Sexually 

Transmitted 

Disease 

Surveillance 

1998 

Division of STD Prevention 

September 1999 

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..................................................Jeffrey P. Koplan, M.D., M.P.H. 

Director 

National Center for 

HIV, STD, and TB Prevention..................Helene D. Gayle, M.D., M.P.H. 

Director 

Division of STD Prevention...............Judith N. Wasserheit, M.D., M.P.H.
 

Director 

Epidemiology and Surveillance Branch .......Michael E. St. Louis, M.D.
 

Chief 

Surveillance and Special Studies 

Section .......................................William C. Levine, M.D., M.Sc. 

Chief 

Statistics and Data Management 

Branch.......................................................Russell H. Roegner, Ph.D. 

Chief 

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

Deputy Chief 

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 

Division of STD Prevention. Sexually Transmitted Disease Surveillance, 1998. Department of 

Health and Human Services, Atlanta: Centers for Disease Control and Prevention (CDC), 

September 1999. 

Copies can be obtained from the Office of Communications, National Center for HIV, STD, and 

TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road, Mailstop E-06, 

Atlanta, Georgia 30333. 

The report is also available by Internet via the CDC home page at: 

http://www.cdc.gov/nchstp/dstd/Stats_Trends/1998_Surv_Rpt_main_pg.htm 

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

. 

1Concluding statement from the Institute of Medicine’s Summary Report, The Hidden Epidemic: Confronting Sexually Transmitted Diseases, National Academy Press, Washington, D.C., 1997, p.43. 

v 
Preface 

Sexually Transmitted Disease Surveillance, 1998 presents statistics and trends of sexually 

transmitted diseases (STDs) in the United States through 1998. 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, STD project areas, the U.S. Job Corps, and Jail STD Prevalence Monitoring Projects; (3) 

sentinel surveillance of gonococcal antimicrobial resistance from the Gonococcal Isolate Surveillance 

Project; 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 most of the information in this publication. These systems are 

an integral part of program management at all levels of STD prevention and control in the United 

States. 

Sexually Transmitted Disease Surveillance, 1998 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; Table A1 displays progress made toward Healthy People 2000 Priority Area 19, 

Objectives 19.1-19.8, on Sexually Transmitted Diseases; and Figures A1-A3 show progress made by 

states in converting from hardcopy aggregate reporting to electronic line-listed data submissions. 

Selected figures and tables in this document include a reference point that is used to monitor progress toward some of the Healthy People 2000 (HP2000) national health status objectives for STDs1

. 

The original HP2000 health status objectives were developed in 1989 and revised in 1995. The revisions are used as reference points in this edition of Sexually Transmitted Disease Surveillance, 1998. 

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. 

1Department of Health and Human Services. Healthy People 2000: Midcourse Review and 1995 Revisions. 

U.S. Department of Health and Human Services, Public Health Service, U.S. Government Printing Office, 

Washington, D.C., 1995. 

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, who 

provided state and local surveillance data to the Centers for Disease Control and Prevention. 

This report was prepared by the following staff members of the Division of STD Prevention, 

National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention: 

Charles Akers, Susan Bradley, Jim Braxton, Sharon Clanton, Darlene Davis, Lyn Finelli, LaZetta 

Grier, Alesia Jester Harvey, Sharon Hixon, Kathleen Hutchins, Kristen Mertz, Debra Mosure, 

Raymond Ransom, LuEtta Schneider, Maya Sternberg, Emmett Swint, Susan Wang and Akbar 

Zaidi. 

Dedication 

We dedicate this volume to our colleague and friend, Russ Roegner. After 3 years as the Chief of 

the Statistics and Data Management Branch, Dr. Roegner is moving on to Washington, D.C. He has 

been an outstanding leader and dedicated member of the team producing this report. We wish him 

the best in the years to come. 

vii 

Contents 

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

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

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

Figures in the National Profile ................................................ x
 

Additional Figures for the Special Focus Profiles.................................. xii 
 

Tables in the National Profile................................................ xiv 
 

Geographic Divisions of the United States ..................................... xvii
 

National Overview of Sexually Transmitted Diseases, 1998 .......................... 1
 

National Profile 

Introduction ........................................................... 3
 

Chlamydia ............................................................ 5
 

Gonorrhea ........................................................... 13 
 

Syphilis ............................................................. 23 
 

Other Sexually Transmitted Diseases ....................................... 33 
 

Special Focus Profiles 

Introduction .......................................................... 37 
 

STDs in Women and Infants ............................................. 39 
 

STDs in Adolescents and Young Adults ..................................... 49 
 

STDs in Minorities ..................................................... 55 
 

STDs in Persons Entering Corrections Facilities ............................... 61 
 

STDs in the South ..................................................... 65 
 

Detailed Tables 

Summary Tables ...................................................... 69 
 

Chlamydia Tables ..................................................... 72 
 

Gonorrhea Tables ..................................................... 82 
 

Syphilis Tables........................................................ 92 
 

Chancroid Tables..................................................... 114 
 

Appendix 

Sources and Limitations of Data.......................................... 117 
 

Figures A1 - A3 ...................................................... 123 
 

Table A1 ........................................................... 125 
 

Contributors......................................................... 126 
 

ix 
Figures in the National Profile 

Chlamydia 

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

trachomatis infections: United States, 1987–1998.................... 7
 

Figure 2. Chlamydia — Reported rates: United States, 1984–1998 ............... 7
 

Figure 3. Chlamydia — Rates by state: United States and outlying areas, 1998 ....... 8
 

Figure 4. Chlamydia — Rates by region: United States, 1984–1998............... 8
 

Figure 5. Chlamydia — Rates in selected U.S. cities of >200,000 population,
 

1984–1998 .................................................. 9
 

Figure 6. Chlamydia — Rates by gender: United States, 1984–1998 .............. 9
 

Figure 7. Chlamydia — Age- and gender-specific rates: United States, 1998 ....... 10 
 

Figure 8. Chlamydia — Positivity among women tested in family planning clinics
 

by state: Region X, 1988–1998 .................................. 10 
 

Figure 9. Chlamydia — Positivity among 15-24 year old women tested in family
 

planning clinics by state, 1998 ................................... 11 
 

Figure 10. Chlamydia — Trends in positivity among 15-44 year old women tested
 

in family planning clinics by HHS regions, 1988–1998 ................ 11 
 

Gonorrhea 

Figure 11. Gonorrhea — Reported rates: United States, 1970–1998 and the
 

Healthy People year 2000 objective .............................. 16 
 

Figure 12. Gonorrhea — Rates by state: United States and outlying areas, 1998 ..... 16 
 

Figure 13. Gonorrhea — Rates by region: United States, 1981–1998 and the
 

Healthy People year 2000 objective .............................. 17 
 

Figure 14. Gonorrhea — Rates in selected U.S. cities of >200,000 population,
 

1981–1998 and the Healthy People year 2000 objective............... 17 
 

Figure 15. Gonorrhea — Rates by gender: United States, 1981–1998 and the
 

Healthy People year 2000 objective .............................. 18 
 

Figure 16. Gonorrhea — Rates by race and ethnicity: United States, 1981–1998
 

and the Healthy People year 2000 objective ........................ 18 
 

Figure 17. Gonorrhea — Age- and gender-specific rates: United States, 1998 ....... 19 
 

Figure 18. Gonorrhea — Positivity among 15-24 year old women tested in family
 

planning clinics by state, 1998 ................................... 19 
 

Figure 19. Gonococcal Isolate Surveillance Project (GISP) — Location of
 

participating clinics and regional laboratories: United States, 1998 ....... 20 
 

Figure 20. Gonococcal Isolate Surveillance Project (GISP) — Trends in plasmidmediated resistance to penicillin and tetracycline, 1988–1998 ........... 20 
 

Figure 21. Gonococcal Isolate Surveillance Project (GISP) — Trends in chromosomally mediated resistance to penicillin and tetracycline, 1988–1998 .... 21 
 

Figure 22. Gonococcal Isolate Surveillance Project (GISP) — Prevalence of
 

Neisseria gonorrhoeae with decreased susceptibility or resistance to
 

ciprofloxacin, 1990–1998 ...................................... 21 
 

Figure 23. Gonococcal Isolate Surveillance Project (GISP) — Proportion of men
 

with gonorrhea who had a previous gonorrhea infection within the
 

past year, 1992–1998 ......................................... 22 
 

x 
Figure 24.	 Gonococcal Isolate Surveillance Project (GISP) — Percent of Neisseria
 

gonorrhoeae isolates obtained from men who have sex with men for
 

STD clinics in nine cities, 1994, 1996 and 1998 ..................... 22 
 

Syphilis 

Figure 25. Syphilis — Reported cases by stage of illness: United States, 1941–1998 . . 26
 

Figure 26. Primary and secondary syphilis — Reported rates: United States,
 

1970–1998 and the Healthy People year 2000 objective............... 26 
 

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

outlying areas, 1998 .......................................... 27 
 

Figure 28. Primary and secondary syphilis — Counties with rates above and
 

counties with rates below the Healthy People year 2000 objective:
 

United States, 1998 ........................................... 27 
 

Figure 29. Primary and secondary syphilis — Rates by region: United States,
 

1981–1998 and the Healthy People year 2000 objective............... 28 
 

Figure 30. Primary and secondary syphilis — Rates by urban-rural category and
 

geographic region, 1998 ....................................... 28 
 

Figure 31. Primary and secondary syphilis — Rates in selected U.S. Cities
 

of >200,000 population, 1981–1998 and the Healthy People year
 

2000 objective............................................... 29 
 

Figure 32. Primary and secondary syphilis — Rates by gender: United States,
 

1981–1998 and the Healthy People year 2000 objective............... 29 
 

Figure 33. Primary and secondary syphilis — Rates by race and ethnicity:
 

United States, 1981–1998 and the Healthy People year 2000 objective . . . 30
 

Figure 34. Primary and secondary syphilis — Age- and gender-specific rates:
 

United States, 1998 ........................................... 30 
 

Figure 35. Congenital syphilis — Reported cases for infants <1 year of age and
 

rates of primary and secondary syphilis among women: United States,
 

1970–1998 ................................................. 31 
 

Figure 36. Congenital syphilis — Rates for infants <1 year of age: United States,
 

1981–1998 and the Healthy People year 2000 objective............... 31 
 

Other Sexually Transmitted Diseases 

Figure 37. Chancroid — Reported cases: United States, 1981–1998 .............. 34 
 

Figure 38. Genital herpes simplex virus infections — Initial visits to physicians’
 

offices: United States, 1966–1998 and the Healthy People year
 

2000 objective............................................... 34 
 

Figure 39. Genital herpes simplex virus type 2 — Percent seroprevalence according
 

to age in NHANES* II (1976–1980) and NHANES III (1988–1994) ...... 35 
 

Figure 40. Human papillomavirus (genital warts) — Initial visits to physicians’
 

offices: United States, 1966–1998 and the Healthy People year
 

2000 objective............................................... 35 
 

Figure 41. Nonspecific urethritis — Initial visits to physicians’ offices by men: United
 

States, 1966–1998............................................ 36 
 

Figure 42. Trichomonal and other vaginal infections — Initial visits to physicians’
 

offices: United States, 1966–1998 ................................ 36 
 

xi 
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, 1998 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 

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

areas, 1998 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 

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

States and outlying areas, 1998 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44 

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

United States and outlying areas, 1998 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44 

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

prenatal clinics by state, 1998 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45 

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

prenatal clinics by state, 1998 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45 

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

United States, 1980-1997 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46 

Figure H. Pelvic inflammatory disease — Hospitalizations of women 15-44 

years of age: United States, 1980–1997. . . . . . . . . . . . . . . . . . . . . . . . . . . . 46 

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

women 15-44 years of age: United States, 1980–1998 and Healthy 

People year 2000 objective . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 

STDs in Adolescents and Young Adults 

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

by age group: Region X, 1988–1998 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51 

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

U.S. Job Corps by state of residence, 1998 . . . . . . . . . . . . . . . . . . . . . . . . . 51 

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

U.S. Job Corps by state of residence, 1998 . . . . . . . . . . . . . . . . . . . . . . . . . 52 

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

United States, 1981–1998 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52 

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

United States, 1981–1998 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53 

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

10-44 years of age: United States, 1981–1998 . . . . . . . . . . . . . . . . . . . . . . 53 

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

10-44 years of age: United States, 1981–1998 . . . . . . . . . . . . . . . . . . . . . . 54 

STDs in Minorities 

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

by race and ethnicity: Region X, 1988–1998 . . . . . . . . . . . . . . . . . . . . . . . . 57 

Figure R. Gonorrhea — Reported rates for 15-19 year old females by race and 

ethnicity: United States, 1981–1998 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57 

Figure S. Gonorrhea — Reported rates for 15-19 year old males by race and 

ethnicity: United States, 1981–1998 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58 

Figure T. Primary and secondary syphilis — Reported rates for 15-19 year old 

females by race and ethnicity: United States, 1981–1998 . . . . . . . . . . . . . . 58 

xii 
Figure U. Primary and secondary syphilis — Reported rates for 15-19 year old 

males by race and ethnicity: United States, 1981–1998 . . . . . . . . . . . . . . . . 59 

Figure V. Congenital syphilis — Rates for infants <1 year of age by race and 

ethnicity: United States, 1991–1998 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59 

STDs in Persons Entering Corrections Facilities 

Figure W. Syphilis serologic tests — Percent seroreactivity in women entering city 

or county jails†, 1998. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62 

Figure X. Syphilis serologic tests — Percent seroreactivity in men entering city or 

county jails†, 1998 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62 

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

facilities†, 1998 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63 

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

facilities†, 1998 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63 

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

facilities†, 1998 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64 

STDs in the South 

Figure BB. South — Primary and secondary syphilis case rates by county, 1998 . . . . . 67 

Figure CC. South — Increases and decreases in cases of primary and secondary 

syphilis in 1998 compared with 1997 cases, by county . . . . . . . . . . . . . . . . 67 
 

Figure DD. South — Chlamydia case rates by county, 1998 . . . . . . . . . . . . . . . . . . . . . 68 
 

Figure EE. South — Gonorrhea case rates by county, 1998 . . . . . . . . . . . . . . . . . . . . . 68 
 

Sources and Limitations of Data 

Figure A1. Chlamydia — National electronic telecommunications surveillance 

system (NETSS) transmission status by state, 1998 . . . . . . . . . . . . . . . . . . 123 

Figure A2. Gonorrhea — National electronic telecommunications surveillance 

system (NETSS) transmission status by state, 1998 . . . . . . . . . . . . . . . . . . 123 

Figure A3. Primary and secondary syphilis — National electronic telecommunications surveillance system (NETSS) transmission status by state, 1998 . . . . 124 

xiii 
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, 

1941–1998* ................................................ 69 
 

Table 2. Reported cases of sexually transmitted disease by gender and reporting 

source: United States, 1998* .................................... 71 
 

Chlamydia 

Table 3A. Chlamydia — Reported cases by age, gender, and race/ethnicity: United 

States, 1996–1998............................................ 72 
 

Table 3B. Chlamydia — Reported rates per 100,000 population by age, gender, 

and race/ethnicity: United States, 1996–1998 ....................... 73 
 

Table 4. Chlamydia — Reported cases and rates by state/area, ranked according 

to rates: United States and outlying areas, 1998 ..................... 74 
 

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

United States and outlying areas, 1994–1998* ...................... 75 
 

Table 6. Chlamydia — Women – Reported cases and rates by state/area: United 

States and outlying areas, 1994–1998* ............................ 76 
 

Table 7. Chlamydia — Men – Reported cases and rates by state/area: United 

States and outlying areas, 1994–1998* ............................ 77 
 

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

population, ranked according to rates: United States and outlying 

areas, 1998* ................................................ 78 
 

Table 9. Chlamydia — Reported cases and rates in selected cities of >200,000 

population: United States and outlying areas, 1994–1998* ............. 79 
 

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

>200,000 population: United States and outlying areas, 1994-1998*..... 80 
 

Table 11. Chlamydia — Men – Reported cases and rates in selected cities of 

>200,000 population: United States and outlying areas, 1994–1998* .... 81 
 

Gonorrhea 

Table 12A. Gonorrhea — Reported cases by age, gender, and race/ethnicity: 

United States, 1994–1998 ...................................... 82 
 

Table 12B. Gonorrhea — Reported rates per 100,000 population by age, gender, 

and race/ethnicity: United States, 1994–1998 ....................... 83 
 

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

to rates: United States and outlying areas, 1998 ..................... 84 
 

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

United States and outlying areas, 1994–1998* ...................... 85 
 

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

United States and outlying areas, 1994–1998* ...................... 86 
 

Table 16. Gonorrhea — Men – Reported cases and rates by state/area: United 

States and outlying areas, 1994–1998* ............................ 87 
 

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

population, ranked according to rates: United States and outlying 

areas, 1998 ................................................. 88 
 

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

population: United States and outlying areas, 1994–1998* ............. 89 
 

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

>200,000 population: United States and outlying areas, 1994-1998*..... 90 
 

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

>200,000 population: United States and outlying areas, 1994–1998* .... 91 
 

Syphilis 

Table 21. All stages of syphilis — Reported cases and rates by state/area:
 

United States and outlying areas, 1994–1998* ...................... 92 
 

Table 22. All stages of syphilis — Reported cases and rates in selected cities of
 

>200,000 population: United States and outlying areas, 1994–1998 ..... 93 
 

Table 23A. Primary and secondary syphilis — Reported cases by age, gender, and
 

race/ethnicity: United States, 1994–1998........................... 94 
 

Table 23B. Primary and secondary syphilis — Reported rates by age, gender, and
 

race/ethnicity: United States, 1994–1998........................... 95 
 

Table 24. Primary and secondary syphilis — Reported cases and rates by state/area,
 

ranked according to rates: United States and outlying areas, 1998........ 96 
 

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

and region: United States and outlying areas, 1994–1998 .............. 97 
 

Table 26. Primary and secondary syphilis — Women – Reported cases and rates by
 

state/area: United States and outlying areas, 1994–1998............... 98 
 

Table 27. Primary and secondary syphilis — Men – Reported cases and rates by
 

state/area: United States and outlying areas, 1994–1998............... 99 
 

Table 28. Primary and secondary syphilis — Reported cases and rates in selected
 

cities of >200,000 population, ranked according to rates: United States
 

and outlying areas, 1998 ...................................... 100 
 

Table 29. Primary and secondary syphilis — Reported cases and rates in selected
 

cities of >200,000 population: United States and outlying areas,
 

1994–1998 ................................................ 101 
 

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

selected cities of >200,000 population: United States and outlying
 

areas, 1994–1998 ........................................... 102 
 

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

selected cities of >200,000 population: United States and outlying
 

areas, 1994–1998 ........................................... 103 
 

Table 32. Primary and secondary syphilis — Counties and independent cities*
 

ranked by number of reported cases: United States, 1998 ............. 104 
 

Table 33. Early latent syphilis — Reported cases and rates by state/area: United
 

States and outlying areas, 1994–1998 ............................ 105 
 

Table 34. Early latent syphilis — Reported cases and rates in selected cities of
 

>200,000 population: United States and outlying areas, 1994–1998 .... 106 
 

Table 35. Late and late latent syphilis — Reported cases and rates by state/area:
 

United States and outlying areas, 1994–1998 ...................... 107 
 

Table 36. Late and late latent syphilis — Reported cases and rates in selected cities
 

of >200,000 population: United States and outlying areas, 1994–1998 . . 108
 

Table 37. Congenital syphilis — Reported cases and rates in infants <1 year of age:
 

United States (excluding outlying areas), 1963-1998 ................. 109 
 

xv 
Table 38. Congenital syphilis — Reported cases and rates in infants <1 year of age
 

by state/area, ranked according to rates: United States and outlying
 

areas, 1998 ................................................ 110 
 

Table 39. Congenital syphilis — Reported cases and rates in infants <1 year of age
 

by state/area: United States and outlying areas, 1994–1998 ........... 111 
 

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

in selected cities of >200,000 population, ranked according to rates:
 

United States and outlying areas, 1998 ........................... 112 
 

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

age in selected cities of >200,000 population: United States and
 

outlying areas, 1994–1998 .................................... 113 
 

Chancroid 

Table 42. Chancroid — Reported cases and rates by state/area: United States
 

and outlying areas, 1994–1998 ................................. 114 
 

Table 43. Chancroid — Reported cases and rates in selected cities of >200,000
 

population: United States and outlying areas, 1994–1998 ............. 115 
 

Appendix 

Table A1.	 Healthy People 2000 Sexually Transmitted Diseases Objective 19.1–19.8
 

Status .................................................... 125 
 

xvi 
West Midwest Northeast

South 

Geographic Divisions of the United States 

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 

xvii 

National Overview of Sexually Transmitted Diseases, 1998 

The logo on the cover of Sexually Transmitted Disease Surveillance, 1998 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 women’s and infants’ health 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 recent report of the Institute of Medicine, 

The Hidden Epidemic: Confronting Sexually Transmitted Diseases1

, 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 we have 

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

1998 are worthy of note. 

In 1998, the reported number of cases of genital Chlamydia trachomatis infections was 607,602 a 

rate of 236.6 per 100,000 persons. In 1998, the overall reported rate for women (382.2 per 

100,000) was nearly five times that for men (83.1). This difference in reported rates is attributable to 

screening strategies that focus on women because the severe sequelae of chlamydial infections 

accrue principally to women, and because these diseases are asymptomatic in the majority of 

infected women. 

Using local, state, and federal resources, chlamydia prevention programs for screening of asymptomatic women have been established throughout the country. In 1998, state-specific chlamydia 

test positivity among women aged 15-24 years who were screened at family planning clinics ranged 

from 2.4% to 11.3%. These screening programs have consistently shown that the highest positivity 

of chlamydial infection in women is in adolescents. In addition, examination of chlamydial screening results for women aged 16-24 years entering the U.S. Job Corps shows that chlamydia is highly 

prevalent in these economically disadvantaged young women, with state-specific prevalence in 

1998 ranging from 4.6% to 20.3%. 

In parts of the United States where large-scale chlamydia programs have been instituted, prevalence of disease has generally declined. During 1988-1998, 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 60% (from 9.3% to 3.7%). During 1994-1998, 

among women under 45 years of age in Region III, positivity declined 6.4% (from 4.7% to 4.4%), 

and in Region VIII, positivity declined 10.3% (from 3.9% to 3.5%). Adjustment for changes in laboratory test method and sensitivity in 1998 may demonstrate larger declines in these and other HHS 

regions. For definition of HHS regions, see the Appendix. 

Recent data on gonorrhea for 1994-1998 suggest that the annual decreases that have generally 

been evident since the national gonorrhea control program began in the mid-1970s may be lessening. In particular, the gonorrhea rate for 1998 (132.9 per 100,000 persons) was greater than the rate 

for 1997 (122.0). Although the 1997 gonorrhea rate was the lowest rate since national reporting 

STD Surveillance 1998 Overview 1 
began, both it and the 1998 rate remain well above the revised Healthy People 2000 (HP2000) 

objective of 100. 

With respect to gender, the gonorrhea rates for males and for females increased between 1997 

and 1998. The gonorrhea rate for males increased from 124.9 to 133.7, and for females increased 

from 119.0 to 131.5. In contrast to earlier years, which generally exhibited decreasing age-specific 

rates for gonorrhea, most 5 year age categories had rates which increased between 1997 and 1998. 

These increases ranged from 6% to 14%. Only the rate for the oldest adults decreased slightly. 

Because men with gonorrhea are often symptomatic and seek medical care, trends in males are 

probably a good measure of trends in disease incidence. Trends in women are determined more by 

screening practices. Similar to chlamydia, rates of gonorrhea in women are particularly high in 

adolescents, with the highest rates in 15- to 19-year-olds. 

With regard to antimicrobial resistance, a small proportion of Neisseria gonorrhoeae isolates 

tested through the Gonococcal Isolate Surveillance Project in 1998 (0.9%) demonstrated decreased susceptibility to ciprofloxacin, one of the currently recommended treatments for gonorrhea. 

However, resistance to ciprofloxacin continued to be rare (0.1%). 

The 6,993 cases of primary and secondary (P&S) syphilis reported in 1998 were the fewest cases 

reported in the United States since 1958. The P&S syphilis rate of 2.6 per 100,000 persons (the 

lowest since national reporting began in 1941) is below the HP2000 objective of 4 per 100,000. 

Syphilis continues to be reported only in specific areas of the country. In 1998, approximately 78% 

of U.S. counties reported no cases of P&S syphilis. However, P&S syphilis rates exceeded 4 per 

100,000 in 312 counties (10% of total counties). These 312 counties accounted for 76% of all 

reported P&S syphilis cases. Most notably, 91% (285 of 312) of these counties were in the South. In 

addition, 9 of the 12 states or outlying areas with P&S syphilis rates greater than 4 per 100,000 were 

located in the South. These data suggest that comprehensive syphilis prevention efforts focused in 

the South could markedly reduce the number of U.S. syphilis cases. 

When STD statistics were examined by race or ethnicity, wide discrepancies in reported STD 

rates persisted between racial or ethnic groups. For example, the gonorrhea rate in blacks is approximately 30 times greater than the rate in whites. The rate of P&S syphilis in blacks is about 34 times 

that in whites; P&S syphilis in Hispanics is about 3 times that in whites. However, in 1998, of the 793 

reported congenital syphilis cases with known race or ethnicity of the mother, blacks and Hispanics 

accounted for 89% of these reported cases, while accounting for only 23% of the female population, and 33% of all births. Race and ethnicity in the United States serve as risk markers that correlate with other, more fundamental determinants of health status such as socioeconomic status and 

access to good quality medical care. Reporting biases also undoubtedly play a role in race 

differentials, while not explaining them completely. 

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

Prevention and Control of Sexually Transmitted Diseases, National Academy Press, Washington, D.C., 

1997. 

2 Overview STD Surveillance 1998 
National Profile 

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

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

Where relevant, the figures illustrate progress toward specific year 2000 goals for the nation 

published in Healthy People 2000: Midcourse Review and 1995 Revisions.* 

*See Appendix for Healthy People Year 2000 Revisions. 

STD Surveillance 1998 National Profile 3 

Chlamydia 

Infections due to Chlamydia trachomatis are among the most prevalent of all sexually transmitted 

diseases. In women these infections often result in pelvic inflammatory disease, which can cause 

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 reduce the 

incidence of PID by as much as 60%1

. In addition, pregnant women infected with chlamydia can 

infect their babies during delivery. 

While case reporting of chlamydial infections is improving, it remains incomplete in many areas 

of the country. A combination of factors limit the documentation of the incidence and prevalence of 

genital chlamydial infection: variable compliance with public health laws and regulations that 

require health care providers and laboratories to report cases to local health authorities; large 

numbers of asymptomatic persons who can be identified only through screening; limited resources 

to support screening activities; and incomplete information management systems for collecting, 

maintaining, and analyzing case reporting and prevalence data. Thus, for most areas, the number of 

chlamydia cases reported to CDC by state health departments reflects many factors, only one of 

which is number of infections in the population. For defined populations of sexually active women, 

data on prevalence obtained through routine screening can provide a more accurate measure of the 

true burden of disease. 

•	 In 1998, 49 states and the District of Columbia required reporting of chlamydia 

and reported cases to CDC. For the state of New York, only cases from New York 

City were reported (Figure 1, Table 5). 

•	 In 1998, 607,602 chlamydial infections were reported to CDC from 49 states, the 

District of Columbia and New York City (Table 1). Reported cases of chlamydia far 

exceed reported cases of gonorrhea (355,642 gonorrhea cases in 1998, Table 1). 

•	 From 1987 through 1998 reported rates of chlamydia increased from 50.8 cases per 

100,000 persons to 236.6 (Figure 2, Table 1). This trend reflects increased screening, 

recognition of asymptomatic infection (mainly in women), and improved reporting, 

as well as the continuing high burden of disease. 

•	 For the years 1996-1998, the chlamydia case rate of the South (203.9, 229.9, 

and 271.9 respectively) was highest among the four regions, reflecting a recent 

expansion of screening activity in the South. Before 1996, reported chlamydia 

rates were highest in the West and Midwest, where substantial public resources 

had been committed for screening programs (e.g., in family planning clinics) 

(Table 5, Figures 3 and 4). 

•	 Between 1997 and 1998, rates of chlamydia reported from selected large cities 

(over 200,000 population) increased 10% from 333.5 cases per 100,000 persons 

to 366.4 (Figure 5, Table 9). 

•	 In 1998, reported rates of chlamydia for women (382.2 per 100,000 persons) 

exceeded those for men (83.1) (Figure 6, Tables 6, 7, 10, and 11). This is mainly 

STD Surveillance 1998 National Profile	 Chlamydia 5 
due to detection of asymptomatic infection in women through screening. The low 

rates in men suggest that many of the sex partners of women with chlamydia are not 

diagnosed or reported. In addition, men diagnosed as having non-gonococcal urethritis 

are treated but frequently not tested. A large proportion of these men are infected with 

chlamydia, but they are not detected by surveillance systems based on laboratory 

reporting of positive chlamydia tests. 

•	 Rates of chlamydia for women were highest in the 15- to 19- year-olds (2,359.4 

per 100,000) and in 20- to 24-year-olds (1,952.7). For men, age-specific rates 

were also highest in these age groups (Figure 7, Table 3B). 

•	 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 

initiated in three additional HHS regions (III, VII, and VIII) and, in 1995, in 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 1998, state-specific chlamydia test positivity among 15- to 24-year-old women 

screened varied from 2.4% to 11.3% among those attending family planning 

clinics (Figure 9). 

•	 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, the screening programs in 

Health and Human Services Region X (Alaska, Idaho, Oregon, Washington) 

family planning clinics have demonstrated a decline in chlamydia positivity of 

60% since 1988 among 15- to 44-year-old women (Figure 10). 

•	 In 1998, chlamydia test positivity increased in nine of ten HHS regions compared 

with 1997. However, these reported increases are most likely due to changes in 

laboratory test method and associated increases in test sensitivity;2 expansion of 

screening programs to populations with higher prevalence of disease may also 

have contributed to these increases. 

•	 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 section. 

1Scholes 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. 

2Dicker LW, Mosure DJ, Levine WC, et al. The impact of switching laboratory tests on reported trends in 

Chlamydia trachomatis infections. Am J Epidemiol (in press). 

6 Chlamydia	 National Profile STD Surveillance 1998 
Figure 1. Chlamydia — Number of states that require reporting of Chlamydia trachomatis 

infections: United States, 1987–1998 

No. of states 

50 

40 

30 

20 

10 

0 

1987 88 89 90 91 92 93 94 95 96 97 98
 

Figure 2. Chlamydia — Reported rates: United States, 1984–1998 

Rate (per 100,000 population)
 

250
 

200 

150 

100 

50 

0 

1984 85 86 87 88 89 90 91 92 93 94 95 96 97 98 

Note: For further information on chlamydia reporting, see the Appendix. 

STD Surveillance 1998 National Profile Chlamydia 7 
Figure 3. Chlamydia — Rates by state: United States and outlying areas, 1998 

Rate per 100,000

population 

<=150 

150.1-300 

>300 

VT 70.1 

NH 81.9 

MA 136.7 

RI 233.6 

CT 213.4 

NJ 145.1 

DE 356.5 

MD 257.1 

Guam 262.5 

Puerto Rico 44.0 Virgin Is. 9.1 

(n=9) 

(n=36) 

(n=8) 

233.0 

313.0 

252.2 163.4 

237.0 234.1 

170.3 

337.3 

219.5 

168.1 

221.6 184.2 

181.4 

215.3 164.8 

349.0 

86.4 

226.7 

148.8 

388.7 

234.5 

160.7 

175.7 198.0 

219.3 

* 

298.9 

161.7 

248.4 

283.2 

180.5 

204.9 

492.3 

213.0 

255.5 

310.9 

107.3 

201.4 

196.0 

153.7 

268.5 

151.1 

*The New York City rate was 357.1 per 100,000 population. No cases were reported outside of New 

York City. 

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

Rico and Virgin Islands) was 233.7 per 100,000 population. For further information on 

chlamydia reporting, see the Appendix. 

Figure 4. Chlamydia — Rates by region: United States, 1984–1998 

Rate (per 100,000 population)
 

300
 

240
 

180
 

120
 

60
 

0
 

West 

Midwest 

Northeast 

South 

1984 85 86 87 88 89 90 91 92 93 94 95 96 97 98
 

Note: For further information on chlamydia reporting, see the Appendix. 

8 Chlamydia National Profile STD Surveillance 1998
 
Figure 5. Chlamydia — Rates in selected U.S. cities of >200,000 population, 1984–1998 

Rate (per 100,000 population) 

400 

320 

240 

160 

80 

0 

1984 85 86 87 88 89 90 91 92 93 94 95 96 97 98 

Note: For further information on chlamydia reporting, see the Appendix. 

Figure 6. Chlamydia — Rates by gender: United States, 1984–1998 

Rate (per 100,000 population)
 

400
 

320
 

240
 

160
 

80
 

0
 

Men 

Women 

1984 85 86 87 88 89 90 91 92 93 94 95 96 97 98
 

Note: For further information on chlamydia reporting, see the Appendix. 

STD Surveillance 1998 National Profile Chlamydia 9 
Figure 7. Chlamydia — Age- and gender-specific rates: United States, 1998 

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 

2,500 2,000	 1,500 1,000 500 0 Age 0 500 1,000 1,500 2,000 2,500 

Total

65+

55-64

45-54

40-44

35-39

30-34

25-29

20-24

15-19

7.9 10-14

308.4

432.5

211.3

94.1

49.0

24.4

10.3

3.7

2.3

85.1

142.5

2,359.4

1,952.7

649.3

217.9

91.7

38.5

13.7

4.0

5.1

Total 369.7

65+

55-64

45-54

40-44

35-39

30-34

25-29

20-24

15-19

7.9 10-14

308.4

432.5

211.3

94.1

49.0

24.4

10.3

3.7

2.3

85.1

142.5

2,359.4

1,952.7

649.3

217.9

91.7

38.5

13.7

4.0

5.1

Total 369.7

65+

55-64

45-54

40-44

35-39

30-34

25-29

20-24

15-19

7.9 10-14

308.4

432.5

211.3

94.1

49.0

24.4

10.3

3.7

2.3

85.1

142.5

2,359.4

1,952.7

649.3

217.9

91.7

38.5

13.7

4.0

5.1

Total 369.7

65+

55-64

45-54

40-44

35-39

30-34

25-29

20-24

15-19

7.9 10-14

308.4

432.5

211.3

94.1

49.0

24.4

10.3

3.7

2.3

85.1

142.5

2,359.4

1,952.7

649.3

217.9

91.7

38.5

13.7

4.0

5.1

Total 369.7

65+

55-64

45-54

40-44

35-39

30-34

25-29

20-24

15-19

7.9 10-14

308.4

432.5

211.3

94.1

49.0

24.4

10.3

3.7

2.3

85.1

142.5

2,359.4

1,952.7

649.3

217.9

91.7

38.5

13.7

4.0

5.1

Total 369.7

65+

55-64

45-54

40-44

35-39

30-34

25-29

20-24

15-19

7.9 10-14

308.4

432.5

211.3

94.1

49.0

24.4

10.3

3.7

2.3

85.1

142.5

2,359.4

1,952.7

649.3

217.9

91.7

38.5

13.7

4.0

5.1

Total 369.7

65+

55-64

45-54

40-44

35-39

30-34

25-29

20-24

15-19

7.9 10-14

308.4

432.5

211.3

94.1

49.0

24.4

10.3

3.7

2.3

85.1

142.5

2,359.4

1,952.7

649.3

217.9

91.7

38.5

13.7

4.0

5.1

Total 369.7

65+

55-64

45-54

40-44

35-39

30-34

25-29

20-24

15-19

7.9 10-14

308.4

432.5

211.3

94.1

49.0

24.4

10.3

3.7

2.3

85.1

142.5

2,359.4

1,952.7

649.3

217.9

91.7

38.5

13.7

4.0

5.1

Total 369.7

65+

55-64

45-54

40-44

35-39

30-34

25-29

20-24

15-19

7.9 10-14

308.4

432.5

211.3

94.1

49.0

24.4

10.3

3.7

2.3

85.1

142.5

2,359.4

1,952.7

649.3

217.9

91.7

38.5

13.7

4.0

5.1

Total 369.7

65+

55-64

45-54

40-44

35-39

30-34

25-29

20-24

15-19

7.9 10-14

308.4

432.5

211.3

94.1

49.0

24.4

10.3

3.7

2.3

85.1

142.5

2,359.4

1,952.7

649.3

217.9

91.7

38.5

13.7

4.0

5.1

Total 369.7

65+

55-64

45-54

40-44

35-39

30-34

25-29

20-24

15-19

7.9 10-14

308.4

432.5

211.3

94.1

49.0

24.4

10.3

3.7

2.3

85.1

142.5

2,359.4

1,952.7

649.3

217.9

91.7

38.5

13.7

4.0

5.1

Total 369.7

65+

55-64

45-54

40-44

35-39

30-34

25-29

20-24

15-19

7.9 10-14

308.4

432.5

211.3

94.1

49.0

24.4

10.3

3.7

2.3

85.1

142.5

2,359.4

1,952.7

649.3

217.9

91.7

38.5

13.7

4.0

5.1

Total 369.7

65+

55-64

45-54

40-44

35-39

30-34

25-29

20-24

15-19

7.9 10-14

308.4

432.5

211.3

94.1

49.0

24.4

10.3

3.7

2.3

85.1

142.5

2,359.4

1,952.7

649.3

217.9

91.7

38.5

13.7

4.0

5.1

Total 369.7

65+

55-64

45-54

40-44

35-39

30-34

25-29

20-24

15-19

7.9 10-14

308.4

432.5

211.3

94.1

49.0

24.4

10.3

3.7

2.3

85.1

142.5

2,359.4

1,952.7

649.3

217.9

91.7

38.5

13.7

4.0

5.1

Total 369.7

65+

55-64

45-54

40-44

35-39

30-34

25-29

20-24

15-19

7.9 10-14

308.4

432.5

211.3

94.1

49.0

24.4

10.3

3.7

2.3

85.1

142.5

2,359.4

1,952.7

649.3

217.9

91.7

38.5

13.7

4.0

5.1

Total 369.7

65+

55-64

45-54

40-44

35-39

30-34

25-29

20-24

15-19

7.9 10-14

308.4

432.5

211.3

94.1

49.0

24.4

10.3

3.7

2.3

85.1

142.5

2,359.4

1,952.7

649.3

217.9

91.7

38.5

13.7

4.0

5.1

Total 369.7

65+

55-64

45-54

40-44

35-39

30-34

25-29

20-24

15-19

7.9 10-14

308.4

432.5

211.3

94.1

49.0

24.4

10.3

3.7

2.3

85.1

142.5

2,359.4

1,952.7

649.3

217.9

91.7

38.5

13.7

4.0

5.1

Total 369.7

65+

55-64

45-54

40-44

35-39

30-34

25-29

20-24

15-19

7.9 10-14

308.4

432.5

211.3

94.1

49.0

24.4

10.3

3.7

2.3

85.1

142.5

2,359.4

1,952.7

649.3

217.9

91.7

38.5

13.7

4.0

5.1

Total 369.7

65+

55-64

45-54

40-44

35-39

30-34

25-29

20-24

15-19

7.9 10-14

308.4

432.5

211.3

94.1

49.0

24.4

10.3

3.7

2.3

85.1

142.5

2,359.4

1,952.7

649.3

217.9

91.7

38.5

13.7

4.0

5.1

Total 369.7

65+

55-64

45-54

40-44

35-39

30-34

25-29

20-24

15-19

7.9 10-14

308.4

432.5

211.3

94.1

49.0

24.4

10.3

3.7

2.3

85.1

142.5

2,359.4

1,952.7

649.3

217.9

91.7

38.5

13.7

4.0

5.1

Total 369.7

65+

55-64

45-54

40-44

35-39

30-34

25-29

20-24

15-19

7.9 10-14

308.4

432.5

211.3

94.1

49.0

24.4

10.3

3.7

2.3

85.1

142.5

2,359.4

1,952.7

649.3

217.9

91.7

38.5

13.7

4.0

5.1

Total 369.7

65+ 

55-64 

45-54 

40-44 

35-39 

30-34 

25-29 

20-24 

15-19 

7.9 10-14

308.4 

432.5 

211.3 

94.1 

49.0 

24.4 

10.3 

3.7 

2.3 

85.1 

142.5 

2,359.4 

1,952.7 

649.3 

217.9 

91.7 

38.5 

13.7 

4.0 

5.1 

369.7 

Figure 8 .	 Chlamydia — Positivity among women tested in family planning clinics by 

state: Region X, 1988–1998 

Percent 

15
 

12
 

9
 

6
 

3
 

0
 

Alaska 

Idaho 

Oregon 

Washington 

1988 89 90 91 92 93 94 95 96 97
 98
 

Note: Women who met screening criteria were tested. Trends not adjusted for changes in 

laboratory test method in 1994 and 1998 and associated increases in test sensitivity. 

