

Minnesota 0 1 0 0 0 0.0 0.0 0.0 0.0

Mississippi 3 0 0 0 0 0.1 0.0 0.0 0.0

Missouri 0 0 0 0 0 0.0 0.0 0.0 0.0

Montana 0 0 0 0 0 0.0 0.0 0.0 0.0

Nebraska 0 0 0 0 0 0.0 0.0 0.0 0.0

Nevada 0 0 0 0 0 0.0 0.0 0.0 0.0

New Hampshire 0 0 0 0 0 0.0 0.0 0.0 0.0

New Jersey 0 0 0 4 0 0.0 0.0 0.0 0.0

New Mexico 0 0 0 0 0 0.0 0.0 0.0 0.0

New York 82 39 26 3 2 0.5 0.2 0.1 0.0 0.0 

North Carolina 9 7 5 3 0 0.1 0.1 0.1 0.0

North Dakota 0 0 0 0 0 0.0 0.0 0.0 0.0

Ohio 3 0 1 0 0 0.0 0.0 0.0 0.0

Oklahoma 0 0 0 0 0 0.0 0.0 0.0 0.0

Oregon 0 1 0 0 0 0.0 0.0 0.0 0.0

Pennsylvania 0 0 0 0 0 0.0 0.0 0.0 0.0

Rhode Island 0 1 0 0 0 0.0 0.1 0.0 0.0

South Carolina 19 48 10 15 43 0.5 1.2 0.2 0.4 1.1 

South Dakota 0 0 0 0 0 0.0 0.0 0.0 0.0

Tennessee 0 0 0 0 0 0.0 0.0 0.0 0.0

Texas 34 16 19 6 5 0.2 0.1 0.1 0.0 0.0 

Utah 0 0 0 1 0 0.0 0.0 0.0 0.0

Vermont 0 0 0 0 0 0.0 0.0 0.0 0.0

Virginia 7 3 2 0 1 0.1 0.0 0.0 0.0

Washington 1 0 0 0 1 0.0 0.0 0.0 0.0

West Virginia 0 0 0 0 0 0.0 0.0 0.0 0.0

Wisconsin 3 4 2 0 1 0.1 0.1 0.0 0.0

Wyoming 1 1 0 0 0 0.2 0.2 0.0 0.0

U.S. TOTAL* 189 142 78 38 67 0.1 0.1 0.0 0.0 0.0 

Guam 

Puerto Rico 

Virgin Islands 

0

2 

0 

0

1 

0 

0

3 

1 

0

4 

0 

0 

2 

0 

0.0 

0.1 

0.0 

0.0 

0.0 

0.0 

0.0 

0.1 

0.9 

0.0

0.1

0.0

OUTLYING AREAS 2 1 4 4 2 0.0 0.0 0.1 0.1

TOTAL 191 143 82 42 69 0.1 0.1 0.0 0.0 0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.1 

0.0 

0.0 

*Includes cases reported by Washington, D.C. 

130 Chancroid Tables STD Surveillance 2002 
Table 47. Chancroid — Reported cases and rates in selected cities of >200,000 population listed in 

alphabetical order: United States and outlying areas, 1998–2002 

City 

Cases Rates per 100,000 Population 

1998 1999 2000 2001 2002
 1998 1999 2000 2001 2002 

Akron, OH 0 0 0 0 0
 0.0 0.0 0.0 0.0

Albuquerque, NM 0 0 0 0 0 0.0 0.0 0.0 0.0

Atlanta, GA 1 0 0 0 0 0.1 0.0 0.0 0.0

Austin, TX 0 0 0 0 0 0.0 0.0 0.0 0.0

Baltimore, MD 0 0 0 0 0 0.0 0.0 0.0 0.0

Birmingham, AL 0 0 0 0 0 0.0 0.0 0.0 0.0

Boston, MA 0 0 0 0 1 0.0 0.0 0.0 0.0

Buffalo, NY 0 0 0 0 0 0.0 0.0 0.0 0.0

Charlotte, NC 0 1 0 1 0 0.0 0.2 0.0 0.1

Chicago, IL 0 0 0 0 0 0.0 0.0 0.0 0.0

Cincinnati, OH 0 0 0 0 0 0.0 0.0 0.0 0.0

Cleveland, OH 2 0 0 0 0 0.1 0.0 0.0 0.0

Columbus, OH 1 0 0 0 0 0.1 0.0 0.0 0.0

Corpus Christi, TX 0 1 0 0 1 0.0 0.3 0.0 0.0

Dallas, TX 6 4 6 1 1 0.3 0.2 0.3 0.0

Dayton, OH 0 0 0 0 0 0.0 0.0 0.0 0.0

Denver, CO 0 0 0 0 0 0.0 0.0 0.0 0.0

Des Moines, IA 0 0 0 0 0 0.0 0.0 0.0 0.0

Detroit, MI 0 0 0 0 0 0.0 0.0 0.0 0.0

El Paso, TX 4 0 1 0 0 0.6 0.0 0.1 0.0

Fort Worth, TX 0 2 2 0 0 0.0 0.1 0.1 0.0

Honolulu, HI 0 0 0 0 0 0.0 0.0 0.0 0.0

Houston, TX 20 7 3 1 3 0.6 0.2 0.1 0.0

Indianapolis, IN 0 0 0 0 0 0.0 0.0 0.0 0.0

Jacksonville, FL 0 0 0 1 0 0.0 0.0 0.0 0.1

Jersey City, NJ 0 0 0 0 0 0.0 0.0 0.0 0.0

Kansas City, MO 0 0 0 0 0 0.0 0.0 0.0 0.0

Los Angeles, CA 0 1 1 0 0 0.0 0.0 0.0 0.0

Louisville, KY 0 0 0 0 0 0.0 0.0 0.0 0.0

Memphis, TN 0 0 0 0 0 0.0 0.0 0.0 0.0

Miami, FL 0 0 0 0 0 0.0 0.0 0.0 0.0

Milwaukee, WI 2 2 0 0 1 0.2 0.2 0.0 0.0

Minneapolis, MN 0 1 0 0 0 0.0 0.3 0.0 0.0

Nashville, TN 0 0 0 0 0 0.0 0.0 0.0 0.0

New Orleans, LA 0 4 6 0 0 0.0 0.9 1.2 0.0

New York City, NY 82 39 26 3 2 1.1 0.5 0.3 0.0 0.0 

Newark, NJ 0 0 0 1 0 0.0 0.0 0.0 0.3

Norfolk, VA 0 1 0 0 0 0.0 0.4 0.0 0.0

Oakland, CA 0 1 0 1 0 0.0 0.1 0.0 0.1

Oklahoma City, OK 0 0 0 0 0 0.0 0.0 0.0 0.0

Omaha, NE 0 0 0 0 0 0.0 0.0 0.0 0.0

Philadelphia, PA 0 0 0 0 0 0.0 0.0 0.0 0.0

Phoenix, AZ 2 0 0 0 0 0.1 0.0 0.0 0.0

Pittsburgh, PA 0 0 0 0 0 0.0 0.0 0.0 0.0

Portland, OR 0 0 0 0 0 0.0 0.0 0.0 0.0

Richmond, VA 0 0 0 0 0 0.0 0.0 0.0 0.0

Rochester, NY 0 0 0 0 0 0.0 0.0 0.0 0.0

Sacramento, CA 0 0 0 0 0 0.0 0.0 0.0 0.0

San Antonio, TX 0 0 1 0 0 0.0 0.0 0.1 0.0

San Diego, CA 0 0 0 0 0 0.0 0.0 0.0 0.0

San Francisco, CA 4 0 0 1 0 0.5 0.0 0.0 0.1

San Jose, CA 0 0 0 0 0 0.0 0.0 0.0 0.0

Seattle, WA 0 0 0 0 0 0.0 0.0 0.0 0.0

St Louis, MO 0 0 0 0 0 0.0 0.0 0.0 0.0

St Paul, MN 0 0 0 0 0 0.0 0.0 0.0 0.0

St Petersburg, FL 0 0 0 0 0 0.0 0.0 0.0 0.0

Tampa, FL 0 0 0 0 0 0.0 0.0 0.0 0.0

Toledo, OH 0 0 0 0 0 0.0 0.0 0.0 0.0

Tucson, AZ 0 0 0 0 0 0.0 0.0 0.0 0.0

Tulsa, OK 0 0 0 0 0 0.0 0.0 0.0 0.0

Washington, DC 0 0 0 0 0 0.0 0.0 0.0 0.0

Wichita, KS 0 0 0 0 0 0.0 0.0 0.0 0.0

Yonkers, NY 0 0 0 0 0 0.0 0.0 0.0 0.0

U.S. CITY TOTAL 124 64 46 10 9 0.2 0.1 0.1 0.0 0.0 

San Juan, PR 1 1 2 1 1 0.1 0.1 0.2 0.1

TOTAL 125 65 48 11 10 0.2 0.1 0.1 0.0 0.0 

0.0 

0.0 

0.0 

0.3 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.2 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.1 

0.0 

0.0 

0.0 

0.0 

0.1 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.1 

STD Surveillance 2002 Chancroid Tables 131 

APPENDIX
 

Sources and Limitations of CDC Surveillance Data 

Much of the information in this document is based on cases of sexually transmitted diseases 

(STDs) reported to the Division of STD Prevention (DSTDP), National Center for HIV, STD, and TB 

Prevention (NCHSTP), Centers for Disease Control and Prevention (CDC), by the STD control programs and health departments in the 50 states, the District of Columbia, selected cities, 3,139 U.S. 

counties, U.S. dependencies and possessions, and independent nations in free association with the 

United States. Included among the dependencies, possessions, and independent nations are 

Guam, Puerto Rico, and the Virgin Islands. These entities are identified as "outlying areas" of the 

United States in selected figures and tables. 

In the past, STD data were submitted to CDC on a variety of hardcopy summary reporting forms 

(monthly, quarterly, and annually). As of December 31, 2002, a total of 49 states (with the exception 

of Arizona, Virgin Islands, Guam and Puerto Rico) had converted from summary hardcopy reporting to electronic submission of line-listed (i.e., case-specific) STD data via the National Electronic 

Telecommunications System for Surveillance (NETSS). Data reported through NETSS comprise 

the notifiable disease information that is published in the Morbidity and Mortality Weekly Report 

(MMWR). 

The data used in this report are based on a combination of aggregated final NETSS electronic 

data and summary hardcopy reporting forms. Monthly hardcopy reporting forms (CDC 73.998) include summary data for syphilis by county and state. Quarterly hardcopy reporting forms (CDC 

73.688) include summary data for early syphilis, gonorrhea, chlamydia, and other STDs by sex and 

source of report (STD clinic or non-STD clinic) for the 50 states, 64 (including San Juan, PR) selected cities (with a population of 200,000 or more as of 1980), and outlying areas of the United 

States. Annual hardcopy reporting forms (CDC 73.2638) include summary data for P&S syphilis, 

gonorrhea, and chlamydia by age, race, and sex for the 50 states and 6 large cities. 

Areas differ in their ability to resolve differences in total cases derived from hardcopy monthly, 

quarterly, and annual reports (as well as electronically submitted line-listed data). Thus, depending 

on the database used, there may be discrepancies in the total number of cases among the figures 

and tables. In most instances, these discrepancies are less than 5% of total reported cases and have 

minimal impact on national case totals and rates. However, for a specific area, the discrepancies 

may be larger. 

Reports and corrections sent to CDC on hardcopy forms and for NETSS electronic

data through May 2, 2003 have been included in this report. Data received after this

date will appear in subsequent issues. The data in the figures and tables in this document supersede those in all earlier publications.

STD Surveillance 2002 Appendix Sources and Limitations of CDC Surveillance Data 133 
Population Denominators and Rate Calculations 

Crude incidence rates (new cases/population) were calculated on an annual basis per 100,000 

population. In this report, the 2001 and 2002 rates for the U.S., all states, cities and outlying areas 

were calculated by dividing the number of cases reported from each area in 2001 and 2002 by the 

estimated area-specific 2000 population (the most current detailed population file available at time 

of publication). For the United States, rates were calculated using Bureau of the Census population 

estimates for 1981 through 1989 (Bureau of the Census; United States Population Estimates by 

Age, Sex and Race: 1980-1989 [Series P-25, No. 1045]; Washington: U.S. Government Printing 

Office, 1990; and United States Population Estimates by Age, Sex and Race: 1989 [Series P-25, No. 

1057]; Washington: U.S. Government Printing Office, 1990). Rates for states and counties were calculated using published intercensal estimates based on Bureau of the Census population estimates 

for 1980-1989 (Irwin R; 1980-1989 Intercensal Population Estimates by Race, Sex, and Age; Alexandria, [VA]: Demo-Detail, 1992; machine-readable data file). Rates for 1990 were calculated using 

population data from the 1990 census (Census of Population and Housing, 1990: Summary Tape 

File 1 (All States) [machine-readable file]; Washington: Bureau of the Census, 1991), which included information on area (County, State), age (5-year age groups), race (White, Black, Asian/Pacific Islander, American Indian/Alaska Native) and ethnicity (Hispanic, non-Hispanic). Rates for 

1991-2002 were updated from previous issues of this report using postcensal population estimates 

based on the Bureau of the Census data (U.S. Bureau of the Census; 1991-2000 Estimates of the 

Population of Counties by Age, Sex and Race/Hispanic Origin: 1990 to 2000; machine-readable 

data files). 