SOURCE: Regional Infertility Prevention Program: Region X Chlamydia Project (Alaska, Idaho, Oregon and Washington) 

10 Chlamydia	 National Profile STD Surveillance 1998
 
Figure 9. Chlamydia — Positivity among 15-24 year old women tested in family planning 

clinics by state, 1998 

5.6 

4.2 3.8 2.7 

3.5 3.6 

4.0 2.7 5.4 4.0 

4.2 4.9 VT 2.7 

7.1 3.2 4.1 

5.3 

5.9 NH 

MA 

5.8 

5.9 

3.1 7.7 5.9 RI 2.5 6.0 5.4 4.3 4.1 3.8 

2.4 7.6 CT 

NJ 

5.3 

6.7 

DE 6.5 

6.2 9.7 MD 5.9 

5.2 6.7 DC 5.1 6.0 9.0 10.4 

11.3 10.8 9.0 Positivity (%) 

4.3 

8.6 

11.3 

6.4 

<4 

4.0-4.9 

>=5 

(n=12) 

(n=9) 

(n=32) 

3.2 

Puerto Rico 8.3 Virgin Is. 17.9 

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

during 1998 except for: Rhode Island - chlamydia positivity data reported for July-December 

only; Puerto Rico - chlamydia positivity data reported for January-April only; and Virgin Islands ­

chlamydia positivity data reported for April-December only. 

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

Centers for Disease Control and Prevention 

Figure 10. Chlamydia — Trends in positivity among 15-44 year old women tested in family 

planning clinics by HHS regions, 1988–1998 

REGION=VIII REGION=V REGION=II 

REGION=I 

4.7 4.7 4.8 REGION=X 3.9 3.4 3.1 3.0 3.5 3.7 4.0 

9.3 

3.1 7.5 3.5 3.3 7.0 

5.8 94 95 96 97 98 96 97 98 97 98 5.2 

3.94.13.83.6 3.7 96 97 98 3.1 

88 89 90 91 92 93 94 95 96 97 98 REGION=III 

4.7 4.0 3.5 4.0 4.4 

REGION=IX 

94 95 96 97 98 

REGION=IV 

4.2 3.2 3.5 

6.6 5.8 

96 97 98 REGION=VI 

4.0 

REGION=VII 

6.3 5.8 5.1 96 97 98 

3.4 3.2 3.1 3.6 

96 97 98 

95 96 97 98 

Note: Trends not adjusted for changes in laboratory test method in 1998 and associated increases in 

test sensitivity. See Appendix for definition of Health and Human Services (HHS) regions. 

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

Centers for Disease Control and Prevention 

STD Surveillance 1998 National Profile Chlamydia 11 

Gonorrhea 

Infections due to Neisseria gonorrhoeae, like those due to Chlamydia trachomatis, remain a 

major cause of pelvic inflammatory disease, tubal infertility, ectopic pregnancy, and chronic pelvic 

pain in the United States. Epidemiologic studies provide strong evidence that gonococcal infections 

facilitate HIV transmission, and biological studies have begun to clarify the specific mechanisms 

through which this facilitation occurs1

. Reporting of gonococcal infections has likely been biased 

towards reporting of infections in persons of minority race or ethnicity who attend public STD 

clinics2

. 

In 1998, case reporting data indicated a reversal in the annual decreases that had been observed 

in preceding years. 

In 1998, 355,642 cases of gonorrhea were reported in the United States. 

Following the introduction of a national control program in the mid-1970s, the 

overall rate of gonorrhea has declined 72% since 1975. However, between 1997 

and 1998 the rate increased by 8.9% from 122.0 cases per 100,000 persons to 

132.9 (Table 1 and Figure 11). 

In 1998, 28 states and 3 outlying areas reported gonorrhea rates below the 

Healthy People 2000 (HP2000) national objective of 100 cases per 100,000 

persons (Figure 12 and Table 13). However, gonorrhea rates decreased between 

1997 and 1998 in only 7 of 35 states reporting more than 1,000 cases in 1998, 

whereas rates in the previous year decreased in 23 of 34 states with more than 

1,000 cases (Table 14). 

Three of the four regions (West, Midwest, and South) exhibited increases in their 

gonorrhea rates between 1997 and 1998. All four of the regions had been 

declining. The South continued to have a higher rate than other regions (Figure 

13, Table 14). 

In contrast to preceding years when consistent decreases occurred, the overall 

gonorrhea rate (244.4 per 100,000) for selected large cities over 200,000 

population increased in 1998 for the second year in a row (Figure 14, Table 18). 

Fifty-five (86%) of the 64 cities had rates exceeding the HP2000 objective (Table 

17). 

The gonorrhea rate in women increased from 119.0 per 100,000 in 1997 to 

131.5 in 1998, and the gonorrhea rate in men also increased from 124.9 in 1997 

to 133.7 in 1998. Rates for men and women were above the HP2000 objective in 

22 and 24 states, respectively (Figure 15, Tables 15 and 16). 

Relative to 1997, gonorrhea rates in 1998 increased among each race/ethnic 

group (non-Hispanic whites increased 8%; non-Hispanic blacks 7%; Hispanics 

10%; Asian Pacific Islanders 12%; and American Indian/Alaska Natives 21% 

(Figure 16 and Table 12B). The gonorrhea rates for non-Hispanic blacks and 

American Indian/Alaska Natives were above the HP2000 objective (Figure 16, 

STD Surveillance 1998 National Profile Gonorrhea 13 
Table 12B). The former rate was about 30 times greater than the rate for 

non-Hispanic whites. 

Between 1997 and 1998, the gonorrhea rates for 15- to 19-year-old adolescents 

increased from 521.6 per 100,000 to 560.6, and for 20- to 24-year-old young 

adults increased from 548.4 to 609.6. Except for adults 65 and older, the rates for 

the other age groups also increased between 1997 and 1998 (Table 12B). 

Among women, 15- to 19-year-olds had the highest rate, while among men, 20- to 

24-year-olds had the highest rate (Table 12B and Figure 17). 

In 1998, state-specific gonorrhea test positivity among 15 to 24-year old women 

screened in selected family planning clinics in 27 states ranged from 0.0% to 5.2% 

(Figure 18). 

Antimicrobial resistance remains an important consideration in the treatment of 

gonorrhea3,4. Overall, 29.4% of isolates collected in 1998 by the Gonococcal Isolate 

Surveillance Project (GISP) were resistant to penicillin, tetracycline, or both. The 

percentage of GISP isolates that were penicillinase-producing Neisseria gonorrhoeae 

(PPNG) declined from a peak of 11.0% in 1991 to 3.0% in 1998 (Figure 20). In 

contrast, the percentage of isolates with chromosomally mediated resistance to 

penicillin has increased annually and went from 0.5% in 1988 to 5.1% in 1998 (Figure 

21). The prevalence of chromosomally mediated tetracycline resistance, 6.8% in 1998, 

has been relatively stable since 1989, except for a transient increase in 1995. However, 

the prevalence of isolates with chromosomally mediated resistance to penicillin and 

tetracycline (CMRNG) increased from 3.0% in 1989 to 7.2% in 1998 (Figure 21). 

The proportion of GISP isolates demonstrating decreased susceptibility to 

ciprofloxacin, one of the currently recommended treatments for gonorrhea, decreased 

from a high of 1.3% in 1994 to 0.5% in 1996 and 1997, but increased to 0.9% in 1998. 

Resistance to ciprofloxacin was first identified in GISP in 1991 but remains rare (0.1%) 

in 1998 (Figure 22). Reduced susceptibility and resistance to ciprofloxacin correlate 

with reduced susceptibility and resistance to other fluoroquinolone antibiotics. 

The proportion of GISP isolates demonstrating decreased susceptibility to cefixime 

remains rare (0.1%). In 1998, all GISP isolates were susceptible to ceftriaxone. To date, 

no cephalosporin resistance has been identified in GISP. 

The percentage of men with gonorrhea who have repeat infection within a one-year 

period, as measured by the GISP, decreased from 21.5% in 1992 to 17.5% in 1998 

(Figure 23), approaching the HP2000 objective of 15%. 

GISP also reports the percentage of Neisseria gonorrhoeae isolates obtained from men 

who have sex with men (MSM)4,5. The proportion of isolates coming from MSM 

increased from 4.0% in 1988 to 12.0% in 1998 for GISP clinics overall. Among the 

nine GISP clinics reporting the majority of MSM cases, the percentage of cases that 

were in MSM in 1998 ranged from 13.0% to 62.5%, with a median of 24.7% (Figure 

24). The increase in MSM with gonorrhea in GISP accelerated after 1993. 

Additional information about gonorrhea in racial and ethnic minority populations and 

adolescents can be found in the Special Focus Profiles section. 

1Cohen 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. 

14 Gonorrhea National Profile STD Surveillance 1998 
2Fox 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. 

3Fox KK, Knapp JS, Holmes KK, Hook III EW, Judson FN, Thompson SE, Washington JA, Whitting WL. 

Antimicrobial resistance in Neisseria gonorrhoeae in the United States, 1988-1994: the emergence of 

decreased susceptibility to the fluoroquinolones, J Infect Dis 1997;175:1396-1403. 

4CDC. Sexually transmitted disease surveillance 1997. Supplement: Gonococcal isolate surveillance project 

(GISP) annual report 1997, U.S. Department of Health and Human Services. Atlanta: Centers for Disease 

Control and Prevention, October 1998. 

5CDC. Gonorrhea among men who have sex with men - selected sexually transmitted disease clinics, 

1993-1996. MMWR 1997;46:889-92. 

STD Surveillance 1998 National Profile Gonorrhea 15 
Figure 11. Gonorrhea — Reported rates: United States, 1970–1998 and the Healthy People 

year 2000 objective 

Rate (per 100,000 population) 

500 

Gonorrhea 

2000 Objective 400 

300 

200 

100 

0 

1970 74 78 82 86 90 94 98 

Note: Georgia did not report gonorrhea statistics in 1994 (see Appendix). 

Figure 12. Gonorrhea — Rates by state: United States and outlying areas, 1998 

34.7 

6.3 12.5 5.4 

27.1 57.8 

15.0 29.9 122.9 105.1 

7.5 167.4 VT 6.5 

86.2 72.7 56.7 

163.4 

97.5 NH 

MA 

7.8 

36.9 11.5 182.7 107.6 RI 43.5 60.5 52.2 101.0 175.2 97.6 

50.7 137.6 CT 

NJ 

97.2 

97.6 

DE 212.7 

220.6 259.0 MD 220.9 92.5 158.1 55.3 156.7 307.8 

Guam 46.1 

391.5 294.9 276.1 Rate per 100,000

population 

168.9 <=100 (n=31) 

54.3 287.2 100.1-200 (n=13) 

130.2 >200 (n=9) 

42.6 

Puerto Rico 10.5 Virgin Is. 35.6 

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

Rico and Virgin Islands) was 131.1 per 100,000 population. The Healthy People year 2000 

objective is 100 per 100,000 population. 

16 Gonorrhea National Profile STD Surveillance 1998 
Figure 13. Gonorrhea — Rates by region: United States, 1981–1998 and the Healthy 

People year 2000 objective 

Rate (per 100,000 population) 

600 

480 

360 

240 

120 

0 

West 

Midwest 

Northeast 

South 

2000 Objective 

1981 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 

Note: Georgia did not report gonorrhea statistics in 1994 (see Appendix). 

Figure 14. Gonorrhea — Rates in selected U.S. cities of >200,000 population, 1981–1998 

and the Healthy People year 2000 objective 

Rate (per 100,000 population) 

900 

720 

540 

360 

180 

0 

Cities 

2000 Objective 

1981 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 

Note: Atlanta, GA did not report gonorrhea statistics in 1994 (see Appendix). 

STD Surveillance 1998 National Profile Gonorrhea 17 
Figure 15. Gonorrhea — Rates by gender: United States, 1981–1998 and the Healthy 

People year 2000 objective 

Rate (per 100,000 population) 

600 

480 

360 

240 

120 

0 

Men 

Women 

2000 Objective 

1981 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 

Note: Georgia did not report gonorrhea statistics in 1994 (see Appendix). 

Figure 16. Gonorrhea — Rates by race and ethnicity: United States, 1981–1998 and the 

Healthy People year 2000 objective 

Rate (per 100,000 population) 

2,500 

2,000 

1,500 

1,000 

500 

0 

White 

Black 

Hispanic 

Other 

2000 Objective 

1981 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 

Note: “Other” includes Asian/Pacific Islander and American Indian/Alaska Native populations. 

Black, White, and Other are non-Hispanic. Georgia did not report gonorrhea statistics in 

1994 (see Appendix). 

18 Gonorrhea National Profile STD Surveillance 1998 
Figure 17. Gonorrhea — Age- and gender-specific rates: United States, 1998 

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 

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

575.1 

8.5 

354.6 

341.5 

198.4 

140.1 

94.4 

47.9 

18.8 

6.4 

135.4 Total 

65+ 

55-64 

45-54 

40-44 

35-39 

30-34 

25-29 

20-24 

15-19 

10-14 58.0 

254.4 

117.3 

65.5 

30.3 

9.0 

2.1 

1.7 

133.7 

779.7 

645.9 

Figure 18. Gonorrhea — Positivity among 15-24 year old women tested in family planning 

clinics by state, 1998 

0.6 

0.2 1.9 VT 0.1 

NH 0.0 1.1 MA 

0.4 2.2 0.9 RI 1.1 0.3 CT 0.8 0.7 1.0 0.7 NJ 

DE 

1.8 MD 

1.0 DC 0.5 2.1 3.0 

5.2 2.4 2.0 Positivity (%) 

1.9 

3.5 

See * 

<1 

(n=26) 

(n=12) 

1.4 1.0-1.9 

>=2 

(n=8) 

(n=7) 

0.0 

Puerto Rico Virgin Is. 

*States reported gonorrhea positivity data on less than 500 women aged 15-24 years during 1998. 

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

Centers for Disease Control and Prevention 

STD Surveillance 1998 National Profile Gonorrhea 19 
Figure 19. Gonococcal Isolate Surveillance Project (GISP) — Location of participating 

clinics and regional laboratories: United States, 1998 

Seattle 

Ft. Lewis 

Portland 

Minneapolis 

Cleveland 

Nassau Co. Philadelphia 

Chicago 

San Francisco Cincinnati Baltimore 

Denver Kansas City 

St. Louis 

Long Beach Ft. Bragg 

Orange Co. 

San Diego 

Phoenix Albuquerque 

Atlanta Birmingham 

New Orleans 

San Antonio Anchorage 

Honolulu STD Clinics 

Laboratories West Palm Beach 

Miami 

Figure 20. Gonococcal Isolate Surveillance Project (GISP) — Trends in plasmid-mediated 

resistance to penicillin and tetracycline, 1988–1998 

Percent 

15 

PPNG 

12 TRNG 

PPNG & TRNG 

9 

6 

3 

0 

1988 89 90 91 92 93 94 95 96 97 98 

Note: “PPNG” (penicillinase-producing Neisseria gonorrhoeae) and “TRNG” (tetracyclineresistant N. gonorrhoeae) refer to plasmid-mediated resistance to penicillin and 

tetracycline, respectively. 

20 Gonorrhea National Profile STD Surveillance 1998 
Figure 21. Gonococcal Isolate Surveillance Project (GISP) — Trends in chromosomally 

mediated resistance to penicillin and tetracycline, 1988–1998 

Percent 

Penicillin 

Tetracycline 

Pen & Tet 

1988 89 90 91 92 93 94 95 96 97 98 

15 

12 

9 

6 

3 

0 

Note: Chromosomally mediated resistance to penicillin denotes a minimum inhibitory 

concentration (MIC) of greater than or equal to 2 g penicillin/mL and beta-lactamase 

negative; chromosomally mediated resistance to tetracycline corresponds to a MIC of 

greater than or equal to 2 g tetracycline/mL without plasmid-mediated tetracycline 

resistance. 

Figure 22. Gonococcal Isolate Surveillance Project (GISP) — Prevalence of Neisseria 

gonorrhoeae with decreased susceptibility or resistance to ciprofloxacin, 

1990–1998 

Decreased susc. 

Resistant 

1990 91 92 93 94 95 96 97 98 

Percent 

1.5 

1.2 

0.9 

0.6 

0.3 

0.0 

Note: Resistant isolates have MICs greater than or equal to 1 g ciprofloxacin/mL. Isolates with 

decreased susceptibility have MICs of 0.125 - 0.5 g ciprofloxacin/mL. There were twenty 

three (23) resistant isolates: one in 1991, one in 1993, two in 1994, eight in 1995, two in 

1996, five in 1997 and four in 1998. Susceptibility to ciprofloxacin was first measured in 

GISP in 1990. 

STD Surveillance 1998 National Profile Gonorrhea 21 
Figure 23. Gonococcal Isolate Surveillance Project (GISP) — Proportion of men with 

gonorrhea who had a previous gonorrhea infection within the past year, 

1992–1998 

Percent 

25 

20 

15 

10 

5 

0 

1992 93 94 95 96 97 98
 

Note: GISP cases with no information on previous episodes of gonorrhea were excluded. Data on 

previous episodes of gonorrhea were first collected in 1992. 

Figure 24. Gonococcal Isolate Surveillance Project (GISP) — Percent of Neisseria 

gonorrhoeae isolates obtained from men who have sex with men for STD clinics 

in nine cities, 1994, 1996 and 1998 

Percent 

75 

60 

45 

30 

15 

0 

1994 

1996 

1998 

CHI DEN HON LBC ORA POR SDG SEA SFO
 

Clinics 

Note: In 1998, these nine clinics reported 87.3% (439/503) of GISP gonorrhea cases in men who 

have sex with men. Chicago first participated in 1996. Clinics include: CHI=Chicago, IL; 

DEN=Denver, CO; HON=Honolulu, HI; LBC=Long Beach, CA; ORA=Orange County, CA; 

POR=Portland, OR; SDG=San Diego, CA; SEA=Seattle, WA; and SFO=San Francisco, CA. 

22 Gonorrhea National Profile STD Surveillance 1998 
Syphilis 

From 1990 to 1998, the U.S. primary and secondary (P&S) syphilis rate declined 87 percent to its 

lowest level since reporting began in 1941. While the U.S. syphilis rate is low and the disease is 

geographically concentrated, a concerted effort could lead to its elimination in the United States. 

Collaboration with diverse organizations, public health professionals, the private medical community, and other partners working in STD and HIV will be essential in this effort1

. 

Despite the overall decline, syphilis remains an important problem in the South and in a small 

number of urban areas outside the South, particularly among African-Americans. Syphilis, a genital 

ulcerative disease, facilitates the transmission of HIV and may be particularly important in 

contributing to HIV transmission in those parts of the country, such as the South, where rates of both 

infections are high. Untreated early syphilis during pregnancy results in perinatal death in up to 40% 

of cases, and if acquired during the previous four years before pregnancy, may lead to infection of 

the fetus in over 70% of cases. For syphilis, as for other STDs, differential reporting of cases from 

public and private sectors may magnify the differences in reported rates by race and ethnicity. 

In 1998, 6,993 cases of P&S syphilis were reported to CDC. This is the lowest 

number of cases reported since 1958. Between 1997 and 1998 the incidence of 

P&S syphilis in the U.S. declined from 3.2 to 2.6 cases per 100,000 persons 

(Figure 26, Table 1), and has been below the Healthy People 2000 (HP2000) 

national objective of 4.0 per 100,000 persons for the last two years. 

Since 1990 the rate of early latent syphilis has exceeded the rate of P&S syphilis. 

There were approximately 0.8 reported cases of early latent syphilis for every 

reported case of P&S syphilis in the five years preceding 1990 and 1.8 reported cases 

of early latent syphilis for every reported case of P&S syphilis in 1998 (Table 1). 

Since the peak of late and late latent syphilis in 1993, the rate of late and late latent 

syphilis has exceeded the rate of P&S syphilis and grows proportionately greater 

every year. There were approximately 0.6 reported cases of late and late latent 

syphilis for every reported case of P&S syphilis in the five years preceding 1993 

and 2.5 reported cases of late and late latent syphilis for every reported case of 

P&S syphilis in 1998 (Table 1). 

In 1998, P&S syphilis rates in 40 states and 1 outlying area were below the 

HP2000 national objective of 4 cases per 100,000 (Figure 27, Table 24). 

Fourteen states and 1 outlying area reported 5 or fewer cases of P&S syphilis in 

1998. 

In 1998, 2,430 (78%) of 3,115 counties in the U.S. reported no cases of P&S 

syphilis compared with 2,324 (75%) of counties in 1997. Of 685 counties 

reporting at least one case of P&S syphilis in 1998, 373 (54%) counties reported 

rates of 4 cases or fewer per 100,000 persons. Therefore, rates of P&S syphilis 

were above the HP2000 objective for 312 counties in 1998 (Figure 28). These 

STD Surveillance 1998 National Profile Syphilis 23 
counties (10% of the total number of counties in the U.S.) accounted for 

approximately 76% of the reported P&S syphilis cases. 

In 1998, the largest numbers of reported cases of P&S syphilis were found in 25 

counties, and the three independent cities of Baltimore, St. Louis, and the District 

of Columbia (Table 32). These 28 areas account for half of the total number of 

reported P&S syphilis cases. 

In 1998, the rates of P&S syphilis continued to decline in the Northeast, Midwest, 

and the South. However, the rate of 5.1 cases per 100,000 persons in the South 

remained above the HP2000 objective (Figure 29, Table 25). The P&S syphilis 

rates of the other 3 regions were below the HP2000 objective. 

Rates for P&S syphilis were calculated within the U.S. and each geographic 

region for each of 4 defined urban-to-rural categories (see Figure 30 and the 

Appendix for definitions of the categories). In general, P&S syphilis rates for 

urban-to-rural categories of the South dominated the corresponding rates of the 

other three regions. Of the 6,969 cases of P&S syphilis reported at the county 

level for 1998, about 69% occurred in the South. In 1998, the highest rate (5.6 per 

100,000 population) was found for urban counties of the South. The South 

accounted for 64% of all P&S cases that occurred in urban counties, and 93% of 

all P&S cases that occurred within each of the other three categories of counties 

(peri-urban, peri-rural, and rural). Within the South, rural counties had the lowest 

rate (2.5 per 100,000). However, this rate was substantially higher than the rates 

found for rural counties in each of the other regions, and was about 2 to 3 times 

greater than the rates for urban counties in the West and Northeast. In the West, 

Midwest, and Northeast, the highest rates were typically found in urban counties. 

The overall rate of P&S syphilis in selected large cities over 200,000 population 

declined from 6.0 cases per 100,000 persons in 1997 to 5.1 in 1998 (Figure 31, 

Table 29). However, rates exceeded the HP2000 objective in 24 (38%) of 64 

large cities in the United States and outlying areas for which data were available 

(Table 28). 

During the period 1994 to 1998, the rates of P&S syphilis within racial and ethnic 

groups have generally declined (Figure 33, Table 23B). However, the 1998 rate 

for non-Hispanic blacks of 17.1 cases per 100,000 persons was 34 times greater 

than the rate for non-Hispanic whites. 

Between 1997 and 1998, the overall rate of congenital syphilis decreased from 

27.5 to 20.6 cases per 100,000 live births (Figure 36, Table 37)2

. However, 

compared with 1997, increases were observed in 1998 for 6 (Arizona, Missouri, 

New Jersey, North Carolina, Oklahoma, and South Carolina) of 21 states 

reporting more than 5 cases and for Puerto Rico (Table 39). 

In 1998, 3 states (Arkansas, Maryland, and New Jersey) and Puerto Rico had 

congenital syphilis rates that exceeded the HP2000 objective of 40 cases per 

100,000 live births (Table 38). 

The HP2000 congenital syphilis objective of 40 cases per 100,000 live births was 

exceeded in 24 (38%) of the 64 selected cities with a population over 200,000 

(Table 40). For 5 of these cities (Baltimore, Houston, Miami, Newark, and 

Oklahoma City), the rate per 100,000 births was 3 to almost 13 times greater than 

the HP2000 objective. 

24 Syphilis National Profile STD Surveillance 1998 
Additional information on syphilis and congenital syphilis can be found in the 

Special Focus Profiles section. 

1CDC. Primary and secondary syphilis—United States, 1997. MMWR 1998;24:493-7. 

2CDC. Congenital syphilis—United States, 1998. MMWR 1998;48:757-61. 

STD Surveillance 1998 National Profile Syphilis 25 
Figure 25. Syphilis — Reported cases by stage of illness: United States, 1941–1998 

Thousands of cases 

600 

480 

360 

240 

120 

0 

P&S 

Early Latent 

Total Syphilis 

1941 46 51 56 61 66 71 76 81 86 91 96
 

Figure 26. Primary and secondary syphilis — Reported rates: United States, 1970–1998 

and the Healthy People year 2000 objective 

Rate (per 100,000 population)
 

25
 

20
 

15
 

10
 

5
 

0
 

P&S Syphilis 

2000 Objective 

1970 74 78 82 86 90 94 98
 

26 Syphilis National Profile STD Surveillance 1998 
Figure 27. Primary and secondary syphilis — Rates by state: United States and outlying areas, 

1998 

0.8 

0.0 0.0 0.1 

0.2 0.2 

0.2 0.1 1.2 0.7 

0.2 2.2 VT 0.7 

0.9 0.5 0.2 

1.2 

0.8 NH 

MA 

0.2 

0.8 0.2 3.6 3.7 RI 0.1 0.9 0.3 0.5 2.0 2.7 

0.2 2.2 CT 

NJ 

0.8 

1.3 

DE 2.9 

10.6 9.7 MD 12.7 4.1 3.0 0.8 4.3 7.2 

Guam 0.0 

9.6 6.3 4.4 Rate per 100,000

population 

2.3 <=4 (n=41) 

0.2 9.9 4.1-8 (n=7) 

2.0 >8 (n=5) 

0.3 

Puerto Rico 4.6 Virgin Is. 6.4 

Note: The total rate of primary and secondary syphilis for the United States and outlying areas 

(including Guam, Puerto Rico and Virgin Islands) was 2.6 per 100,000 population. The Healthy 

People year 2000 objective is 4.0 per 100,000 population. 

Figure 28. Primary and secondary syphilis — Counties with rates above and counties with 

rates below the Healthy People year 2000 objective: United States, 1998 

Rates per 100,000

Population 

<=4 (n=2,803) 

>4 (n=312) 

STD Surveillance 1998 National Profile Syphilis 27 
Figure 29. Primary and secondary syphilis — Rates by region: United States, 1981–1998 

and the Healthy People year 2000 objective 

Rate (per 100,000 population) 

50
 

40
 

30
 

20
 

10
 

0 

West 

Midwest 

Northeast 

South 

2000 Objective 

1981 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98
 

Figure 30. Primary and secondary syphilis — Rates by urban-rural category and
 

geographic region, 1998
 

Rate (per 100,000 population) 

Urban 

Peri-urban 

Peri-rural 

Rural 

0.0 

1.2 

2.4 

3.6 

4.8 

6.0 

U.S. West Midwest Northeast South 

Note: See Appendix for definitions and source of urban-to-rural categories. 

28 Syphilis National Profile STD Surveillance 1998
 
Figure 31. Primary and secondary syphilis — Rates in selected U.S. cities of >200,000 

population, 1981–1998 and the Healthy People year 2000 objective 

Rate (per 100,000 population) 

50 

40 

30 

20 

10 

0 

Cities 

2000 Objective 

1981 82 83 8 4 85 86 87 88 89 90 91 92 93 94 95 96 97 98 

Figure 32. Primary and secondary syphilis — Rates by gender: United States, 1981–1998 

and the Healthy People year 2000 objective 

Rate (per 100,000 population) 

25 

20 

15 

10 

5 

0 

Men 

Women 

2000 Objective 

1981 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 

STD Surveillance 1998 National Profile Syphilis 29 
Figure 33. Primary and secondary syphilis — Rates by race and ethnicity: United States, 

1981–1998 and the Healthy People year 2000 objective 

Rate (per 100,000 population) 

White 

Black 

Hispanic 

Other 

2000 Objective 

0 

30 

60 

90 

120 

150 

1981 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 

Note: “Other” includes Asian/Pacific Islander and American Indian/Alaska Native populations. 

Black, White, and Other are non-Hispanic. 

Men Rate (per 100,000 population) Women

10 8 6 4 2 0 Age 0 2 4 6 8 10

Total

65+

55-64

45-54

40-44

35-39

30-34

25-29

20-24

15-19

0.1 10-14

1.9

5.6

5.4

6.0

6.0

5.1

3.5

1.9

0.6

3.0

0.4

4.5

6.1

5.5

5.3

4.4

2.7

1.2

0.3

0.1

2.3

Men Rate (per 100,000 population) Women

10 8 6 4 2 0 Age 0 2 4 6 8 10

Total

65+

55-64

45-54

40-44

35-39

30-34

25-29

20-24

15-19

0.1 10-14

1.9

5.6

5.4

6.0

6.0

5.1

3.5

1.9

0.6

3.0

0.4

4.5

6.1

5.5

5.3

4.4

2.7

1.2

0.3

0.1 

2.3

Men Rate (per 100,000 population) Women

10 8 6 4 2 0 Age 0 2 4 6 8 10

Total

65+

55-64

45-54

40-44

35-39

30-34

25-29

20-24

15-19

0.1 10-14

1.9

5.6

5.4

6.0

6.0

5.1

3.5

1.9

0.6

3.0

0.4

4.5

6.1

5.5

5.3

4.4

2.7

1.2

0.3

0.1

2.3

Men Rate (per 100,000 population) Women

10 8 6 4 2 0 Age 0 2 4 6 8 10

Total

65+

55-64

45-54

40-44

35-39

30-34

25-29

20-24

15-19

0.1 10-14

1.9

5.6

5.4

6.0

6.0

5.1

3.5

1.9

0.6

3.0

0.4

4.5

6.1

5.5

5.3

4.4

2.7

1.2

0.3

0.1

2.3

Men Rate (per 100,000 population) Women

10 8 6 4 2 0 Age 0 2 4 6 8 10

Total

65+

55-64

45-54

40-44

35-39

30-34

25-29

20-24

15-19

0.1 10-14

1.9

5.6

5.4

6.0

6.0

5.1

3.5

1.9

0.6

3.0

0.4

4.5

6.1

5.5

5.3

4.4

2.7

1.2

0.3

0.1

2.3

Men Rate (per 100,000 population) Women

10 8 6 4 2 0 Age 0 2 4 6 8 10

Total

65+

55-64

45-54

40-44

35-39

30-34

25-29

20-24

15-19

0.1 10-14

1.9

5.6

5.4

6.0

6.0

5.1

3.5

1.9

0.6

3.0

0.4

4.5

6.1

5.5

5.3

4.4

2.7

1.2

0.3

0.1

2.3

Men Rate (per 100,000 population) Women

10 8 6 4 2 0 Age 0 2 4 6 8 10

Total

65+

55-64

45-54

40-44

35-39

30-34

25-29

20-24

15-19

0.1 10-14

1.9

5.6

5.4

6.0

6.0

5.1

3.5

1.9

0.6

3.0

0.4

4.5

6.1

5.5

5.3

4.4

2.7

1.2

0.3

0.1

2.3

Men Rate (per 100,000 population) Women

10 8 6 4 2 0 Age 0 2 4 6 8 10

Total

65+

55-64

45-54

40-44

35-39

30-34

25-29

20-24

15-19

0.1 10-14

1.9

5.6

5.4

6.0

6.0

5.1

3.5

1.9

0.6

3.0

0.4

4.5

6.1

5.5

5.3

4.4

2.7

1.2

0.3

0.1

2.3

Men Rate (per 100,000 population) Women

10 8 6 4 2 0 Age 0 2 4 6 8 10

Total

65+

55-64

45-54

40-44

35-39

30-34

25-29

20-24

15-19

0.1 10-14

1.9

5.6

5.4

6.0

6.0

5.1

3.5

1.9

0.6

3.0

0.4

4.5

6.1

5.5

5.3

4.4

2.7

1.2

0.3

0.1

2.3

Men Rate (per 100,000 population) Women

10 8 6 4 2 0 Age 0 2 4 6 8 10

Total

65+

55-64

45-54

40-44

35-39

30-34

25-29

20-24

15-19

0.1 10-14

1.9

5.6

5.4

6.0

6.0

5.1

3.5

1.9

0.6

3.0

0.4

4.5

6.1

5.5

5.3

4.4

2.7

1.2

0.3

0.1

2.3

Men Rate (per 100,000 population) Women

10 8 6 4 2 0 Age 0 2 4 6 8 10

Total

65+

55-64

45-54

40-44

35-39

30-34

25-29

20-24

15-19

0.1 10-14

1.9

5.6

5.4

6.0

6.0

5.1

3.5

1.9

0.6

3.0

0.4

4.5

6.1

5.5

5.3

4.4

2.7

1.2

0.3

0.1

2.3

Men Rate (per 100,000 population) Women

10 8 6 4 2 0 Age 0 2 4 6 8 10

Total

65+

55-64

45-54

40-44

35-39

30-34

25-29

20-24

15-19

0.1 10-14

1.9

5.6

5.4

6.0

6.0

5.1

3.5

1.9

0.6

3.0

0.4

4.5

6.1

5.5

5.3

4.4

2.7

1.2

0.3

0.1

2.3

Men Rate (per 100,000 population) Women

10 8 6 4 2 0 Age 0 2 4 6 8 10

Total

65+

55-64

45-54

40-44

35-39

30-34

25-29

20-24

15-19

0.1 10-14

1.9

5.6

5.4

6.0

6.0

5.1

3.5

1.9

0.6

3.0

0.4

4.5

6.1

5.5

5.3

4.4

2.7

1.2

0.3

0.1

2.3

Men Rate (per 100,000 population) Women

10 8 6 4 2 0 Age 0 2 4 6 8 10

Total

65+

55-64

45-54

40-44

35-39

30-34

25-29

20-24

15-19

0.1 10-14

1.9

5.6

5.4

6.0

6.0

5.1

3.5

1.9

0.6

3.0

0.4

4.5

6.1

5.5

5.3

4.4

2.7

1.2

0.3

0.1

2.3

Men Rate (per 100,000 population) Women

10 8 6 4 2 0 Age 0 2 4 6 8 10

Total

65+

55-64

45-54

40-44

35-39

30-34

25-29

20-24

15-19

0.1 10-14

1.9

5.6

5.4

6.0

6.0

5.1

3.5

1.9

0.6

3.0

0.4

4.5

6.1

5.5

5.3

4.4

2.7

1.2

0.3

0.1

2.3

Men Rate (per 100,000 population) Women

10 8 6 4 2 0 Age 0 2 4 6 8 10

Total

65+

55-64

45-54

40-44

35-39

30-34

25-29

20-24

15-19

0.1 10-14

1.9

5.6

5.4

6.0

6.0

5.1

3.5

1.9

0.6

3.0

0.4

4.5

6.1

5.5

5.3

4.4

2.7

1.2

0.3

0.1

2.3

Men Rate (per 100,000 population) Women

10 8 6 4 2 0 Age 0 2 4 6 8 10

Total

65+

55-64

45-54

40-44

35-39

30-34

25-29

20-24

15-19

0.1 10-14

1.9

5.6

5.4

6.0

6.0

5.1

3.5

1.9

0.6

3.0

0.4

4.5

6.1

5.5

5.3

4.4

2.7

1.2

0.3

0.1

2.3

Men Rate (per 100,000 population) Women

10 8 6 4 2 0 Age 0 2 4 6 8 10

Total

65+

55-64

45-54

40-44

35-39

30-34

25-29

20-24

15-19

0.1 10-14

1.9

5.6

5.4

6.0

6.0

5.1

3.5

1.9

0.6

3.0

0.4

4.5

6.1

5.5

5.3

4.4

2.7

1.2

0.3

0.1

2.3

Men Rate (per 100,000 population) Women

10 8 6 4 2 0 Age 0 2 4 6 8 10

Total

65+

55-64

45-54

40-44

35-39

30-34

25-29

20-24

15-19

0.1 10-14

1.9

5.6

5.4

6.0

6.0

5.1

3.5

1.9

0.6

3.0

0.4

4.5

6.1

5.5

5.3

4.4

2.7

1.2

0.3

0.1

2.3

Men Rate (per 100,000 population) Women

10 8 6 4 2 0 Age 0 2 4 6 8 10

Total

65+

55-64

45-54

40-44

35-39

30-34

25-29

20-24

15-19

0.1 10-14

1.9

5.6

5.4

6.0

6.0

5.1

3.5

1.9

0.6

3.0

0.4

4.5

6.1

5.5

5.3

4.4

2.7

1.2

0.3

0.1

2.3

Men Rate (per 100,000 population) Women

10 8 6 4 2 0 Age 0 2 4 6 8 10

Total

65+

55-64

45-54

40-44

35-39

30-34

25-29

20-24

15-19

0.1 10-14

1.9

5.6

5.4

6.0

6.0

5.1

3.5

1.9

0.6

3.0

0.4

4.5

6.1

5.5

5.3

4.4

2.7

1.2

0.3

0.1

2.3

Men Rate (per 100,000 population) Women 

10 8 6 4 2 0 Age 0 2 4 6 8 10 

Total 

65+ 

55-64 

45-54 

40-44 

35-39 

30-34 

25-29 

20-24 

15-19 

0.1 10-14

1.9 

5.6 

5.4 

6.0 

6.0 

5.1 

3.5 

1.9 

0.6 

3.0 

0.4 

4.5 

6.1 

5.5 

5.3 

4.4 

2.7 

1.2 

0.3 

0.1 

2.3 

Figure 34. Primary and secondary syphilis — Age- and gender-specific rates: United 

States, 1998 

30 Syphilis National Profile STD Surveillance 1998 
Figure 35. Congenital syphilis — Reported cases for infants <1 year of age and rates of 

primary and secondary syphilis among women: United States, 1970–1998 

P&S rate (per 100,000 population) 

20 

CS cases (in thousands) 

7.5 

16 6.0 

12 4.5 

8 3.0 

4 1.5 

0 0.0 

P&S Syphilis 

Congenital 

Syphilis 

Kaufman Criteria 

CDC Surveillance Definition 

1970 74 78 82 86 90 94 98
 

Note: The surveillance case definition for congenital syphilis changed in 1988 (see Appendix). 

Figure 36. Congenital syphilis — Rates for infants <1 year of age: United States, 

1981–1998 

Rate (per 100,000 live births) 

125 

100 

75 

50 

25 

0 

Cong. Syphilis 

2000 Objective 

1981 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 

Note: The surveillance case definition for congenital syphilis changed in 1988 (see Appendix). 