Many cities do not have a separate health jurisdiction that collects and reports cases of STDs. For 

these cities, case numbers and crude incidence rates are equal to those of the county or combination 

of counties in which the city is located. These city population numbers are updated yearly, based on 

estimates from the Bureau of Census, and verified by the city project areas. 

Population estimates for 1980-1988 for areas outside the United States were obtained from the 

Bureau of the Census (Bureau of the Census; population estimates for Puerto Rico and the outlying 

areas: 1980 to 1988; Current Population Reports [Series P-25, No. 1049]; Washington: U.S. Government Printing Office, 1989). After 1988, population estimates for outlying areas were obtained 

from the health departments located in these areas. Population estimates for the Virgin Islands were 

used to calculate the rates through 1999. Population estimates for Guam were projected for each 

year through 1999 based on the 1990 census. Population estimates for both Guam and Virgin Islands were available from the Bureau of the Census for 2000 and were used to calculate 2000-2002 

rates. Puerto Rico’s population estimates from 1997 to 2000 were obtained from the Bureau of the 

Census. 

The percentage of reported cases for which race/ethnicity and age information was missing differed substantially by year, area, and disease. States were excluded from comparison across 

race/ethnicity categories if race/ethnicity data were missing from 50% or more of the state’s reported 

cases (these exclusions, if any, are described in the footnote in the race-specific tables). Similarly, 

states in which age information was missing from the majority of reported cases were excluded from 

comparison across age categories. For the remaining states, cases with unknown race/ethnicity or 

age were redistributed to known race/ethnicity or age categories based on the proportion of cases in 

each race/ethnicity or age category. 

134 Sources and Limitations of CDC Surveillance Data Appendix STD Surveillance 2002 
Rates of congenital syphilis for 1989-2002 were calculated using live births from the National 

Center for Health Statistics (NCHS) (Vital Statistics: Natality Tapes 1989-2001 or Vital Statistics Reports, United States 1999, Vol. 48 No.10-Natality). Race-specific rates for 2001-2002 were calculated using live births for 2001. Rates before 1989 were calculated using published live birth data 

(NCHS; Vital Statistics Report, United States, 1988 [Vol.1–Natality]). 

Reporting Practices 

Although most areas generally adhere to the case definitions for STDs found in Case Definitions 

for Infectious Conditions under Public Health Surveillance,1 there may be differences in the policies 

and systems for collecting surveillance data. Thus, comparisons of case numbers and rates among 

areas should be interpreted with caution. However, since case definitions and surveillance activities 

within a given area remain relatively stable, trends should be minimally affected by these differences. In many areas, the reporting from publicly supported institutions (e.g., STD clinics) has been 

more complete than from other sources (e.g., private practitioners). Thus, trends may not be representative of all segments of the population. Military cases are not reported as a separate category. 

Reporting of Chlamydia Cases 

New York City has been reporting chlamydia cases since 1984. However, the State of New York, 

with the exception of New York City, initiated chlamydia reporting during the year 2000. As a result, 

the number of chlamydia cases reported by the state of New York (including the cities of Buffalo, 

Rochester and Yonkers) prior to the year 2001 may be incomplete, and the rate for New York State is 

underestimated. To be consistent with the practice used in earlier years, New York State chlamydia 

reporting data were included in the calculation of overall national chlamydia rates. The number of 

chlamydia cases occurring in the fourth quarter of 2000 for the State of Colorado was projected 

based on case counts from the first three quarters. 

Trends in many areas were more reflective of changes in reporting of cases rather than actual 

trends in disease. Cases and rates of chlamydia reported in sex-specific tables are underestimated 

due to some reported cases with unknown sex. Despite problems with under-reporting, it is important to publish available data to emphasize the large numbers of cases of chlamydia being detected 

in the United States. As areas develop chlamydia prevention and control programs, including improved surveillance systems to monitor trends, the data should improve and become more 

representative of true trends in disease. 

Reporting of Syphilis Cases 

"Total syphilis" or "all stages of syphilis" includes primary, secondary, early latent, late (including 

neurosyphilis, late latent, late with clinical manifestations, and unknown latent), and congenital 

syphilis. Cases of latent syphilis of unknown duration, neurosyphilis, and late syphilis with clinical 

manifestations are included in late and late latent syphilis totals. 

Reporting of Congenital Syphilis Cases 

In 1988, the surveillance case definition for congenital syphilis was changed. This case definition 

has greater sensitivity than the former definition.2 In addition, many areas have greatly enhanced 

active case finding for congenital syphilis since 1988. For these reasons, the number of reported 

STD Surveillance 2002 Appendix Sources and Limitations of CDC Surveillance Data 135 
cases increased dramatically during 1989-1991. As a result of this change in surveillance activity a 

period of transition during which trends cannot be clearly interpreted has resulted; however, all reporting areas had implemented the new case definition for reporting all cases of congenital syphilis 

by January 1, 1992. Therefore, the reliability of trends is expected to have stabilized after this date. 

In addition to changing the case definition for congenital syphilis, CDC introduced a new data 

collection form (CDC 73.126) in 1990. Beginning with 1995, the data collected on this form are 

used for reporting congenital syphilis reported cases and associated rates. This form is used to collect individual case information which allows more thorough analysis of cases. For the purpose of 

analyses by race/ethnicity, if either the race or ethnicity question was answered, the case was included. For example, if "white" race was marked, but ethnicity was left blank, the individual was 

counted as "non-Hispanic white". Congenital syphilis cases were reported by state and city of residence of the mother for 1995 through 2002. 

Chlamydia, Gonorrhea, and Syphilis Prevalence Monitoring 

Chlamydia and gonorrhea test positivity for women attending family planning clinics, prenatal 

clinics, Indian Health Service clinics, the National Job Training Program, men attending STD clinics 

participating in the MSM Prevalence Monitoring Project, the adolescent women attending organizations participating in the Adolescent Women Reproductive Health Monitoring Project, and men and 

women entering corrections facilities was calculated by dividing the number of persons testing positive for chlamydia or gonorrhea (numerator) by the total number of persons screened for each disease (denominator) and was expressed as a percentage. Except for the National Job Training 

Program screening data, the denominators for these data sources may include more than one test 

from the same individual if that person was tested more than once during a year. Various laboratory 

test methods were used for all of these data sources except the National Job Training Program and, 

for most of the figures shown, no adjustments of test positivity were made based on laboratory test 

type and sensitivity. However, for Figure 9, the chlamydia test results for each test type were 

weighted to reflect the sensitivity of the test used.3 The weights used in this adjustment are the reciprocals of the sensitivities of the laboratory test methods used. These test-specific sensitivities were 

defined as estimates from published evaluations of chlamydia screening tests.4,5 Limitations of this 

adjustment include: unknown dates when laboratories changed tests, missing information on the 

test method, variation of test sensitivity within a technology type, and no adjustment for supplemental testing such as negative grey zone testing. 

For more details on chlamydia prevalence, refer to the following annual publication: Centers for 

Disease Control and Prevention. Sexually Transmitted Disease Surveillance 2002 Supplement: 

Chlamydia Prevalence Monitoring Project Annual Report 2002. Atlanta, GA: U.S. Department of 

Health and Human Services (in press). 

Data on antimicrobial susceptibility in Neisseria gonorrhoeae were collected through the 

Gonococcal Isolate Surveillance Project (GISP), a sentinel system of 27 STD clinics and five regional laboratories located throughout the United States. For more details on findings from GISP 

gonorrhea cases, refer to the following annual publication: Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance 2002 Supplement: Gonococcal Isolate Surveillance Project (GISP) Annual Report 2002. Atlanta, GA: U.S. Department of Health and 

Human Services (in press). 

136 Sources and Limitations of CDC Surveillance Data Appendix STD Surveillance 2002 
Syphilis seroreactivity data on men attending STD clinics participating in the MSM Prevalence 

Monitoring Project, and on men and women entering jails and juvenile corrections facilities were 

calculated by dividing the number of persons with a reactive syphilis serologic test (numerator) by 

the total number of persons screened for syphilis (denominator) and expressed as a percentage. 

These seroreactivity data in most instances do not reflect confirmatory testing and thus biologic false 

positive test results were not systematically excluded. The extent to which these data reflect 

prevalence of active syphilis infection varies by site. 

Prevalence data for region- and state-specific figures were published with permission from the Regional Infertility Prevention Program, selected state STD prevention programs, the National Job 

Training Program, U.S. Department of Labor, and the Indian Health Service. 

Definition of HHS Regions 

The ten Health and Human Services (HHS) regions referred to in the text and figures are as follows: Region I = Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont; 

Region II = New Jersey, New York, Puerto Rico, and U.S. Virgin Islands; Region III = Delaware, District of Columbia, Maryland, Pennsylvania, Virginia, and West Virginia; Region IV = Alabama, 

Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, and Tennessee; Region V 

= Illinois, Indiana, Michigan, Minnesota, Ohio, and Wisconsin; Region VI = Arkansas, Louisiana, 

New Mexico, Oklahoma, and Texas; Region VII = Iowa, Kansas, Missouri, and Nebraska; Region 

VIII = Colorado, Montana, North Dakota, South Dakota, Utah, and Wyoming; Region IX = Arizona, California, Guam, Hawaii, and Nevada; and Region X = Alaska, Idaho, Oregon, and 

Washington. 

Definition of IHS Areas 

The 12 Indian Health Service (IHS) Areas referred to in the text and figures are as follows, with 

overlap in some states: Aberdeen Area (Iowa, North Dakota, Nebraska, and South Dakota); Alaska 

Area (Alaska); Albuquerque Area (Colorado and New Mexico); Bemidji Area (Illinois, Indiana, 

Michigan, Minnesota, and Wisconsin); Billings Area (Montana and Wyoming); California Area (California); Nashville Area (Alabama, Connecticut, Florida, Louisiana, Maine, Maryland, Massachusetts, Mississippi, New York, North Carolina, Rhode Island, South Carolina, and Tennessee); 

Navajo Area (Arizona, New Mexico, and Utah); Oklahoma City Area (Kansas, Oklahoma, and 

Texas); Phoenix Area (Arizona, Nevada and Utah); Portland Area (Idaho, Oregon, and 

Washington); and Tucson Area (Arizona). 

Other Data Sources 

The information on the number of initial visits to private physicians’ offices for sexually transmitted diseases was based on analysis of data from the National Disease and Therapeutic Index (NDTI) 

(machine-readable files or summary statistics for years 1966-2002). For more information on this 

database, contact IMS Health, 660 W. Germantown Pike, Plymouth Meeting, PA 19462; 

Telephone: (800) 523-5333. 

The information on patients hospitalized for pelvic inflammatory disease or ectopic pregnancy 

was based on analysis of data from the National Hospital Discharge Survey (machine-readable files 

for years 1980-2000), an ongoing nationwide sample survey of short-stay hospitals in the United 

States, conducted by the National Center for Health Statistics. For more information, see Graves EJ; 

STD Surveillance 2002 Appendix Sources and Limitations of CDC Surveillance Data 137 
1988 Summary: National Hospital Discharge Survey; Advance data No. 185; Hyattsville (MD): National Center for Health Statistics, 1990. The National Hospital Ambulatory Medical Care Survey 

(NHAMCS-ER) (machine-readable files for 1995-2000) was used to obtain estimates of the number 

of emergency room visits for pelvic inflammatory disease among women ages 15 to 44. Data on 

HSV-2 seroprevalence among the non-institutionalized U.S. population were obtained from the 

National Health and Nutrition Examination Survey (NHANES). The estimates generated using 

these data sources (NHDS, NHAMCS, and NHANES) are based on statistical surveys and therefore 

have sampling variability associated with the estimates. 

Healthy People 2010 Objectives 

In January 2000, CDC released objectives for Healthy People 2010 (HP2010).6 The year 2010 rate 

objectives for the diseases addressed in this report are: primary and secondary syphilis–0.2 case per 

100,000 population; congenital syphilis–1.0 case per 100,000 live births; and gonorrhea–19.0 cases 

per 100,000 population. An additional target established in the HP2010 objectives is to reduce the 

Chlamydia trachomatis test positivity to 3.0% among females aged 15 to 24 years who attend family 

planning and STD clinics and among males aged 15 to 24 who attend STD clinics (Table A1). 

1	 Centers for Disease Control and Prevention. Case Definitions for infectious conditions under public health 

surveillance, 1997. MMWR 1997;46(No. RR-10;1). 

2	 Kaufman RE, Jones, OG, Blount, JH, Wiesner PJ. Questionnaire survey of reported early congenital 

syphilis: problems in diagnosis, prevention, and treatment. Sex Transm Dis 1977;4:135-9. 

3	 Webster Dicker L, Mosure DJ, Levine WC, Black CM, Berman SM. The impact of switching laboratory 

tests on reported trends in Chlamydia trachomatis infections. Am J Epidemiol 2000;151:430-435. 

4	 Newhall WJ, DeLisle, S, Fine D, et al. Head-to-head evaluation of five different non-culture chlamydia 

tests relative to a quality-assured culture standard. Sex Transm Dis 1994;21:S165-6. 

5	 Black CM, Marrazzo J, Johnson RE, et al. Head-to-head multicenter comparision of DNA probe and 

nucleic acid amplification tests for Chlamydia trachomatis infection in women performed with an 

improved reference standard. J Clin Micro 2002;40:3757-3763. 