STD Surveillance 1998 National Profile Syphilis 31 

Other Sexually Transmitted Diseases 

Since 1987, reported cases of chancroid have declined steadily (Table 1, Figure 37). In 1998, a 

total of 189 cases of chancroid were reported from 20 states (Table 42). Six states (Arkansas, 

California, New York, North Carolina, South Carolina, and Texas) accounted for nearly 85% of the 

189 reported cases. Chancroid is difficult to culture and may be substantially underdiagnosed1,2. 

Comprehensive surveillance data for non-gonococcal urethritis, genital herpes simplex virus 

(HSV), human papillomavirus, and trichomoniasis are not available. Ongoing trend data are limited to estimates of trends in physicians’ office practices provided by the National Disease and 

Therapeutic Index (Figures 38 and 40-42). 

Data on genital 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%. The HSV-2 seroprevalence in NHANES III was 30% higher than the age-adjusted 

HSV-2 seroprevalence from NHANES II (1976-1980). Increases in HSV-2 seroprevalence between 

NHANES II and NHANES III were concentrated in the younger age groups. There were statistically 

significant increases overall in the three youngest age groups, including persons aged 12 to 39 years 

(Figure 39)3

. 

For data on PID, see the Special Focus Profile on Women and Infants. 

1Schulte 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. 

2Mertz KJ, Trees D, Levine WC, et al. Etiology of genital ulcers and prevalence of human immunodeficiency 

virus coinfection in 10 US cities. JID 1998;178:1795-8 

3Fleming 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. 

STD Surveillance 1998 National Profile Other Sexually Transmitted Diseases 33 
Figure 37. Chancroid — Reported cases: United States, 1981–1998 

Cases (in thousands) 

5 

4 

3 

2 

1 

0 

1981 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98
 

Figure 38. Genital herpes simplex virus infections — Initial visits to physicians’ offices: 

United States, 1966–1998 and the Healthy People year 2000 objective 

Visits (in thousands) 

250 

200 

150 

100 

50 

0 

Genital herpes 

2000 Objective 

1966 70 74 78 82 86 90 94 98 

Note: See Appendix.
 

SOURCE: National Disease and Therapeutic Index (IMS America, Ltd.)
 

34 Other Sexually Transmitted Diseases National Profile STD Surveillance 1998 
Figure 39. Genital herpes simplex virus type 2 — Percent seroprevalence according to age 

in NHANES* II (1976–1980) and NHANES III (1988–1994) 

Percent 

NHANES II 

NHANES III 

0 

8 

16 

24 

32 

40 

12-19 20-29 30-39 40-49 50-59 60-69 70+ 

Age Group 

Note: Bars indicate 95% confidence intervals. 

*National Health and Nutrition Examination Survey 

Figure 40.	 Human papillomavirus (genital warts) — Initial visits to physicians’ offices: 

United States, 1966–1998 and the Healthy People year 2000 objective 

Visits (in thousands) 

Genital warts 

2000 Objective 

0 

80 

160 

240 

320 

400 

1966 70 74 78 82 86 90 94 98 

Note: See Appendix.
 

SOURCE: National Disease and Therapeutic Index (IMS America, Ltd.)
 

STD Surveillance 1998 National Profile Other Sexually Transmitted Diseases 35 
Figure 41. Nonspecific urethritis — Initial visits to physicians’ offices by men: 

United States, 1966–1998 

Visits (in thousands) 

400 

320 

240 

160 

80 

0 

1966 70 74 78 82 86 90 94 98
 

Note: See Appendix.
 

SOURCE: National Disease and Therapeutic Index (IMS America, Ltd.)
 

Figure 42. Trichomonal and other vaginal infections — Initial visits to physicians’ offices: 

United States, 1966–1998 

Visits (in thousands) 

4,500 

3,600 

2,700 

1,800 

900 

0 

Trichomonal 

Other Vaginitis 

1966 70 74 78 82 86 90 94 98
 

Note: See Appendix.
 

SOURCE: National Disease and Therapeutic Index (IMS America, Ltd.)
 

36 Other Sexually Transmitted Diseases National Profile STD Surveillance 1998 
Special Focus Profiles 

The Special Focus Profiles section highlights 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; persons entering corrections facilities; 

and populations in the southern United States. The Special Focus Profiles refer to figures located 

in disease-specific sections in the National Profile. In addition, there are figures (Figures A-EE) that 

highlight specific points made in the following text. 

STD Surveillance 1998 Special Focus Profiles Special Focus Profiles 37 

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 adverse reproductive consequences, e.g., 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 develop PID. Among women with 

PID, scarring sequelae 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 asymptomatic4-6. These 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 

pregnancy7

. 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 also result in adverse outcomes of pregnancy, including neonatal 

ophthalmia and, in the case of chlamydia, neonatal pneumonia. Although topical prophylaxis at 

delivery is effective for prevention of ophthalmia neonatorum, prevention of neonatal pneumonia 

requires antenatal detection and treatment. 

Infections with human papillomavirus (HPV) in women are a major concern because specific 

HPV subtypes (e.g., types 16, 18, 31, 33, and 35) have been associated epidemiologically with 

cervical dysplasia and cervical cancer. HPV types 6 and 11 in child bearing women can cause 

laryngeal papillomatosis in infants. 

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 preventable if women are screened for syphilis and 

treated early during prenatal care9

. 

Observations 

•	 Between 1997 and 1998, the reported rate of chlamydial infections in women 

increased from 336.9 per 100,000 population to 382.2 (Figure 6, Table 6). This 

increase most likely reflects a variety of different factors (e.g., increased screening 

activities, the increased use of more recently developed diagnostic test 

procedures, changes to information systems to incorporate laboratory reporting, 

etc.) rather than an increase in number of cases in women; even as reported cases 

have increased, prevalence among women screened in the U.S. has generally 

declined (see section on Chlamydia). Despite considerable under-reporting, it is 

STD Surveillance 1998	 Special Focus Profiles STDs in Women and Infants 39 
important to note that chlamydia rates exceed gonorrhea rates in women in many 

states (Figures A and B, Tables 6 and 15). 

•	 For gonorrhea, the Healthy People year 2000 objective is 100 cases per 100,000 

persons. Gonorrhea rates for women alone exceeded this HP2000 objective in 

24 states (Figure B, Table 15), an increase of 4 additional states over the 

preceding year. The highest rates of gonorrhea for women were concentrated in 

the South. 

•	 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 15, Tables 15 and 16). Gonorrhea 

rates for women increased from 119.0 cases per 100,000 population in 1997 to 

131.5 in 1998; rates for men also increased from 124.9 to 133.7 between 1997 

and 1998. Men with gonorrhea are usually symptomatic and may seek care; 

therefore, trends in men may be a relatively good indicator of trends in incidence 

of disease. However, trends in women are determined more by screening 

practices, similar to chlamydia. 

•	 The Healthy People year 2000 objective for primary and secondary syphilis is 4.0 

per 100,000 persons. Primary and secondary syphilis rates for women exceeded 

the HP2000 objective in 8 southern states and 1 outlying area (Figure C, Table 

26). Five southern states (Louisiana, Maryland, Mississippi, North Carolina, and 

Tennessee) had rates for women that were at least twice the HP2000 objective for 

primary and secondary syphilis (Table 26). For congenital syphilis, the Healthy 

People year 2000 objective is 40 per 100,000 live births. Three states (Arkansas, 

Maryland, and New Jersey) and Puerto Rico had rates that exceeded the HP2000 

objective (Figure D, Table 38). 

•	 The rate of congenital syphilis closely follows the trend of P&S syphilis in women 

(Figure 35). Peaks in congenital syphilis usually occur one year after peaks in P&S 

syphilis in women. The congenital syphilis rate peaked in 1991 at 107.3 cases per 

100,000 live births and has declined by approximately 80% to 20.6 in 1998 

(Figure 36, Table 37). The rate of P&S syphilis in women peaked at 17.3 per 

100,000 persons in 1990 and declined 87% to 2.3 in 1998 (Figure 35, Table 26). 

•	 In 1998, state-specific chlamydia test positivity among 15 to 24 year old women 

screened in selected prenatal clinics in 21 states ranged from 3.7%-14.5% (Figure E). 

•	 In 1998, state-specific gonorrhea test positivity among 15 to 24 year old women 

screened in selected prenatal clinics in 8 states ranged from 0.9%-4.7% (Figure F). 

•	 Although the 1998 rate of congenital syphilis was below the Healthy People 2000 

objective of 40 cases per 100,000 live births, this objective is many times greater 

than the rate of congenital syphilis of most industrialized countries where syphilis 

and congenital syphilis have nearly been eliminated10. 

•	 Accurate estimates of pelvic inflammatory disease (PID) and tubal factor infertility 

from gonococcal and chlamydial infections are difficult to obtain. Definitive 

diagnosis of these conditions can be complex, requiring for example, laparoscopy 

or laparotomy, while tubal patency studies may be needed to accurately 

document these conditions. Most cases of PID are treated on the basis of 

interpretations of clinical findings, which vary between individual practitioners. In 

40 STDs in Women and Infants Special Focus Profiles	 STD Surveillance 1998 
addition, the settings in which care is provided can vary considerably over time. 

For example, women with PID who would have been hospitalized in the 1980s 

may be treated in out-patient facilities during the 1990s. Trends in hospitalized 

PID have declined steadily throughout the 1980s and early 1990s but were 

similar for 1994-1997 (Figure H). However, these trends may be more reflective 

of changes in the etiologic spectrum (with increasing proportions of more indolent 

chlamydial infection) and clinical management of PID (from in-patient to out-patient) 

rather than true trends in disease11. 

•	 Recent evidence suggests that health care practices associated with ectopic 

pregnancy also 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 (Figure G). Beginning in 1990, hospitalizations for ectopic pregnancy 

began to decline. Data from outpatient care surveys suggest that nearly half of all 

ectopic pregnancies are treated on an outpatient basis12. The total number of 

ectopic pregnancies in the U.S. in 1992 was estimated to be 108,800 (or 19.7 

cases per 1,000 pregnancies), the highest level in more than two decades12. 

•	 Initial visits to physicians’ offices for PID declined from 1993 to 1995, increased in 

1996, and again decreased in 1997 and 1998 (Figure I). Among women 15 to 44 

years of age, the estimated number of PID cases diagnosed in emergency 

departments was about 233,000 in 1997 (National Hospital Ambulatory Medical 

Care Survey, NCHS). This estimate has a relative standard error of 18%. 

1Stamm 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. 

2Platt 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. 

3Westrom 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;19:185-92. 

4Hook 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. 

5Stamm 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. 

6Zimmerman HL, Potterat JJ, Dukes RL, et al. Epidemiologic differences between chlamydia and gonorrhea. 

Am J Public Health 1990;80:1338-42. 

7Hillis 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. 

8Scholes 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. 

9CDC. Guidelines for prevention and control of congenital syphilis. MMWR 1988;37(No.S-1). 

10Division of STD/HIV Prevention. Healthy People 2000: National Health Promotion and Disease Objectives. 

Progress Review: Sexually Transmitted Diseases, October 26, 1994. 

STD Surveillance 1998	 Special Focus Profiles STDs in Women and Infants 41 
11Rolfs 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. 

12CDC. Ectopic pregnancy—United States, 1990-1992. MMWR 1995;44:46-8. 

42 STDs in Women and Infants Special Focus Profiles STD Surveillance 1998 
Figure A. Chlamydia — Rates for women by state: United States and outlying areas, 1998 

297.7 

256.6 141.5 235.1 

262.8 215.7 

256.7 312.9 408.3 * 249.9 374.7 VT 119.5 

343.2 282.9 279.1 

403.1 

335.1 NH 

MA 

122.0 

215.4 156.4 359.0 293.6 RI 347.5 370.9 355.8 353.0 397.8 255.2 

249.2 336.7 CT 

NJ 

346.9 

259.0 

DE 564.5 

380.6 488.8 MD 424.4 392.5 454.4 365.4 295.9 848.5 

Guam 478.1 

647.5 410.2 551.5 Rate per 100,000

population 

508.1 <=150 (n=5) 

511.6 539.8 150.1-300 (n=17) 

267.9 >300 (n=31) 

374.5 

Puerto Rico 66.7 Virgin Is. 17.5 

*The New York City rate was 604.6 per 100,000 population. No cases were reported outside of New 

York City. 

Note: The total rate of chlamydia for women in the United States and outlying areas (including Guam, 

Puerto Rico and Virgin Islands) was 377.4 per 100,000 population. For further information on 

chlamydia reporting see the Appendix. 

Figure B. Gonorrhea — Rates for women by state: United States and outlying areas, 1998 

30.7 

7.5 4.9 17.4 

26.2 60.8 

12.2 142.2 33.1 112.7

9.7 165.0 VT 7.4 61.3 103.9 NH 7.9 80.9 71.9 175.4 MA 36.5 6.8 110.1 184.9 RI 50.4 57.7 53.8 58.5 132.2 CT 102.0 110.4 177.1 92.9 NJ 90.8 

DE 228.0 239.3 189.8 MD 206.3 75.3 173.1 60.4 147.5 294.9 

Guam 34.0 Rate per 100,000 281.5 262.2 population 421.1 

170.0 <=100 (n=29) 

62.6 272.5 100.1-175 (n=12)

118.5 (n=12) >175 

47.1 

Puerto Rico 8.2 Virgin Is. 28.1 

Note: The total rate of gonorrhea for women in the United States and outlying areas (including Guam, 

Puerto Rico and Virgin Islands) was 129.6 per 100,000 population. The Healthy People year 

2000 objective is 175 per 100,000 population for women aged 15-44. 

STD Surveillance 1998 National Profile STDs in Women and Infants 43 
Figure C. Primary and secondary syphilis — Rates for women by state: United States and 

outlying areas, 1998 

0.2 

0.0 0.0 0.0 

0.1 0.2 

0.0 1.2 0.3 0.3

0.0 1.7 VT 0.3 0.0 0.5 NH 0.2 0.4 0.4 1.2 MA 0.5 0.0 3.8 2.8 RI 0.2 0.7 0.2 0.2 1.8 CT 1.0 0.5 1.8 2.4 NJ 0.9 

DE 2.9 9.1 10.2 MD 11.6 2.9 2.7 0.9 4.5 6.7 

Guam 0.0 Rate per 100,000 5.9 3.4 population 9.0 

1.9 <=4 (n=44) 

0.0 8.7 4.1-8 (n=4)

1.5 (n=5) >8 

0.0 

Puerto Rico 4.1 Virgin Is. 1.8 

Note: The total rate of primary and secondary syphilis for women in the United States and outlying 

areas (including Guam, Puerto Rico and Virgin Islands) was 2.3 per 100,000 population. The 

Healthy People year 2000 objective is 4.0 per 100,000 population. 

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

outlying areas, 1998 

1.3 

0.0 0.0 0.0 

0.0 0.0 

0.0 8.9 0.0 21.2

0.0 12.0 VT 0.0 0.0 14.2 NH 0.0 0.0 0.0 2.6 MA 2.5 2.4 0.0 38.8 RI 0.0 22.1 1.8 0.0 4.3 CT 0.0 0.0 20.3 9.5 NJ 75.2 

DE 0.0 23.0 12.2 MD 61.5 33.2 32.5 0.0 82.5 37.2 

Guam 0.0 Rate per 100,000 12.3 live births 14.9 36.6 

30.9 <1 (n=24) 

0.0 12.3 1-40 (n=25)

37.5 (n=4) >40 

0.0 

Puerto Rico 42.8 Virgin Is. 0.0 

Note: The total rate of congenital syphilis for infants <1 year of age for the United States and outlying 

areas (including Guam, Puerto Rico and Virgin Islands) was 20.9 per 100,000 live births. The 

Healthy People year 2000 objective is 40.0 per 100,000 live births. 

44 STDs in Women and Infants Special Focus Profiles STD Surveillance 1998 
4.0 

VT 7.8 NH 4.6 7.5 MA 

7.2 RI 

8.5 6.3 4.6 5.1 

10.1 CT 

NJ 

DE 5.0 

7.8 10.3 MD 3.7 

8.1 DC 11.8 12.5 10.5 

Positivity (%) 

See * (n=32) 

14.5 <5 (n=4) 

7.4 5.0-.9.9 

>=10 

(n=10) 

(n=7) 

Puerto Rico 11.4 Virgin Is. 

VT 

NH 

MA 

1.6 RI 

0.9 CT 0.9 1.0 NJ 

DE 

MD 

1.5 DC 1.3 2.5 

Positivity (%) 

See * (n=45) 

4.7 <1 (n=2) 

1.0-1.9 (n=4) 

>=2 (n=2) 

Puerto Rico Virgin Is. 

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

clinics by state, 1998 

*States not reporting chlamydia positivity data in prenatal clinics. 

Note: States reported chlamydia positivity data on at least 500 women aged 15-24 years during 1998 

except for Colorado, Nevada, New Mexico, and Oregon. Puerto Rico reported chlamydia 

positivity data for January - April only. 

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

Centers for Disease Control and Prevention 

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

clinics by state, 1998 

*States not reporting gonorrhea positivity data in prenatal clinics. 

Note: States reported gonorrhea positivity data on at least 500 women aged 15-24 years during 1998 

except for Colorado and New Mexico. 

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

Centers for Disease Control and Prevention 

STD Surveillance 1998	 Special Focus Profiles STDs in Women and Infants 45 
Figure G. Ectopic pregnancy — Hospitalizations of women 15-44 years of age: United 

States, 1980-1997 

Ectopic Pregnancies (in thousands) 

100 

80 

60 

40 

20 

0 

1980 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 

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) 

Figure H. Pelvic inflammatory disease — Hospitalizations of women 15-44 years of age: 

United States, 1980–1997 

Hospitalizations (in thousands) 

300 

240 

180 

120 

60 

0 

Acute, Unspec. 

Chronic 

1980 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97
 

Note: The relative standard error for the estimates of the overall total number of PID cases range 

from 6% to 9%. 

SOURCE: National Hospital Discharge Survey (National Center for Health Statistics, CDC) 

46 STDs in Women and Infants Special Focus Profiles STD Surveillance 1998 
Figure I.	 Pelvic inflammatory disease — Initial visits to physicians’ offices by women
 

15-44 years of age: United States, 1980–1998 and Healthy People year 2000
 

objective
 

Visits (in thousands) 

500
 

400
 

300
 

200
 

100
 

0
 

PID 

2000 Objective 

1980 82 84 86 88 90 92 94 96 98
 

Note: See Appendix.
 

SOURCE: National Disease and Therapeutic Index (IMS America, Ltd.)
 

STD Surveillance 1998 Special Focus Profiles STDs in Women and Infants 47
 

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: they may be more likely 

to have multiple (sequential or concurrent) sexual partners rather than a single, long-term relationship; they may be more likely to engage in unprotected intercourse; and they may select partners at 

higher risk. In addition, for some STDs, e.g., Chlamydia trachomatis, adolescent women may have 

a physiologically increased susceptibility to infection due to increased cervical ectopy and lack of 

immunity. During the past two decades, the age of initiation of sexual activity has steadily decreased 

and age at first marriage has increased, resulting in increases in premarital sexual experience among 

adolescent women and in an enlarging pool of young women at risk1,2,3. In addition, the higher 

prevalence of STDs among adolescents 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 infection4

. The 

Chlamydia Regional Projects that perform large-scale screening among women 

attending family planning clinics demonstrate that younger women consistently 

have higher positivity rates of chlamydia than older women, even as prevalence 

declines. An example is the Region X Project, which has screened women since 

19885 (Figure J). 

•	 Among women, 15- to 19-year-olds had the highest rate of gonorrhea in 1998 

(Figure M, Table 12B), and 20- to 24-year-olds had the highest rate of primary 

and secondary syphilis (Figure O, Table 23B). Among men, 20- to 24-year-olds 

had the highest rate of gonorrhea and third highest rate of primary and secondary 

syphilis (Figures N and P, Tables 12B and 23B). 

•	 Rates of gonorrhea among male adolescents generally decreased during 1994-98 

(Table 12B). In the 10- to 14-year-old group, the rate for males remained stable at 

8.5 per 100,000 for 1997 and 1998. In the 15- to 19-year-old group, the rate 

declined from 585.2 in 1994 to 354.6 in 1998, a 39% decrease. However, the 

rate for this male adolescent age group increased from 348.1 in 1997 to 354.6 in 

1998. Among young adult men in the 20- to 24-year-old group, the rate of 

gonorrhea also increased between 1997 and 1998 (537.1 and 575.1, 

respectively); however, relative to the 1994 rate of 739.1, the 1998 rate reflected 

a decline of 22%. 

•	 Rates of gonorrhea among female adolescents also generally decreased during 

the 5 year period 1994-98 (Table 12B). In the 10- to 14-year-old group, the rate 

STD Surveillance 1998 Special Focus Profiles STDs in Adolescents and Young Adults 49 
for females decreased from 82.3 per 100,000 in 1994 to 58.0 in 1998, a decrease 

of 30%. In the 15- to 19-year-old group, the rate declined from 890.2 in 1994 to 

779.7 in 1998, a 12% decrease. However, the rates for female adolescents 

increased between 1997 and 1998 in both age groups. Among young adult 

women in the 20- to 24-year-old group, the rate of gonorrhea increased from 

560.4 in 1997 to 645.9 in 1998; relative to the 1994 rate of 650.4, the 1998 rate 

decreased slightly. 

•	 In 1998, the highest age-specific gonorrhea rates among women and the second 

highest rates among men were in the 15- to 19-year-old group (Figure 17). 

•	 Since 1990, approximately 20,000 female Job Corps entrants have been 

screened each year for chlamydia. The Job Corps, administered by the U.S. 

Department of Labor at more than 100 sites throughout the country, is a job 

training program for disadvantaged youth aged 16-24 years. Among women 

entering the Job Corps in 1998, based on their place of residence just before 

program entry, state-specific chlamydia prevalence ranged from 4.6% to 20.3% 

(Figure K). Chlamydial infection is widespread geographically and highly 

prevalent among these economically disadvantaged young women. 

•	 Data from Job Corps centers submitting gonorrhea specimens for female students 

aged 16- 24 years to the national contract laboratory indicate a high prevalence of 

gonococcal infection in this population. At least 100 students from each of 12 

states were tested; state-specific gonorrhea prevalence ranged from 1.4% to 8.4% 

in 1998 (Figure L). 

1CDC. Premarital sexual experience among adolescent women—United States, 1970-1988. MMWR 

1991;39:929-32. 

2CDC. Pregnancy, Sexually Transmitted Diseases and Related Risk Behaviors Among U.S. Adolescents. 

Atlanta: Centers for Disease Control and Prevention, 1994. Adolescent Health: State of the Nation monograph series, No. 2. CDC Publication No. 099-4630. 

3Forrest JD. Timing of reproductive life stages. Obstet Gynecol 1993;82(1) 

4CDC. Recommendations for the prevention and management of Chlamydia trachomatis infections, 1993. 

MMWR 1993;42(No. RR-12). 

5Lossick 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. 

50 STDs in Adolescents and Young Adults Special Focus Profiles STD Surveillance 1998 
Figure J.	 Chlamydia — Positivity among women tested in family planning clinics by 

age group: Region X, 1988–1998 

Percent
 

15
 

12
 

9
 

6
 

3
 

0
 

<18 Years 

18-19 Years 

20-24 Years 

25-29 Years 

30+ Years 

1988 89 90 91 92 93 94 95 96 97 98
 

Note: Women who met screening criteria were tested. Trends not adjusted for changes in 

laboratory test method in 1994 and 1998 and associated increases in test sensitivity. 

SOURCE: Regional Infertility Prevention Program: Region X Chlamydia Project (Alaska, Idaho, Oregon and Washington) 

Figure K. Chlamydia — Prevalence among 16-24 year-old women entering the U.S. Job 

Corps by state of residence, 1998 

Prevalence (%) 

See * 

<10 

10.0-14.9 

>=15 

VT 

NH 

MA 8.4 

RI 

CT 10.9 

NJ 11.2 

DE 

MD 14.0 

DC 

Puerto Rico 5.7 Virgin Is. 

(n=19) 

(n=11) 

(n=17) 

(n=6) 

17.7 

15.8 19.2 

10.1 10.1 

12.8 

18.5 

12.1 12.8 

9.1 11.2 

13.1 

11.1 

20.3 

14.3 

11.5 

11.4 

17.3 

9.5 

11.3 

4.6 

8.8 

9.4 

6.9 

14.8 

7.6 

14.9 

6.8 

9.0 

*Fewer than 100 women residing in these states and entering the U.S. Job Corps were screened for 

chlamydia in 1998. 

Note: The overall chlamydia prevalence among female students entering the U.S. Job Corps in 1998 

was 11.7%. The increase in prevalence since 1997, when the overall prevalence was 10.4%, 

may have been due to the change in test type from EIA to DNA probe in August 1997. 

SOURCE: U.S. Department of Labor 

STD Surveillance 1998 Special Focus Profiles STDs in Adolescents and Young Adults 51 
Figure L. Gonorrhea — Prevalence among 16-24 year-old women entering the U.S. Job 

Corps by state of residence, 1998 

2.3 

VT 

2.2 NH 

MA 1.5 

7.7 3.2 RI 1.4 1.4 CT 

8.4 NJ 

DE 

3.1 MD 

1.4 7.5 DC 

Prevalence (%) 6.2 

See * (n=41) 

<2 (n=4) 

2.0-4.9 (n=4) 

>=5 (n=4) 

Puerto Rico Virgin Is. 

*Fewer than 100 women residing in these states and entering the U.S. Job Corps were screened 

for gonorrhea by the national contract laboratory in 1998. 

Note: Many Job Corps 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. 

SOURCE: U.S. Department of Labor 

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

States, 1981–1998 

Rate (per 100,000 population) 

1,500 10-14 

15-19 

20-24 

25-29 1,200 30-34 

35-39 

40-44 

900 

600 

300 

0 

1981 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 

Note: See Appendix. 

52 STDs in Adolescents and Young Adults Special Focus Profiles STD Surveillance 1998 
Figure N. Gonorrhea — Age-specific rates among men 10-44 years of age: United States, 

1981–1998 

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 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 

Note: See Appendix. 

Figure O. Primary and secondary syphilis — Age-specific rates among women 10-44 

years of age: United States, 1981–1998 

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 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 

STD Surveillance 1998 Special Focus Profiles STDs in Adolescents and Young Adults 53 
Figure P. Primary and secondary syphilis — Age-specific rates among men 10-44 years of 

age: United States, 1981–1998 

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 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98
 

54 STDs in Adolescents and Young Adults Special Focus Profiles STD Surveillance 1998
 
STDs in Minorities
 

Public Health Impact 

Surveillance data show high rates of STDs for some minority racial or ethnic groups when 

compared with rates for 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 (e.g., 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 Health and Human Services 

Region X (Alaska, Idaho, Oregon, and Washington) show consistently higher 

rates among minorities (Figure Q). 

•	 In 1998, African-Americans accounted for about 77% of total reported cases of 

gonorrhea (Table 12A). The overall gonorrhea rates in 1998 were 861.6 cases 

per 100,000 population for African-Americans and 74.3 for Hispanics compared 

with 28.3 for non-Hispanic whites (Figure 16, Table 12B). Compared with 1997, 

1998 rates of gonorrhea increased for all race/ethnic groups reported. 

•	 Gonorrhea rates are high for African-American adolescents and young adults. In 

1998, black females aged 15 to 19 years had a gonorrhea rate of 3,851.7 cases 

per 100,000 population. Black men in this age group had a gonorrhea rate of 

2,075.9. These rates were on average about 23 times higher than those of 15- to 

19-year-old white adolescents (Table 12B). Among 20- to 24-year-olds in 1998, 

the gonorrhea rate among blacks was almost 27 times greater than that of whites 

(3,408.9 vs. 126.5, respectively) (Table 12B). 

•	 Despite declines in gonorrhea rates for most age and race/ethnic groups during 

the 1980s, African-American adolescents did not show declining trends in rates 

until 1991 (black women) and 1992 (black men). However between 1997 and 

1998, gonorrhea rates increased nearly 10% for black females aged 15 to 19 

years, and decreased slightly for black males in this age group (Table 12B, Figures 

R and S). 

•	 The most recent epidemic of syphilis was largely an epidemic in heterosexual, 

minority populations1

. Since 1990, rates of primary and secondary (P&S) syphilis 

STD Surveillance 1998	 Special Focus Profiles STDs in Minorities 55 
have declined among all racial and ethnic groups except American Indian/Alaska 

Natives. However, rates for African-Americans and Hispanics continue to be 

higher than for non-Hispanic whites. In 1998, African-Americans accounted for 

about 79% of all reported cases of P&S syphilis (Table 23A). Although the rate for 

African-Americans declined from 21.8 cases per 100,000 population in 1997 to 

17.1 in 1998, the latter rate was 34-fold greater than the non-Hispanic white rate 

of 0.5 per 100,000 population. Between 1997 and 1998, primary and secondary 

syphilis rates for black females aged 15 to 19 years declined by 21.4%, and for 

black males in this age group, by 24.2% (Figures T and U, Table 23B). Similarly, 

the P&S rates declined about 25% between 1997 and 1998 among young black 

adults aged 20 to 24 years. The 1998 rate of P&S syphilis in Hispanics was 1.5 

(Figure 33, Table 23B). 

•	 In 1998, the rate of congenital syphilis in African-Americans was 87.0 per 

100,000 live births and 27.9 in Hispanics compared with 2.9 in whites (Figure V). 

Compared with 1997, this represented a 29% decrease for blacks and a 17% 

decrease for Hispanics. 

1Nakashima 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. 

56 STDs in Minorities	 Special Focus Profiles STD Surveillance 1998 
Figure Q. Chlamydia — Positivity among women tested in family planning clinics 

by race and ethnicity: Region X, 1988–1998 

Percent 

15 

12 

9 

6 

3 

0 

White 

Black 

Hispanic 

Asian/Pac Isl 

Nat Am/AK Nat 

1988 89 90 91 92 93 94 95 96 97 98
 

Note: Women who met screening criteria were tested. Trends not adjusted for changes in 

laboratory test method in 1994 and 1998 and associated increases in test sensitivity. 

SOURCE: Regional Infertility Prevention Program: Region X Chlamydia Project (Alaska, Idaho, Oregon and Washington) 

Figure R. Gonorrhea — Reported rates for 15-19 year old females by race and ethnicity: 

United States, 1981–1998 

Rate (per 100,000 population) 

7,000 

5,600 

4,200 

2,800 

1,400 

0 

White 

Black 

Hispanic 

Other 

1981 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 

Note: See Appendix. Black, White, and Other are non-Hispanic. 

STD Surveillance 1998 Special Focus Profiles STDs in Minorities 57 
Figure S. Gonorrhea — Reported rates for 15-19 year old males by race and ethnicity: 

United States, 1981–1998 

Rate (per 100,000 population) 

7,000 

5,600 

4,200 

2,800 

1,400 

0 

White 

Black 

Hispanic 

Other 

1981 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 

Note: See Appendix. Black, White, and Other are non-Hispanic. 

Figure T.	 Primary and secondary syphilis — Reported rates for 15-19 year old females by 

race and ethnicity: United States, 1981–1998 

Rate (per 100,000 population) 

250 

200 

150 

100 

50 

0 

White 

Black 

Hispanic 

Other 

1981 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 

Note: See Appendix. Black, White, and Other are non-Hispanic. 

58 STDs in Minorities	 Special Focus Profiles STD Surveillance 1998 
Figure U. Primary and secondary syphilis — Reported rates for 15-19 year old males by 

race and ethnicity: United States, 1981–1998 

Rate (per 100,000 population) 

125 

100 

75 

50 

25 

0 

White 

Black 

Hispanic 

Other 

1981 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 

Note: See Appendix. Black, White, and Other are non-Hispanic. 

Figure V. Congenital syphilis — Rates for infants <1 year of age by race and ethnicity: 

United States, 1991–1998 

Rate (per 100,000 live births) 

450 

360 

270 

180 

90 

0 

White 

Black 

Hispanic 

Other 

2000 Objective 

1991 92 93 94 95 96 97 98
 

Note: See Appendix. Less than 5% of cases had missing race/ethnicity information and were 

excluded. Black, White, and Other are non-Hispanic. 

STD Surveillance 1998 Special Focus Profiles STDs in Minorities 59 

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 detention facilities. 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 are identified in jails1

. Compiling data and analyzing trends in STD 

prevalence in this population provides a method for monitoring trends in STD prevalence in the 

community. 

Observations 

•	 In 1998, 12 states reported chlamydia, gonorrhea, or syphilis data to CDC as part 

of the Jail STD Prevalence Monitoring Project, 4 states reported syphilis data as 

part of the Innovations in Syphilis Prevention Project, 10 additional states 

reported data (at least 100 test results) from corrections facilities as part of the 

Regional Infertility Prevention Project, and 4 additional states reported data in 

response to CDC’s request for data. 

•	 The maps shown below represent approximately 186,000 syphilis tests and 

33,000 chlamydia tests for men, and 47,000 syphilis tests, 25,000 chlamydia 

tests, and 28,000 gonorrhea tests for women. 

•	 The percentage of reactive syphilis tests was higher for women than for men in 17 

(94%) of 18 facilities reporting syphilis test results for both sexes (Figures W, X). 

In women tested for syphilis, seroreactivity was greater than 5% in 15 (75%) of 20 

facilities reporting syphilis test results for women (Figure W). The percentage of 

reactive syphilis tests representing new cases of syphilis varied from site to site 

(data not shown). 

•	 The positivity for chlamydia and gonorrhea in women was higher in juvenile 

facilities than in adult facilities. In adolescent women entering juvenile detention 

facilities, the positivity for chlamydia was greater than 8% in all 14 facilities 

reporting data (Figure Y) and the positivity for gonorrhea was at least 3% in 6 

(86%) of 7 facilities (Figure AA). 

•	 The positivity for chlamydial infection in men, although generally lower than that 

in women, was greater than 5% in 14 (64%) of 22 juvenile facilities (Figure Z). 

1CDC. Syphilis screening among women arrestees at the Cook County Jail — Chicago, 1996. MMWR 

1998;47:432-3. 

STD Surveillance 1998 Special Focus Profiles STDs in Persons Entering Corrections Facilities 61 
Figure W. Syphilis serologic tests — Percent seroreactivity in women entering city or county 

jails†

, 1998 

†

From facilities reporting >100 test results.
 

NOTE: Data from Tennessee is from June 1998 only.
 

SOURCE: Local and State STD Control Programs; Regional Infertility Prevention Programs; Centers for Disease Control and 

Prevention 

Figure X. Syphilis serologic tests — Percent seroreactivity in men entering city or county 

jails†

, 1998 

†

From facilities reporting >100 test results.
 

NOTE: Data from Tennessee is from June 1998 only.
 

SOURCE: Local and State STD Control Programs; Regional Infertility Prevention Programs; Centers for Disease Control and
 

Prevention 

62 STDs in Persons Entering Corrections Facilities Special Focus Profiles STD Surveillance 1998 
Figure Y. Chlamydia — Positivity in women entering juvenile and adult corrections 

facilities†

, 1998 

†

From facilities reporting >100 test results. 

SOURCE: Local and State STD Control Programs; Regional Infertility Prevention Programs; Centers for Disease Control and 

Prevention 

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

facilities†

, 1998 

†

From facilities reporting >100 test results. 

SOURCE: Local and State STD Control Programs; Regional Infertility Prevention Programs; Centers for Disease Control and 

Prevention 

STD Surveillance 1998 Special Focus Profiles STDs in Persons Entering Corrections Facilities 63 
Figure AA. Gonorrhea — Positivity in women entering juvenile and adult corrections 

facilities†

, 1998 

†

From facilities reporting >100 test results. 

SOURCE: Local and State STD Control Programs; Regional Infertility Prevention Programs; Centers for Disease Control and 

Prevention 

64 STDs in Persons Entering Corrections Facilities Special Focus Profiles STD Surveillance 1998 
STDs in the South
 

Public Health Impact 

The southern region of the U.S. (Alabama, Arkansas, Delaware, District of Columbia, Florida, 

Georgia, Kentucky, Louisiana, Maryland, Mississippi, North Carolina, Oklahoma, South Carolina, 

Tennessee, Texas, Virginia, and West Virginia) has higher rates of primary and secondary (P&S) 

syphilis and gonorrhea than other regions of the country. The reasons for regional differences in 

rates are not well understood, but may include differences in racial and ethnic distribution of the 

population, poverty, and availability and quality of health care services. These racial and ethnic 

differentials in STD rates are particularly disturbing in light of the fact that STDs facilitate HIV 

transmission at least two to five fold. High HIV prevalence among childbearing women living in the 

South may be due, in part, to the high rates of these other STDs. Data from a randomized controlled 

trial of STD treatment to prevent HIV infection suggest that as much as a 40% reduction in HIV incidence might be achieved in areas with high STD rates1

. 

Observations 

•	 The South has consistently had higher rates of both gonorrhea and P&S syphilis 

compared with other regions throughout the 1980s and 1990s (Figures 12, 13, 27 

and 29, Tables 14 and 25). During 1996-1998, the South also had the highest 

rate of chlamydia (Table 5) compared to the other regions. 

•	 In 1998, 8 of the 10 states with the highest chlamydia rates were in the South 

(Table 4). Similarly, 9 of the 10 states with the highest rates of gonorrhea were 

located in the South (Figure 12, Table 13). Nine southern states, 1 western state, 

and 2 outlying areas had rates of P&S syphilis above the HP2000 objective of 4 

per 100,000 (Figure 27, Table 24). Seven of the 9 southern states had rates of 

P&S syphilis that were 1.6 to 3.2 times greater than the HP2000 national 

objective (Figure 27, Table 24). 

•	 In 1998, 285 (91%) of 312 counties with P&S syphilis rates above the HP2000 

objective were located in the South (Figure 28 and Figure BB). 

•	 Of the 285 counties in the South that had a 1998 P&S syphilis rate above 4.0 per 

100,000 population, 159 (56%) had an increase in the rate from 1997 to 1998 

(Figures BB and CC). 

•	 County-specific rates of chlamydia and gonorrhea in 1998 were produced for 

those southern states submitting county level data (Figures DD and EE). These 

county level data were reported through the National Electronic 

Telecommunications System for Surveillance (NETSS), and are provisional for 

all states shown except Alabama, Arkansas, Delaware, Oklahoma, Texas, and 

STD Surveillance 1998	 Special Focus Profiles STDs in the South 65 
Virginia where hardcopy reports have been discontinued based on the submission 

of consistent, quality, and timely submissions of NETSS data. 

1Grosskurth H, Mosha F, Todd J, et al. Impact of improved treatment of sexually transmitted diseases on HIV 

infection in rural Tanzania: randomized controlled trial. Lancet 1995;346:530-6. 

66 STDs in the South Special Focus Profiles STD Surveillance 1998 
Figure BB. South — Primary and secondary syphilis case rates by county, 1998 

Rates per 100,000 Population 

(n=1,138) <=4 

(n=112) 4.1-8 

(n=173) >8 

Figure CC. South — Increases and decreases in cases of primary and secondary syphilis in 

1998 compared with 1997 cases, by county 

Difference in 1997-1998 Cases 

No Change or 1998 Rate <=4 (n=1,172)
 

Decrease* (n=92)
 

Increase** (n=159)
 

*Decrease in cases in 1998 vs. 1997; 1998 rate >4.0/100,000 population. 

**Increase in cases in 1998 vs. 1997; 1998 rate >4.0/100,000 population. 

STD Surveillance 1998 Special Focus Profiles STDs in the South 67 
Figure DD. South — Chlamydia case rates by county, 1998 

Rates per 100,000 population 

See* (n= 308) 

<=150 (n= 519) 

150.1-300 (n= 349) 

>300 (n= 247) 

*States not submitting county level data.
 