6	 U.S. Department of Health and Human Services. Healthy People 2010. 2ndnd ed. With Understanding and 

Improving Health and Objectives for Improving Health. 2 vols. Washington, DC: U.S. Government 

Printing Office, November 2000. 

138 Sources and Limitations of CDC Surveillance Data Appendix STD Surveillance 2002 
Table A1. Healthy People 2010 Sexually Transmitted Diseases Objective Status 

Baseline HP 2010 

HP 2010 Objectives Year Baseline 1997 1998 1999 2000 2001 2002 Target 

25-1 Reduce the proportion of 

adolescents and young adults 

with Chlamydia trachomatis 

infections 

a. Females aged 15 to 24 years attending family planning

clinics 

1997 5.0% 5.0%* 6.1%* 5.6%* 5.9%* 5.8%* 6.0%* 3.0% 

b. Females aged 15 to 24 years attending STD clinics 1997 12.2% 12.2%* 13.5%* 13.7%* 13.5%* 13.3%* 13.5%* 3.0% 

c. Males aged 15 to 24 years attending STD clinics 1997 15.7% 15.7%* 16.9%* 17.0%* 16.4%* 17.0%* 17.5%* 3.0% 

25-2 Reduce gonorrhea (cases per 

100,000 population) 

1997 123.0 122.4 131.9 132.3 129.0 128.5 125.0 19.0 

25-3 Eliminate sustained domestic 1997 3.2 3.2 2.6 2.4 2.1 2.2 2.4 0.2 

transmission of primary and 

secondary syphilis (cases per 

100,000 population) 

25-4 Reduce the proportion of adults 

aged 20 to 29 years with genital 

herpes infection 

1988-94 17.0% NA NA NA NA NA NA 14.0% 

25-6 Reduce the proportion of females 

aged 15 to 44 years who have 

ever required treatment for 

pelvic inflammatory disease 

(PID) 

1995 8.0% NA NA NA NA NA NA 5.0% 

25-7 Reduce the proportion of 

childless females with fertility 

problems who have had a 

sexually transmitted disease or 

who have required treatment for 

pelvic inflammatory disease 

(PID) 

1995 27.0% NA NA NA NA NA NA 15.0% 

25-9 Reduce congenital syphilis (cases 

per 100,000 live births) 

1997 27.0 27.8 21.3 14.5 14.1 12.2 10.2 1.0 

HP 2010 Objective Data Source 

25-1 STD Surveillance System, CDC, NCHSTP. 

25-2 STD Surveillance System, CDC, NCHSTP. 

25-3 STD Surveillance System, CDC, NCHSTP. 

25-4 National Health and Nutrition Examination Survey (NHANES), CDC, NCHS. 

25-6 National Survey of Family Growth (NSFG), CDC, NCHS. 

25-7 National Survey of Family Growth (NSFG), CDC, NCHS. 

25-9 STD Surveillance System, CDC, NCHSTP. 

*Positivity not adjusted for changes in laboratory test method and associated increases in test sensitivity.
 

NOTE: Healthy People 2010 developmental objectives are not addressed in this report.
 

NA=Not available
 

STD Surveillance 2002 Appendix Healthy People 2010 139 

STD Surveillance Case Definitions 

PART 1. CASE DEFINITIONS1 FOR NATIONALLY NOTIFIABLE INFECTIOUS DISEASES 

Chancroid (Revised 9/96)

Clinical description

A sexually transmitted disease characterized by painful genital ulceration and inflammatory inguinal adenopathy. The disease is caused by infection with Haemophilus ducreyi. 

Laboratory criteria for diagnosis

• Isolation of H. ducreyi from a clinical specimen 

Case classification

Probable: a clinically compatible case with both a) no evidence of Treponema pallidum infection by 

darkfield microscopic examination of ulcer exudate or by a serologic test for syphilis performed ≥7 

days after onset of ulcers and b) either a clinical presentation of the ulcer(s) not typical of disease 

caused by herpes simplex virus (HSV) or a culture negative for HSV. 

Confirmed: a clinically compatible case that is laboratory confirmed 

Chlamydia trachomatis, Genital Infections (Revised 9/96)

Clinical description

Infection with Chlamydia trachomatis may result in urethritis, epididymitis, cervicitis, acute 

salpingitis, or other syndromes when sexually transmitted; however, the infection is often asymptomatic in women. Perinatal infections may result in inclusion conjunctivitis and pneumonia in newborns. Other syndromes caused by C. trachomatis include lymphogranuloma venereum (see 

Lymphogranuloma Venereum) and trachoma. 

Laboratory criteria for diagnosis

• Isolation of C. trachomatis by culture or 

• Demonstration of C. trachomatis in a clinical specimen by detection of antigen or
 

nucleic acid
 

Case classification

Confirmed: a case that is laboratory confirmed 

Gonorrhea (Revised 9/96)

Clinical description

A sexually transmitted infection commonly manifested by urethritis, cervicitis, or salpingitis. 

Infection may be asymptomatic. 

Laboratory criteria for diagnosis

• Isolation of typical gram-negative, oxidase-positive diplococci (presumptive 

Neisseria gonorrhoeae) from a clinical specimen, or 

STD Surveillance 2002 Appendix STD Surveillance Case Definitions 141 
• Demonstration of N. gonorrhoeae in a clinical specimen by detection of antigen or 

nucleic acid, or 

• Observation of gram-negative intracellular diplococci in a urethral smear obtained 

from a male 

Case classification

Probable: a) demonstration of gram-negative intracellular diplococci in an endocervical smear obtained from a female or b) a written morbidity report of gonorrhea submitted by a physician 

Confirmed: a case that is laboratory confirmed 

Syphilis (All Definitions Revised 9/96)

Syphilis is a complex sexually transmitted disease that has a highly variable clinical course. Classification by a clinician with expertise in syphilis may take precedence over the following case definitions developed for surveillance purposes. 

Syphilis, primary

Clinical description

A stage of infection with Treponema pallidum characterized by one or more chancres (ulcers); 

chancres might differ considerably in clinical appearance. 

Laboratory criteria for diagnosis

• Demonstration of T. pallidum in clinical specimens by darkfield microscopy, direct 

fluorescent antibody (DFA-TP), or equivalent methods 

Case classification

Probable: a clinically compatible case with one or more ulcers (chancres) consistent with primary 

syphilis and a reactive serologic test (nontreponemal: Venereal Disease Research Laboratory 

[VDRL] or rapid plasma reagin [RPR]; treponemal: fluorescent treponemal antibody absorbed 

[FTA-ABS] or microhemagglutination assay for antibody to T. pallidum [MHA-TP]) 

Confirmed: a clinically compatible case that is laboratory confirmed 

Syphilis, secondary

Clinical description

A stage of infection caused by T. pallidum and characterized by localized or diffuse 

mucocutaneous lesions, often with generalized lymphadenopathy. The primary chancre may still 

be present. 