SOURCE: National Electronic Telecommunications System for Surveillance (NETSS) data
 

Figure EE. South — Gonorrhea case rates by county, 1998 

Rates per 100,000 population 

See* (n= 308) 

<=100 (n= 637) 

100.1-200 (n= 203) 

>200 (n= 275) 

*States not submitting county level data.
 

SOURCE: National Electronic Telecommunications System for Surveillance (NETSS) data
 

68 STDs in the South Special Focus Profiles STD Surveillance 1998 
Table 1. Cases of sexually transmitted diseases reported by state health departments and rates per 100,000 

civilian population: United States, 1941–1998* 

Syphilis 

Primary Lymphoand Early Late and Granuloma granuloma All Stages Secondary Latent Late Latent Congenital Chlamydia Gonorrhea Chancroid Inguinale Venereum 

Year1 Cases Rate Cases Rate Cases Rate Cases Rate Cases Rate2 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 . 1,001,994 464.1 628 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 . 1,002,219 459.5 455 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 . 1,013,436 459.7 521 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 . 1,004,058 450.3 840 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 . 1,004,029 445.1 788 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 69,873 29.8 28,607 12.2 23,132 9.9 17,829 7.6 305 0.1 7,594 6.5 878,556 374.8 665 0.3 30 0.0 170 0.1 

1985 67,563 28.5 27,131 11.5 21,689 9.2 18,414 7.8 329 0.1 25,848 17.4 911,419 384.3 2,067 0.9 44 0.0 226 0.1 

STD Surveillance 1998 National Summary Tables 69 
Table 1. Cases of sexually transmitted diseases reported by state health departments and rates per 100,000 

civilian population: United States, 1941–1998* (continued) 

Syphilis 

Chlamydia Gonorrhea Chancroid 

Granuloma 

Inguinale 

Lymphogranuloma All Stages Venereum

Primary 

and 

Secondary Early Latent 

Late and 

Late Latent Congenital 

Year1 Cases Rate Cases Rate Cases Rate Cases Rate Cases Rate2 Cases Rate Cases Rate Cases Rate Cases Rate Cases Rate 

1986 67,771 28.3 27,667 11.6 21,656 9.0 18,046 7.5 410 0.2 58,001 35.2 892,229 372.8 3,045 1.3 48 0.0 307 0.1 

1987 87,278 35.9 35,585 14.6 28,233 11.6 22,988 9.4 480 0.2 91,913 50.8 787,532 323.6 4,986 2.0 22 0.0 302 0.1 

1988 104,546 42.5 40,474 16.5 35,968 14.6 27,363 11.1 741 0.3 157,807 87.1 738,160 300.3 4,891 2.0 11 0.0 194 0.1 

1989 115,067 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 135,043 54.3 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 128,637 51.0 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 112,855 44.3 33,962 13.3 49,903 19.6 25,099 9.8 3,890 1.5 409,634 183.4 502,785 197.1 1,885 0.7 6 0.0 289 0.1 

1993 101,335 39.3 26,497 10.3 41,902 16.3 29,675 11.5 3,261 1.3 405,275 179.5 444,578 172.5 1,237 0.5 19 0.0 286 0.1 

1994 82,334 31.6 20,645 7.9 32,020 12.3 27,452 10.5 2,217 0.8 451,758 194.5 419,577 165.7 779 0.3 3 0.0 237 0.1 

1995 69,345 26.4 16,543 6.3 26,657 10.1 24,295 9.2 1,850 0.7 478,577 190.4 392,651 149.4 607 0.2 0 0.0 188 0.1 

1996 53,226 20.1 11,388 4.3 20,187 7.6 20,356 7.7 1,295 0.5 490,615 192.9 326,805 123.2 386 0.1 10 0.0 72 0.0 

1997 46,642 17.4 8,556 3.2 16,631 6.2 20,385 7.6 1,070 0.4 531,529 206.9 326,564 122.0 246 0.1 8 0.0 114 0.0 

1998 37,977 14.2 6,993 2.6 12,613 4.7 17,570 6.6 801 0.3 607,602 236.6 355,642 132.9 189 0.1 3 0.0 86 0.0 

*NR = No report 

1

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. 

2

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 37, 38 and 39. As of 1995, 

cases of congenital syphilis <1 year of age are obtained using case reporting form CDC 73.126. 

Note: Adjustments to the number of cases reported from state health departments were made through June 15, 1999 for hardcopy forms and through 

July 19, 1999 for electronic data submissions (see Appendix). The number of cases and the rates shown here supersede those published in previous 

reports. Georgia did not report gonorrhea statistics for 1994 (see Appendix). Cases and rates shown in this table exclude the outlying areas of Guam, 

Puerto Rico and Virgin Islands. 

70 National Summary Tables STD Surveillance 1998 
Table 2. Reported cases of sexually transmitted disease by gender and reporting source: United

States, 1998* 

Disease

Non-STD Clinic STD Clinic Total†

Male Female Total Male Female Total Male Female Total

Total Chlamydia Trachomatis

Chlamydial PID‡

54,774

NA

383,520

2,616

439,700

2,616

48,900

NA

113,620

475

162,989

479

104,435

NA

501,128

3,099

607,602

3,103

Ophthalmia Neonatorum 105 187 292 6 5 11 116 202 318

Total Gonorrhea 72,455 119,504 192,501 101,671 58,757 160,626 175,233 179,651 355,642

Gonococcal PID NA 2,566 2,567 NA 1,445 1,450 NA 4,013 4,019

Ophthalmia Neonatorum 17 16 33 3 2 5 20 19 39

§ Total Syphilis

Primary

 NA 

570

 NA 

198

 NA 

769

 NA 

1,301

 NA 

340

 NA 

1,640

 19,739 

1,878

 18,179 

541

 37,977

2,420

Secondary

Early Latent + Late and Late Latent

828

2,853

4,817

1,128

3,128

4,699

1,957

5,985

9,529

1,187

3,439

4,319

1,413

3,143

3,684

2,600

6,583

8,008

2,024

6,311

9,157

2,548

6,298

8,406

4,573

12,613

17,570

Neurosyphilis ¥ Congenital <1 year201

NR

62

NR

264

NR

14

NR

3

NR

17

NR

215

369

65

386

281

801

Chancroid 17 29 46 95 47 142 112 76 189

Granuloma Inguinale 0 2 2 1 0 1 1 2 3

Lymphogranuloma Venereum 18 9 27 44 15 59 62 24 86

¤ Genital Herpes 649 2,744 3,393 2,369 2,150 4,524 3,019 4,894 7,918

Other and Nonspecified PID NA 1,216 1,219 NA 1,141 1,141 NA 2,549 2,552

Nonspecific Urethritis in Men 2,152 NA 2,152 22,660 NA 22,707 26,818 NA 26,865

*NA = Not applicable. NR = No report.

 †

Totals include unknown gender and reporting source. 

‡

PID = Pelvic inflammatory disease. 

§

Neurosyphilis cases are not included with Total Syphilis cases. 

+Cases of unknown duration for syphilis are included in late and late latent syphilis. 

¥Cases of congenital syphilis <1 year of age are obtained using reporting from CDC 73.126. Clinic reporting source is not available from that form. 

¤

Genital herpes data are only available for a limited number of states.

STD Surveillance 1998 National Summary Tables 71
Table 3A. Chlamydia — Reported cases by age, gender, and race/ethnicity: United States, 1996–1998 

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 9,351 459 8,892 2,672 89 2,583 4,862 253 4,609 1,482 86 1,396 122 15 107 213 16 197 

15-19 151,344 16,897 134,447 52,737 4,167 48,570 68,501 9,133 59,368 24,823 2,963 21,860 1,935 213 1,722 3,348 421 2,927 

20-24 119,705 21,016 98,689 41,561 6,199 35,362 49,276 10,077 39,199 23,742 3,943 19,799 2,258 340 1,918 2,868 457 2,411 

199625-29 

30-34 

35-39 

47,092 

19,730 

9,350 

10,432 36,660 

5,181 14,549 

2,623 6,727 

14,943 3,135 11,808 

6,020 1,590 4,430 

3,105 871 2,234 

18,606 4,745 13,861 

7,630 2,335 5,295 

3,615 1,185 2,430 

11,171 

4,873 

2,006 

2,108 

988 

454 

9,063 

3,885 

1,552 

1,118 197 921 

565 123 442 

293 62 231 

1,254 247 1,007 

642 145 497 

331 51 280 

40-44 4,079 1,272 2,807 1,368 409 959 1,583 568 1,015 836 222 614 138 44 94 154 29 125 

45-54 2,596 936 1,660 985 359 626 957 419 538 472 122 350 93 24 69 89 12 77 

55-64 517 237 280 210 88 122 181 104 77 88 33 55 13 5 8 25 7 18 

65+ 479 117 362 206 63 143 145 30 115 106 16 90 11 5 6 11 3 8 

TOTAL 366,836 59,787 307,049 124,735 17,169 107,566 156,305 29,090 127,215 70,170 11,093 59,077 6,615 1,033 5,582 9,011 1,402 7,609 

10-14 8,871 429 8,442 2,594 70 2,524 4,382 221 4,161 1,540 122 1,418 119 8 111 236 8 228 

15-19 154,992 18,940 136,052 52,717 4,379 48,338 69,632 10,180 59,452 27,320 3,787 23,533 2,235 277 1,958 3,088 317 2,771 

20-24 127,676 25,121 102,555 41,935 6,782 35,153 54,042 12,501 41,541 26,598 5,039 21,559 2,416 424 1,992 2,685 375 2,310 

199725-29 

30-34 

35-39 

50,374 

20,698 

9,597 

12,566 37,808 

6,260 14,438 

3,246 6,351 

15,188 3,381 11,807 

5,910 1,658 4,252 

2,948 896 2,052 

20,357 6,122 14,235 

8,157 3,068 5,089 

3,782 1,581 2,201 

12,433 

5,441 

2,248 

2,646 

1,287 

640 

9,787 

4,154 

1,608 

1,202 244 958 

599 152 447 

328 62 266 

1,194 173 1,021 

591 95 496 

291 67 224 

40-44 4,126 1,522 2,604 1,343 454 889 1,586 750 836 917 267 650 163 36 127 117 15 102 

45-54 2,602 1,114 1,488 889 382 507 947 503 444 572 180 392 118 38 80 76 11 65 

55-64 544 267 277 182 84 98 206 116 90 119 54 65 15 3 12 22 10 12 

65+ 1,096 260 836 370 73 297 456 122 334 218 56 162 17 5 12 35 4 31 

TOTAL 382,249 70,250 311,999 124,587 18,302 106,285 164,231 35,386 128,845 77,814 14,222 63,592 7,250 1,260 5,990 8,367 1,080 7,287 

10-14 11,190 615 10,575 2,984 89 2,895 6,135 377 5,758 1,647 125 1,522 141 11 130 283 13 270 

15-19 198,558 24,287 174,271 63,883 5,257 58,626 96,960 13,848 83,112 30,820 4,355 26,465 3,014 363 2,651 3,881 464 3,417 

20-24 163,993 31,182 132,811 50,826 8,191 42,635 76,442 15,923 60,519 30,445 6,034 24,411 3,132 534 2,598 3,148 500 2,648 

199825-29 

30-34 

35-39 

64,304 

25,614 

12,592 

15,960 48,344 

7,721 17,893 

4,384 8,208 

17,784 4,075 13,709 

6,746 2,100 4,646 

3,483 1,145 2,338 

29,209 8,109 21,100 

11,336 3,846 7,490 

5,644 2,295 3,349 

14,316 

6,086 

2,646 

3,225 

1,524 

729 

11,091 

4,562 

1,917 

1,676 354 1,322 

770 163 607 

465 136 329 

1,319 197 1,122 

676 88 588 

354 79 275 

40-44 5,322 2,049 3,273 1,585 608 977 2,367 1,102 1,265 995 257 738 214 50 164 161 32 129 

45-54 3,185 1,342 1,843 1,030 450 580 1,378 702 676 541 136 405 118 42 76 118 12 106 

55-64 661 306 355 173 82 91 322 176 146 115 34 81 28 8 20 23 6 17 

65+ 1,066 254 812 308 88 220 553 124 429 164 34 130 29 8 21 12 0 12 

TOTAL 488,421 88,669 399,752 149,309 22,251 127,058 231,257 46,756 184,501 88,209 16,581 71,628 9,623 1,677 7,946 10,023 1,404 8,619 

NOTE: In most instances, 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 race/ethnicity for most cases and were excluded: 1996 (Colorado, Delaware, 

Georgia, Maryland, Michigan, New Jersey, New York, Ohio, and South Carolina): 1997 (Colorado, Delaware, District of Columbia, Georgia, Maryland, 

Michigan, Mississippi, New Jersey, New York, Ohio and South Carolina): 1998 (Colorado, District of Columbia, Michigan, New Jersey, New York, Ohio 

and South Carolina). 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. Cases and rates for the 0 to 9 year age group are not shown 

because some of these may not be due to sexual transmission; however, they are included in the totals. 

72 Chlamydia Tables STD Surveillance 1998 
Table 3B. Chlamydia — Reported rates per 100,000 population by age, gender, and race/ethnicity: United 

States, 1996–1998 

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 65.6 6.3 128.0 27.8 1.8 55.3 264.6 27.1 509.6 71.8 8.1 138.8 21.7 5.2 38.9 117.3 17.4 219.5 

15-19 1,080.0 233.6 1,982.6 560.8 86.1 1,064.5 3,720.0 975.9 6,555.8 1,188.0 266.6 2,235.1 373.8 81.1 674.8 2,077.1 518.7 3,657.9 

20-24 908.3 309.8 1,542.9 475.9 139.0 827.3 3,026.1 1,245.8 4,783.2 1,125.6 340.3 2,083.1 396.8 118.9 677.8 2,062.2 651.3 3,499.2 

25-29 

30-34 

35-39 

333.3 

125.3 

56.1 

146.5 523.0 

65.7 185.1 

31.4 80.8 

155.0 65.1 244.8 

54.2 28.6 79.7 

25.3 14.2 36.6 

1,168.1 621.3 1,671.8 

448.4 290.9 589.0 

207.1 143.9 263.5 

526.2 

225.1 

105.3 

180.4 949.3 

85.0 387.5 

45.2 172.3 

174.4 64.3 275.3 

89.1 40.6 133.3 

47.1 20.9 71.1 

917.8 354.6 1,503.5 

1996

469.7 214.1 720.5 

243.3 76.8 401.9 

40-44 26.5 16.6 36.2 11.7 7.0 16.5 103.0 78.8 124.4 54.7 28.2 82.9 23.8 16.3 30.3 125.9 49.4 196.7 

45-54 10.9 8.0 13.7 5.2 3.9 6.6 46.3 44.4 47.9 23.9 12.4 35.3 11.1 6.2 15.4 50.1 14.1 83.4 

55-64 3.3 3.1 3.4 1.6 1.4 1.9 13.6 18.0 10.3 7.6 6.0 9.0 2.7 2.2 3.0 23.4 14.0 31.7 

65+ 1.9 1.1 2.4 1.0 0.7 1.1 8.2 4.3 10.7 8.1 2.9 12.0 2.0 2.2 1.9 9.2 5.9 11.6 

TOTAL 185.7 61.7 305.2 86.5 24.3 145.9 751.0 293.6 1,166.7 298.8 91.4 520.4 92.1 29.9 149.9 515.9 163.3 856.4 

10-14 63.0 5.9 123.0 27.4 1.4 54.8 251.6 25.0 485.5 72.8 11.3 137.6 21.0 2.8 40.0 129.4 8.7 253.5 

15-19 1,098.8 260.1 1,993.6 556.6 89.8 1,051.7 3,955.5 1,135.4 6,882.5 1,260.0 328.4 2,318.1 413.5 101.2 733.9 1,864.3 381.7 3,355.3 

20-24 987.1 376.8 1,636.1 490.7 155.2 842.1 3,531.9 1,640.3 5,409.0 1,228.0 425.0 2,199.5 435.4 152.5 719.5 1,946.3 540.1 3,371.4 

25-29 

30-34 

35-39 

364.8 

137.4 

58.3 

180.4 552.4 

83.0 192.0 

39.3 77.2 

162.0 72.2 251.7 

56.2 31.6 80.7 

24.4 14.8 34.1 

1,358.4 849.1 1,830.7 

518.1 412.3 613.0 

228.7 202.1 252.6 

580.9 

246.7 

113.2 

224.9 1,015.8 

108.4 408.1 

61.0 171.7 

182.4 77.7 277.7 

93.5 50.0 132.7 

51.9 20.5 80.6 

865.0 245.0 1,514.5 

1997

443.9 143.6 740.4 

213.5 100.4 322.2 

40-44 26.4 19.6 33.2 11.4 7.7 15.1 105.4 105.8 105.0 56.6 31.9 83.2 27.1 12.8 39.7 94.0 25.1 157.8 

45-54 10.6 9.3 12.0 4.6 4.0 5.2 46.4 53.9 40.0 27.2 17.1 37.2 13.3 9.3 16.8 41.6 12.5 68.4 

55-64 3.4 3.5 3.3 1.4 1.4 1.5 16.2 20.9 12.5 9.9 9.5 10.3 2.9 1.3 4.3 20.2 19.6 20.7 

65+ 4.4 2.5 5.7 1.7 0.8 2.4 27.7 18.8 33.4 16.1 9.7 20.8 3.0 2.1 3.6 28.5 7.7 43.8 

TOTAL 194.8 72.9 312.4 87.1 26.1 145.5 832.1 375.8 1,248.3 320.0 113.2 541.1 98.2 35.5 156.2 476.0 125.0 815.1 

10-14 73.5 7.9 142.5 29.4 1.7 58.6 287.1 34.7 547.4 76.6 11.3 145.4 23.8 3.6 44.8 152.4 13.8 294.7 

15-19 1,301.2 308.4 2,359.4 629.4 100.6 1,190.8 4,468.6 1,256.2 7,786.3 1,397.5 371.2 2,564.2 532.7 126.6 949.8 2,295.8 547.1 4,056.7 

20-24 1,170.5 432.5 1,952.7 552.7 174.1 949.2 4,054.0 1,706.0 6,355.3 1,380.5 499.4 2,448.2 537.6 182.8 894.4 2,230.6 702.9 3,783.2 

25-29 

30-34 

35-39 

428.8 

156.0 

70.4 

211.3 649.3 

94.1 217.9 

49.0 91.7 

175.7 80.5 270.9 

59.3 37.0 81.5 

26.8 17.6 36.1 

1,568.7 911.5 2,170.2 

573.4 415.1 713.0 

273.9 237.3 306.3 

655.7 

270.2 

130.5 

268.5 1,129.4 

125.6 439.0 

68.0 200.7 

242.4 107.5 365.1 

114.1 50.9 171.2 

69.9 42.8 94.7 

932.1 272.0 1,624.1 

1998

494.9 129.6 855.9 

253.5 115.4 386.3 

40-44 31.5 24.4 38.5 12.6 9.6 15.5 126.8 126.0 127.5 60.3 30.1 92.8 33.9 17.0 48.9 126.1 52.1 194.7 

45-54 12.0 10.3 13.7 5.0 4.4 5.6 54.4 60.8 49.1 25.3 12.7 37.8 12.7 9.8 15.2 62.7 13.2 108.6 

55-64 3.9 3.7 4.0 1.3 1.2 1.3 20.8 26.1 16.7 9.4 5.9 12.6 5.2 3.3 6.9 20.6 11.5 28.6 

65+ 4.0 2.3 5.1 1.3 0.9 1.6 27.8 15.9 35.5 11.9 5.8 16.5 4.9 3.2 6.1 9.6 0.0 16.6 

TOTAL 230.1 85.1 369.7 97.2 29.6 161.9 949.8 403.9 1,444.6 356.4 129.6 599.1 124.4 45.1 197.8 557.5 158.8 943.2 

NOTE: For the following years the states listed did not report race/ethnicity for most cases and were excluded: 1996 (Colorado, Delaware, Georgia, 

Maryland, Michigan, New Jersey, New York, Ohio, and South Carolina): 1997 (Colorado, Delaware, District of Columbia, Georgia, Maryland, 

Michigan, Mississippi, New Jersey, New York, Ohio and South Carolina): 1998 (Colorado, District of Columbia, Michigan, New Jersey, New York, 

Ohio and South Carolina). Cases and population denominators have been excluded for these states/areas. Rates for the 0 to 9 year age group are 

not shown because some of these may not be due to sexual transmission; however, they are included in the totals. 

STD Surveillance 1998 Chlamydia Tables 73 
Table 4. Chlamydia — Reported cases and rates by state/area, ranked according to rates: United States and 

outlying areas, 1998 

Rank State/Area Cases Rate per 100,000 Population 

1 South Carolina 18,510 492.3 

2 Mississippi 10,614 388.7 

3 New York1 26,218 357.1 

4 Delaware 2,608 356.5 

5 Louisiana 15,188 349.0 

6 Georgia 25,250 337.3 

7 Alaska 1,907 313.0 

8 Texas 60,436 310.9 

9 North Carolina 22,197 298.9 

10 Oklahoma 9,393 283.2 

11 Wisconsin 13,878 268.5 

12 Guam 410 262.5 

13 Maryland 13,097 257.1 

14 Tennessee 13,717 255.5 

15 Arizona 11,489 252.2 

16 Ohio 27,786 248.4 

17 California 76,490 237.0 

U.S. TOTAL2 607,602 236.6 

18 Missouri 12,670 234.5 

19 Colorado 9,113 234.1 

20 Rhode Island 2,307 233.6 

21 Alabama 10,065 233.0 

22 Michigan 22,156 226.7 

23 Illinois 26,363 221.6 

24 Hawaii 2,604 219.5 

25 New Mexico 3,793 219.3 

26 Kansas 5,587 215.3 

27 Connecticut 6,977 213.4 

28 South Dakota 1,572 213.0 

29 Pennsylvania 24,629 204.9 

30 Virginia 13,561 201.4 

31 Nevada 3,320 198.0 

32 Washington 10,998 196.0 

33 Indiana 10,801 184.2 

34 Iowa 5,174 181.4 

35 Oregon 5,855 180.5 

36 Nebraska 2,911 175.7 

37 Florida 24,949 170.3 

38 Idaho 2,035 168.1 

39 Kentucky 6,441 164.8 

40 Arkansas 4,123 163.4 

41 North Dakota 1,036 161.7 

42 Montana 1,412 160.7 

43 West Virginia 2,791 153.7 

44 Wyoming 725 151.1 

45 Minnesota 6,970 148.8 

46 New Jersey 11,686 145.1 

47 Massachusetts 8,363 136.7 

48 Utah 2,209 107.3 

49 Maine 1,073 86.4 

50 New Hampshire 960 81.9 

51 Vermont 413 70.1 

52 Puerto Rico 1,685 44.0 

53 Virgin Islands 10 9.1 

1

New York’s cases and rate are based on New York City. No cases were reported outside of New York City. 

2

Includes cases reported by Washington, D.C., but excludes outlying areas (Guam, Puerto Rico and Virgin Islands). 

74 Chlamydia Tables STD Surveillance 1998 
Table 5. Chlamydia — Reported cases and rates by state/area and region: United States and outlying areas, 

1994–1998* 

Cases Rates per 100,000 Population 

State/Area 1994 1995 1996 1997 1998 1994 1995 1996 1997 1998 

Alabama 508 3,188 8,306 8,704 10,065 12.0 75.0 193.7 201.5 233.0 

Alaska NR NR 1,360 1,616 1,907 . . 224.8 265.2 313.0 

Arizona 9,211 10,061 10,692 10,783 11,489 226.0 238.5 241.1 236.7 252.2 

Arkansas 788 680 2,111 2,503 4,123 32.1 27.4 84.2 99.2 163.4 

California 72,766 61,802 61,593 68,737 76,490 231.5 195.6 193.3 213.0 237.0 

Colorado 9,031 6,650 7,282 7,749 9,113 247.0 177.5 190.8 199.1 234.1 

Connecticut 7,146 6,440 6,269 6,377 6,977 218.2 196.7 191.9 195.0 213.4 

Delaware 2,478 2,701 2,271 2,613 2,608 349.4 376.6 313.9 357.2 356.5 

Florida NR 22,294 24,763 26,788 24,949 . 157.4 171.7 182.8 170.3 

Georgia 168 11,193 13,555 15,911 25,250 2.4 155.4 184.8 212.5 337.3 

Hawaii 2,484 2,135 1,816 1,829 2,604 210.8 179.9 153.5 154.1 219.5 

Idaho 1,752 1,739 1,524 1,709 2,035 154.6 149.5 128.3 141.2 168.1 

Illinois 24,605 24,645 24,430 23,024 26,363 209.4 208.3 206.2 193.5 221.6 

Indiana 10,346 9,102 10,334 9,600 10,801 179.9 156.8 177.3 163.7 184.2 

Iowa 5,413 5,089 4,165 4,907 5,174 191.3 179.1 146.2 172.0 181.4 

Kansas 6,391 5,314 4,449 4,627 5,587 250.2 207.1 172.5 178.3 215.3 

Kentucky 5,630 6,904 6,805 6,332 6,441 147.1 178.9 175.3 162.0 164.8 

Louisiana 10,650 9,111 11,020 11,545 15,188 246.8 209.8 253.9 265.3 349.0 

Maine 1,195 1,144 967 1,066 1,073 96.3 92.2 78.1 85.8 86.4 

Maryland 6,709 10,378 11,901 13,763 13,097 134.1 205.8 235.2 270.2 257.1 

Massachusetts 8,066 7,402 6,837 7,984 8,363 133.5 121.9 112.4 130.5 136.7 

Michigan 17,686 21,666 19,865 21,399 22,156 186.2 226.9 204.1 218.9 226.7 

Minnesota 7,317 6,032 5,607 6,631 6,970 160.2 130.9 120.6 141.5 148.8 

Mississippi NR 912 4,848 10,020 10,614 . 33.8 178.8 367.0 388.7 

Missouri 12,249 12,110 11,959 12,257 12,670 232.1 227.5 223.0 226.9 234.5 

Montana 1,403 1,198 1,124 1,146 1,412 163.9 137.7 128.2 130.4 160.7 

Nebraska 3,336 2,873 2,478 2,766 2,911 205.5 175.5 150.3 166.9 175.7 

Nevada 3,149 3,049 2,847 2,887 3,320 216.1 199.3 177.8 172.2 198.0 

New Hampshire 967 898 732 816 960 85.1 78.2 63.1 69.6 81.9 

New Jersey 1,831 4,056 12,273 10,339 11,686 23.2 51.0 153.4 128.4 145.1 

New Mexico 5,037 4,285 4,007 4,021 3,793 304.6 254.2 234.2 232.5 219.3 

New York1 26,472 26,686 26,455 28,468 26,218 361.0 365.0 360.7 387.7 357.1 

North Carolina 17,796 15,780 15,078 17,108 22,197 251.8 219.3 206.3 230.4 298.9 

North Dakota 1,079 1,324 1,016 902 1,036 169.0 206.4 158.1 140.7 161.7 

Ohio 32,475 29,124 20,653 22,827 27,786 292.5 261.2 185.0 204.1 248.4 

Oklahoma 3,729 5,065 7,379 7,419 9,393 114.5 154.5 223.9 223.7 283.2 

Oregon 5,495 5,465 5,457 5,270 5,855 178.0 174.0 170.7 162.5 180.5 

Pennsylvania 19,746 22,961 19,275 19,838 24,629 163.8 190.2 160.1 165.0 204.9 

Rhode Island 2,095 1,902 1,833 2,069 2,307 210.2 192.2 185.5 209.5 233.6 

South Carolina 8,153 8,591 9,391 12,511 18,510 222.5 233.9 252.7 332.7 492.3 

South Dakota 1,427 1,313 1,538 1,439 1,572 197.2 180.1 208.5 195.0 213.0 

Tennessee 6,787 13,154 13,125 12,502 13,717 131.1 250.3 247.3 232.9 255.5 

Texas 46,046 44,627 43,003 50,675 60,436 250.5 238.3 225.3 260.7 310.9 

Utah 1,801 1,676 1,598 1,774 2,209 94.4 85.9 79.2 86.2 107.3 

Vermont 522 462 398 434 413 90.0 79.0 67.9 73.7 70.1 

Virginia 12,976 12,285 11,756 11,955 13,561 198.1 185.6 176.4 177.5 201.4 

Washington 10,577 9,462 9,236 9,523 10,998 198.0 174.2 167.3 169.7 196.0 

West Virginia 2,602 2,326 2,325 3,108 2,791 142.8 127.2 127.7 171.2 153.7 

Wisconsin 11,769 8,955 10,290 9,554 13,878 231.6 174.8 200.0 184.8 268.5 

Wyoming 816 703 621 635 725 171.4 146.4 129.4 132.4 151.1 

U.S. TOTAL2 451,758 478,577 490,615 531,529 607,602 194.5 190.4 192.9 206.9 236.6 

Northeast 68,040 71,951 75,039 77,391 82,626 167.8 177.0 184.4 189.7 202.5 

Midwest 134,093 127,547 116,784 119,933 136,904 218.4 206.4 187.8 192.0 219.2 

South 126,103 170,854 189,635 216,526 256,122 170.3 185.9 203.9 229.9 271.9 

West 123,522 108,225 109,157 117,679 131,950 219.6 189.9 186.6 198.1 222.1 

Guam 275 461 304 368 410 188.5 308.9 199.1 235.6 262.5 

Puerto Rico 2,443 2,305 2,481 2,123 1,685 66.8 62.4 66.7 55.5 44.0 

Virgin Islands 50 17 11 14 10 46.2 15.5 10.0 12.8 9.1 

OUTLYING AREAS 2,768 2,783 2,796 2,505 2,105 70.8 70.4 70.2 61.2 51.4 

TOTAL 454,526 481,360 493,411 534,034 609,707 192.4 188.6 191.0 204.7 233.7 

*NR = No report (see Appendix).
 

1

New York’s cases and rate are based on New York City. No cases were reported outside of New York City.
 

2

Includes cases reported by Washington, D.C., and rates exclude population of states that did not report.
 

STD Surveillance 1998 Chlamydia Tables 75 
Table 6. Chlamydia — Women – Reported cases and rates by state/area: United States and outlying areas, 

1994–1998* 

Cases Rates per 100,000 Population 

State/Area 1994 1995 1996 1997 1998
 1994 1995 1996 1997 1998
 

Alabama 425 2,888 7,623 7,957 9,197 19.4 130.5 342.4 354.9 410.2 

Alaska NR NR 1,071 1,291 1,479 . . 373.4 446.6 511.6 

Arizona 7,680 8,315 8,635 8,597 9,015 372.6 389.8 385.9 374.3 392.5 

Arkansas 654 596 1,933 2,346 3,850
 51.5 46.4 149.4 180.3 295.9 

California 55,828 50,314 49,158 53,536 59,739 355.4 318.6 309.1 332.4 370.9 

Colorado NG NG 5,692 5,958 6,979 . . 295.9 303.8 355.8 

Connecticut 6,288 5,624 5,321 5,282 5,828 372.5 333.2 316.8 314.4 346.9 

Delaware 2,171 2,295 1,877 2,070 2,117 595.9 623.4 506.0 551.9 564.5 

Florida NR 18,251 20,160 21,953 20,171 . 249.9 271.8 291.5 267.9 

Georgia 148 10,263 11,744 13,927 21,156 4.1 277.4 312.3 363.1 551.5 

Hawaii 2,127 1,878 1,568 1,548 2,209 365.6 320.2 267.5 262.4 374.5 

Idaho 1,411 1,370 1,177 1,336 1,553 248.4 235.1 198.1 220.8 256.7 

Illinois 21,660 20,443 21,111 17,302 21,845 358.9 336.6 348.2 284.4 359.0 

Indiana 8,637 7,564 8,592 7,819 8,823 291.9 253.5 287.5 260.2 293.6 

Iowa 4,405 4,210 3,443 3,900 4,077 302.9 288.4 235.9 267.0 279.1 

Kansas 5,225 4,453 3,744 3,840 4,649 402.4 341.6 285.8 291.5 353.0 

Kentucky 5,009 5,995 5,604 5,128 5,126 254.0 301.4 280.8 255.3 255.2 

Louisiana 8,540 7,569 9,490 9,414 12,169 381.4 335.8 422.0 417.6 539.8 

Maine 1,048 1,024 829 898 899
 164.7 160.7 130.8 141.4 141.5 

Maryland 6,036 9,150 10,249 11,969 11,093 234.6 352.9 394.6 457.9 424.4 

Massachusetts 6,867 6,237 5,783 6,522 6,812 219.1 198.1 183.7 206.2 215.4 

Michigan 14,938 18,750 16,851 18,289 18,769 306.1 382.3 337.7 365.1 374.7 

Minnesota 5,689 4,681 4,328 4,953 5,119 245.1 199.9 183.7 208.7 215.7 

Mississippi NR 849 4,100 8,590 9,185 . 60.5 291.0 605.6 647.5 

Missouri 11,199 10,866 10,578 10,749 11,063 410.4 395.0 382.7 386.5 397.8 

Montana 1,143 995 899 941 1,131
 265.5 227.5 204.4 213.5 256.6 

Nebraska 2,661 2,346 2,020 2,288 2,390 320.4 280.2 240.2 270.9 282.9 

Nevada 2,668 2,649 2,463 2,484 2,820 372.9 352.6 313.9 302.3 343.2 

New Hampshire 817 725 578 639 726
 141.0 124.0 98.1 107.4 122.0 

New Jersey 1,733 3,902 11,463 9,641 10,735 42.5 95.2 278.2 232.6 259.0 

New Mexico 4,536 3,721 3,417 3,503 3,204 540.6 435.2 394.1 399.5 365.4 

New York1 24,317 24,600 24,375 25,706 23,449 626.0 635.4 628.7 662.8 604.6 

North Carolina 14,907 13,589 13,072 14,553 18,646 409.6 366.8 347.9 381.5 488.8 

North Dakota 827 1,025 714 684 755
 258.2 318.6 221.9 212.9 235.1 

Ohio 27,881 24,883 18,050 19,727 23,248 485.5 431.6 313.4 342.0 403.1 

Oklahoma 3,305 4,467 6,269 6,269 7,696 198.0 266.2 372.4 370.1 454.4 

Oregon 4,023 4,145 4,095 3,848 4,307 257.0 260.4 253.3 234.8 262.8 

Pennsylvania 17,418 20,290 17,227 17,257 20,878 278.0 323.5 275.9 277.0 335.1 

Rhode Island 1,753 1,598 1,600 1,738 1,779 338.5 310.8 312.0 339.4 347.5 

South Carolina 7,097 6,932 7,918 11,120 16,489 374.7 364.8 412.2 572.2 848.5 

South Dakota 1,114 1,039 1,184 1,021 1,171 303.3 280.8 316.6 272.9 312.9 

Tennessee 6,109 10,517 10,004 9,605 10,552 227.9 386.5 365.0 346.4 380.6 

Texas 39,314 38,517 37,240 42,750 49,940 421.9 405.9 385.6 435.0 508.1 

Utah 1,403 1,316 1,229 1,357 1,616 146.3 134.2 121.4 131.3 156.4 

Vermont 457 408 336 379 357
 154.8 137.2 112.9 126.9 119.5 

Virginia 12,086 11,253 10,630 10,452 11,567 361.5 333.0 312.7 304.2 336.7 

Washington 8,458 7,508 7,194 7,331 8,377 314.3 274.6 259.7 260.5 297.7 

West Virginia 2,271 1,961 1,894 2,590 2,340 240.2 206.9 201.1 275.8 249.2 

Wisconsin 9,086 6,860 8,170 7,459 10,716 350.9 262.9 312.5 284.2 408.3 

Wyoming 681 560 521 536 595
 287.6 234.7 218.6 225.1 249.9 

U.S. TOTAL2 372,990 400,840 414,987 441,710 501,128 318.8 316.3 319.4 336.9 382.2 

Guam 227 393 260 325 351
 331.1 560.3 362.3 442.6 478.1 

Puerto Rico 1,974 1,905 1,989 1,722 1,327 104.5 99.8 103.4 86.5 66.7 

Virgin Islands 39 9 11 13 10
 69.3 15.8 19.3 22.8 17.5 

OUTLYING AREAS 2,240 2,307 2,260 2,060 1,688 111.2 113.3 110.1 97.1 79.6 

TOTAL 375,230 403,147 417,247 443,770 502,816 315.3 313.1 316.2 333.1 377.4 

*NR = No report (see Appendix). NG= Not reported by gender.
 

1

New York’s cases and rate are based on New York City. No cases were reported outside of New York City.
 

2

Includes cases reported by Washington, D.C., and rates exclude population of states that did not report.
 

NOTE: Cases and rates underestimated in some areas because of under-reporting or non-reporting by gender.
 

76 Chlamydia Tables STD Surveillance 1998
 
Table 7. Chlamydia — Men – Reported cases and rates by state/area: United States and outlying areas, 

1994–1998* 

Cases Rates per 100,000 Population 

State/Area 1994 1995 1996 1997 1998 1994 1995 1996 1997 1998 

Alabama 68 285 662 708 844 3.4 14.0 32.1 34.1 40.6 

Alaska NR NR 289 325 428 . . 90.8 101.5 133.7 

Arizona 1,531 1,746 2,057 2,186 2,474 76.0 83.7 93.6 96.8 109.6 

Arkansas 134 79 178 143 267 11.3 6.6 14.7 11.7 21.9 

California 11,274 11,248 12,157 14,875 16,504 71.7 71.2 76.2 92.0 102.1 

Colorado NG NG 1,585 1,784 2,115 . . 83.7 92.4 109.5 

Connecticut 858 816 948 1,095 1,149 54.1 51.4 59.7 68.9 72.3 

Delaware 307 406 394 543 491 89.0 116.3 111.8 152.3 137.7 

Florida NR 4,043 4,603 4,835 4,363 . 58.9 65.7 67.9 61.3 

Georgia 20 930 1,811 1,962 3,932 0.6 26.6 50.7 53.7 107.7 

Hawaii 357 257 248 281 395 59.8 42.8 41.6 47.1 66.2 

Idaho 341 369 347 373 482 60.4 63.6 58.5 61.6 79.6 

Illinois 2,923 4,202 3,319 5,722 4,518 51.1 73.0 57.4 98.5 77.7 

Indiana 1,709 1,537 1,742 1,773 1,968 61.2 54.5 61.3 62.0 68.8 

Iowa 1,008 879 722 1,007 1,096 73.3 63.6 52.0 72.4 78.8 

Kansas 1,166 860 705 787 938 92.9 68.2 55.5 61.6 73.4 

Kentucky 621 909 1,201 1,182 1,093 33.5 48.6 63.7 62.2 57.5 

Louisiana 2,110 1,542 1,530 2,131 3,019 101.6 73.8 73.1 101.6 143.9 

Maine 147 120 138 168 174 24.3 19.9 22.8 27.7 28.7 

Maryland 673 1,228 1,652 1,794 1,973 27.7 50.1 67.1 72.3 79.5 

Massachusetts 1,199 1,165 1,054 1,462 1,551 41.2 39.8 35.9 49.5 52.5 

Michigan 2,748 2,916 3,014 3,110 3,387 59.5 62.8 63.6 65.3 71.1 

Minnesota 1,628 1,351 1,279 1,678 1,851 72.5 59.6 55.8 72.6 80.0 

Mississippi NR 63 703 1,180 1,355 . 4.9 54.0 89.9 103.3 

Missouri 1,050 1,244 1,381 1,508 1,607 41.2 48.4 53.1 57.5 61.3 

Montana 260 203 180 198 281 61.1 46.9 41.2 45.2 64.2 

Nebraska 647 526 452 473 520 81.6 65.8 56.0 58.2 64.0 

Nevada 480 400 384 403 498 64.7 51.4 47.0 47.1 58.2 

New Hampshire 149 173 154 177 234 26.7 30.7 27.0 30.6 40.5 

New Jersey 98 154 801 689 944 2.6 4.0 20.6 17.6 24.2 

New Mexico 501 564 590 518 589 61.5 67.9 69.9 60.7 69.1 

New York1 2,155 2,086 2,080 2,762 2,669 62.5 60.6 60.2 79.7 77.0 

North Carolina 2,889 2,191 2,006 2,555 3,551 84.2 62.8 56.5 70.8 98.3 

North Dakota 252 299 302 218 281 79.2 93.5 94.1 68.2 87.9 

Ohio 4,594 4,048 2,405 2,884 4,211 85.7 75.2 44.5 53.2 77.7 

Oklahoma 418 598 1,110 1,150 1,697 26.3 37.4 68.9 70.8 104.5 

Oregon 1,472 1,320 1,362 1,422 1,548 96.8 85.2 86.2 88.6 96.5 

Pennsylvania 2,328 2,671 2,048 2,581 3,751 40.2 46.1 35.3 44.6 64.8 

Rhode Island 342 304 233 331 528 71.4 63.9 49.0 69.6 111.1 

South Carolina 836 813 881 1,215 1,837 47.2 45.9 49.1 66.9 101.1 

South Dakota 313 274 354 417 400 87.8 76.3 97.4 114.6 110.0 

Tennessee 678 2,637 3,121 2,897 3,165 27.2 104.0 121.6 111.6 121.9 

Texas 6,732 6,110 5,763 7,925 10,301 74.3 66.2 61.1 82.5 107.2 

Utah 398 360 368 417 593 41.9 37.1 36.6 40.7 57.8 

Vermont 65 54 62 55 56 22.8 18.8 21.5 19.0 19.3 

Virginia 834 989 1,109 1,379 1,988 26.0 30.5 33.9 41.8 60.3 

Washington 2,119 1,954 2,042 2,192 2,621 79.9 72.5 74.3 78.4 93.7 

West Virginia 323 359 429 515 448 36.8 40.8 48.8 58.7 51.1 

Wisconsin 2,683 2,095 2,120 2,095 3,160 107.7 83.3 83.7 82.3 124.2 

Wyoming 135 143 100 99 130 56.4 59.2 41.4 41.0 53.8 

U.S. TOTAL2 63,716 69,736 74,409 88,590 104,435 57.1 57.7 59.8 70.5 83.1 

Guam 48 68 44 43 59 62.1 86.0 54.4 51.9 71.3 

Puerto Rico 469 400 492 401 358 26.6 22.4 27.4 21.8 19.5 

Virgin Islands 11 8 NR 1 NR 21.2 15.2 . 1.9 . 