Laboratory criteria for diagnosis

• Demonstration of T. pallidum in clinical specimens by darkfield microscopy, DFATP, 

or equivalent methods 

Case classification

Probable: a clinically compatible case with a nontreponemal (VDRL or RPR) titer ≥4 

Confirmed: a clinically compatible case that is laboratory confirmed 

142 STD Surveillance Case Definitions Appendix STD Surveillance 2002 
Syphilis, latent

Clinical description

A stage of infection caused by T. pallidum in which organisms persist in the body of the infected 

person without causing symptoms or signs. Latent syphilis is subdivided into early, late, and unknown categories based on the duration of infection. 

Case classification

Probable: no clinical signs or symptoms of syphilis and the presence of one of the following: 

• No past diagnosis of syphilis, a reactive nontreponemal test (i.e., VDRL or RPR), and 

a reactive treponemal test (i.e., FTA-ABS or MHA-TP) 

• A past history of syphilis therapy and a current nontreponemal test titer demonstrating 

fourfold or greater increase from the last nontreponemal test titer 

Syphilis, early latent

Clinical description

A subcategory of latent syphilis. When initial infection has occurred within the previous 12 

months, latent syphilis is classified as early latent. 

Case classification

Probable: latent syphilis (see Syphilis, latent) in a person who has evidence of having acquired the 

infection within the previous 12 months based on one or more of the following criteria: 

• Documented seroconversion or fourfold or greater increase in titer of a 

nontreponemal test during the previous 12 months 

• A history of symptoms consistent with primary or secondary syphilis during the 

previous 12 months 

• A history of sexual exposure to a partner who had confirmed or probable primary or 

secondary syphilis or probable early latent syphilis (documented independently as 

duration <1 year) 

• Reactive nontreponemal and treponemal tests from a person whose only possible 

exposure occurred within the preceding 12 months 

Syphilis, late latent

Clinical description

A subcategory of latent syphilis. When initial infection has occurred >1 year previously, latent 

syphilis is classified as late latent. 

Case classification

Probable: latent syphilis (see Syphilis, latent) in a patient who has no evidence of having acquired 

the disease within the preceding 12 months (see Syphilis, early latent) and whose age and titer do 

not meet the criteria specified for latent syphilis of unknown duration. 

Syphilis, latent, of unknown duration

Clinical description

A subcategory of latent syphilis. When the date of initial infection cannot be established as having 

occurred within the previous year and the patient’s age and titer meet criteria described below, latent syphilis is classified as latent syphilis of unknown duration. 

STD Surveillance 2002 Appendix STD Surveillance Case Definitions 143 
Case classification

Probable: latent syphilis (see Syphilis, latent) that does not meet the criteria for early latent syphilis, and the patient is aged 13–35 years and has a nontreponemal titer ≥32 

Neurosyphilis

Clinical description

Evidence of central nervous system infection with T. pallidum

Laboratory criteria for diagnosis

• A reactive serologic test for syphilis and reactive VDRL in cerebrospinal fluid (CSF)
 

Case classification
 

Case classification

Probable: syphilis of any stage, a negative VDRL in CSF, and both the following: 

• Elevated CSF protein or leukocyte count in the absence of other known causes of
 

these abnormalities
 

• Clinical symptoms or signs consistent with neurosyphilis without other known causes
 

for these clinical abnormalities
 

Confirmed: syphilis of any stage that meets the laboratory criteria for neurosyphilis 

Syphilis, late, with clinical manifestations other than neurosyphilis (late benign syphilis

and cardiovascular syphilis)

Clinical description

Clinical manifestations of late syphilis other than neurosyphilis may include inflammatory lesions 

of the cardiovascular system, skin, and bone. Rarely, other structures (e.g., the upper and lower respiratory tracts, mouth, eye, abdominal organs, reproductive organs, lymph nodes, and skeletal 

muscle) may be involved. Late syphilis usually becomes clinically manifest only after a period of 

15–30 years of untreated infection. 

Laboratory criteria for diagnosis

Demonstration of T. pallidum in late lesions by fluorescent antibody or special stains (although organisms are rarely visualized in late lesions) 

Case classification

Probable: characteristic abnormalities or lesions of the cardiovascular system, skin, bone, or 

other structures with a reactive treponemal test, in the absence of other known causes of these abnormalities, and without CSF abnormalities and clinical symptoms or signs consistent with 

neurosyphilis 

Confirmed: a clinically compatible case that is laboratory confirmed 

Comment

Analysis of CSF for evidence of neurosyphilis is necessary in the evaluation of late syphilis with 

clinical manifestations. 

144 STD Surveillance Case Definitions Appendix STD Surveillance 2002 
Syphilitic Stillbirth

Clinical description

A fetal death that occurs after a 20-week gestation or in which the fetus weighs >500 g and the 

mother had untreated or inadequately treated* syphilis at delivery 

Comment

For reporting purposes, syphilitic stillbirths should be reported as cases of congenital syphilis. 

Syphilis, Congenital (Revised 9/96)

Clinical description

A condition caused by infection in utero with Treponema pallidum. A wide spectrum of severity 

exists, and only severe cases are clinically apparent at birth. An infant or child (aged <2 years) may 

have signs such as hepatosplenomegaly, rash, condyloma lata, snuffles, jaundice (nonviral hepatitis), pseudoparalysis, anemia, or edema (nephrotic syndrome and/or malnutrition). An older child 

may have stigmata (e.g., interstitial keratitis, nerve deafness, anterior bowing of shins, frontal bossing, mulberry molars, Hutchinson teeth, saddle nose, rhagades, or Clutton joints). 

Laboratory criteria for diagnosis

Demonstration of T. pallidum by darkfield microscopy, fluorescent antibody, or other specific 

stains in specimens from lesions, placenta, umbilical cord, or autopsy material 

Case classification

Probable: a condition affecting an infant whose mother had untreated or inadequately treated* 

syphilis at delivery, regardless of signs in the infant, or an infant or child who has a reactive 

treponemal test for syphilis and any one of the following: 

• Any evidence of congenital syphilis on physical examination 

• Any evidence of congenital syphilis on radiographs of long bones 

• A reactive cerebrospinal fluid (CSF) venereal disease research laboratory (VDRL) 

• An elevated CSF cell count or protein (without other cause) 

• A reactive fluorescent treponemal antibody absorbed—19S-IgM antibody test or IgM
 

enzyme-linked immunosorbent assay
 

Confirmed: a case that is laboratory confirmed 

Comment

Congenital and acquired syphilis may be difficult to distinguish when a child is seropositive after 

infancy. Signs of congenital syphilis may not be obvious, and stigmata may not yet have developed. 