OUTLYING AREAS 528 476 536 445 417 27.9 24.9 28.6 22.6 21.7 

TOTAL 64,244 70,212 74,945 89,035 104,852 56.6 57.2 59.3 69.7 82.1 

*NR = No report (see Appendix). NG= Not reported by gender.
 

1

New York’s cases and rate are based on New York City. No cases were reported outside of New York City.
 

2

Includes cases reported by Washington, D.C., and rates exclude population of states that did not report.
 

Note: Cases and rates underestimated in some areas because of under-reporting or non-reporting by gender.
 

STD Surveillance 1998 Chlamydia Tables 77 
5

10

15

20

25

30

35

40

45

50

55

60

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

to rates: United States and outlying areas, 1998* 

Rank City Cases Rate per 100,000 Population 

1 Milwaukee, WI 7,851 863.8 

2 Baltimore, MD 5,663 861.6 

3 St Louis, MO 2,921 854.4 

4 Richmond, VA 1,619 841.5 

Philadelphia, PA 11,763 810.5 

6 Atlanta, GA 5,276 730.2 

7 New Orleans, LA 3,331 710.1 

8 Kansas City, MO 3,105 694.5 

9 Detroit, MI 7,351 675.0 

Minneapolis, MN 2,555 666.5 

11 Newark, NJ 1,725 606.2 

12 Washington, DC 3,182 601.6 

13 Cincinnati, OH 4,840 568.3 

14 Denver, CO 2,834 568.0 

Indianapolis, IN 4,584 563.4 

16 Memphis, TN 4,791 553.3 

17 Boston, MA 2,588 464.3 

18 Tulsa, OK 1,782 461.8 

19 Oklahoma City, OK 2,008 455.7 

St Paul, MN 1,233 446.6 

21 San Antonio, TX 5,909 443.4 

22 Dallas, TX 8,893 439.6 

23 Austin, TX 3,030 436.8 

24 Portland, OR 2,128 431.8 

Norfolk, VA 954 415.9 

26 Corpus Christi, TX 1,220 384.3 

27 Columbus, OH 3,854 378.9 

28 Chicago, IL 11,009 377.8 

29 Birmingham, AL 2,476 375.9 

Nashville, TN 1,981 371.2 

31 Houston, TX 11,561 366.1 

32 San Francisco, CA 2,616 357.2 

33 New York City, NY 26,218 357.1 

34 Sacramento, CA 4,005 355.7 

Albuquerque, NM 1,715 326.0 

36 Omaha, NE 1,410 319.7 

37 Jersey City, NJ 678 311.3 

38 Fort Worth, TX 4,089 308.1 

39 Oakland, CA 3,651 291.3 

Los Angeles, CA 24,131 281.9 

41 Phoenix, AZ 7,549 280.0 

42 Charlotte, NC 1,695 276.4 

43 Cleveland, OH 3,650 263.2 

44 Jacksonville, FL 1,913 261.1 

San Diego, CA 7,044 258.7 

46 Honolulu, HI 2,205 253.5 

47 Tampa, FL 2,240 246.3 

48 El Paso, TX 1,697 241.9 

49 Pittsburgh, PA 2,980 232.7 

Seattle, WA 3,486 213.5 

51 Des Moines, IA 743 209.7 

52 San Jose, CA 3,349 208.1 

53 Tucson, AZ 1,610 206.4 

54 Wichita, KS 861 196.3 

St Petersburg, FL 1,692 194.1 

56 Louisville, KY 1,253 186.8 

57 Toledo, OH 780 172.8 

58 Miami, FL 3,486 170.5 

59 Dayton, OH 929 165.5 

Akron, OH 859 161.6 

61 San Juan, PR 615 70.5 

62 Buffalo, NY NR . 

63 Rochester, NY NR . 

64 Yonkers, NY NR . 

*NR = No report (see Appendix). 

78 Chlamydia Tables STD Surveillance 1998 
Table 9. Chlamydia — Reported cases and rates in selected cities of >200,000 population: United States and 

outlying areas, 1994–1998* 

Cases 

City	 1994 1995 1996 1997 1998 

Akron, OH 2,132 

Albuquerque, NM 2,080 

Atlanta, GA NR 

Austin, TX 2,572 

Baltimore, MD 3,638 

Birmingham, AL 273 

Boston, MA 2,452 

Buffalo, NY NR 

Charlotte, NC NR 

Chicago, IL 11,984 

Cincinnati, OH 2,885 

Cleveland, OH 7,036 

Columbus, OH 5,380 

Corpus Christi, TX 567 

Dallas, TX 3,909 

Dayton, OH 1,372 

Denver, CO NR 

Des Moines, IA 692 

Detroit, MI 4,496 

El Paso, TX 2,238 

Fort Worth, TX 2,437 

Honolulu, HI 2,147 

Houston, TX 9,377 

Indianapolis, IN 5,049 

Jacksonville, FL NR 

Jersey City, NJ 83 

Kansas City, MO 1,839 

Los Angeles, CA 20,459 

Louisville, KY 1,130 

Memphis, TN 2,489 

Miami, FL NR 

Milwaukee, WI 5,452 

Minneapolis, MN 2,394 

Nashville, TN 1,190 

New Orleans, LA 2,733 

New York City, NY 26,472 

Newark, NJ 292 

Norfolk, VA 944 

Oakland, CA 3,434 

Oklahoma City, OK 1,528 

Omaha, NE 1,808 

Philadelphia, PA 9,957 

Phoenix, AZ 5,218 

Pittsburgh, PA 3,294 

Portland, OR 2,072 

Richmond, VA 994 

Rochester, NY NR 

Sacramento, CA 3,800 

San Antonio, TX 4,519 

San Diego, CA 6,413 

San Francisco, CA 2,120 

San Jose, CA 4,047 

Seattle, WA 3,578 

St Louis, MO 3,013 

St Paul, MN 1,119 

St Petersburg, FL NR 

Tampa, FL NR 

Toledo, OH 2,181 

Tucson, AZ 1,847 

Tulsa, OK 831 

Washington, DC 1,083 

Wichita, KS 1,642 

Yonkers, NY NR 

1,457 

1,651 

4,411 

2,977 

5,638 

992 

2,179 

NR 

1,063 

11,687 

2,846 

5,770 

3,500 

1,167 

5,115 

869 

NR 

699 

9,026 

1,245 

2,540 

1,738 

8,075 

4,662 

1,611 

182 

1,997 

18,659 

1,618 

3,728 

2,004 

4,332 

1,922 

1,926 

3,107 

26,686 

1,077 

832 

3,461 

1,232 

1,335 

8,079 

5,896 

2,865 

1,945 

2,150 

NR 

3,760 

4,348 

5,250 

2,008 

2,838 

3,286 

2,796 

1,027 

1,579 

2,063 

968 

1,915 

1,028 

1,665 

1,324 

NR 

711 

1,624 

4,091 

2,699 

4,812 

2,349 

1,985 

NR 

803 

12,356 

1,699 

3,465 

2,267 

1,070 

5,309 

509 

2,563 

727 

7,460 

2,457 

1,864 

1,473 

8,488 

4,814 

2,431 

647 

3,165 

20,196 

1,761 

4,474 

2,606 

5,568 

1,922 

1,965 

4,140 

26,455 

1,944 

801 

3,375 

2,154 

819 

8,118 

6,342 

2,494 

1,937 

2,036 

NR 

3,584 

4,338 

5,642 

1,819 

2,971 

3,229 

2,386 

1,054 

1,522 

2,083 

484 

2,201 

1,663 

1,998 

1,086 

NR 

852 

1,635 

4,208 

2,977 

6,066 

2,372 

2,450 

NR 

1,049 

9,375 

2,617 

3,056 

3,133 

986 

7,990 

813 

2,726 

567 

6,622 

1,439 

2,402 

1,488 

10,756 

3,693 

2,402 

553 

3,086 

23,346 

1,598 

4,244 

3,579 

5,121 

2,473 

1,820 

2,869 

28,468 

1,669 

899 

3,419 

1,013 

1,349 

10,480 

6,580 

2,879 

1,844 

2,175 

NR 

3,499 

4,838 

6,397 

2,243 

2,751 

3,174 

2,653 

1,112 

1,789 

2,836 

528 

1,888 

793 

3,069 

1,159 

NR 

859 

1,715 

5,276 

3,030 

5,663 

2,476 

2,588 

NR 

1,695 

11,009 

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 

24,131 

1,253 

4,791 

3,486 

7,851 

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 

U.S. CITY TOTAL1 202,691 211,806 217,005 229,867 252,551 

San Juan, PR 821 742 916 739 615 

TOTAL 203,512 212,548 217,921 230,606 253,166 

Rates per 100,000 Population 

1994 1995 1996 1997 1998 

403.8 

403.4 

. 

397.9 

517.5 

41.6 

446.6 

. 

. 

406.1 

332.5 

501.4 

535.2 

182.4 

201.3 

239.8 

. 

200.1 

425.3 

336.6 

193.8 

245.6 

307.9 

617.2 

. 

38.0 

419.9 

238.9 

168.1 

290.2 

. 

581.2 

626.1 

225.7 

564.5 

361.0 

100.7 

391.0 

284.7 

350.5 

420.2 

653.2 

222.4 

249.4 

429.3 

493.3 

. 

346.0 

353.0 

243.6 

288.6 

259.9 

225.4 

818.3 

406.1 

. 

. 

476.6 

252.5 

220.0 

191.0 

391.5 

. 

274.8 134.2 160.3 161.6 

316.1 309.3 310.8 326.0 

629.5 572.5 582.4 730.2 

447.8 395.9 429.2 436.8 

815.8 716.4 922.9 861.6 

150.8 355.4 360.1 375.9 

392.0	 355.8 439.5 464.3 

. . . . 

183.4 134.7 171.0 276.4 

396.4 423.3 321.7 377.8 

329.4 198.5 307.3 568.3 

412.7 248.0 220.4 263.2 

346.2 223.9 308.0 378.9 

373.2 340.0 310.6 384.3 

261.1 266.2 394.9 439.6 

152.3	 90.0 144.8 165.5 

. 516.3 546.3 568.0 

200.0 205.9 160.1 209.7 

857.7 681.7 608.0 675.0 

183.5 358.7 205.1 241.9 

198.7 143.4 181.0 308.1 

198.1 169.4 171.1 253.5 

262.4 272.5 340.6 366.1 

570.2 590.8 453.9 563.4 

229.6 335.3 327.9 261.1 

83.7 298.2 253.9 311.3 

455.3 710.7 690.2 694.5 

218.1 237.5 272.7 281.9 

240.4 262.6 238.3 186.8 

431.0 517.3 490.1 553.3 

98.7 127.9 175.0 170.5 

465.2 606.4 563.4 863.8 

501.2 501.2 645.1 666.5 

362.8 368.8 341.0 371.2 

644.7 873.1 611.6 710.1 

365.0 360.7 387.7 357.1 

374.6 680.5 586.5 606.2 

350.2 344.3 391.9 415.9 

286.1 272.7 272.8 291.3 

281.8 490.9 229.9 455.7 

307.5 187.0 305.9 319.7 

539.0 551.0 722.1 810.5 

242.4 242.7 244.0 280.0 

218.7 193.0 224.8 232.7 

401.4 395.2 374.2 431.8 

1,084.3	 1,066.2 1,130.5 841.5 

. . . . 

340.7 321.5 310.8 355.7 

335.3 330.1 363.1 443.4 

198.6 210.7 235.0 258.7 

274.9 249.2 306.3 357.2 

181.3 187.1 171.0 208.1 

206.0 200.1 194.4 213.5 

779.5 683.1 776.0 854.4 

373.7 382.8 402.8 446.6 

181.3 175.3 205.2 194.1 

233.2 232.8 311.8 246.3 

212.7 107.1 117.0 172.8 

254.5 286.7 242.0 206.4 

271.9 435.9 205.5 461.8 

300.4 370.5 580.2 601.6 

315.7	 250.9 264.2 196.3 

. . . . 

328.5 313.2 316.7 333.5 366.4 

94.1 85.1 105.0 84.7 70.5 

325.3 310.3 314.0 330.4 362.7 

*NR = No report (see Appendix).
 

1

Rates exclude population of cities that did not report.
 

STD Surveillance 1998	 Chlamydia Tables 79 
Table 10. Chlamydia — Women – Reported cases and rates in selected cities of >200,000 population: 

United States and outlying areas, 1994-1998* 

Cases 

City 

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 

1994 

1,804 

1,876 

NR 

2,257 

3,327 

231 

1,966 

NR 

NR 

10,927 

2,370 

6,163 

4,239 

430 

3,445 

1,244 

NR 

566 

4,138 

2,011 

1,905 

1,830 

7,665 

3,902 

NR 

83 

1,705 

17,112 

1,022 

2,256 

NR 

4,300 

1,791 

1,022 

1,840 

24,317 

284 

895 

2,884 

1,350 

1,435 

9,095 

4,247 

2,674 

1,460 

913 

NR 

3,018 

3,895 

5,093 

1,637 

3,117 

2,755 

2,810 

824 

NR 

NR 

1,926 

1,533 

774 

940 

1,253 

NR 

1995 

1,265 

1,403 

4,084 

2,600 

5,197 

867 

1,696 

NR 

926 

9,720 

2,176 

5,050 

2,862 

978 

3,950 

787 

NR 

571 

8,009 

1,112 

2,069 

1,502 

7,388 

3,629 

1,275 

176 

1,848 

15,119 

1,343 

3,090 

1,519 

3,275 

1,442 

1,431 

2,438 

24,600 

1,022 

768 

2,939 

1,069 

1,079 

7,446 

4,813 

2,353 

1,444 

1,955 

NR 

2,897 

3,785 

4,034 

1,535 

2,189 

2,474 

2,609 

784 

1,346 

1,646 

805 

1,545 

946 

1,449 

1,036 

NR 

1996 1997 1998 

616 

1,332 

3,190 

2,257 

4,442 

2,258 

1,584 

NR 

702 

11,428 

1,538 

3,059 

1,830 

888 

4,123 

471 

1,907 

583 

6,409 

2,241 

1,586 

1,244 

7,811 

3,718 

1,840 

628 

2,890 

15,813 

1,345 

3,427 

2,106 

4,574 

1,437 

1,428 

3,593 

24,375 

1,887 

705 

2,793 

1,887 

682 

7,483 

4,937 

2,064 

1,410 

1,835 

NR 

2,855 

3,775 

4,143 

1,324 

2,414 

2,352 

2,194 

782 

1,213 

1,707 

420 

1,796 

1,375 

1,764 

878 

NR 

666 

1,386 

3,596 

2,468 

5,607 

2,269 

1,842 

NR 

576 

6,362 

2,349 

2,672 

2,666 

802 

6,159 

756 

2,076 

430 

5,863 

1,263 

1,968 

1,236 

9,326 

2,680 

1,753 

536 

2,779 

17,911 

1,248 

3,325 

2,884 

4,051 

1,710 

1,308 

2,266 

25,706 

1,615 

801 

2,715 

892 

1,107 

9,300 

5,064 

2,416 

1,248 

1,931 

NR 

2,750 

4,093 

4,733 

1,426 

2,135 

2,279 

2,442 

830 

1,486 

2,371 

480 

1,510 

622 

2,658 

915 

NR 

697 

1,437 

4,217 

2,463 

5,066 

2,352 

1,920 

NR 

1,395 

9,480 

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 

18,922 

985 

3,786 

2,799 

6,298 

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 

U.S. CITY TOTAL1 172,556 179,365 183,348 188,314 206,483 

San Juan, PR 606 560 681 580 445 

TOTAL 173,162 179,925 184,029 188,894 206,928 

Rates per 100,000 Population 

1994 1995 1996 1997 1998 

656.4 

711.5 

. 

698.5 

886.9 

66.0 

689.9 

. 

. 

713.5 

518.8 

828.8 

814.5 

270.6 

349.6 

417.6 

. 

313.4 

744.1 

586.5 

300.1 

424.0 

501.0 

909.4 

. 

73.7 

743.3 

397.6 

287.9 

502.4 

. 

872.7 

909.3 

369.3 

708.8 

626.0 

185.7 

783.7 

469.7 

596.8 

644.3 

1,114.9 

357.1 

381.6 

590.0 

831.3 

. 

538.9 

590.4 

392.9 

443.6 

405.2 

342.3 

1,402.0 

573.7 

. 

. 

805.7 

410.2 

395.9 

310.8 

586.4 

. 

458.5 223.7 241.2 252.5 

525.3 496.3 515.1 534.0 

1,115.0 855.2 954.0 1,118.8 

782.5 660.5 710.2 708.7 

1,408.7 1,237.5 1,595.4 1,441.4 

247.5 642.3 647.6 671.3 

588.0	 548.6 638.8 665.9 

. . . . 

308.1 227.5 181.5 439.6 

635.2 756.6 422.1 629.0 

478.5 341.9 524.9 921.2 

681.7 413.8 364.3 432.6 

546.8 349.4 506.7 575.3 

611.9 553.7 495.9 637.6 

397.5 407.3 600.1 652.7 

265.0	 160.2 259.1 249.8 

. 747.3 809.8 837.1 

313.1 317.3 233.4 315.4 

1,446.8 1,114.4 1,024.4 1,134.1 

317.7 635.8 349.9 393.7 

320.6 240.8 292.7 487.6 

346.3 288.5 285.5 427.3 

478.1 499.1 588.1 625.0 

846.6 871.3 629.4 815.4 

354.4 492.0 464.1 362.1 

156.9 562.3 477.8 585.6 

804.8 1,242.3 1,190.7 1,193.3 

351.5 371.2 417.6 441.2 

378.0 381.0 353.7 279.2 

682.4 757.7 734.0 835.8 

143.2 199.1 271.8 263.8 

669.7 950.4 850.5 1,322.3 

730.4 728.9 868.1 894.5 

513.6 511.6 467.7 509.9 

943.0 1,413.7 901.0 1,023.5 

635.4 628.7 662.8 604.6 

674.5 1,256.2 1,079.4 1,090.7 

681.0 624.1 719.3 741.8 

477.0 446.0 427.1 462.8 

471.6 830.9 391.1 695.0 

480.4 301.5 486.2 500.3 

927.9 948.3 1,196.5 1,309.9 

390.5 373.7 371.8 415.0 

338.6 301.0 355.5 355.4 

581.5 562.5 495.4 576.8 

1,807.4	 1,760.2 1,837.7 1,381.9 

. . . . 

514.8 500.5 477.0 532.3 

566.3 557.7 596.5 707.4 

309.5 312.3 350.8 399.8 

417.7 358.6 384.3 415.3 

282.9 307.2 268.0 325.7 

306.0 288.7 276.6 294.9 

1,336.4 1,155.5 1,314.7 1,416.0 

547.5 546.0 578.3 625.0 

290.1 262.5 320.7 300.2 

362.8 372.5 509.5 397.8 

338.8 178.3 204.1 267.9 

401.9 459.5 380.5 327.3 

483.7 698.1 312.3 736.5 

490.0 615.2 946.7 969.5 

485.0	 398.4 409.6 297.7 

. . . . 

543.4 514.8 520.0 531.2 582.5 

126.3 116.7 142.0 120.9 92.8 

537.2 509.4 515.0 525.7 575.9 

*NR = No report (see Appendix).
 

1

Rates exclude population of cities that did not report.
 

80 Chlamydia Tables	 STD Surveillance 1998 
Table 11. Chlamydia — Men – Reported cases and rates in selected cities of >200,000 population: 

United States and outlying areas, 1994–1998* 

Cases 

City	 1994 1995 1996 1997 1998
 

Akron, OH 328
 

Albuquerque, NM 204
 

Atlanta, GA NR
 

Austin, TX 315
 

Baltimore, MD 311
 

Birmingham, AL 33
 

Boston, MA 486
 

Buffalo, NY NR
 

Charlotte, NC NR
 

Chicago, IL 1,057
 

Cincinnati, OH 515
 

Cleveland, OH 873
 

Columbus, OH 1,141
 

Corpus Christi, TX 137
 

Dallas, TX 464
 

Dayton, OH 128
 

Denver, CO NR
 

Des Moines, IA 126
 

Detroit, MI 358
 

El Paso, TX 227
 

Fort Worth, TX 532
 

Honolulu, HI 317
 

Houston, TX 1,712
 

Indianapolis, IN 1,147
 

Jacksonville, FL NR
 

Jersey City, NJ NR
 

Kansas City, MO 134
 

Los Angeles, CA 3,347
 

Louisville, KY 108
 

Memphis, TN 233
 

Miami, FL NR
 

Milwaukee, WI 1,154
 

Minneapolis, MN 603
 

Nashville, TN 168
 

New Orleans, LA 893
 

New York City, NY 2,155
 

Newark, NJ 8
 

Norfolk, VA 42
 

Oakland, CA 516
 

Oklahoma City, OK 176
 

Omaha, NE 349
 

Philadelphia, PA 862
 

Phoenix, AZ 971
 

Pittsburgh, PA 620
 

Portland, OR 612
 

Richmond, VA 79
 

Rochester, NY NR
 

Sacramento, CA 756
 

San Antonio, TX 624
 

San Diego, CA 1,206
 

San Francisco, CA 483
 

San Jose, CA 818
 

Seattle, WA 823
 

St Louis, MO 203
 

St Paul, MN 295
 

St Petersburg, FL NR
 

Tampa, FL NR
 

Toledo, OH 255
 

Tucson, AZ 314
 

Tulsa, OK 55
 

Washington, DC 143
 

Wichita, KS 389
 

Yonkers, NY NR
 

191
 

248
 

327
 

377
 

441
 

116
 

483
 

NR
 

137
 

1,967
 

656
 

697
 

617
 

189
 

1,165
 

79
 

NR
 

128
 

1,017
 

133
 

471
 

236
 

687
 

1,033
 

336
 

6
 

149
 

3,540
 

275
 

638
 

485
 

1,057
 

480
 

495
 

669
 

2,086
 

55
 

59
 

522
 

163
 

256
 

633
 

1,083
 

512
 

501
 

194
 

NR
 

824
 

563
 

1,141
 

473
 

629
 

812
 

187
 

243
 

233
 

417
 

160
 

370
 

82
 

216
 

288
 

NR
 

92
 

292
 

899
 

442
 

370
 

85
 

401
 

NR
 

101
 

928
 

155
 

392
 

429
 

182
 

1,186
 

36
 

655
 

144
 

1,051
 

216
 

278
 

229
 

677
 

1,096
 

591
 

19
 

275
 

4,383
 

416
 

1,047
 

500
 

994
 

485
 

537
 

547
 

2,080
 

56
 

96
 

582
 

267
 

137
 

635
 

1,405
 

430
 

527
 

201
 

NR
 

714
 

563
 

1,304
 

495
 

538
 

877
 

192
 

272
 

309
 

376
 

63
 

405
 

288
 

234
 

208
 

NR
 

179
 

249
 

597
 

509
 

459
 

101
 

608
 

NR
 

174
 

3,013
 

247
 

365
 

459
 

184
 

1,831
 

54
 

645
 

137
 

759
 

176
 

434
 

252
 

1,430
 

1,013
 

649
 

16
 

307
 

5,373
 

349
 

919
 

695
 

1,070
 

763
 

512
 

603
 

2,762
 

52
 

84
 

704
 

121
 

237
 

1,180
 

1,516
 

463
 

596
 

234
 

NR
 

725
 

745
 

1,477
 

817
 

607
 

895
 

211
 

282
 

303
 

465
 

44
 

378
 

171
 

411
 

244
 

NR
 

161
 

278
 

1,038
 

564
 

566
 

123
 

668
 

NR
 

300
 

1,529
 

688
 

463
 

812
 

188
 

2,156
 

198
 

676
 

162
 

860
 

273
 

763
 

355
 

1,648
 

1,112
 

544
 

21
 

320
 

5,209
 

260
 

1,005
 

685
 

1,553
 

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
 

U.S. CITY TOTAL1 29,805 32,227 33,384 40,855 45,534 

San Juan, PR 215 182 235 159 170
 

TOTAL 30,020 32,409 33,619 41,014 45,704 

Rates per 100,000 Population 

1994 1995 1996 1997 1998
 

129.6 

81.0 

. 

97.4 

94.9 

10.8 

184.0 

. 

. 

74.5 

125.3 

132.4 

235.4 

90.1 

48.5 

46.7 

. 

76.2 

71.4 

70.5 

85.5 

71.6 

113.0 

294.9 

. 

. 

64.2 

78.6 

34.0 

57.0 

. 

259.1 

325.2 

67.1 

397.7 

62.5 

5.8 

33.0 

87.2 

83.9 

168.1 

121.7 

83.9 

100.0 

260.2 

86.2 

. 

140.5 

100.6 

90.3 

132.1 

103.8 

105.2 

121.0 

223.7 

. 

. 

116.7 

87.8 

30.2 

54.0 

189.1 

. 

75.1 36.1 70.0 63.0 

97.2 113.7 96.9 108.2 

97.8 263.2 172.7 300.3 

113.4 130.0 147.1 163.0 

136.9 118.3 150.1 185.1 

37.7 27.5 32.8 39.9 

180.6	 149.0 226.0 248.3 

. . . . 

49.1 35.1 58.8 101.4 

138.7 65.9 214.2 108.7 

160.3 38.2 61.1 170.2 

106.0 59.6 55.9 70.9 

126.5 87.8 93.5 165.3 

123.6 117.9 118.1 120.7 

120.6 120.8 183.7 216.3 

28.9	 13.3 20.0 73.5 

. 271.5 265.9 278.6 

76.6 85.0 80.6 95.3 

203.9 202.4 146.9 166.4 

40.5 64.9 51.7 80.1 

74.4 43.3 66.3 116.5 

53.2 52.3 57.7 81.3 

44.9 43.7 91.0 104.8 

265.6 282.4 261.2 286.7 

98.3 168.3 182.9 153.3 

5.7 18.0 15.1 19.9 

71.3 129.3 143.7 149.7 

83.2 103.3 125.8 122.0 

86.6 130.9 109.8 81.8 

154.8 253.7 222.5 243.3 

50.0 51.0 70.7 69.7 

239.0 227.5 247.3 359.0 

258.0 260.3 409.4 425.5 

196.3 211.7 201.6 218.5 

299.5 248.6 277.1 347.9 

60.6 60.2 79.7 77.0 

40.4 41.3 38.5 68.9 

47.3 80.2 71.2 108.4 

88.0 95.2 114.0 113.1 

77.4 126.1 56.9 199.0 

122.2 64.7 111.1 126.6 

90.9 92.8 175.1 234.5 

90.3 108.7 113.6 142.1 

83.3 70.9 77.0 94.0 

212.1 220.1 247.4 280.2 

215.3	 231.8 268.0 191.3 

. . . . 

152.4 131.2 132.0 165.1 

89.6 88.4 115.3 162.1 

85.1 96.5 107.5 115.2 

130.3 137.2 226.2 297.6 

79.5 67.0 74.7 88.2 

103.2 109.8 110.6 130.6 

114.4 120.5 135.1 186.4 

184.6 205.9 212.7 253.5 

57.3 76.1 74.2 72.0 

96.8 86.1 104.7 79.5 

73.6 29.1 20.4 66.6 

100.5 107.5 98.6 81.1 

44.9 156.1 91.6 168.8 

83.5 92.7 165.6 185.3 

140.0	 97.9 113.3 91.0 

. . . . 

99.9 98.3 100.4 122.1 136.0 

54.8 46.4 59.9 40.5 43.3 

99.3 97.7 99.9 121.1 135.0 

*NR = No report (see Appendix).
 

1

Rates exclude population of cities that did not report.
 

STD Surveillance 1998	 Chlamydia Tables 81
 
Table 12A. Gonorrhea — Reported cases by age, gender, and race/ethnicity: United States, 1994–1998 

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 8,239 1,391 6,848 1,244 92 1,152 6,492 1,220 5,272 408 71 337 39 6 33 56 2 54 

15-19 117,189 47,960 69,229 16,669 2,822 13,847 94,699 43,079 51,620 4,784 1,775 3,009 466 115 351 571 169 402 

20-24 115,090 62,217 52,873 13,958 4,471 9,487 94,675 54,464 40,211 5,268 2,800 2,468 497 168 329 692 314 378 

199425-29 

30-34 

35-39 

56,554 32,803 23,751 

37,331 23,779 13,552 

22,840 16,489 6,351 

7,613 3,393 4,220 

5,561 2,911 2,650 

3,299 1,988 1,311 

45,374 27,392 17,982 

29,575 19,503 10,072 

18,332 13,681 4,651 

2,970 

1,801 

972 

1,749 

1,151 

666 

1,221 

650 

306 

264 128 136 

156 98 58 

120 77 43 

333 141 192 

238 116 122 

117 77 40 

40-44 11,761 9,411 2,350 1,745 1,228 517 9,436 7,793 1,643 472 325 147 55 36 19 53 29 24 

45-54 8,056 6,930 1,126 1,427 1,092 335 6,203 5,532 671 340 245 95 43 28 15 43 33 10 

55-64 2,206 1,993 213 370 319 51 1,716 1,577 139 100 81 19 9 7 2 11 9 2 

65+ 1,552 1,079 473 260 159 101 1,116 826 290 143 74 69 25 12 13 8 8 0 

TOTAL 382,899 204,920 177,979 52,332 18,550 33,782 309,404 175,832 133,572 17,331 8,957 8,374 1,682 676 1,006 2,150 905 1,245 

10-14 6,965 1,072 5,893 1,033 71 962 5,445 928 4,517 415 62 353 35 2 33 37 9 28 

15-19 104,753 40,311 64,442 15,661 2,500 13,161 82,894 35,649 47,245 5,290 1,953 3,337 430 94 336 478 115 363 

20-24 100,107 52,577 47,530 13,213 4,071 9,142 80,385 45,171 35,214 5,600 2,978 2,622 430 183 247 479 174 305 

199525-29 

30-34 

35-39 

51,167 29,789 21,378 

33,761 21,411 12,350 

22,045 15,479 6,566 

7,440 3,212 4,228 

5,638 3,008 2,630 

3,616 2,204 1,412 

40,158 24,532 15,626 

25,865 17,015 8,850 

17,135 12,429 4,706 

3,027 

1,887 

1,082 

1,771 

1,204 

727 

1,256 

683 

355 

281 161 120 

160 96 64 

70 45 25 

261 113 148 

211 88 123 

142 74 68 

40-44 11,528 9,164 2,364 1,707 1,197 510 9,205 7,551 1,654 510 351 159 46 28 18 60 37 23 

45-54 7,778 6,726 1,052 1,465 1,156 309 5,884 5,244 640 356 279 77 36 23 13 37 24 13 

55-64 1,990 1,810 180 358 311 47 1,511 1,396 115 108 90 18 9 9 0 4 4 0 

65+ 920 754 166 160 129 31 712 597 115 31 17 14 11 7 4 6 4 2 

TOTAL 343,127 179,985 163,142 50,565 17,956 32,609 270,898 151,263 119,635 18,430 9,472 8,958 1,514 650 864 1,720 644 1,076 

10-14 5,725 807 4,918 884 62 822 4,433 696 3,737 346 40 306 20 4 16 42 5 37 

15-19 92,253 32,683 59,570 14,517 2,655 11,862 71,870 28,047 43,823 4,932 1,790 3,142 364 62 302 570 129 441 

20-24 85,731 43,556 42,175 11,801 3,677 8,124 68,108 37,077 31,031 4,866 2,452 2,414 407 169 238 549 181 368 

199625-29 

30-34 

35-39 

44,639 25,609 19,030 

28,257 17,777 10,480 

18,464 12,702 5,762 

6,764 3,029 3,735 

4,930 2,704 2,226 

3,174 1,927 1,247 

34,569 20,789 13,780 

21,402 13,900 7,502 

14,125 10,073 4,052 

2,728 

1,553 

921 

1,527 

988 

566 

1,201 

565 

355 

258 132 126 

158 92 66 

94 55 39 

320 132 188 

214 93 121 

150 81 69 

40-44 10,289 7,953 2,336 1,689 1,172 517 8,003 6,397 1,606 468 305 163 52 31 21 77 48 29 

45-54 7,069 5,999 1,070 1,441 1,122 319 5,238 4,601 637 313 232 81 37 23 14 40 21 19 

55-64 1,717 1,552 165 333 282 51 1,295 1,200 95 74 63 11 11 5 6 4 2 2 

65+ 930 701 229 187 133 54 675 532 143 60 32 28 6 4 2 2 0 2 

TOTAL 296,393 149,814 146,579 45,991 16,852 29,139 230,616 123,656 106,960 16,394 8,031 8,363 1,416 579 837 1,976 696 1,280 

10-14 5,283 746 4,537 842 61 781 4,038 627 3,411 335 51 284 22 3 19 46 4 42 

15-19 90,096 30,995 59,101 13,710 2,389 11,321 70,242 26,642 43,600 5,127 1,735 3,392 408 95 313 609 134 475 

20-24 86,853 43,644 43,209 12,068 3,760 8,308 68,778 36,978 31,800 5,038 2,522 2,516 459 215 244 510 169 341 

25-29 

30-34 

35-39

1997

45,645 26,478 19,167 

27,570 17,441 10,129 

18,666 12,810 5,856 

7,012 3,047 3,965 

4,871 2,664 2,207 

3,547 2,118 1,429 

35,121 21,434 13,687 

20,561 13,446 7,115 

13,868 9,892 3,976 

2,950 

1,735 

1,056 

1,752 

1,111 

703 

1,198 

624 

353 

278 130 148 

198 127 71 

88 51 37 

284 115 169 

205 93 112 

107 46 61 

40-44 10,556 8,225 2,331 1,830 1,282 548 8,088 6,517 1,571 509 356 153 63 39 24 66 31 35 

45-54 7,433 6,331 1,102 1,433 1,136 297 5,586 4,910 676 326 231 95 51 36 15 37 18 19 

55-64 1,820 1,617 203 370 286 84 1,349 1,247 102 83 70 13 9 7 2 9 7 2 

65+ 1,251 866 385 228 150 78 939 658 281 79 55 24 3 1 2 2 2 0 

TOTAL 296,222 149,547 146,675 46,068 16,933 29,135 229,358 122,665 106,693 17,331 8,624 8,707 1,583 706 877 1,882 619 1,263 

10-14 6,009 801 5,208 837 57 780 4,757 684 4,073 341 53 288 24 3 21 50 4 46 

15-19 103,428 33,717 69,711 15,768 2,657 13,111 80,641 28,779 51,862 5,817 2,056 3,761 467 82 385 735 143 592 

20-24 103,327 49,985 53,342 14,223 4,351 9,872 81,446 41,980 39,466 6,432 3,245 3,187 585 202 383 641 207 434 

199825-29 

30-34 

35-39 

54,496 31,331 23,165 

31,563 19,793 11,770 

22,395 15,241 7,154 

7,946 3,520 4,426 

5,565 3,092 2,473 

4,098 2,555 1,543 

42,162 25,380 16,782 

23,477 15,129 8,348 

16,683 11,660 5,023 

3,641 

2,113 

1,298 

2,136 

1,380 

864 

1,505 

733 

434 

370 172 198 

210 106 104 

154 92 62 

377 123 254 

198 86 112 

162 70 92 

40-44 12,806 9,654 3,152 2,218 1,478 740 9,767 7,619 2,148 651 451 200 87 57 30 83 49 34 

45-54 9,097 7,606 1,491 1,646 1,267 379 6,886 5,947 939 460 328 132 48 25 23 57 39 18 

55-64 2,120 1,886 234 403 349 54 1,582 1,436 146 112 87 25 10 6 4 13 8 5 

65+ 1,197 860 337 243 170 73 844 624 220 82 62 20 11 3 8 17 1 16 

TOTAL 347,572 171,271 176,301 53,129 19,552 33,577 269,091 139,539 129,552 21,033 10,689 10,344 1,975 752 1,223 2,344 739 1,605 

NOTE: In most instances, 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 race/ethnicity for most cases and were excluded: 1994 (Georgia, and New York); 1995 

(Georgia, New Jersey, and New York); 1996 (New Jersey, and New York); 1997 (Idaho, New Jersey, and New York); 1998 (Idaho and New Jersey). 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. Cases aged 0 to 9 years are not shown because some of these may not be due to sexual transmission; 

however, they are included in the totals. 