Abnormal values for CSF VDRL, cell count, and protein, as well as IgM antibodies, may be found in 

either congenital or acquired syphilis. Findings on radiographs of long bones may help because radiographic changes in the metaphysis and epiphysis are considered classic signs of congenitally acquired syphilis. The decision may ultimately be based on maternal history and clinical judgment. In 

a young child, the possibility of sexual abuse should be considered as a cause of acquired rather 

than congenital syphilis, depending on the clinical picture. For reporting purposes, congenital syphilis includes cases of congenitally acquired syphilis among infants and children as well as syphilitic 

stillbirths. 

*Inadequate treatment consists of any nonpenicillin therapy or penicillin administered <30 days before delivery. 

STD Surveillance 2002 Appendix STD Surveillance Case Definitions 145 
PART 2. CASE DEFINITIONS1 FOR NON-NOTIFIABLE INFECTIOUS DISEASES 

Genital Herpes (Herpes Simplex Virus) (Revised 9/96)

Clinical description

A condition characterized by visible, painful genital or anal lesions 

Laboratory criteria for diagnosis

• Isolation of herpes simplex virus from cervix, urethra, or anogenital lesion, or 

• Demonstration of virus by antigen detection technique in clinical specimens from 

cervix, urethra, or anogenital lesion, or 

• Demonstration of multinucleated giant cells on a Tzanck smear of scrapings from an 

anogenital lesion 

Case classification

Probable: a clinically compatible case (in which primary and secondary syphilis have been excluded by appropriate serologic tests and darkfield microscopy, when available) with either a diagnosis of genital herpes based on clinical presentation (without laboratory confirmation) or a history 

of one or more previous episodes of similar genital lesions 

Confirmed: a clinically compatible case that is laboratory confirmed 

Comment

Genital herpes should be reported only once per patient. The first diagnosis for a patient with no 

previous diagnosis should be reported. 

Genital Warts (Revised 9/96)

Clinical description

An infection characterized by the presence of visible, exophytic (raised) growths on the internal or 

external genitalia, perineum, or perianal region 

Laboratory criteria for diagnosis

• Histopathologic changes characteristic of human papillomavirus infection in 

specimens obtained by biopsy or exfoliative cytology or 

• Demonstration of virus by antigen or nucleic acid detection in a lesion biopsy 

Case classification

Probable: a clinically compatible case without histopathologic diagnosis and without microscopic or 

serologic evidence that the growth is the result of secondary syphilis 

Confirmed: a clinically compatible case that is laboratory confirmed 

Comment

Genital warts should be reported only once per patient. The first diagnosis for a patient with no 

previous diagnosis should be reported. 

Granuloma Inguinale

Clinical description

A slowly progressive ulcerative disease of the skin and lymphatics of the genital and perianal area 

caused by infection with Calymmatobacterium granulomatis. A clinically compatible case would 

have one or more painless or minimally painful granulomatous lesions in the anogenital area. 

146 STD Surveillance Case Definitions Appendix STD Surveillance 2002 
Laboratory criteria for diagnosis

• Demonstration of intracytoplasmic Donovan bodies in Wright or Giemsa-stained 

smears or biopsies of granulation tissue 

Case classification

Confirmed: a clinically compatible case that is laboratory confirmed 

Lymphogranuloma Venereum

Clinical description

Infection with L1, L2, or, L3 serovars of Chlamydia trachomatis may result in a disease characterized by genital lesions, suppurative regional lymphadenopathy, or hemorrhagic proctitis. The infection is usually sexually transmitted. 

Laboratory criteria for diagnosis

•	 Isolation of C. trachomatis, serotype L1, L2, or L3 from clinical specimen, or 

• Demonstration by immunofluorescence of inclusion bodies in leukocytes of an 

inguinal lymph node (bubo) aspirate, or 

• Positive microimmunofluorescent serologic test for a lymphogranuloma venereum 

strain of C. trachomatis

Case classification

Probable: a clinically compatible case with one or more tender fluctuant inguinal lymph nodes or 

characteristic proctogenital lesions with supportive laboratory findings of a single C. trachomatis

complement fixation titer of >64 

Confirmed: a clinically compatible case that is laboratory confirmed 

Mucopurulent Cervicitis (Revised 9/96)

Clinical description

Cervical inflammation that is not the result of infection with Neisseria gonorrhoeae or 

Trichomonas vaginalis. Cervical inflammation is defined by the presence of one of the following 

criteria: 

• Mucopurulent secretion (from the endocervix) that is yellow or green when viewed on
 

a white, cotton-tipped swab (positive swab test)
 

•	 Induced endocervical bleeding (bleeding when the first swab is placed in the 

endocervix) 

Laboratory criteria for diagnosis

• No evidence of N. gonorrhoeae by culture, Gram stain, or antigen or nucleic acid 

detection, and no evidence of T. vaginalis on wet mount 

Case classification

Confirmed: a clinically compatible case in a female who does not have either gonorrhea or 

trichomoniasis 

Comment

Mucopurulent cervicitis (MPC) is a clinical diagnosis of exclusion. The syndrome may result from 

infection with any of several agents (see Chlamydia trachomatis, Genital Infections). If gonorrhea, 

trichomoniasis, and chlamydia are excluded, a clinically compatible illness should be classified as 

STD Surveillance 2002	 Appendix STD Surveillance Case Definitions 147 
MPC. An illness in a female that meets the case definition of MPC and C. trachomatis infection 

should be classified as chlamydia. 

Nongonococcal Urethritis (Revised 9/96)

Clinical description

Urethral inflammation that is not the result of infection with Neisseria gonorrhoeae. Urethral inflammation may be diagnosed by the presence of one of the following criteria: 

• A visible abnormal urethral discharge, or 

• A positive leukocyte esterase test from a male aged <60 years who does not have a
 

history of kidney disease or bladder infection, prostate enlargement, urogenital
 

anatomic anomaly, or recent urinary tract instrumentation, or
 

• Microscopic evidence of urethritis (≥5 white blood cells per high-power field) on a
 

Gram stain of a urethral smear
 

Laboratory criteria for diagnosis

• No evidence of N. gonorrhoeae infection by culture, Gram stain, or antigen or nucleic
 

acid detection
 

Case classification

Confirmed: a clinically compatible case in a male in whom gonorrhea is not found, either by culture, 

Gram stain, or antigen or nucleic acid detection 

Comment

Nongonococcal urethritis (NGU) is a clinical diagnosis of exclusion. The syndrome may result 

from infection with any of several agents (see Chlamydia trachomatis, Genital Infection). If gonorrhea and chlamydia are excluded, a clinically compatible illness should be classified as NGU. An illness in a male that meets the case definition of NGU and C. trachomatis infection should be 

classified as chlamydia. 