82 Gonorrhea Tables STD Surveillance 1998 
Table 12B. Gonorrhea — Reported rates per 100,000 population by age, gender, and race/ethnicity: United States, 

1994–1998 

Age 

Group Total 

Total 

Male Female 

White, Non-Hispanic 

Total Male Female 

Black, Non-Hispanic 

Total Male Female Total 

Hispanic 

Male Female 

American Indian/ 

Alaska Native 

Total Male Female 

Asian/Pacific Islander 

Total Male Female 

10-14 48.3 15.9 82.3 10.6 1.5 20.2 276.4 102.5 455.2 19.0 6.5 32.1 29.5 2.1 57.6 6.3 1.9 10.7 

15-19 733.7 585.2 890.2 151.0 49.7 258.5 4,235.8 3,801.3 4,682.5 240.3 173.5 310.9 355.0 207.6 506.1 84.9 41.3 129.8 

20-24 695.5 739.1 650.4 121.5 76.7 167.8 4,357.0 5,092.9 3,643.9 249.4 248.2 250.8 448.9 398.8 501.2 79.5 53.6 105.5 

25-29 

30-34 

35-39 

328.5 

187.2 

115.2 

379.4 

238.9 

167.0 

277.1 

135.7 

63.8 

62.9 56.0 69.9 

38.1 39.8 36.4 

22.1 26.6 17.6 

2,168.9 2,751.0 1,640.2 

1,299.3 1,833.0 830.9 

824.0 1,314.6 392.8 

133.1 

81.6 

52.7 

145.4 

99.0 

69.9 

118.8 

62.3 

34.3 

231.8 194.3 270.0 

155.6 154.2 156.8 

81.2 110.1 54.0 

40.7 40.7 40.7 

1994

21.9 28.6 15.7 

17.6 23.8 12.0 

40-44 66.1 106.9 26.1 12.7 17.9 7.5 501.3 892.0 162.9 32.4 44.2 20.4 41.7 47.4 36.3 9.0 12.8 5.8 

45-54 30.0 52.6 8.2 6.6 10.3 3.1 249.0 488.0 49.4 18.0 26.5 9.9 23.8 38.0 10.7 5.2 7.3 3.4 

55-64 11.6 22.1 2.1 2.4 4.3 0.6 100.0 210.2 14.4 8.4 14.5 3.0 9.9 17.2 3.4 1.8 3.1 0.7 

65+ 5.2 8.8 2.7 1.0 1.5 0.7 49.5 93.8 21.1 11.2 13.8 9.3 6.7 15.8 0.0 4.9 5.5 4.4 

TOTAL 162.9 178.3 148.1 29.8 21.6 37.6 1,163.0 1,393.3 955.2 74.0 75.1 72.8 116.7 99.9 133.0 22.3 18.6 25.8 

10-14 41.3 12.4 71.7 8.9 1.2 17.1 237.0 79.7 398.9 19.3 5.7 33.6 19.0 9.2 29.1 5.6 0.6 10.7 

15-19 671.0 503.2 847.8 145.1 45.0 251.6 3,815.3 3,234.6 4,413.1 270.3 195.3 348.6 296.2 141.1 454.4 81.0 35.0 128.0 

20-24 633.1 653.8 611.6 121.0 73.4 170.2 3,841.8 4,376.7 3,321.1 275.3 276.2 274.3 309.5 220.3 402.4 70.2 59.9 80.5 

25-29 

30-34 

35-39 

316.1 

175.7 

112.9 

366.6 

223.1 

159.0 

265.2 

128.4 

67.0 

65.9 56.9 75.0 

40.3 42.9 37.7 

24.7 30.0 19.3 

2,044.9 2,623.9 1,518.7 

1,184.0 1,665.3 761.1 

778.5 1,205.2 402.3 

139.6 

86.0 

58.4 

151.2 

103.9 

75.8 

126.0 

66.0 

39.7 

186.7 159.4 214.8 

138.9 117.4 159.8 

97.8 104.6 91.4 

44.4 52.6 36.7 

1995

23.0 28.6 17.7 

10.5 14.2 7.1 

40-44 66.0 105.9 26.8 12.7 17.9 7.6 491.4 866.9 165.1 34.9 47.4 22.0 46.6 59.9 34.3 7.7 10.1 5.5 

45-54 28.7 50.6 7.6 6.7 10.8 2.8 236.7 462.8 47.3 18.7 29.9 8.0 20.0 26.9 13.5 4.3 6.0 2.9 

55-64 10.9 20.8 1.9 2.4 4.3 0.6 91.7 194.0 12.4 9.3 16.5 2.9 3.6 7.6 0.0 1.8 4.0 0.0 

65+ 3.1 6.3 1.0 0.6 1.2 0.2 32.4 69.3 8.6 2.4 3.2 1.9 4.9 7.8 2.8 2.1 3.2 1.3 

TOTAL 149.5 160.4 139.1 29.6 21.5 37.3 1,045.9 1,230.2 879.4 79.2 80.0 78.3 92.9 70.7 114.3 20.3 18.1 22.3 

10-14 33.2 9.1 58.6 7.5 1.0 14.4 179.8 55.6 307.8 15.8 3.6 28.8 21.7 5.1 38.6 3.3 1.3 5.3 

15-19 543.6 373.6 724.5 125.8 44.7 211.8 2,904.8 2,235.0 3,594.2 222.7 152.1 302.9 329.0 147.7 513.3 64.1 21.5 107.8 

20-24 537.3 532.4 542.6 109.8 67.1 154.3 3,096.2 3,418.2 2,783.0 218.2 200.4 239.9 364.9 238.1 494.4 64.8 53.5 76.2 

25-29 

30-34 

35-39 

260.6 

147.6 

91.0 

297.6 

186.0 

125.4 

223.3 

109.3 

56.7 

57.0 51.1 62.9 

36.1 39.6 32.5 

21.1 25.5 16.6 

1,594.2 2,015.2 1,212.1 

916.4 1,273.3 603.2 

591.8 902.3 319.0 

121.7 

67.9 

45.6 

124.0 

80.5 

53.1 

118.9 

53.2 

37.2 

215.6 174.0 258.9 

143.9 126.0 161.6 

101.3 111.8 91.2 

36.6 39.1 34.3 

1996

22.6 27.5 18.1 

13.8 16.9 10.9 

40-44 54.8 85.3 24.7 11.8 16.4 7.2 380.1 652.5 142.7 28.8 36.4 20.7 57.5 74.6 41.7 8.2 10.5 6.2 

45-54 24.3 42.1 7.2 6.3 9.8 2.7 183.8 354.7 41.0 14.9 22.1 7.7 20.5 22.4 18.8 4.0 5.4 2.8 

55-64 9.0 17.0 1.6 2.2 3.8 0.6 72.2 153.9 9.4 6.0 10.9 1.7 3.4 3.7 3.3 2.1 2.1 2.1 

65+ 3.1 5.6 1.3 0.7 1.2 0.4 28.5 57.4 9.9 4.4 5.5 3.5 1.6 0.0 2.7 1.0 1.6 0.6 

TOTAL 124.0 127.9 120.2 26.1 19.6 32.4 816.8 923.4 720.7 66.0 62.6 69.6 104.8 75.1 133.7 18.0 15.3 20.5 

10-14 30.7 8.5 54.1 7.2 1.0 13.8 162.2 49.6 278.3 15.0 4.4 26.1 23.7 4.1 43.8 3.5 0.9 6.2 

15-19 521.6 348.1 706.2 117.4 39.7 199.7 2,780.0 2,077.3 3,504.3 223.5 142.3 315.6 342.9 150.3 537.2 68.6 31.5 106.5 

20-24 548.4 537.1 560.4 114.0 69.6 160.5 3,124.8 3,404.5 2,852.4 220.2 201.6 242.7 342.6 225.5 461.4 74.5 69.7 79.4 

25-29 

30-34 

35-39 

268.8 

148.7 

92.1 

310.5 

188.5 

126.5 

226.8 

109.0 

57.7 

60.2 52.3 68.0 

37.3 40.9 33.7 

23.8 28.3 19.2 

1,606.8 2,059.4 1,195.3 

897.0 1,255.2 582.7 

577.4 880.4 311.1 

130.4 

74.4 

50.1 

141.0 

88.6 

63.2 

117.5 

57.9 

35.5 

189.8 150.0 231.5 

141.7 129.1 154.2 

72.3 63.4 81.0 

38.1 37.4 38.8 

1997

27.9 37.6 19.0 

12.6 15.3 10.2 

40-44 55.0 86.2 24.1 12.6 17.7 7.6 368.9 636.7 134.4 29.6 40.0 18.4 48.6 47.3 49.7 9.5 12.6 6.8 

45-54 24.7 42.9 7.2 6.0 9.7 2.5 186.3 359.7 41.4 14.6 20.7 8.5 18.5 18.6 18.3 5.2 8.0 2.9 

55-64 9.3 17.4 2.0 2.4 3.8 1.0 73.4 156.1 9.8 6.5 11.6 1.9 7.6 12.6 3.2 1.6 2.7 0.7 

65+ 4.1 6.9 2.2 0.9 1.4 0.5 39.2 70.1 19.3 5.5 9.0 2.9 1.5 3.6 0.0 0.5 0.4 0.6 

TOTAL 123.3 127.0 119.8 26.2 19.7 32.4 802.4 904.5 710.2 67.4 64.9 70.0 99.4 66.4 131.3 19.5 18.1 20.8 

10-14 32.6 8.5 58.0 6.8 0.9 12.9 175.9 49.8 305.8 14.0 4.3 24.3 25.1 4.0 46.9 3.5 0.9 6.3 

15-19 560.6 354.6 779.7 127.3 41.7 218.2 2,950.8 2,075.9 3,851.7 233.2 155.5 320.8 404.4 156.7 654.4 71.4 24.8 119.4 

20-24 609.6 575.1 645.9 126.5 75.8 179.5 3,408.9 3,562.8 3,259.2 258.8 239.9 281.5 419.5 268.7 573.0 85.7 59.1 112.4 

25-29 

30-34 

35-39 

298.1 

157.7 

102.7 

341.5 

198.4 

140.1 

254.4 

117.3 

65.5 

63.9 56.7 71.1 

39.8 44.3 35.3 

25.7 32.0 19.4 

1,759.8 2,223.9 1,337.7 

932.5 1,286.9 622.1 

636.2 951.8 359.5 

146.9 

82.4 

55.9 

157.7 

100.7 

70.9 

133.8 

61.5 

39.4 

243.6 155.0 336.7 

132.5 115.5 149.4 

106.1 93.3 118.5 

45.5 44.4 46.5 

1998

26.3 27.9 24.9 

19.7 24.4 15.2 

40-44 62.1 94.4 30.3 14.4 19.1 9.6 409.6 687.2 168.4 34.3 46.3 21.6 59.2 72.5 46.8 11.8 16.4 7.7 

45-54 28.1 47.9 9.0 6.5 10.1 3.0 208.2 397.6 51.8 18.4 26.4 10.4 27.6 39.2 16.8 4.4 4.9 3.9 

55-64 10.1 18.8 2.1 2.4 4.3 0.6 77.3 162.1 12.6 7.7 12.8 3.3 10.6 13.9 7.7 1.6 2.1 1.2 

65+ 3.6 6.4 1.7 0.9 1.5 0.4 32.1 60.8 13.7 5.1 9.2 2.2 12.5 1.7 20.3 1.7 1.1 2.1 

TOTAL 134.5 135.4 133.7 28.3 21.3 35.0 861.6 943.9 787.6 74.3 73.5 75.2 120.4 77.1 162.2 21.9 17.3 26.2 

NOTE: For the following years, the states listed did not report race/ethnicity for most cases and were excluded: 1994 (Georgia, and New York); 1995 (Georgia, 

New Jersey, and New York); 1996 (New Jersey, and New York); 1997 (Idaho, New Jersey, and New York); 1998 (Idaho and New Jersey). Cases and population denominators have been excluded for these states/areas. Rates for the 0 to 9 year age group are not shown because some of these may not be due to 

sexual transmission; however, these cases are included in the calculation of total rates. 

STD Surveillance 1998 Gonorrhea Tables 83 
Table 13. Gonorrhea — Reported cases and rates by state/area, ranked according to rates: United States and 

outlying areas, 1998 

Rank State/Area Cases Rate per 100,000 Population 

1 Mississippi 10,689 391.5 

2 South Carolina 11,575 307.8 

3 Alabama 12,737 294.9 

4 Louisiana 12,499 287.2 

5 Georgia 20,666 276.1 

6 North Carolina 19,230 259.0 

7 Maryland 11,254 220.9 

8 Tennessee 11,840 220.6 

9 Delaware 1,556 212.7 

10 Illinois 21,735 182.7 

11 Missouri 9,463 175.2 

12 Texas 32,833 168.9 

13 Michigan 16,359 167.4 

14 Ohio 18,275 163.4 

15 Oklahoma 5,243 158.1 

16 Arkansas 3,953 156.7 

17 Virginia 9,265 137.6 

U.S. TOTAL1 355,642 132.9 

18 Florida 19,080 130.2 

19 Wisconsin 6,351 122.9 

20 Indiana 6,307 107.6 

21 New York 19,062 105.1 

22 Kansas 2,622 101.0 

YEAR 2000 OBJECTIVE 100.0 

23 Kentucky 3,813 97.6 

24 New Jersey 7,858 97.6 

25 Pennsylvania 11,719 97.5 

26 Connecticut 3,177 97.2 

27 Arizona 4,213 92.5 

28 Nevada 1,445 86.2 

29 Nebraska 1,204 72.7 

30 California 19,518 60.5 

31 Minnesota 2,708 57.8 

32 Iowa 1,616 56.7 

33 New Mexico 957 55.3 

34 Alaska 331 54.3 

35 Colorado 2,033 52.2 

36 West Virginia 920 50.7 

37 Guam 72 46.1 

38 Rhode Island 430 43.5 

39 Hawaii 506 42.6 

40 Massachusetts 2,258 36.9 

41 Virgin Islands 39 35.6 

42 Washington 1,948 34.7 

43 South Dakota 221 29.9 

44 Oregon 880 27.1 

45 Idaho 182 15.0 

46 North Dakota 80 12.5 

47 Utah 236 11.5 

48 Puerto Rico 400 10.5 

49 New Hampshire 91 7.8 

50 Wyoming 36 7.5 

51 Vermont 38 6.5 

52 Montana 55 6.3 

53 Maine 67 5.4 

1

Includes cases reported by Washington, D.C., but excludes outlying areas (Guam, Puerto Rico and Virgin Islands). 

84 Gonorrhea Tables STD Surveillance 1998 
Table 14. Gonorrhea — Reported cases and rates by state/area and region: United States and outlying areas, 

1994–1998* 

Cases Rates per 100,000 Population 

State/Area 1994 1995 1996 1997 1998 1994 1995 1996 1997 1998 

Alabama 15,881 14,683 13,169 12,031 12,737 376.4 345.2 307.2 278.5 294.9 

Alaska 918 660 466 391 331 151.7 109.3 77.0 64.2 54.3 

Arizona 3,603 3,844 3,709 3,802 4,213 88.4 91.1 83.6 83.5 92.5 

Arkansas 6,892 5,630 5,056 4,382 3,953 281.0 226.7 201.7 173.7 156.7 

California 29,102 24,606 18,674 17,979 19,518 92.6 77.9 58.6 55.7 60.5 

Colorado 3,632 2,803 2,021 2,315 2,033 99.4 74.8 53.0 59.5 52.2 

Connecticut 4,767 4,055 3,388 3,154 3,177 145.5 123.8 103.7 96.5 97.2 

Delaware 2,038 2,201 1,456 1,273 1,556 287.3 306.9 201.3 174.0 212.7 

Florida 24,367 20,874 19,181 19,079 19,080 174.7 147.4 133.0 130.2 130.2 

Georgia NR 21,025 19,806 18,471 20,666 . 292.0 270.0 246.7 276.1 

Hawaii 700 563 497 510 506 59.4 47.4 42.0 43.0 42.6 

Idaho 98 149 98 158 182 8.6 12.8 8.3 13.1 15.0 

Illinois 26,571 21,747 17,964 18,423 21,735 226.1 183.8 151.7 154.9 182.7 

Indiana 9,757 8,880 6,638 6,155 6,307 169.6 153.0 113.9 105.0 107.6 

Iowa 1,645 1,723 1,145 1,311 1,616 58.1 60.6 40.2 46.0 56.7 

Kansas 3,673 2,797 2,044 2,075 2,622 143.8 109.0 79.3 80.0 101.0 

Kentucky 5,127 4,751 4,229 4,027 3,813 134.0 123.1 108.9 103.0 97.6 

Louisiana 11,992 9,292 9,315 10,782 12,499 277.9 214.0 214.6 247.8 287.2 

Maine 93 94 55 66 67 7.5 7.6 4.4 5.3 5.4 

Maryland 15,137 12,984 11,592 11,568 11,254 302.6 257.5 229.1 227.1 220.9 

Massachusetts 3,159 2,658 2,189 2,225 2,258 52.3 43.8 36.0 36.4 36.9 

Michigan 18,215 18,220 15,130 15,736 16,359 191.8 190.8 155.5 161.0 167.4 

Minnesota 3,346 2,852 2,697 2,417 2,708 73.3 61.9 58.0 51.6 57.8 

Mississippi 11,455 9,511 6,988 9,367 10,689 429.1 352.6 257.8 343.1 391.5 

Missouri 12,557 11,326 8,421 7,658 9,463 237.9 212.8 157.0 141.8 175.2 

Montana 85 65 38 66 55 9.9 7.5 4.3 7.5 6.3 

Nebraska 1,335 1,133 1,164 1,210 1,204 82.2 69.2 70.6 73.0 72.7 

Nevada 1,736 1,237 1,025 829 1,445 119.1 80.8 64.0 49.4 86.2 

New Hampshire 103 118 153 96 91 9.1 10.3 13.2 8.2 7.8 

New Jersey 5,269 5,783 8,721 7,566 7,858 66.7 72.8 109.0 94.0 97.6 

New Mexico 1,130 1,054 890 857 957 68.3 62.5 52.0 49.5 55.3 

New York 30,997 25,992 20,604 22,393 19,062 170.6 143.3 113.6 123.5 105.1 

North Carolina 28,936 23,961 18,229 16,888 19,230 409.3 333.0 249.4 227.4 259.0 

North Dakota 35 38 37 68 80 5.5 5.9 5.8 10.6 12.5 

Ohio 24,746 23,176 14,946 14,961 18,275 222.9 207.8 133.9 133.7 163.4 

Oklahoma 4,888 5,077 4,897 4,760 5,243 150.0 154.9 148.6 143.5 158.1 

Oregon 978 854 887 773 880 31.7 27.2 27.8 23.8 27.1 

Pennsylvania 13,184 13,038 10,803 9,967 11,719 109.4 108.0 89.7 82.9 97.5 

Rhode Island 478 545 486 422 430 48.0 55.1 49.2 42.7 43.5 

South Carolina 13,067 12,120 11,661 11,487 11,575 356.6 330.0 313.8 305.5 307.8 

South Dakota 243 237 176 172 221 33.6 32.5 23.9 23.3 29.9 

Tennessee 15,745 13,892 11,709 11,023 11,840 304.2 264.3 220.6 205.3 220.6 

Texas 29,757 30,801 23,124 26,612 32,833 161.9 164.5 121.1 136.9 168.9 

Utah 303 306 277 278 236 15.9 15.7 13.7 13.5 11.5 

Vermont 40 69 47 53 38 6.9 11.8 8.0 9.0 6.5 

Virginia 13,414 10,340 9,293 8,888 9,265 204.8 156.2 139.4 132.0 137.6 

Washington 2,893 2,765 2,020 1,956 1,948 54.1 50.9 36.6 34.9 34.7 

West Virginia 805 860 736 957 920 44.2 47.0 40.4 52.7 50.7 

Wisconsin 7,776 5,524 4,481 4,316 6,351 153.0 107.8 87.1 83.5 122.9 

Wyoming 82 51 41 54 36 17.2 10.6 8.5 11.3 7.5 

U.S. TOTAL1 419,577 392,651 326,805 326,564 355,642 165.7 149.4 123.2 122.0 132.9 

Northeast 58,090 52,352 46,446 45,942 44,700 113.0 101.7 90.2 89.1 86.6 

Midwest 109,899 97,653 74,843 74,502 86,941 179.0 158.0 120.4 119.3 139.2 

South 206,328 203,689 174,873 176,152 191,661 246.7 221.7 188.0 187.0 203.5 

West 45,260 38,957 30,643 29,968 32,340 79.6 67.6 52.4 50.5 54.4 

Guam 110 90 56 47 72 75.4 60.3 36.7 30.1 46.1 

Puerto Rico 500 618 648 526 400 13.7 16.7 17.4 13.7 10.5 

Virgin Islands 60 31 12 40 39 55.5 28.3 10.9 36.5 35.6 

OUTLYING AREAS 670 739 716 613 511 17.1 18.7 18.0 15.0 12.5 

TOTAL 420,247 393,390 327,521 327,177 356,153 163.4 147.5 121.7 120.4 131.1 

*NR = No report (see Appendix). 

1

Includes cases reported by Washington, D.C. 

STD Surveillance 1998 Gonorrhea Tables 85 
Table 15. Gonorrhea — Women – Reported cases and rates by state/area: United States and outlying areas, 

1994–1998* 

Cases Rates per 100,000 Population 

State/Area 1994 1995 1996 1997 1998 1994 1995 1996 1997 1998 

Alabama 6,816 6,938 6,730 5,984 6,313 310.5 313.6 302.3 266.9 281.5 

Alaska 431 318 242 230 181 150.6 111.4 84.4 79.6 62.6 

Arizona 1,601 1,700 1,690 1,625 1,730 77.7 79.7 75.5 70.8 75.3 

Arkansas 3,316 2,592 2,506 2,071 1,919 261.2 201.7 193.7 159.2 147.5 

California 13,429 11,349 8,847 8,462 9,300 85.5 71.9 55.6 52.5 57.7 

Colorado 1,765 1,401 1,028 1,224 1,055 95.7 74.1 53.4 62.4 53.8 

Connecticut 2,439 2,075 1,815 1,642 1,714 144.5 122.9 108.1 97.7 102.0 

Delaware 1,074 1,171 799 705 855 294.8 318.1 215.4 188.0 228.0 

Florida 11,144 9,439 9,409 9,513 8,923 154.9 129.2 126.9 126.3 118.5 

Georgia NR 9,995 9,806 9,532 10,056 . 270.2 260.7 248.5 262.2 

Hawaii 369 290 244 264 278 63.4 49.4 41.6 44.8 47.1 

Idaho 53 68 53 83 74 9.3 11.7 8.9 13.7 12.2 

Illinois 13,199 11,027 9,112 6,765 11,250 218.7 181.6 150.3 111.2 184.9 

Indiana 4,485 4,143 3,305 3,141 3,308 151.6 138.9 110.6 104.5 110.1 

Iowa 864 950 666 762 895 59.4 65.1 45.6 52.2 61.3 

Kansas 1,968 1,528 1,084 1,133 1,454 151.6 117.2 82.8 86.0 110.4 

Kentucky 2,229 2,259 2,013 1,882 1,866 113.0 113.6 100.9 93.7 92.9 

Louisiana 4,838 4,003 3,923 5,202 6,143 216.1 177.6 174.4 230.7 272.5 

Maine 58 56 27 31 31 9.1 8.8 4.3 4.9 4.9 

Maryland 7,644 6,323 5,692 5,767 5,391 297.1 243.9 219.2 220.6 206.3 

Massachusetts 1,562 1,231 1,146 1,151 1,155 49.8 39.1 36.4 36.4 36.5 

Michigan 8,319 8,117 7,780 7,969 8,265 170.5 165.5 155.9 159.1 165.0 

Minnesota 1,683 1,488 1,383 1,307 1,443 72.5 63.6 58.7 55.1 60.8 

Mississippi 6,003 5,218 3,681 5,188 5,973 431.7 371.5 261.3 365.7 421.1 

Missouri 5,876 5,315 4,193 4,113 4,924 215.3 193.2 151.7 147.9 177.1 

Montana 44 27 19 31 33 10.2 6.2 4.3 7.0 7.5 

Nebraska 700 600 604 670 683 84.3 71.7 71.8 79.3 80.9 

Nevada 630 448 362 317 591 88.1 59.6 46.1 38.6 71.9 

New Hampshire 50 70 95 57 47 8.6 12.0 16.1 9.6 7.9 

New Jersey 2,263 2,706 3,743 3,564 3,763 55.5 66.0 90.8 86.0 90.8 

New Mexico 646 583 459 509 530 77.0 68.2 52.9 58.0 60.4 

New York 16,470 13,999 10,952 12,833 10,586 174.5 148.7 116.5 136.6 112.7 

North Carolina 13,039 11,101 8,482 7,844 9,129 358.3 299.7 225.8 205.6 239.3 

North Dakota 13 15 18 42 56 4.1 4.7 5.6 13.1 17.4 

Ohio 12,774 11,978 8,161 8,349 10,117 222.4 207.8 141.7 144.8 175.4 

Oklahoma 2,512 2,764 2,610 2,418 2,932 150.5 164.7 155.1 142.8 173.1 

Oregon 438 387 418 348 430 28.0 24.3 25.9 21.2 26.2 

Pennsylvania 6,452 6,805 5,730 5,396 6,472 103.0 108.5 91.8 86.6 103.9 

Rhode Island 241 274 245 263 258 46.5 53.3 47.8 51.4 50.4 

South Carolina 4,486 4,597 4,807 5,128 5,730 236.9 241.9 250.2 263.9 294.9 

South Dakota 116 117 94 87 124 31.6 31.6 25.1 23.3 33.1 

Tennessee 6,780 6,197 5,106 4,940 5,263 252.9 227.7 186.3 178.2 189.8 

Texas 13,670 15,008 11,933 13,797 16,704 146.7 158.2 123.6 140.4 170.0 

Utah 127 121 95 84 70 13.2 12.3 9.4 8.1 6.8 

Vermont 24 43 23 32 22 8.1 14.5 7.7 10.7 7.4 

Virginia 6,025 4,886 4,495 4,290 4,543 180.2 144.6 132.2 124.9 132.2 

Washington 1,370 1,301 929 965 863 50.9 47.6 33.5 34.3 30.7 

West Virginia 429 459 363 512 549 45.4 48.4 38.5 54.5 58.5 

Wisconsin 3,892 2,713 2,343 2,344 3,733 150.3 104.0 89.6 89.3 142.2 

Wyoming 44 30 25 30 23 18.6 12.6 10.5 12.6 9.7 

U.S. TOTAL1 197,218 188,460 161,126 162,515 179,651 152.1 140.2 119.0 119.0 131.5 

Guam 58 49 30 12 25 84.6 69.9 41.8 16.3 34.0 

Puerto Rico 138 205 219 212 163 7.3 10.7 11.4 10.7 8.2 

Virgin Islands 27 14 4 19 16 48.0 24.5 7.0 33.3 28.1 

OUTLYING AREAS 223 268 253 243 204 11.1 13.2 12.3 11.5 9.6 

TOTAL 197,441 188,728 161,379 162,758 179,855 150.0 138.3 117.4 117.3 129.6 

*NR = No report (see Appendix).
 

1

Includes cases reported by Washington, D.C.
 

NOTE: Cases and rates underestimated in some areas because of under-reporting or non-reporting by gender.
 

86 Gonorrhea Tables STD Surveillance 1998 
Table 16. Gonorrhea — Men – Reported cases and rates by state/area: United States and outlying areas, 

1994–1998* 

Cases Rates per 100,000 Population 

State/Area 1994 1995 1996 1997 1998 1994 1995 1996 1997 1998 

Alabama 8,943 7,698 6,409 6,022 6,411 442.0 377.2 311.0 290.0 308.7 

Alaska 487 342 224 161 150 152.6 107.5 70.4 50.3 46.8 

Arizona 2,002 2,144 2,019 2,177 2,483 99.4 102.8 91.9 96.4 109.9 

Arkansas 3,576 3,031 2,536 2,295 2,029 302.3 252.9 209.1 187.9 166.1 

California 15,501 13,121 9,729 9,452 10,165 98.6 83.1 61.0 58.5 62.9 

Colorado 1,867 1,402 992 1,091 978 103.1 75.5 52.4 56.5 50.6 

Connecticut 2,328 1,980 1,573 1,512 1,463 146.7 124.8 99.1 95.1 92.0 

Delaware 964 1,030 657 568 701 279.4 295.1 186.4 159.3 196.6 

Florida 13,223 11,435 9,772 9,566 10,054 195.7 166.6 139.5 134.3 141.1 

Georgia NR 11,030 10,000 8,916 10,525 . 315.0 279.8 244.2 288.3 

Hawaii 331 273 253 246 228 55.5 45.5 42.4 41.2 38.2 

Idaho 45 81 45 75 108 8.0 14.0 7.6 12.4 17.8 

Illinois 13,371 10,720 8,852 11,658 10,485 233.9 186.2 153.1 200.6 180.4 

Indiana 5,272 4,737 3,331 3,006 2,991 188.7 168.0 117.3 105.1 104.6 

Iowa 781 773 479 549 721 56.8 55.9 34.5 39.4 51.8 

Kansas 1,705 1,269 960 942 1,168 135.8 100.6 75.6 73.7 91.4 

Kentucky 2,898 2,492 2,216 2,137 1,887 156.3 133.2 117.5 112.5 99.3 

Louisiana 7,154 5,289 5,392 5,580 6,356 344.6 253.3 257.8 266.1 303.1 

Maine 35 38 28 35 36 5.8 6.3 4.6 5.8 5.9 

Maryland 7,493 6,661 5,897 5,801 5,846 308.5 271.9 239.4 233.9 235.7 

Massachusetts 1,597 1,427 1,043 1,074 1,103 54.9 48.8 35.5 36.4 37.3 

Michigan 9,896 10,103 7,350 7,767 8,094 214.3 217.5 155.0 163.0 169.9 

Minnesota 1,663 1,364 1,314 1,110 1,265 74.0 60.1 57.3 48.0 54.7 

Mississippi 5,452 4,284 3,266 4,049 4,653 426.3 331.4 250.9 308.6 354.7 

Missouri 6,681 6,011 4,228 3,545 4,539 262.1 233.6 162.6 135.2 173.2 

Montana 41 38 19 35 22 9.6 8.8 4.3 8.0 5.0 

Nebraska 619 532 551 537 520 78.1 66.5 68.2 66.1 64.0 

Nevada 1,106 789 663 512 854 149.1 101.3 81.2 59.9 99.9 

New Hampshire 53 48 58 39 44 9.5 8.5 10.2 6.7 7.6 

New Jersey 3,006 3,077 4,972 3,999 4,094 78.6 80.0 128.1 102.3 104.8 

New Mexico 484 471 431 348 427 59.4 56.7 51.1 40.8 50.1 

New York 14,527 11,993 9,652 9,560 8,476 166.3 137.5 110.5 109.3 96.9 

North Carolina 15,897 12,860 9,747 9,044 10,101 463.6 368.5 274.4 250.5 279.7 

North Dakota 22 23 19 26 24 6.9 7.2 5.9 8.1 7.5 

Ohio 11,972 10,940 6,672 6,506 8,023 223.4 203.1 123.5 120.1 148.1 

Oklahoma 2,366 2,313 2,287 2,342 2,311 148.9 144.6 141.9 144.3 142.4 

Oregon 540 467 469 425 450 35.5 30.2 29.7 26.5 28.0 

Pennsylvania 6,732 6,233 5,073 4,571 5,247 116.3 107.5 87.5 79.0 90.6 

Rhode Island 237 271 241 159 172 49.5 57.0 50.7 33.4 36.2 

South Carolina 8,382 7,388 6,828 6,340 5,769 473.5 416.7 380.2 349.0 317.5 

South Dakota 127 120 82 85 97 35.6 33.4 22.6 23.4 26.7 

Tennessee 8,965 7,695 6,603 6,083 6,577 359.4 303.6 257.3 234.4 253.4 

Texas 16,087 15,793 11,191 12,815 15,995 177.6 171.0 118.6 133.3 166.4 

Utah 176 185 182 194 166 18.5 19.1 18.1 18.9 16.2 

Vermont 16 26 24 21 16 5.6 9.0 8.3 7.2 5.5 

Virginia 7,349 5,414 4,783 4,590 4,720 229.1 167.1 146.4 139.2 143.1 

Washington 1,523 1,464 1,091 991 1,085 57.4 54.3 39.7 35.4 38.8 

West Virginia 376 401 373 445 369 42.9 45.5 42.5 50.8 42.1 

Wisconsin 3,884 2,811 2,138 1,972 2,618 155.9 111.8 84.5 77.5 102.9 

Wyoming 38 21 16 24 13 15.9 8.7 6.6 9.9 5.4 

U.S. TOTAL1 221,799 203,557 165,321 163,634 175,233 179.4 158.7 127.4 124.9 133.7 

Guam 52 41 26 35 47 67.3 51.8 32.1 42.3 56.8 

Puerto Rico 362 413 429 314 237 20.5 23.2 23.9 17.1 12.9 

Virgin Islands 33 17 8 21 23 63.5 32.3 15.2 39.9 43.7 

OUTLYING AREAS 447 471 463 370 307 23.6 24.6 24.0 18.8 15.6 

TOTAL 222,246 204,028 165,784 164,004 175,540 177.0 156.7 125.9 123.3 132.0 

*NR = No report (see Appendix).
 

1

Includes cases reported by Washington, D.C.
 

NOTE: Cases and rates underestimated in some areas because of under-reporting or non-reporting by gender.
 

STD Surveillance 1998 Gonorrhea Tables 87 
10

20

30

40

50

60

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

to rates: United States and outlying areas, 1998 

Rank City Cases Rate per 100,000 Population 

1 St Louis, MO 3,652 1,068.2 

2 Baltimore, MD 6,989 1,063.4 

3 Washington, DC 4,508 852.2 

4 Rochester, NY 1,992 826.0 

5 Richmond, VA 1,527 793.7 

6 Detroit, MI 8,459 776.7 

7 Atlanta, GA 5,599 774.9 

8 Newark, NJ 1,781 625.9 

9 Norfolk, VA 1,415 616.9 

Memphis, TN 5,235 604.5 

11 New Orleans, LA 2,691 573.7 

12 Kansas City, MO 2,538 567.7 

13 Milwaukee, WI 5,080 558.9 

14 Philadelphia, PA 7,271 501.0 

15 Birmingham, AL 3,172 481.6 

16 Chicago, IL 13,959 479.0 

17 Cincinnati, OH 3,583 420.7 

18 Minneapolis, MN 1,562 407.5 

19 Indianapolis, IN 3,071 377.4 

Dallas, TX 7,421 366.8 

21 Oklahoma City, OK 1,571 356.5 

22 Buffalo, NY 1,108 346.1 

23 Tulsa, OK 1,308 339.0 

24 Jacksonville, FL 2,463 336.2 

25 Nashville, TN 1,777 333.0 

26 Charlotte, NC 1,911 311.6 

27 Columbus, OH 3,082 303.0 

28 Austin, TX 1,803 259.9 

29 San Francisco, CA 1,858 253.7 

Fort Worth, TX 3,310 249.4 

31 Houston, TX 7,226 228.8 

32 Jersey City, NJ 491 225.4 

33 Cleveland, OH 3,030 218.5 

34 Louisville, KY 1,462 218.0 

35 Omaha, NE 871 197.5 

36 Denver, CO 973 195.0 

37 Dayton, OH 1,092 194.5 

38 St Paul, MN 519 188.0 

39 Tampa, FL 1,696 186.5 

Boston, MA 982 176.2 

41 St Petersburg, FL 1,468 168.4 

42 New York City, NY 12,097 164.8 

43 Akron, OH 823 154.8 

44 Toledo, OH 655 145.1 

45 Corpus Christi, TX 449 141.4 

46 San Antonio, TX 1,862 139.7 

47 Oakland, CA 1,742 139.0 

48 Sacramento, CA 1,546 137.3 

49 Phoenix, AZ 3,543 131.4 

Miami, FL 2,573 125.8 

51 Albuquerque, NM 570 108.3 

52 Portland, OR 527 106.9 

53 Wichita, KS 466 106.2 

54 Pittsburgh, PA 1,351 105.5 

55 Des Moines, IA 371 104.7 

YEAR 2000 OBJECTIVE 100.0 

56 Los Angeles, CA 5,914 69.1 

57 Seattle, WA 975 59.7 

58 San Diego, CA 1,595 58.6 

59 Honolulu, HI 481 55.3 

Yonkers, NY 105 54.5 

61 Tucson, AZ 403 51.7 

62 El Paso, TX 252 35.9 

63 San Jose, CA 453 28.2 

64 San Juan, PR 227 26.0 

88 Gonorrhea Tables STD Surveillance 1998 
Table 18. Gonorrhea — Reported cases and rates in selected cities of >200,000 population: United States and 

outlying areas, 1994–1998* 

Cases 

City 1994 1995 1996 1997 1998
 

Akron, OH 1,285 

Albuquerque, NM 759 

Atlanta, GA NR 

Austin, TX 1,349 

Baltimore, MD 9,099 

Birmingham, AL 5,309 

Boston, MA 1,199 

Buffalo, NY 1,768 

Charlotte, NC 4,137 

Chicago, IL 16,868 

Cincinnati, OH 2,822 

Cleveland, OH 6,580 

Columbus, OH 4,009 

Corpus Christi, TX 344 

Dallas, TX 6,170 

Dayton, OH 1,925 

Denver, CO 1,735 

Des Moines, IA 431 

Detroit, MI 8,637 

El Paso, TX 171 

Fort Worth, TX 2,752 

Honolulu, HI 675 

Houston, TX 7,429 

Indianapolis, IN 5,430 

Jacksonville, FL 3,555 

Jersey City, NJ 298 

Kansas City, MO 2,997 

Los Angeles, CA 9,143 

Louisville, KY 2,637 

Memphis, TN 6,973 

Miami, FL 2,857 

Milwaukee, WI 6,284 

Minneapolis, MN 1,933 

Nashville, TN 3,110 

New Orleans, LA 4,056 

New York City, NY 19,491 

Newark, NJ 1,464 

Norfolk, VA 2,519 

Oakland, CA 2,427 

Oklahoma City, OK 1,763 

Omaha, NE 1,060 

Philadelphia, PA 8,026 

Phoenix, AZ 2,797 

Pittsburgh, PA 2,602 

Portland, OR 706 

Richmond, VA 2,621 

Rochester, NY 2,876 

Sacramento, CA 1,805 

San Antonio, TX 1,738 

San Diego, CA 2,656 

San Francisco, CA 1,885 

San Jose, CA 773 

Seattle, WA 1,213 

St Louis, MO 5,228 

St Paul, MN 656 

St Petersburg, FL 1,787 

Tampa, FL 2,181 

Toledo, OH 2,262 

Tucson, AZ 439 

Tulsa, OK 1,444 

Washington, DC 6,827 

Wichita, KS 1,078 

Yonkers, NY 131 

1,043
 

625
 

7,330
 

1,600
 

6,928
 

4,321
 

917
 

1,691
 

2,146
 

12,586
 

2,590
 

5,746
 

2,887
 

373
 

8,027
 

1,603
 

1,375
 

362
 

8,553
 

159
 

2,442
 

543
 

6,984
 

4,709
 

2,476
 

223
 

3,186
 

7,935
 

2,441
 

6,108
 

2,338
 

4,160
 

1,689
 

2,622
 

3,353
 

16,499
 

2,222
 

1,679
 

2,195
 

2,028
 

880
 

6,565
 

3,149
 

1,598
 

543
 

2,371
 

2,210
 

1,828
 

1,914
 

2,176
 

1,853
 

492
 

1,295
 

4,425
 

560
 

1,545
 

1,833
 

944
 

359
 

1,452
 

5,687
 

713
 

121
 

646
 

560
 

5,211
 

1,363
 

6,495
 

3,239
 

821
 

1,284
 

1,823
 

11,383
 

1,442
 

3,362
 

1,480
 

367
 

5,795
 

954
 

992
 

310
 

7,048
 

157
 

1,331
 

457
 

5,999
 

3,178
 

2,352
 

371
 

2,401
 

5,716
 

2,059
 

5,242
 

2,317
 

3,528
 

1,548
 

2,033
 

3,013
 

12,998
 

2,710
 

1,451
 

1,714
 

1,986
 

612
 

6,415
 

2,906
 

1,058
 

564
 

1,737
 

2,126
 

1,393
 

1,349
 

1,815
 

1,626
 

481
 

925
 

2,890
 

597
 

1,165
 

1,574
 

419
 

518
 

1,284
 

4,432
 

585
 

98
 

669
 

544
 

5,468
 

1,531
 

6,693
 

3,104
 

939
 

1,172
 

1,703
 

11,498
 

2,552
 

2,743
 

2,218
 

351
 

6,645
 

1,070
 

1,140
 

330
 

7,518
 

155
 

1,759
 

484
 

6,606
 

2,912
 

2,089
 

373
 

1,872
 

5,810
 

1,817
 

4,876
 

2,168
 

3,303
 

1,430
 

2,050
 

2,743
 

15,592
 

1,967
 

1,466
 

1,559
 

982
 

813
 

6,504
 

3,007
 

1,026
 

478
 

1,465
 

1,867
 

1,380
 

1,751
 

1,509
 

1,510
 

471
 

918
 

2,806
 

383
 

1,201
 

2,246
 

346
 

575
 

618
 

4,557
 

614
 

79
 

823
 

570
 

5,599
 

1,803
 

6,989
 

3,172
 

982
 

1,108
 

1,911
 

13,959
 

3,583
 

3,030
 

3,082
 

449
 

7,421
 

1,092
 

973
 

371
 

8,459
 

252
 

3,310
 

481
 

7,226
 

3,071
 

2,463
 

491
 

2,538
 

5,914
 

1,462
 

5,235
 

2,573
 

5,080
 

1,562
 

1,777
 

2,691
 

12,097
 

1,781
 

1,415
 

1,742
 

1,571
 

871
 

7,271
 

3,543
 

1,351
 

527
 

1,527
 

1,992
 

1,546
 

1,862
 

1,595
 

1,858
 

453
 

975
 

3,652
 

519
 

1,468
 

1,696
 

655
 

403
 

1,308
 

4,508
 

466
 

105
 

U.S. CITY TOTAL 215,181 191,207 153,705 156,025 170,259 

San Juan, PR 256 349 343 233 227
 

TOTAL 215,437 191,556 154,048 156,258 170,486 

Rates per 100,000 Population 

1994 1995 1996 1997 1998
 

243.4 

147.2 

. 

208.7 

1,294.3 

808.5 

218.4 

539.0 

733.9 

571.6 

325.2 

468.9 

398.8 

110.7 

317.7 

336.5 

351.5 

124.6 

817.0 

25.7 

218.9 

77.2 

244.0 

663.8 

505.3 

136.6 

684.3 

106.8 

392.2 

813.1 

141.1 

669.9 

505.5 

589.9 

837.8 

265.8 

504.7 

1,043.4 

201.2 

404.4 

246.3 

526.6 

119.2 

197.0 

146.3 

1,300.9 

1,177.5 

164.4 

135.8 

100.9 

256.6 

49.6 

76.4 

1,419.8 

238.1 

206.1 

249.5 

494.3 

60.0 

382.3 

1,203.9 

257.1 

68.5 

196.7 121.9 125.8 154.8 

119.7 106.6 103.4 108.3 

1,046.1 729.2 756.8 774.9 

240.7 199.9 220.7 259.9 

1,002.4 966.9 1,018.3 1,063.4 

656.9 490.0 471.3 481.6 

165.0 147.2 168.5 176.2 

518.5 397.7 366.0 346.1 

370.3 305.8 277.7 311.6 

426.9 389.9 394.6 479.0 

299.8 168.5 299.7 420.7 

411.0 240.6 197.8 218.5 

285.6 146.2 218.0 303.0 

119.3 116.6 110.6 141.4 

409.7 290.6 328.4 366.8 

281.0 168.7 190.6 194.5 

278.1 199.8 228.5 195.0 

103.6 87.8 93.2 104.7 

812.7 644.1 690.3 776.7 

23.4 22.9 22.1 35.9 

191.0 102.4 132.5 249.4 

61.9 52.6 55.6 55.3 

227.0 192.6 209.2 228.8 

575.9 390.0 357.9 377.4 

352.9 324.4 285.1 336.2 

102.6 171.0 171.2 225.4 

726.4 539.2 418.7 567.7 

92.8 67.2 67.9 69.1 

362.7 307.0 270.9 218.0 

706.1 606.0 563.1 604.5 

115.1 113.7 106.0 125.8 

446.7 384.2 363.4 558.9 

440.5 403.7 373.0 407.5 

494.0 381.6 384.1 333.0 

695.8 635.4 584.8 573.7 

225.6 177.2 212.3 164.8 

772.8 948.7 691.2 625.9 

706.7 623.7 639.1 616.9 

181.5 138.5 124.4 139.0 

464.0 452.6 222.9 356.5 

202.7 139.7 184.4 197.5 

438.0 435.4 448.1 501.0 

129.5 111.2 111.5 131.4 

122.0 81.9 80.1 105.5 

112.1 115.1 97.0 106.9 

1,195.8 909.6 761.5 793.7 

909.5 879.2 774.1 826.0 

165.7 125.0 122.6 137.3 

147.6 102.7 131.4 139.7 

82.3 67.8 55.4 58.6 

253.6 222.8 206.2 253.7 

31.4 30.3 29.3 28.2 

81.2 57.3 56.2 59.7 

1,233.6 827.4 820.8 1,068.2 

203.8 216.8 138.7 188.0 

177.4 134.2 137.8 168.4 

207.2 175.9 247.0 186.5 

207.5 92.7 76.7 145.1 

47.7 67.5 73.7 51.7 

384.0 336.6 160.2 339.0 

1,026.1 821.8 861.5 852.2 

170.0 135.2 140.0 106.2 

63.2 51.1 41.0 54.5 

316.5 277.6 221.9 223.9 244.4 

29.4 40.0 39.3 26.7 26.0 

312.9 274.6 219.6 221.5 241.7 

*NR = No report (see Appendix). 

STD Surveillance 1998 Gonorrhea Tables 89
 
Table 19. Gonorrhea — Women – Reported cases and rates in selected cities of >200,000 population: 

United States and outlying areas, 1994-1998* 

Cases 

City 1994 1995 1996 1997 1998 

Akron, OH 761 

Albuquerque, NM 418 

Atlanta, GA NR 

Austin, TX 705 

Baltimore, MD 4,592 

Birmingham, AL 2,423 

Boston, MA 585 

Buffalo, NY 1,029 

Charlotte, NC 1,578 

Chicago, IL 8,430 

Cincinnati, OH 1,253 

Cleveland, OH 3,323 

Columbus, OH 2,085 

Corpus Christi, TX 139 

Dallas, TX 2,631 

Dayton, OH 1,083 

Denver, CO 827 

Des Moines, IA 210 

Detroit, MI 3,290 

El Paso, TX 93 

Fort Worth, TX 1,371 

Honolulu, HI 353 

Houston, TX 2,813 

Indianapolis, IN 2,565 

Jacksonville, FL 1,399 

Jersey City, NJ 108 

Kansas City, MO 1,465 

Los Angeles, CA 3,987 

Louisville, KY 1,057 

Memphis, TN 2,904 

Miami, FL 937 

Milwaukee, WI 3,266 

Minneapolis, MN 877 

Nashville, TN 1,222 

New Orleans, LA 1,262 

New York City, NY 10,383 

Newark, NJ 458 

Norfolk, VA 1,004 

Oakland, CA 1,298 

Oklahoma City, OK 946 

Omaha, NE 553 

Philadelphia, PA 3,809 

Phoenix, AZ 1,171 

Pittsburgh, PA 1,335 

Portland, OR 311 

Richmond, VA 1,015 

Rochester, NY 1,565 

Sacramento, CA 964 

San Antonio, TX 866 

San Diego, CA 999 

San Francisco, CA 697 

San Jose, CA 379 

Seattle, WA 541 

St Louis, MO 2,206 

St Paul, MN 354 

St Petersburg, FL 875 

Tampa, FL 986 

Toledo, OH 1,071 

Tucson, AZ 229 

Tulsa, OK 668 

Washington, DC 2,818 

Wichita, KS 555 

Yonkers, NY 69 

600 

324 

3,426 

815 

3,065 

2,145 

432 

984 

823 

6,507 

1,268 

2,856 

1,498 

192 

3,758 

876 

646 

181 

3,080 

72 

1,239 

284 

2,976 

2,186 

1,025 

100 

1,556 

3,361 

1,039 

2,711 

767 

1,954 

808 

1,035 

1,088 

8,792 

994 

722 

1,316 

1,115 

462 

3,330 

1,325 

875 

243 

1,067 

1,219 

1,013 

998 

834 

598 

285 

533 

1,897 

298 

706 

830 

466 

194 

715 

2,237 

394 

62 

366 

261 

2,437 

714 

3,054 

1,668 

405 

772 

737 

5,710 

1,007 

1,881 

797 

192 

3,121 

458 

474 

169 

3,312 

75 

748 

223 

2,636 

1,550 

1,129 

175 

1,212 

2,612 

889 

2,303 

1,048 

1,832 

740 

779 

1,216 

6,788 

998 

614 

1,004 

1,010 

314 

3,387 

1,243 

574 

272 

817 

1,107 

736 

708 

883 

390 

254 

349 

1,302 

314 

619 

752 

221 

283 

670 

1,841 

301 

54 

356 

306 

2,544 

860 

3,279 

1,567 

445 

720 

644 

3,087 

1,515 

1,573 

1,214 

163 

3,319 

502 

577 

160 

3,583 

76 

1,014 

252 

3,082 

1,401 

1,009 

204 

1,072 

2,645 

745 

2,175 

987 

1,707 

737 

845 

1,226 

9,101 

848 

636 

901 

503 

456 

3,507 

1,209 

543 

203 

650 

959 

765 

955 

660 

298 

205 

403 

1,409 

203 

648 

1,214 

162 

285 

299 

1,919 

321 

35 

435 

308 

2,462 

894 

3,258 

1,555 

477 

682 

830 

7,022 

2,044 

1,672 

1,584 

181 

3,591 

490 

463 

189 

4,147 

123 

1,743 

262 

3,285 

1,532 

898 

231 

1,382 

2,747 

624 

2,259 

1,053 

2,982 

806 

718 

1,158 

6,791 

794 

593 

987 

839 

494 

3,938 

1,415 

788 

246 

752 

1,031 

869 

1,012 

688 

402 

224 

324 

1,685 

278 

738 

886 

350 

175 

728 

1,904 

243 

55 

U.S. CITY TOTAL 99,166 89,197 74,507 74,888 83,316 

San Juan, PR 52 102 102 83 85 

TOTAL 99,218 89,299 74,609 74,971 83,401 

Rates per 100,000 Population 

1994 1995 1996 1997 1998 

276.9 

158.5 

. 

218.2 

1,224.2 

692.7 

205.3 

600.3 

539.6 

550.4 

274.3 

446.9 

400.6 

87.5 

267.0 

363.6 

326.1 

116.3 

591.6 

27.1 

216.0 

81.8 

183.9 

597.8 

388.0 

95.9 

638.7 

92.6 

297.7 

646.7 

88.7 

662.8 

445.3 

441.5 

486.1 

267.3 

299.5 

879.2 

211.4 

418.2 

248.3 

466.9 

98.5 

190.5 

125.7 

924.2 

1,234.9 

172.1 

131.3 

77.1 

188.9 

49.3 

67.2 

1,100.6 

246.4 

189.4 

219.9 

448.0 

61.3 

341.7 

931.6 

259.7 

68.9 

217.5 132.9 128.9 157.6 

121.3 97.2 113.7 114.5 

935.4 653.3 674.9 653.2 

245.3 209.0 247.5 257.3 

830.8 850.8 933.0 927.0 

612.3 474.4 447.3 443.8 

149.8 140.3 154.3 165.4 

577.7 458.5 431.4 408.6 

273.9 238.8 203.0 261.6 

425.2 378.1 204.8 465.9 

278.8 223.9 338.6 456.8 

385.5 254.4 214.4 227.9 

286.2 152.2 230.7 301.1 

120.1 119.7 100.8 111.9 

378.2 308.3 323.4 349.9 

295.0 155.8 172.0 167.9 

254.3 185.8 225.1 180.6 

99.2 92.0 86.9 102.6 

556.4 575.9 626.0 724.6 

20.6 21.3 21.1 34.1 

192.0 113.6 150.8 259.3 

65.5 51.7 58.2 60.5 

192.6 168.4 194.3 207.1 

509.9 363.3 329.0 359.8 

284.9 301.9 267.1 237.7 

89.2 156.7 181.8 205.9 

677.6 521.0 459.3 592.1 

78.1 61.3 61.7 64.0 

292.4 251.8 211.1 176.8 

598.7 509.2 480.2 498.7 

72.3 99.1 93.0 99.2 

399.6 380.7 358.4 626.1 

409.2 375.4 374.1 409.2 

371.5 279.1 302.1 256.7 

420.8 478.4 487.5 460.5 

227.1 175.1 234.6 175.1 

656.0 664.4 566.7 530.7 

640.2 543.6 571.1 532.5 

213.6 160.3 141.7 155.3 

491.9 444.7 220.6 367.9 

205.7 138.8 200.3 217.0 

415.0 429.2 451.2 506.6 

107.5 94.1 88.8 103.9 

125.9 83.7 79.9 116.0 

97.9 108.5 80.6 97.7 

986.4 783.7 618.6 715.7 

967.4 884.1 768.4 826.1 

180.0 129.0 132.7 150.7 

149.3 104.6 139.2 147.5 

64.0 66.6 48.9 51.0 

162.7 105.6 80.3 108.3 

36.8 32.3 25.7 28.1 

65.9 42.8 48.9 39.3 

971.7 685.7 758.6 907.2 

208.1 219.2 141.4 193.7 

152.2 133.9 139.8 159.2 

182.9 164.1 260.9 190.4 

196.1 93.8 68.9 148.8 

50.5 72.4 71.8 44.1 

365.6 340.2 150.1 365.5 

756.4 642.0 683.5 678.1 

184.4 136.6 143.7 108.8 

61.8 53.8 34.8 54.6 

283.1 251.3 209.0 208.9 232.5 

10.8 21.3 21.3 17.3 17.7 

279.5 248.3 206.5 206.4 229.6 

*NR = No report (see Appendix). 

90 Gonorrhea Tables STD Surveillance 1998 
Table 20. Gonorrhea — Men – Reported cases and rates in selected cities of >200,000 population: United 

States and outlying areas, 1994–1998* 

Cases 

City 1994 1995 1996 1997 1998 

Akron, OH 524 

Albuquerque, NM 341 

Atlanta, GA NR 

Austin, TX 644 

Baltimore, MD 4,507 

Birmingham, AL 2,801 

Boston, MA 614 

Buffalo, NY 739 

Charlotte, NC 2,559 

Chicago, IL 8,438 

Cincinnati, OH 1,569 

Cleveland, OH 3,257 

Columbus, OH 1,924 

Corpus Christi, TX 205 

Dallas, TX 3,539 

Dayton, OH 842 

Denver, CO 908 

Des Moines, IA 221 

Detroit, MI 5,347 

El Paso, TX 78 

Fort Worth, TX 1,381 

Honolulu, HI 322 

Houston, TX 4,616 

Indianapolis, IN 2,865 

Jacksonville, FL 2,156 

Jersey City, NJ 190 

Kansas City, MO 1,532 

Los Angeles, CA 5,156 

Louisville, KY 1,580 

Memphis, TN 4,069 

Miami, FL 1,920 

Milwaukee, WI 3,018 

Minneapolis, MN 1,056 

Nashville, TN 1,888 

New Orleans, LA 2,794 

New York City, NY 9,108 

Newark, NJ 1,006 

Norfolk, VA 1,501 

Oakland, CA 1,107 

Oklahoma City, OK 814 

Omaha, NE 492 

Philadelphia, PA 4,217 

Phoenix, AZ 1,626 

Pittsburgh, PA 1,267 

Portland, OR 395 

Richmond, VA 1,600 

Rochester, NY 1,311 

Sacramento, CA 833 

San Antonio, TX 872 

San Diego, CA 1,537 

San Francisco, CA 1,188 

San Jose, CA 375 

Seattle, WA 672 

St Louis, MO 3,022 

St Paul, MN 302 

St Petersburg, FL 912 

Tampa, FL 1,195 

Toledo, OH 1,191 

Tucson, AZ 210 

Tulsa, OK 776 

Washington, DC 4,009 

Wichita, KS 523 

Yonkers, NY 62 

440 

301 

3,904 

785 

3,863 

2,146 

485 

707 

1,323 

6,079 

1,308 

2,855 

1,371 

181 

4,269 

726 

729 

181 

5,473 

87 

1,203 

259 

4,008 

2,523 

1,451 

123 

1,630 

4,574 

1,402 

3,397 

1,571 

2,206 

871 

1,587 

2,265 

7,707 

1,228 

945 

879 

913 

417 

3,235 

1,824 

723 

300 

1,301 

991 

805 

916 

1,237 

1,255 

204 

762 

2,528 

262 

839 

1,003 

478 

165 

737 

3,449 

319 

59 

277 

299 

2,774 

649 

3,441 

1,569 

416 

512 

1,086 

5,673 

432 

1,462 

675 

175 

2,674 

493 

517 

141 

3,736 

82 

583 

234 

3,363 

1,627 

1,223 

195 

1,189 

3,104 

1,170 

2,939 

1,269 

1,696 

808 

1,254 

1,797 

6,210 

1,712 

834 

710 

976 

296 

3,028 

1,663 

484 

292 

919 

1,019 

655 

641 

859 

1,236 

220 

576 

1,588 

283 

546 

822 

196 

235 

614 

2,591 

284 

44 

310 

238 

2,917 

671 

3,414 

1,531 

494 

452 

1,059 

8,411 

1,023 

1,153 

997 

188 

3,326 

566 

563 

170 

3,935 

79 

745 

232 

3,524 

1,511 

1,081 

169 

800 

3,165 

1,071 

2,701 

1,181 

1,596 

693 

1,205 

1,517 

6,491 

1,119 

828 

658 

479 

355 

2,997 

1,798 

483 

275 

815 

908 

606 

796 

805 

1,212 

264 

515 

1,397 

180 

553 

1,032 

184 

290 

319 

2,637 

293 

44 

380 

262 

3,118 

905 

3,714 

1,614 

505 

426 

1,081 

6,937 

1,518 

1,347 

1,488 

268 

3,814 

601 

510 

182 

4,312 

129 

1,537 

219 

3,937 

1,539 

1,564 

260 

1,156 

3,167 

831 

2,976 

1,518 

2,098 

756 

1,059 

1,533 

5,306 

987 

822 

749 

732 

376 

3,333 

2,128 

563 

281 

775 

961 

673 

846 

883 

1,456 

227 

651 

1,967 

241 

728 

800 

305 

228 

580 

2,604 

223 

50 

U.S. CITY TOTAL 115,723 101,764 79,067 81,021 86,736 

San Juan, PR 204 247 241 150 142 

TOTAL 115,927 102,011 79,308 81,171 86,878 

Rates per 100,000 Population 

1994 1995 1996 1997 1998 

207.1 

135.4 

. 

199.2 

1,374.6 

912.9 

232.5 

471.9 

943.4 

594.4 

381.9 

493.8 

396.9 

134.9 

369.9 

307.0 

378.3 

133.7 

1,067.1 

24.2 

221.9 

72.7 

304.7 

736.6 

628.6 

179.9 

734.4 

121.0 

498.0 

995.8 

198.3 

677.6 

569.5 

753.9 

1,244.3 

264.1 

733.4 

1,179.8 

187.0 

388.0 

237.0 

595.2 

140.5 

204.4 

168.0 

1,745.7 

1,115.5 

154.8 

140.6 

115.1 

324.9 

47.6 

85.9 

1,801.1 

229.0 

225.1 

280.6 

544.8 

58.7 

425.8 

1,515.1 

254.3 

68.2 

173.1 108.8 121.3 148.7 

117.9 116.5 92.6 102.0 

1,167.4 812.1 844.0 902.2 

236.1 190.8 193.9 261.5 

1,198.9 1,100.2 1,116.4 1,214.5 

697.9 507.1 496.6 523.5 

181.3 154.6 183.6 187.7 

453.7 331.5 294.9 277.9 

474.3 377.8 357.8 365.2 

428.6 402.7 597.8 493.1 

319.7 106.4 253.1 375.6 

434.3 222.2 176.5 206.2 

281.2 138.1 203.0 303.0 

118.4 113.4 120.7 172.1 

442.1 272.3 333.7 382.6 

265.4 181.6 210.0 223.0 

303.3 214.3 232.1 210.2 

108.3 83.3 100.0 107.0 

1,097.2 719.6 761.5 834.5 

26.5 24.7 23.2 37.9 

190.0 90.9 113.7 234.6 

58.4 53.4 53.1 50.1 

261.7 217.0 224.1 250.4 

648.7 419.2 389.6 396.8 

424.4 348.3 304.6 440.7 

116.9 185.2 160.0 246.1 

780.1 559.1 374.3 540.9 

107.6 73.2 74.1 74.1 

441.4 368.2 337.0 261.5 

824.0 712.2 654.0 720.6 

161.8 129.6 120.1 154.4 

498.8 388.1 368.9 484.9 

468.2 433.7 371.9 405.7 

629.3 494.4 474.4 416.9 

1,014.0 816.8 697.2 704.5 

224.0 179.6 187.4 153.2 

903.0 1,264.0 829.2 731.4 

757.2 696.9 701.5 696.4 

148.1 116.1 106.6 121.3 

433.8 461.1 225.3 344.3 

199.0 139.8 166.4 176.2 

464.5 442.6 444.6 494.4 

152.0 128.7 134.8 159.5 

117.6 79.8 80.4 93.7 

127.0 121.9 114.2 116.6 

1,443.7 1,059.8 933.3 887.5 

847.1 874.0 780.3 825.8 

148.9 120.3 110.3 122.5 

145.8 100.6 123.1 130.9 

92.3 63.6 58.6 64.3 

345.7 342.7 335.5 403.1 

25.8 27.4 32.5 27.9 

96.9 72.1 63.7 80.5 

1,546.3 996.2 894.8 1,259.9 

199.0 214.2 135.8 181.8 

206.2 134.4 135.4 178.3 

232.8 188.2 232.4 180.1 

219.9 90.6 85.1 141.1 

44.8 62.4 75.7 59.5 

403.8 332.8 170.9 310.7 

1,334.1 1,026.0 1,062.5 1,049.2 

155.1 133.7 136.1 103.6 

64.7 48.1 47.8 54.4 

351.1 304.7 235.1 239.5 256.3 

52.0 62.9 61.4 38.2 36.2 

347.6 301.9 233.1 237.2 253.8 

*NR = No report (see Appendix). 

STD Surveillance 1998 Gonorrhea Tables 91 
Table 21. All stages of syphilis — Reported cases and rates by state/area: United States and outlying areas, 

1994–1998* 

Cases Rates per 100,000 Population 

State/Area 1994 1995 1996 1997 1998 1994 1995 1996 1997 1998 

Alabama 1,933 1,640 1,890 1,483 1,133 45.8 38.6 44.1 34.3 26.2 

Alaska 22 20 15 12 13 3.6 3.3 2.5 2.0 2.1 

Arizona 419 417 468 600 697 10.3 9.9 10.6 13.2 15.3 

Arkansas 1,328 1,270 843 571 506 54.1 51.1 33.6 22.6 20.1 

California 7,959 5,771 4,419 3,825 2,618 25.3 18.3 13.9 11.9 8.1 

Colorado 296 303 162 151 118 8.1 8.1 4.2 3.9 3.0 

Connecticut 337 270 334 325 177 10.3 8.2 10.2 9.9 5.4 

Delaware 138 129 124 113 114 19.5 18.0 17.1 15.4 15.6 

Florida 5,048 3,465 2,912 2,745 2,539 36.2 24.5 20.2 18.7 17.3 

Georgia 3,185 3,666 2,953 2,835 1,836 45.1 50.9 40.3 37.9 24.5 

Hawaii 41 25 30 45 15 3.5 2.1 2.5 3.8 1.3 

Idaho 10 12 24 24 15 0.9 1.0 2.0 2.0 1.2 

Illinois 3,877 3,712 2,071 1,954 2,028 33.0 31.4 17.5 16.4 17.0 

Indiana 844 870 675 522 509 14.7 15.0 11.6 8.9 8.7 

Iowa 235 170 86 72 48 8.3 6.0 3.0 2.5 1.7 

Kansas 187 150 136 168 113 7.3 5.8 5.3 6.5 4.4 

Kentucky 534 501 398 403 339 14.0 13.0 10.3 10.3 8.7 

Louisiana 5,422 3,692 2,409 1,808 1,651 125.7 85.0 55.5 41.5 37.9 

Maine 9 4 4 13 4 0.7 0.3 0.3 1.0 0.3 

Maryland 1,538 1,679 2,234 2,455 2,156 30.7 33.3 44.1 48.2 42.3 

Massachusetts 622 506 633 730 568 10.3 8.3 10.4 11.9 9.3 

Michigan 1,234 1,203 851 788 686 13.0 12.6 8.7 8.1 7.0 

Minnesota 201 187 116 124 74 4.4 4.1 2.5 2.6 1.6 

Mississippi 4,547 4,532 2,365 1,441 1,161 170.3 168.0 87.2 52.8 42.5 

Missouri 1,985 1,265 618 502 375 37.6 23.8 11.5 9.3 6.9 

Montana 9 13 4 5 0 1.1 1.5 0.5 0.6 0.0 

Nebraska 46 35 27 32 33 2.8 2.1 1.6 1.9 2.0 

Nevada 171 193 142 119 136 11.7 12.6 8.9 7.1 8.1 

New Hampshire 18 32 29 23 14 1.6 2.8 2.5 2.0 1.2 

New Jersey 2,188 1,469 1,467 1,151 826 27.7 18.5 18.3 14.3 10.3 

New Mexico 178 138 78 103 76 10.8 8.2 4.6 6.0 4.4 

New York 9,376 8,880 6,529 5,645 5,145 51.6 49.0 36.0 31.1 28.4 

North Carolina 4,023 3,066 2,670 2,202 2,133 56.9 42.6 36.5 29.7 28.7 

North Dakota 1 0 0 0 0 0.2 0.0 0.0 0.0 0.0 

Ohio 2,740 1,938 1,324 761 474 24.7 17.4 11.9 6.8 4.2 

Oklahoma 497 589 467 405 363 15.3 18.0 14.2 12.2 10.9 

Oregon 100 67 70 48 32 3.2 2.1 2.2 1.5 1.0 

Pennsylvania 2,738 1,948 1,440 1,182 910 22.7 16.1 12.0 9.8 7.6 

Rhode Island 141 90 72 84 55 14.1 9.1 7.3 8.5 5.6 

South Carolina 1,945 1,669 1,286 1,138 871 53.1 45.4 34.6 30.3 23.2 

South Dakota 8 7 2 7 2 1.1 1.0 0.3 0.9 0.3 

Tennessee 2,978 2,604 2,321 2,368 1,750 57.5 49.5 43.7 44.1 32.6 

Texas 9,028 7,923 5,895 5,382 3,955 49.1 42.3 30.9 27.7 20.3 

Utah 51 50 49 56 55 2.7 2.6 2.4 2.7 2.7 

Vermont 1 0 1 1 6 0.2 0.0 0.2 0.2 1.0 

Virginia 1,919 1,590 1,265 1,108 707 29.3 24.0 19.0 16.5 10.5 

Washington 281 211 129 131 141 5.3 3.9 2.3 2.3 2.5 

West Virginia 179 65 59 20 11 9.8 3.6 3.2 1.1 0.6 

Wisconsin 797 585 496 317 208 15.7 11.4 9.6 6.1 4.0 

Wyoming 3 2 8 1 2 0.6 0.4 1.7 0.2 0.4 

U.S. TOTAL1 82,334 69,345 53,226 46,642 37,977 31.6 26.4 20.1 17.4 14.2 

Guam 7 6 3 1 3 4.8 4.0 2.0 0.6 1.9 

Puerto Rico 2,018 1,619 1,469 1,577 1,460 55.2 43.9 39.5 41.2 38.1 

Virgin Islands 30 19 17 10 35 27.7 17.3 15.5 9.1 31.9 

OUTLYING AREAS 2,055 1,644 1,489 1,588 1,498 52.6 41.6 37.4 38.8 36.6 

TOTAL 84,389 70,989 54,715 48,230 39,475 31.9 26.6 20.3 17.7 14.5 

1

Includes cases reported by Washington, D.C. 

92 Syphilis Tables STD Surveillance 1998 
Table 22. All stages of syphilis — Reported cases and rates in selected cities of >200,000 population: 

United States and outlying areas, 1994–1998 

Cases 

City 1994 1995 1996 1997 1998 

Akron, OH 13 

Albuquerque, NM 87 

Atlanta, GA 917 

Austin, TX 260 

Baltimore, MD 673 

Birmingham, AL 664 

Boston, MA 219 

Buffalo, NY 52 

Charlotte, NC 506 

Chicago, IL 2,335 

Cincinnati, OH 839 

Cleveland, OH 1,160 

Columbus, OH 71 

Corpus Christi, TX 83 

Dallas, TX 1,130 

Dayton, OH 236 

Denver, CO 177 

Des Moines, IA 110 

Detroit, MI 775 

El Paso, TX 183 

Fort Worth, TX 592 

Honolulu, HI 41 

Houston, TX 2,909 

Indianapolis, IN 176 

Jacksonville, FL 289 

Jersey City, NJ 171 

Kansas City, MO 168 

Los Angeles, CA 3,931 

Louisville, KY 325 

Memphis, TN 1,738 

Miami, FL 1,453 

Milwaukee, WI 688 

Minneapolis, MN 122 

Nashville, TN 234 

New Orleans, LA 845 

New York City, NY 8,001 

Newark, NJ 518 

Norfolk, VA 247 

Oakland, CA 313 

Oklahoma City, OK 299 

Omaha, NE 28 

Philadelphia, PA 2,394 

Phoenix, AZ 237 

Pittsburgh, PA 39 

Portland, OR 63 

Richmond, VA 128 

Rochester, NY 200 

Sacramento, CA 126 

San Antonio, TX 491 

San Diego, CA 493 

San Francisco, CA 89 

San Jose, CA 131 

Seattle, WA 126 

St Louis, MO 1,212 

St Paul, MN 27 

St Petersburg, FL 317 

Tampa, FL 355 

Toledo, OH 79 

Tucson, AZ 104 

Tulsa, OK 52 

Washington, DC 967 

Wichita, KS 27 

Yonkers, NY 74 

8 

41 

1,074 

183 

1,089 

640 

193 

32 

347 

2,244 

399 

750 

31 

62 

1,022 

399 

179 

92 

707 

142 

489 

22 

2,691 

168 

192 

136 

68 

2,955 

272 

1,596 

1,006 

464 

86 

202 

649 

7,881 

392 

278 

185 

291 

21 

1,696 

270 

27 

42 

122 

104 

86 

394 

371 

84 

78 

93 

734 

28 

168 

277 

52 

78 

105 

722 

42 

64 

8 

33 

835 

88 

1,552 

703 

257 

22 

312 

1,254 

166 

377 

89 

29 

790 

367 

67 

34 

522 

118 

379 

26 

2,047 

186 

228 

97 

38 

2,164 

227 

1,370 

876 

397 

52 

293 

520 

5,801 

371 

222 

139 

227 

1 

1,293 

342 

16 

45 

171 

68 

58 

378 

227 

151 

70 

59 

329 

17 

86 

314 

63 

61 

109 

626 

58 

33 

4 

56 

872 

98 

1,781 

474 

305 

23 

153 

1,314 

93 

250 

117 

22 

717 

126 

70 

26 

544 

112 

299 

40 

1,937 

125 

206 

84 

13 

1,613 

232 

1,435 

874 

275 

53 

412 

463 

4,961 

239 

157 

128 

109 

15 

1,093 

473 

21 

23 

135 

32 

55 

309 

259 

171 

93 

58 

261 

8 

79 

207 

25 

52 

35 

644 

85 

34 

7 

45 

591 

56 

1,472 

244 

240 

12 

210 

1,457 

32 

151 

115 

27 

735 

39 

35 

20 

474 

81 

175 

15 

1,397 

239 

154 

34 

13 

994 

213 

1,034 

773 

168 

33 

416 

348 

4,650 

187 

106 

128 

178 

24 

804 

572 

12 

17 

80 

39 

31 

237 

187 

129 

62 

67 

170 

10 

56 

177 

23 

36 

75 

579 

20 

22 

U.S. CITY TOTAL 41,309 35,315 27,858 24,979 20,727 

San Juan, PR 1,015 692 722 719 673 

TOTAL 42,324 36,007 28,580 25,698 21,400 

Rates per 100,000 Population 

1994 1995 1996 1997 1998 

2.5 

16.9 

132.8 

40.2 

95.7 

101.1 

39.9 

15.9 

89.8 

79.1 

96.7 

82.7 

7.1 

26.7 

58.2 

41.2 

35.9 

31.8 

73.3 

27.5 

47.1 

4.7 

95.5 

21.5 

41.1 

78.4 

38.4 

45.9 

48.3 

202.7 

71.8 

73.3 

31.9 

44.4 

174.5 

109.1 

178.6 

102.3 

26.0 

68.6 

6.5 

157.1 

10.1 

3.0 

13.1 

63.5 

81.9 

11.5 

38.4 

18.7 

12.1 

8.4 

7.9 

329.2 

9.8 

36.6 

40.6 

17.3 

14.2 

13.8 

170.5 

6.4 

38.7 

1.5 1.5 0.8 1.3 

7.8 6.3 10.6 8.6 

153.3 116.9 120.7 81.8 

27.5 12.9 14.1 8.1 

157.6 231.0 271.0 224.0 

97.3 106.4 72.0 37.0 

34.7 46.1 54.7 43.1 

9.8 6.8 7.2 3.7 

59.9 52.3 24.9 34.2 

76.1 43.0 45.1 50.0 

46.2 19.4 10.9 3.8 

53.6 27.0 18.0 10.9 

3.1 8.8 11.5 11.3 

19.8 9.2 6.9 8.5 

52.2 39.6 35.4 36.3 

69.9 64.9 22.4 6.9 

36.2 13.5 14.0 7.0 

26.3 9.6 7.3 5.6 

67.2 47.7 50.0 43.5 

20.9 17.2 16.0 11.5 

38.2 29.2 22.5 13.2 

2.5 3.0 4.6 1.7 

87.5 65.7 61.3 44.2 

20.5 22.8 15.4 29.4 

27.4 31.4 28.1 21.0 

62.6 44.7 38.6 15.6 

15.5 8.5 2.9 2.9 

34.5 25.5 18.8 11.6 

40.4 33.8 34.6 31.8 

184.5 158.4 165.7 119.4 

49.5 43.0 42.7 37.8 

49.8 43.2 30.3 18.5 

22.4 13.6 13.8 8.6 

38.1 55.0 77.2 77.9 

134.7 109.7 98.7 74.2 

107.8 79.1 67.6 63.3 

136.3 129.9 84.0 65.7 

117.0 95.4 68.4 46.2 

15.3 11.2 10.2 10.2 

66.6 51.7 24.7 40.4 

4.8 0.2 3.4 5.4 

113.1 87.8 75.3 55.4 

11.1 13.1 17.5 21.2 

2.1 1.2 1.6 0.9 

8.7 9.2 4.7 3.4 

61.5 89.5 70.2 41.6 

42.8 28.1 13.3 16.2 

7.8 5.2 4.9 2.8 

30.4 28.8 23.2 17.8 

14.0 8.5 9.5 6.9 

11.5 20.7 23.4 17.6 

5.0 4.4 5.8 3.9 

5.8 3.7 3.6 4.1 

204.6 94.2 76.3 49.7 

10.2 6.2 2.9 3.6 

19.3 9.9 9.1 6.4 

31.3 35.1 22.8 19.5 

11.4 13.9 5.5 5.1 

10.4 7.9 6.7 4.6 

27.8 28.6 9.1 19.4 

130.3 116.1 121.7 109.5 

10.0 13.4 19.4 4.6 

33.4 17.2 17.6 11.4 

60.2 51.3 40.2 35.8 29.7 

116.4 79.3 82.8 82.4 77.2 

60.9 51.6 40.7 36.4 30.3 

STD Surveillance 1998 Syphilis Tables 93 
Table 23A. Primary and secondary syphilis — Reported cases by age, gender, and race/ethnicity: United States, 

1994–1998 

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 

10-14 118 9 109 10 1 9 105 8 97 3 0 3 0 0 0 0 0 0 

15-19 2,234 747 1,487 167 44 123 1,996 662 1,334 62 38 24 5 1 4 4 2 2 

20-24 4,071 1,821 2,250 291 102 189 3,603 1,619 1,984 160 90 70 12 8 4 5 2 3 

199425-29 

30-34 

35-39 

3,819 

3,755 

2,893 

1,759 

1,922 

1,722 

2,060 

1,833 

1,171 

304 134 170 

382 189 193 

272 162 110 

3,321 1,507 1,814 

3,198 1,609 1,589 

2,492 1,474 1,018 

160 

153 

108 

99 

109 

74 

61 

44 

34 

22 15 7 

13 11 2 

12 8 4 

12 4 8 

9 4 5 

9 4 5 

40-44 1,632 1,079 553 168 121 47 1,396 912 484 64 43 21 1 1 0 3 2 1 

45-54 1,364 1,013 351 164 119 45 1,150 862 288 47 31 16 3 1 2 0 0 0 

55-64 504 409 95 74 64 10 392 312 80 35 31 4 3 2 1 0 0 0 

65+ 195 168 27 23 21 2 159 137 22 11 9 2 2 1 1 0 0 0 

TOTAL 20,618 10,666 9,952 1,856 957 899 17,843 9,119 8,724 804 524 280 73 48 25 42 18 24 

10-14 106 11 95 5 0 5 98 11 87 3 0 3 0 0 0 0 0 0 

15-19 1,796 604 1,192 132 28 104 1,601 555 1,046 53 20 33 3 0 3 7 1 6 

20-24 3,067 1,476 1,591 242 99 143 2,683 1,303 1,380 126 70 56 12 1 11 4 3 1 

199525-29 

30-34 

35-39 

2,853 

2,919 

2,412 

1,390 

1,482 

1,369 

1,463 

1,437 

1,043 

258 121 137 

255 130 125 

253 146 107 

2,433 1,174 1,259 

2,506 1,260 1,246 

2,043 1,148 895 

141 

134 

108 

86 

81 

72 

55 

53 

36 

9 3 6 

15 6 9 

5 1 4 

12 6 6 

9 5 4 

3 2 1 

40-44 1,472 980 492 153 100 53 1,265 840 425 46 36 10 4 2 2 4 2 2 

45-54 1,272 939 333 140 108 32 1,067 784 283 57 43 14 3 1 2 5 3 2 

55-64 385 311 74 51 45 6 317 254 63 16 11 5 1 1 0 0 0 0 

65+ 186 149 37 29 23 6 139 111 28 14 11 3 2 2 0 2 2 0 

TOTAL 16,503 8,729 7,774 1,519 801 718 14,186 7,457 6,729 698 430 268 54 17 37 46 24 22 

10-14 49 6 43 3 0 3 43 6 37 3 0 3 0 0 0 0 0 0 

15-19 1,125 388 737 107 28 79 968 340 628 43 18 25 5 1 4 2 1 1 

20-24 1,933 875 1,058 162 41 121 1,645 762 883 106 65 41 13 5 8 7 2 5 

199625-29 

30-34 

35-39 

1,889 

2,001 

1,854 

919 

1,026 

1,022 

970 

975 

832 

211 99 112 

197 103 94 

203 107 96 

1,562 738 824 

1,704 853 851 

1,563 854 709 

100 

85 

78 

72 

63 

55 

28 

22 

23 

10 6 4 

6 3 3 

6 4 2 

6 4 2 

9 4 5 

4 2 2 

40-44 1,122 703 419 110 65 45 962 605 357 40 30 10 5 3 2 5 0 5 

45-54 967 714 253 130 97 33 795 585 210 32 22 10 3 3 0 7 7 0 

55-64 281 234 47 55 48 7 210 172 38 16 14 2 0 0 0 0 0 0 

65+ 107 93 14 18 18 0 78 66 12 9 7 2 2 2 0 0 0 0 

TOTAL 11,339 5,982 5,357 1,197 606 591 9,540 4,983 4,557 512 346 166 50 27 23 40 20 20 

10-14 43 4 39 4 0 4 36 3 33 3 1 2 0 0 0 0 0 0 

15-19 775 253 522 69 16 53 648 213 435 54 23 31 3 1 2 1 0 1 

20-24 1,318 619 699 110 44 66 1,116 518 598 79 53 26 6 1 5 7 3 4 

199725-29 

30-34 

35-39 

1,434 

1,475 

1,405 

720 

759 

779 

714 

716 

626 

143 67 76 

162 73 89 

197 101 96 

1,179 568 611 

1,227 630 597 

1,151 637 514 

101 

73 

49 

76 

51 

37 

25 

22 

12 

4 4 0 

7 3 4 

3 2 1 

7 5 2 

6 2 4 

5 2 3 

40-44 942 626 316 106 74 32 786 521 265 38 24 14 5 2 3 7 5 2 

45-54 770 565 205 108 82 26 621 456 165 30 20 10 4 2 2 7 5 2 

55-64 255 223 32 52 44 8 186 162 24 17 17 0 0 0 0 0 0 0 

65+ 107 99 8 25 24 1 74 67 7 8 8 0 0 0 0 0 0 0 

TOTAL 8,536 4,652 3,884 977 525 452 7,035 3,780 3,255 452 310 142 32 15 17 40 22 18 

10-14 39 5 34 4 0 4 34 5 29 1 0 1 0 0 0 0 0 0 

15-19 605 191 414 53 11 42 503 162 341 39 15 24 3 0 3 7 3 4 

20-24 1,022 502 520 103 29 74 835 415 420 68 49 19 5 3 2 11 6 5 

199825-29 

30-34 

35-39 

1,026 

1,175 

1,172 

507 

624 

678 

519 

551 

494 

128 49 79 

146 77 69 

172 104 68 

782 385 397 

943 481 462 

924 520 404 

99 

68 

62 

64 

55 

44 

35 

13 

18 

5 4 1 

9 7 2 

7 6 1 

12 5 7 

9 4 5 

7 4 3 

40-44 829 536 293 129 95 34 650 404 246 42 32 10 3 2 1 5 3 2 

45-54 773 573 200 121 101 20 608 438 170 42 33 9 1 1 0 1 0 1 

55-64 233 194 39 50 47 3 162 129 33 17 14 3 2 2 0 2 2 0 

65+ 103 87 16 21 18 3 71 60 11 9 7 2 1 1 0 1 1 0 

TOTAL 6,985 3,899 3,086 928 531 397 5,519 3,001 2,518 447 313 134 36 26 10 55 28 27 

NOTE: In most instances, if age or race/ethnicity was not specified, cases were prorated according to the distribution of cases for which these variables were 

specified. In 1996, cases from Rhode Island were excluded because race was not reported for most cases. Differences between total cases from this table and 

others in the report are due to different reporting forms and above exclusions. Cases aged 0 to 9 years are not shown because some of these may not be due 

to sexual transmission; however, they are included in the totals. 