Pelvic Inflammatory Disease (Revised 9/96)

Clinical case definition

A clinical syndrome resulting from the ascending spread of microorganisms from the vagina and 

endocervix to the endometrium, fallopian tubes, and/or contiguous structures. In a female who has 

lower abdominal pain and who has not been diagnosed as having an established cause other than 

pelvic inflammatory disease (PID) (e.g., ectopic pregnancy, acute appendicitis, and functional 

pain), all the following clinical criteria must be present: 

• Lower abdominal tenderness, and 

• Tenderness with motion of the cervix, and 

• Adnexal tenderness 

In addition to the preceding criteria, at least one of the following findings must also be present: 

• Meets the surveillance case definition of C. trachomatis infection or gonorrhea 

• Temperature >100.4 F (>38.0 C) 

• Leukocytosis >10,000 white blood cells/mm3 

• Purulent material in the peritoneal cavity obtained by culdocentesis or laparoscopy 

148 STD Surveillance Case Definitions Appendix STD Surveillance 2002 
• Pelvic abscess or inflammatory complex detected by bimanual examination or by 

sonography 

• Patient is a sexual contact of a person known to have gonorrhea, chlamydia, or 

nongonococcal urethritis 

Case classification

Confirmed: a case that meets the clinical case definition 

Comment

For reporting purposes, a clinician’s report of PID should be counted as a case. 

1 Centers for Disease Control and Prevention. Case Definitions for infectious conditions under public health 

surveillance, 1997. MMWR 1997;46(No. RR-10;1). 

STD Surveillance 2002 Appendix STD Surveillance Case Definitions 149 
STD Project Directors, STD Program Managers, and State and Territorial Epidemiologists 

We gratefully acknowledge the contributions of state STD project directors, STD program managers, and state and territorial 

epidemiologists to this report. The persons listed were in the positions shown as of August 15, 2003. 

STD Project Directors STD Program Managers State Epidemiologists 

Alabama Charles H. Woernle Maxie Fleming Charles Woernle 

Alaska Allison Bell Donna Cecere John P. Middaugh 

Arizona Victorio Vaz Victorio Vaz Bob England 

Arkansas Renee Patrick Kaleemulla Sayyed Frank Wilson 

California Gail Bolan Romni Neiman Duc J. Vugia 

Los Angeles Peter Kerndt Kerry Kenney Duc J. Vugia 

San Francisco Jeffrey Klausner Wendy Wolf Duc J. Vugia 

Colorado Maureen Bush Terry Tiller-Taylor Ned Calonge 

Connecticut James L. Hadler Heidi Jenkins James L. Hadler 

Delaware James C. Welch Catherine Mosley A. LeRoy Hathcock 

District of Columbia Karen Berry John Heath John Davies-Cole 

Florida Landis Crockett Karla Schmitt Landis Crockett 

Georgia Veronica Hartwell Veronica Hartwell Paul Blake 

Hawaii Peter Whiticar Roy Ohye Paul Effler 

Idaho Russell Duke Anne Williamson Christine G. Hahn 

Illinois Charlie Rabins Charlie Rabins Mark Dworkin 

Chicago Janice Johnson Dawn Broussard Mark Dworkin 

Indiana Michael Butler Jim Beall Robert Teclaw 

Iowa Julie McMahon Jim Goodrich Patricia Quinlisk 

Kansas Sharon Patnode R. Allen Mayer Gianfranco Pezzino 

Kentucky Barry Wainscott David Raines Steven Englender 

Louisiana Lisa Ann Longfellow Dennis Dorst Raoult Ratard 

Maine Sally Lou Patterson Charles Dwyer Kathleen F. Gensheimer 

Maryland Tory Ameree Scott Tulloch David Blythe 

Baltimore Claude Jacob Glen Oltoff David Blythe 

Massachusetts Thomas Bertrand Thomas Bertrand Alfred DeMaria 

Michigan Loretta Davis-Satterla Mark A. Miller Matthew L. Boulton 

Minnesota Julia Ashley Julia Ashley Harry Hull 

Mississippi Craig Thompson Vacant Mary Currier 

Missouri Mary Menges Nyla DeArmitt Joseph Malone 

Montana Amy Kelly Laurie Kops Todd A. Damrow 

Nebraska Phil Medina Phil Medina Thomas J. Safranek 

Nevada Richard Whitley Doug Banghart Randall Todd 

New Hampshire Heather Hauck Heather Hauck Jesse Greenblatt 

New Jersey Janet DeGraaf Jerry Carolina Eddy A. Bresnitz 

New Mexico Don Torres Al Chowning C. Mack Sewell 

New York F. Bruce Coles Steve Brooks Perry F. Smith 

New York City Susan Blank Steve Rubin Benjamin Mojica 

North Carolina Evelyn M. Foust Evelyn M. Foust Jeffrey Engel 

North Dakota Larry Shireley Kirby Kruger Larry Shireley 

Ohio Jeff Vasiloff Timothy Bahns Forrest W. Smith 

Oklahoma William R. Pierson Mark Turner Michael Crutcher 

Oregon Mark Loveless Jan Karius Melvin Kohn 

Pennsylvania Weston Ruhrig Steve Kowalewski James T. Rankin, Jr. 

Philadelphia Robert Levenson Martin Goldberg James T. Rankin, Jr. 

Rhode Island Larry Reynolds Nancy Walsh Utpala Bandy 

South Carolina Lynda Kettinger Lynda Kettinger James Jerry Gibson 

South Dakota Laurie Gill David Morgan Lon Kightlinger 

Tennessee Keith Williams Robert Burke Allen Craig 

Texas Felipe Rocha Jim Lee Dennis M. Perotta 

Utah Teresa Garrett Tim Lane Robert T. Rolfs 

Vermont Marilyn Richards-Proulx Marilyn Richards-Proulx Susan Schoenfeld 

Virginia Casey Riley Casey Riley John Marr 

Washington Larry Klopfenstein Larry Klopfenstein Jo Hofmann 

West Virginia Loretta E. Haddy Margaret Taylor Loretta E. Haddy 

Wisconsin Herb Bostrom Anthony Wade Jeffrey Davis 

Wyoming Jimm Murray Roger Burr Karl Musgrave 

American Samoa Joseph Tufa Tai Ripley Joseph Tufa 

Federated States of 

Micronesia Eliuel K. Pretrick Kidsen K. Iohp Jean Paul Chaine 

Government of the 

Marshall Islands James Hosfschneider Altina Anien James Hosfschneider 

Guam Josie O'Mallan Bernadette Schumann Robert L. Haddock 

Puerto Rico Alberto Carrera Baquero Trinidad Garcia Angeles Redriguez 

Republic of Palau Caleb Otto Johana Ngiruchelbad Jill McCready 

Virgin Islands Mavis Matthews Lucien Moolenaar Mavis Matthew 

150 Contributors Appendix STD Surveillance 2002