94 Syphilis Tables STD Surveillance 1998 
Table 23B. Primary and secondary syphilis — Reported rates by age, gender, and race/ethnicity: United States, 

1994–1998 

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 0.6 0.1 1.2 0.1 0.0 0.1 3.8 0.6 7.2 0.1 0.0 0.3 0.0 0.0 0.0 0.0 0.0 0.0 

15-19 12.7 8.3 17.3 1.4 0.7 2.1 76.5 50.1 103.5 2.8 3.4 2.2 0.8 0.3 1.3 2.4 2.4 2.4 

20-24 22.2 19.6 25.0 2.3 1.6 3.0 141.9 129.9 153.4 6.8 7.2 6.4 1.7 2.3 1.1 3.1 2.5 3.8 

25-29 

30-34 

35-39 

19.9 

16.9 

13.2 

18.3 

17.4 

15.8 

21.6 

16.5 

10.6 

2.3 2.0 2.6 

2.4 2.4 2.4 

1.7 2.0 1.3 

134.2 128.3 139.5 

118.8 128.2 110.5 

95.5 121.3 73.1 

6.4 

6.2 

5.2 

7.4 

8.4 

7.0 

5.3 

3.8 

3.4 

3.0 4.2 1.9 

1.6 2.8 0.5 

1.6 2.2 1.0 

8.0 5.3 10.8 

1994

5.7 5.1 6.2 

6.0 5.5 6.5 

40-44 8.3 11.1 5.5 1.1 1.6 0.6 63.2 89.4 40.7 3.9 5.3 2.6 0.1 0.3 0.0 2.3 3.1 1.5 

45-54 4.6 6.9 2.3 0.7 1.0 0.4 38.9 64.5 17.8 2.2 3.0 1.5 0.3 0.2 0.4 0.0 0.0 0.0 

55-64 2.4 4.1 0.9 0.4 0.8 0.1 19.4 35.6 7.0 2.6 4.9 0.6 0.5 0.8 0.3 0.0 0.0 0.0 

65+ 0.6 1.2 0.1 0.1 0.2 0.0 6.1 13.6 1.4 0.8 1.5 0.2 0.4 0.4 0.3 0.0 0.0 0.0 

TOTAL 7.9 8.4 7.5 1.0 1.0 0.9 57.2 61.8 53.1 3.1 4.0 2.2 0.9 1.2 0.6 2.2 1.9 2.5 

10-14 0.6 0.1 1.0 0.0 0.0 0.1 3.5 0.8 6.4 0.1 0.0 0.3 0.0 0.0 0.0 0.0 0.0 0.0 

15-19 10.1 6.6 13.8 1.1 0.4 1.8 60.9 41.6 80.6 2.4 1.8 3.0 0.5 0.0 1.0 4.2 1.2 7.3 

20-24 17.0 16.1 17.9 2.0 1.6 2.4 105.9 104.5 107.2 5.4 5.7 5.1 1.7 0.3 3.1 2.5 3.7 1.3 

25-29 

30-34 

35-39 

15.3 

13.2 

10.8 

14.9 

13.4 

12.3 

15.8 

12.9 

9.3 

2.0 1.9 2.1 

1.6 1.6 1.6 

1.5 1.8 1.3 

100.5 102.1 99.1 

92.7 99.9 86.4 

76.1 91.6 62.5 

5.6 

5.3 

5.0 

6.4 

6.0 

6.5 

4.8 

4.4 

3.4 

1.2 0.8 1.6 

1.8 1.5 2.1 

0.6 0.3 1.0 

8.2 8.1 8.3 

1995

5.6 6.3 5.0 

2.0 2.7 1.3 

40-44 7.4 9.9 4.9 1.0 1.3 0.7 55.4 79.7 34.6 2.7 4.2 1.2 0.6 0.6 0.5 3.0 3.1 2.8 

45-54 4.1 6.2 2.1 0.6 0.9 0.3 34.6 56.3 16.8 2.5 3.9 1.2 0.3 0.2 0.4 2.6 3.2 2.0 

55-64 1.8 3.1 0.7 0.3 0.6 0.1 15.6 28.8 5.5 1.2 1.7 0.7 0.2 0.4 0.0 0.0 0.0 0.0 

65+ 0.6 1.1 0.2 0.1 0.2 0.0 5.3 10.8 1.7 0.9 1.8 0.3 0.3 0.8 0.0 1.6 3.7 0.0 

TOTAL 6.3 6.8 5.8 0.8 0.8 0.7 44.9 49.9 40.4 2.6 3.2 2.0 0.6 0.4 0.8 2.4 2.5 2.2 

10-14 0.3 0.1 0.5 0.0 0.0 0.0 1.6 0.4 2.7 0.1 0.0 0.3 0.0 0.0 0.0 0.0 0.0 0.0 

15-19 6.1 4.1 8.2 0.9 0.4 1.3 35.1 24.3 46.1 1.7 1.4 2.1 0.8 0.3 1.2 1.1 1.1 1.1 

20-24 11.0 9.8 12.4 1.4 0.7 2.1 66.8 62.8 70.7 4.2 4.8 3.6 1.8 1.4 2.2 4.5 2.5 6.5 

25-29 

30-34 

35-39 

10.0 

9.4 

8.3 

9.7 

9.7 

9.1 

10.3 

9.2 

7.4 

1.6 1.5 1.7 

1.3 1.4 1.3 

1.2 1.3 1.2 

63.5 63.1 63.9 

64.2 68.8 60.1 

58.0 67.9 49.4 

3.9 

3.3 

3.4 

5.2 

4.5 

4.5 

2.4 

1.8 

2.1 

1.2 1.5 0.9 

0.7 0.8 0.7 

0.7 1.0 0.5 

3.9 5.1 2.7 

1996

5.8 5.2 6.4 

2.6 2.7 2.5 

40-44 5.4 6.8 4.0 0.7 0.8 0.6 40.6 55.2 28.1 2.1 3.2 1.1 0.7 0.9 0.5 3.6 0.0 6.9 

45-54 3.0 4.5 1.5 0.5 0.8 0.3 24.3 39.6 11.7 1.3 1.8 0.8 0.3 0.6 0.0 3.5 7.2 0.0 

55-64 1.3 2.3 0.4 0.3 0.6 0.1 10.1 19.1 3.2 1.1 2.1 0.3 0.0 0.0 0.0 0.0 0.0 0.0 

65+ 0.3 0.7 0.1 0.1 0.2 0.0 2.9 6.3 0.7 0.6 1.0 0.2 0.3 0.7 0.0 0.0 0.0 0.0 

TOTAL 4.3 4.6 4.0 0.6 0.6 0.6 29.9 33.0 27.1 1.8 2.4 1.2 0.5 0.6 0.5 2.1 2.1 2.0 

10-14 0.2 0.0 0.4 0.0 0.0 0.1 1.3 0.2 2.4 0.1 0.1 0.2 0.0 0.0 0.0 0.0 0.0 0.0 

15-19 4.1 2.6 5.6 0.5 0.2 0.9 23.0 14.9 31.3 2.1 1.7 2.6 0.4 0.3 0.6 0.5 0.0 1.1 

20-24 7.5 6.9 8.2 0.9 0.7 1.2 45.3 42.6 47.9 3.1 3.8 2.2 0.8 0.3 1.4 4.5 3.8 5.2 

25-29 

30-34 

35-39 

7.6 

7.1 

6.2 

7.6 

7.3 

6.9 

7.6 

6.9 

5.5 

1.1 1.0 1.2 

1.1 1.0 1.2 

1.2 1.2 1.2 

47.6 48.1 47.1 

47.0 51.7 42.9 

42.4 50.2 35.5 

3.9 

2.7 

2.0 

5.4 

3.6 

2.9 

2.1 

1.8 

1.0 

0.5 1.0 0.0 

0.8 0.8 0.9 

0.4 0.5 0.2 

4.5 6.2 2.6 

1997

4.0 2.6 5.3 

3.2 2.6 3.8 

40-44 4.4 5.9 2.9 0.7 0.9 0.4 31.9 45.5 20.1 1.9 2.4 1.5 0.6 0.5 0.7 4.9 7.3 2.7 

45-54 2.3 3.4 1.2 0.4 0.6 0.2 18.1 29.4 8.8 1.1 1.5 0.8 0.3 0.4 0.3 3.3 4.9 1.8 

55-64 1.2 2.1 0.3 0.3 0.5 0.1 8.7 17.6 2.0 1.1 2.4 0.0 0.0 0.0 0.0 0.0 0.0 0.0 

65+ 0.3 0.7 0.0 0.1 0.2 0.0 2.7 6.3 0.4 0.5 1.1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 

TOTAL 3.2 3.6 2.8 0.5 0.6 0.5 21.8 24.7 19.1 1.5 2.1 1.0 0.3 0.3 0.3 2.0 2.3 1.8 

10-14 0.2 0.1 0.4 0.0 0.0 0.1 1.2 0.4 2.1 0.0 0.0 0.1 0.0 0.0 0.0 0.0 0.0 0.0 

15-19 3.2 1.9 4.5 0.4 0.2 0.7 17.8 11.3 24.6 1.5 1.1 2.0 0.4 0.0 0.9 3.8 3.2 4.4 

20-24 5.8 5.6 6.1 0.9 0.5 1.3 33.9 34.1 33.6 2.6 3.5 1.6 0.7 0.8 0.6 7.1 7.7 6.5 

25-29 

30-34 

35-39 

5.4 

5.7 

5.2 

5.4 

6.0 

6.0 

5.5 

5.3 

4.4 

1.0 0.8 1.2 

1.0 1.1 1.0 

1.0 1.3 0.8 

31.6 32.6 30.6 

36.1 39.5 33.2 

34.0 41.0 27.9 

3.9 

2.6 

2.6 

4.6 

3.9 

3.5 

3.0 

1.0 

1.6 

0.6 1.0 0.2 

1.1 1.8 0.5 

0.8 1.5 0.2 

7.6 6.2 9.2 

1998

5.9 5.3 6.6 

4.5 5.2 3.8 

40-44 3.9 5.1 2.7 0.8 1.2 0.4 26.4 35.3 18.6 2.1 3.2 1.0 0.4 0.5 0.2 3.5 4.4 2.7 

45-54 2.3 3.5 1.2 0.5 0.8 0.2 17.7 28.3 9.0 1.6 2.6 0.7 0.1 0.2 0.0 0.5 0.0 0.9 

55-64 1.1 1.9 0.3 0.3 0.6 0.0 7.6 14.0 2.7 1.1 2.0 0.4 0.3 0.7 0.0 1.6 3.4 0.0 

65+ 0.3 0.6 0.1 0.1 0.2 0.0 2.6 5.7 0.7 0.5 1.0 0.2 0.1 0.3 0.0 0.7 1.7 0.0 

TOTAL 2.6 3.0 2.3 0.5 0.6 0.4 17.1 19.6 14.8 1.5 2.1 0.9 0.4 0.6 0.2 2.8 2.9 2.7 

NOTE: In 1996, cases from Rhode Island were excluded because race was not reported for most cases. Rates for the 0-9 year age group are not shown: 

however, these cases are included in the calculation of total rates. 

STD Surveillance 1998 Syphilis Tables 95 
Table 24. Primary and secondary syphilis — Reported cases and rates by state/area, ranked according to 

rates: United States and outlying areas, 1998 

Rank State/Area Cases Rate per 100,000 Population 

1 Maryland 648 12.7 

2 Tennessee 567 10.6 

3 Louisiana 430 9.9 

4 North Carolina 723 9.7 

5 Mississippi 261 9.6 

6 South Carolina 271 7.2 

7 Virgin Islands 7 6.4 

8 Alabama 274 6.3 

9 Puerto Rico 177 4.6 

10 Georgia 333 4.4 

11 Arkansas 108 4.3 

12 Arizona 185 4.1 

YEAR 2000 OBJECTIVE 4.0 

13 Indiana 215 3.7 

14 Illinois 424 3.6 

15 Oklahoma 98 3.0 

16 Delaware 21 2.9 

17 Kentucky 106 2.7 

U.S. TOTAL1 6,993 2.6 

18 Texas 443 2.3 

19 Michigan 211 2.2 

20 Virginia 149 2.2 

21 Florida 294 2.0 

22 Missouri 109 2.0 

23 New Jersey 107 1.3 

24 Ohio 134 1.2 

25 Wisconsin 60 1.2 

26 California 303 0.9 

27 Nevada 15 0.9 

28 Connecticut 26 0.8 

29 Massachusetts 46 0.8 

30 New Mexico 14 0.8 

31 Pennsylvania 98 0.8 

32 Washington 44 0.8 

33 New York 119 0.7 

34 Vermont 4 0.7 

35 Kansas 14 0.5 

36 Nebraska 8 0.5 

37 Colorado 10 0.3 

38 Hawaii 4 0.3 

39 Alaska 1 0.2 

40 Idaho 2 0.2 

41 Iowa 5 0.2 

42 Minnesota 9 0.2 

43 New Hampshire 2 0.2 

44 Oregon 6 0.2 

45 Utah 4 0.2 

46 West Virginia 3 0.2 

47 Wyoming 1 0.2 

48 Maine 1 0.1 

49 Rhode Island 1 0.1 

50 South Dakota 1 0.1 

51 Montana 0 0.0 

52 North Dakota 0 0.0 

53 Guam 0 0.0 

1

Includes cases reported by Washington, D.C., but excludes outlying areas (Guam, Puerto Rico and Virgin Islands). 

96 Syphilis Tables STD Surveillance 1998 
Table 25. Primary and secondary syphilis — Reported cases and rates by state/area and region: United States 

and outlying areas, 1994–1998 

Cases Rates per 100,000 Population 

State/Area 1994 1995 1996 1997 1998 1994 1995 1996 1997 1998 

Alabama 661 612 528 410 274 15.7 14.4 12.3 9.5 6.3 

Alaska 3 2 0 1 1 0.5 0.3 0.0 0.2 0.2 

Arizona 50 46 102 132 185 1.2 1.1 2.3 2.9 4.1 

Arkansas 446 495 262 173 108 18.2 19.9 10.5 6.9 4.3 

California 825 584 509 386 303 2.6 1.8 1.6 1.2 0.9 

Colorado 126 100 26 15 10 3.4 2.7 0.7 0.4 0.3 

Connecticut 105 86 103 62 26 3.2 2.6 3.2 1.9 0.8 

Delaware 27 19 35 22 21 3.8 2.6 4.8 3.0 2.9 

Florida 745 383 368 296 294 5.3 2.7 2.6 2.0 2.0 

Georgia 820 901 689 515 333 11.6 12.5 9.4 6.9 4.4 

Hawaii 4 0 3 1 4 0.3 0.0 0.3 0.1 0.3 

Idaho 2 0 4 1 2 0.2 0.0 0.3 0.1 0.2 

Illinois 1,099 1,026 501 435 424 9.4 8.7 4.2 3.7 3.6 

Indiana 286 321 207 151 215 5.0 5.5 3.6 2.6 3.7 

Iowa 75 48 23 7 5 2.7 1.7 0.8 0.2 0.2 

Kansas 73 47 28 32 14 2.9 1.8 1.1 1.2 0.5 

Kentucky 208 185 154 135 106 5.4 4.8 4.0 3.5 2.7 

Louisiana 1,608 1,024 533 364 430 37.3 23.6 12.3 8.4 9.9 

Maine 4 2 1 2 1 0.3 0.2 0.1 0.2 0.1 

Maryland 325 554 729 891 648 6.5 11.0 14.4 17.5 12.7 

Massachusetts 90 69 85 78 46 1.5 1.1 1.4 1.3 0.8 

Michigan 292 304 183 153 211 3.1 3.2 1.9 1.6 2.2 

Minnesota 56 45 16 16 9 1.2 1.0 0.3 0.3 0.2 

Mississippi 2,084 1,952 817 390 261 78.1 72.4 30.1 14.3 9.6 

Missouri 987 584 221 118 109 18.7 11.0 4.1 2.2 2.0 

Montana 3 4 0 0 0 0.4 0.5 0.0 0.0 0.0 

Nebraska 10 14 6 3 8 0.6 0.9 0.4 0.2 0.5 

Nevada 31 36 20 11 15 2.1 2.4 1.2 0.7 0.9 

New Hampshire 4 0 1 0 2 0.4 0.0 0.1 0.0 0.2 

New Jersey 240 188 177 150 107 3.0 2.4 2.2 1.9 1.3 

New Mexico 18 13 3 9 14 1.1 0.8 0.2 0.5 0.8 

New York 802 449 214 138 119 4.4 2.5 1.2 0.8 0.7 

North Carolina 1,672 1,132 1,052 721 723 23.7 15.7 14.4 9.7 9.7 

North Dakota 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Ohio 1,187 896 584 218 134 10.7 8.0 5.2 1.9 1.2 

Oklahoma 157 197 179 117 98 4.8 6.0 5.4 3.5 3.0 

Oregon 22 5 9 10 6 0.7 0.2 0.3 0.3 0.2 

Pennsylvania 404 248 164 123 98 3.4 2.1 1.4 1.0 0.8 

Rhode Island 16 4 4 2 1 1.6 0.4 0.4 0.2 0.1 

South Carolina 799 570 402 378 271 21.8 15.5 10.8 10.1 7.2 

South Dakota 2 0 0 1 1 0.3 0.0 0.0 0.1 0.1 

Tennessee 1,044 906 850 747 567 20.2 17.2 16.0 13.9 10.6 

Texas 1,913 1,557 890 676 443 10.4 8.3 4.7 3.5 2.3 

Utah 12 4 3 5 4 0.6 0.2 0.1 0.2 0.2 

Vermont 0 0 0 0 4 0.0 0.0 0.0 0.0 0.7 

Virginia 796 600 393 237 149 12.2 9.1 5.9 3.5 2.2 

Washington 36 17 9 17 44 0.7 0.3 0.2 0.3 0.8 

West Virginia 8 16 7 1 3 0.4 0.9 0.4 0.1 0.2 

Wisconsin 298 185 176 89 60 5.9 3.6 3.4 1.7 1.2 

Wyoming 0 1 2 0 1 0.0 0.2 0.4 0.0 0.2 

U.S. TOTAL1 20,645 16,543 11,388 8,556 6,993 7.9 6.3 4.3 3.2 2.6 

Northeast 1,665 1,046 749 555 404 3.2 2.0 1.5 1.1 0.8 

Midwest 4,365 3,470 1,945 1,223 1,190 7.1 5.6 3.1 2.0 1.9 

South 13,483 11,215 8,004 6,190 4,810 14.9 12.2 8.6 6.6 5.1 

West 1,132 812 690 588 589 2.0 1.4 1.2 1.0 1.0 

Guam 2 0 0 0 0 1.4 0.0 0.0 0.0 0.0 

Puerto Rico 311 285 208 249 177 8.5 7.7 5.6 6.5 4.6 

Virgin Islands 7 2 11 2 7 6.5 1.8 10.0 1.8 6.4 

OUTLYING AREAS 320 287 219 251 184 8.2 7.3 5.5 6.1 4.5 

TOTAL 20,965 16,830 11,607 8,807 7,177 7.9 6.3 4.3 3.2 2.6 

1

Includes cases reported by Washington, D.C. 

STD Surveillance 1998 Syphilis Tables 97 
Table 26. Primary and secondary syphilis — Women – Reported cases and rates by state/area: United States 

and outlying areas, 1994–1998 

Cases Rates per 100,000 Population 

State/Area 1994 1995 1996 1997 1998 1994 1995 1996 1997 1998 

Alabama 289 257 244 183 133 13.2 11.6 11.0 8.2 5.9 

Alaska 1 1 0 0 0 0.3 0.4 0.0 0.0 0.0 

Arizona 13 14 43 37 67 0.6 0.7 1.9 1.6 2.9 

Arkansas 229 267 144 103 59 18.0 20.8 11.1 7.9 4.5 

California 314 219 187 116 120 2.0 1.4 1.2 0.7 0.7 

Colorado 48 42 10 5 3 2.6 2.2 0.5 0.3 0.2 

Connecticut 54 34 58 25 16 3.2 2.0 3.5 1.5 1.0 

Delaware 12 7 14 10 11 3.3 1.9 3.8 2.7 2.9 

Florida 337 189 172 131 116 4.7 2.6 2.3 1.7 1.5 

Georgia 350 360 284 194 130 9.7 9.7 7.6 5.1 3.4 

Hawaii 0 0 1 0 0 0.0 0.0 0.2 0.0 0.0 

Idaho 2 0 3 0 0 0.4 0.0 0.5 0.0 0.0 

Illinois 536 500 246 194 171 8.9 8.2 4.1 3.2 2.8 

Indiana 147 151 115 82 113 5.0 5.1 3.8 2.7 3.8 

Iowa 41 31 16 4 0 2.8 2.1 1.1 0.3 0.0 

Kansas 46 22 10 12 6 3.5 1.7 0.8 0.9 0.5 

Kentucky 108 83 81 66 49 5.5 4.2 4.1 3.3 2.4 

Louisiana 853 505 271 187 196 38.1 22.4 12.0 8.3 8.7 

Maine 3 0 0 1 0 0.5 0.0 0.0 0.2 0.0 

Maryland 129 233 329 400 302 5.0 9.0 12.7 15.3 11.6 

Massachusetts 39 27 30 33 15 1.2 0.9 1.0 1.0 0.5 

Michigan 138 132 82 68 86 2.8 2.7 1.6 1.4 1.7 

Minnesota 23 25 8 4 4 1.0 1.1 0.3 0.2 0.2 

Mississippi 1,058 1,000 427 201 128 76.1 71.2 30.3 14.2 9.0 

Missouri 450 283 103 63 50 16.5 10.3 3.7 2.3 1.8 

Montana 3 2 0 0 0 0.7 0.5 0.0 0.0 0.0 

Nebraska 3 4 4 0 3 0.4 0.5 0.5 0.0 0.4 

Nevada 9 12 10 6 3 1.3 1.6 1.3 0.7 0.4 

New Hampshire 0 0 0 0 1 0.0 0.0 0.0 0.0 0.2 

New Jersey 113 72 81 59 37 2.8 1.8 2.0 1.4 0.9 

New Mexico 10 3 1 5 8 1.2 0.4 0.1 0.6 0.9 

New York 322 218 92 56 28 3.4 2.3 1.0 0.6 0.3 

North Carolina 838 536 484 353 347 23.0 14.5 12.9 9.3 9.1 

North Dakota 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Ohio 601 417 287 101 72 10.5 7.2 5.0 1.8 1.2 

Oklahoma 70 90 80 53 45 4.2 5.4 4.8 3.1 2.7 

Oregon 11 2 3 2 2 0.7 0.1 0.2 0.1 0.1 

Pennsylvania 164 92 62 52 31 2.6 1.5 1.0 0.8 0.5 

Rhode Island 7 2 1 1 1 1.4 0.4 0.2 0.2 0.2 

South Carolina 403 285 182 173 131 21.3 15.0 9.5 8.9 6.7 

South Dakota 0 0 0 0 1 0.0 0.0 0.0 0.0 0.3 

Tennessee 510 432 422 370 284 19.0 15.9 15.4 13.3 10.2 

Texas 993 770 437 315 183 10.7 8.1 4.5 3.2 1.9 

Utah 4 0 0 2 0 0.4 0.0 0.0 0.2 0.0 

Vermont 0 0 0 0 1 0.0 0.0 0.0 0.0 0.3 

Virginia 400 299 204 112 61 12.0 8.8 6.0 3.3 1.8 

Washington 11 6 2 8 7 0.4 0.2 0.1 0.3 0.2 

West Virginia 1 11 6 1 2 0.1 1.2 0.6 0.1 0.2 

Wisconsin 170 93 85 49 32 6.6 3.6 3.3 1.9 1.2 

Wyoming 0 0 1 0 0 0.0 0.0 0.4 0.0 0.0 

U.S. TOTAL1 9,935 7,776 5,379 3,895 3,089 7.5 5.8 4.0 2.9 2.3 

Guam 1 0 0 0 0 1.5 0.0 0.0 0.0 0.0 

Puerto Rico 152 141 100 116 81 8.0 7.4 5.2 5.8 4.1 

Virgin Islands 4 0 5 0 1 7.1 0.0 8.8 0.0 1.8 

OUTLYING AREAS 157 141 105 116 82 7.8 6.9 5.1 5.5 3.9 

TOTAL 10,092 7,917 5,484 4,011 3,171 7.5 5.8 4.0 2.9 2.3 

1

Includes cases reported by Washington, D.C.
 

NOTE: Cases and rates underestimated in some areas because of under-reporting or non-reporting by gender.
 

98 Syphilis Tables STD Surveillance 1998 
Table 27. Primary and secondary syphilis — Men – Reported cases and rates by state/area: United States and 

outlying areas, 1994–1998 

Cases Rates per 100,000 Population 

State/Area 1994 1995 1996 1997 1998 1994 1995 1996 1997 1998 

Alabama 372 355 284 227 141 18.4 17.4 13.8 10.9 6.8 

Alaska 2 1 0 1 1 0.6 0.3 0.0 0.3 0.3 

Arizona 37 32 59 95 118 1.8 1.5 2.7 4.2 5.2 

Arkansas 217 228 118 70 49 18.3 19.0 9.7 5.7 4.0 

California 511 363 322 270 183 3.3 2.3 2.0 1.7 1.1 

Colorado 78 58 16 10 7 4.3 3.1 0.8 0.5 0.4 

Connecticut 51 52 45 37 10 3.2 3.3 2.8 2.3 0.6 

Delaware 15 12 21 12 10 4.3 3.4 6.0 3.4 2.8 

Florida 408 194 196 165 178 6.0 2.8 2.8 2.3 2.5 

Georgia 470 541 405 321 203 13.7 15.5 11.3 8.8 5.6 

Hawaii 4 0 2 1 4 0.7 0.0 0.3 0.2 0.7 

Idaho 0 0 1 1 2 0.0 0.0 0.2 0.2 0.3 

Illinois 563 526 255 241 253 9.8 9.1 4.4 4.1 4.4 

Indiana 139 169 92 69 102 5.0 6.0 3.2 2.4 3.6 

Iowa 34 17 7 3 5 2.5 1.2 0.5 0.2 0.4 

Kansas 27 25 18 20 8 2.2 2.0 1.4 1.6 0.6 

Kentucky 100 102 73 69 57 5.4 5.5 3.9 3.6 3.0 

Louisiana 755 519 262 177 234 36.4 24.9 12.5 8.4 11.2 

Maine 1 2 1 1 1 0.2 0.3 0.2 0.2 0.2 

Maryland 163 321 400 490 346 6.7 13.1 16.2 19.8 13.9 

Massachusetts 51 42 55 45 31 1.8 1.4 1.9 1.5 1.0 

Michigan 154 172 101 85 125 3.3 3.7 2.1 1.8 2.6 

Minnesota 33 20 8 12 5 1.5 0.9 0.3 0.5 0.2 

Mississippi 1,026 952 390 189 131 80.2 73.6 30.0 14.4 10.0 

Missouri 537 301 118 55 59 21.1 11.7 4.5 2.1 2.3 

Montana 0 2 0 0 0 0.0 0.5 0.0 0.0 0.0 

Nebraska 7 10 2 3 5 0.9 1.3 0.2 0.4 0.6 

Nevada 22 24 10 5 12 3.0 3.1 1.2 0.6 1.4 

New Hampshire 4 0 1 0 1 0.7 0.0 0.2 0.0 0.2 

New Jersey 127 116 96 91 70 3.3 3.0 2.5 2.3 1.8 

New Mexico 8 10 2 4 6 1.0 1.2 0.2 0.5 0.7 

New York 480 231 122 82 91 5.5 2.6 1.4 0.9 1.0 

North Carolina 834 596 568 368 376 24.3 17.1 16.0 10.2 10.4 

North Dakota 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Ohio 586 479 297 117 62 10.9 8.9 5.5 2.2 1.1 

Oklahoma 87 107 99 64 53 5.5 6.7 6.1 3.9 3.3 

Oregon 11 3 6 8 4 0.7 0.2 0.4 0.5 0.2 

Pennsylvania 240 156 102 71 67 4.1 2.7 1.8 1.2 1.2 

Rhode Island 9 2 3 1 0 1.9 0.4 0.6 0.2 0.0 

South Carolina 396 285 220 205 140 22.4 16.1 12.3 11.3 7.7 

South Dakota 2 0 0 1 0 0.6 0.0 0.0 0.3 0.0 

Tennessee 534 474 428 377 283 21.4 18.7 16.7 14.5 10.9 

Texas 920 787 453 361 260 10.2 8.5 4.8 3.8 2.7 

Utah 8 4 3 3 4 0.8 0.4 0.3 0.3 0.4 

Vermont 0 0 0 0 3 0.0 0.0 0.0 0.0 1.0 

Virginia 396 301 189 125 88 12.3 9.3 5.8 3.8 2.7 

Washington 25 11 7 9 37 0.9 0.4 0.3 0.3 1.3 

West Virginia 7 5 1 0 1 0.8 0.6 0.1 0.0 0.1 

Wisconsin 128 92 91 40 28 5.1 3.7 3.6 1.6 1.1 

Wyoming 0 1 1 0 1 0.0 0.4 0.4 0.0 0.4 

U.S. TOTAL1 10,677 8,764 6,009 4,660 3,902 8.4 6.8 4.6 3.6 3.0 

Guam 1 0 0 0 0 1.3 0.0 0.0 0.0 0.0 

Puerto Rico 159 144 108 133 96 9.0 8.1 6.0 7.2 5.2 

Virgin Islands 3 2 6 2 6 5.8 3.8 11.4 3.8 11.4 

OUTLYING AREAS 163 146 114 135 102 8.6 7.6 5.9 6.8 5.2 

TOTAL 10,840 8,910 6,123 4,795 4,004 8.4 6.8 4.7 3.6 3.0 

1

Includes cases reported by Washington, D.C.
 

NOTE: Cases and rates underestimated in some areas because of under-reporting or non-reporting by gender.
 

STD Surveillance 1998 Syphilis Tables 99 
5

10

15

20

25

30

35

40

45

50

55

60

Table 28. Primary and secondary syphilis — Reported cases and rates in selected cities of >200,000 

population, ranked according to rates: United States and outlying areas, 1998 

Rank City Cases Rate per 100,000 Population 

1 Baltimore, MD 466 70.9 

2 Nashville, TN 210 39.3 

3 Memphis, TN 260 30.0 

4 Atlanta, GA 163 22.6 

New Orleans, LA 105 22.4 

6 Indianapolis, IN 165 20.3 

7 St Louis, MO 58 17.0 

8 Washington, DC 81 15.3 

9 Norfolk, VA 33 14.4 

Detroit, MI 152 14.0 

11 Oklahoma City, OK 61 13.8 

12 Louisville, KY 91 13.6 

13 Chicago, IL 338 11.6 

14 Richmond, VA 22 11.4 

Charlotte, NC 69 11.3 

16 Newark, NJ 27 9.5 

17 San Juan, PR 79 9.1 

18 Phoenix, AZ 173 6.4 

19 Dallas, TX 126 6.2 

Philadelphia, PA 89 6.1 

21 Milwaukee, WI 54 5.9 

22 Birmingham, AL 36 5.5 

23 Columbus, OH 55 5.4 

24 Boston, MA 23 4.1 

YEAR 2000 OBJECTIVE 4.0 

Tulsa, OK 14 3.6 

26 Tampa, FL 32 3.5 

27 San Francisco, CA 25 3.4 

28 Houston, TX 99 3.1 

29 Rochester, NY 7 2.9 

Jacksonville, FL 16 2.2 

31 Cleveland, OH 30 2.2 

32 Austin, TX 15 2.2 

33 Albuquerque, NM 11 2.1 

34 Fort Worth, TX 26 2.0 

San Antonio, TX 26 2.0 

36 Seattle, WA 33 2.0 

37 Toledo, OH 8 1.8 

38 Miami, FL 31 1.5 

39 Cincinnati, OH 12 1.4 

Kansas City, MO 6 1.3 

41 Buffalo, NY 4 1.2 

42 Los Angeles, CA 96 1.1 

43 St Paul, MN 3 1.1 

44 New York City, NY 81 1.1 

Dayton, OH 6 1.1 

46 Minneapolis, MN 4 1.0 

47 Tucson, AZ 7 0.9 

48 Oakland, CA 11 0.9 

49 San Diego, CA 24 0.9 

St Petersburg, FL 8 0.9 

51 Omaha, NE 4 0.9 

52 Des Moines, IA 3 0.8 

53 Portland, OR 4 0.8 

54 Wichita, KS 3 0.7 

Denver, CO 3 0.6 

56 Akron, OH 3 0.6 

57 Honolulu, HI 4 0.5 

58 Jersey City, NJ 1 0.5 

59 Yonkers, NY 1 0.5 

El Paso, TX 2 0.3 

61 San Jose, CA 3 0.2 

62 Sacramento, CA 1 0.1 

63 Pittsburgh, PA 0 0.0 

64 Corpus Christi, TX 0 0.0 

100 Syphilis Tables STD Surveillance 1998 
Table 29. Primary and secondary syphilis — Reported cases and rates in selected cities of >200,000 

population: United States and outlying areas, 1994–1998 

Cases 

City 1994 1995 1996 1997 1998 

Akron, OH 2 

Albuquerque, NM 13 

Atlanta, GA 261 

Austin, TX 60 

Baltimore, MD 192 

Birmingham, AL 260 

Boston, MA 24 

Buffalo, NY 8 

Charlotte, NC 214 

Chicago, IL 648 

Cincinnati, OH 473 

Cleveland, OH 411 

Columbus, OH 8 

Corpus Christi, TX 20 

Dallas, TX 292 

Dayton, OH 127 

Denver, CO 83 

Des Moines, IA 37 

Detroit, MI 153 

El Paso, TX 5 

Fort Worth, TX 190 

Honolulu, HI 4 

Houston, TX 443 

Indianapolis, IN 62 

Jacksonville, FL 108 

Jersey City, NJ 14 

Kansas City, MO 73 

Los Angeles, CA 346 

Louisville, KY 147 

Memphis, TN 533 

Miami, FL 175 

Milwaukee, WI 279 

Minneapolis, MN 38 

Nashville, TN 100 

New Orleans, LA 203 

New York City, NY 629 

Newark, NJ 60 

Norfolk, VA 122 

Oakland, CA 47 

Oklahoma City, OK 115 

Omaha, NE 5 

Philadelphia, PA 298 

Phoenix, AZ 28 

Pittsburgh, PA 9 

Portland, OR 18 

Richmond, VA 39 

Rochester, NY 59 

Sacramento, CA 9 

San Antonio, TX 62 

San Diego, CA 100 

San Francisco, CA 45 

San Jose, CA 4 

Seattle, WA 11 

St Louis, MO 651 

St Paul, MN 7 

St Petersburg, FL 74 

Tampa, FL 31 

Toledo, OH 35 

Tucson, AZ 12 

Tulsa, OK 9 

Washington, DC 170 

Wichita, KS 10 

Yonkers, NY 5 

1 

6 

320 

17 

417 

264 

40 

2 

125 

582 

252 

263 

7 

8 

268 

244 

68 

27 

130 

2 

140 

0 

417 

74 

50 

27 

24 

273 

128 

477 

51 

150 

24 

97 

221 

364 

43 

130 

16 

106 

7 

199 

43 

4 

4 

37 

18 

5 

50 

53 

32 

2 

5 

361 

7 

20 

33 

22 

1 

48 

112 

16 

2 

0 

2 

247 

9 

553 

202 

42 

6 

135 

343 

76 

130 

54 

0 

236 

201 

11 

6 

92 

10 

95 

3 

151 

85 

75 

10 

7 

213 

104 

397 

38 

158 

4 

193 

169 

138 

25 

92 

10 

114 

0 

141 

89 

2 

7 

66 

13 

6 

25 

36 

33 

3 

1 

142 

3 

8 

44 

30 

10 

40 

116 

15 

0 

4 

9 

204 

8 

669 

107 

52 

2 

48 

346 

34 

61 

54 

2 

148 

28 

8 

0 

94 

3 

39 

1 

180 

71 

36 

9 

2 

108 

107 

343 

49 

84 

12 

203 

132 

97 

26 

44 

7 

39 

1 

108 

118 

5 

3 

49 

2 

4 

27 

23 

52 

5 

11 

64 

0 

11 

34 

6 

12 

8 

117 

16 

2 

3 

11 

163 

15 

466 

36 

23 

4 

69 

338 

12 

30 

55 

0 

126 

6 

3 

3 

152 

2 

26 

4 

99 

165 

16 

1 

6 

96 

91 

260 

31 

54 

4 

210 

105 

81 

27 

33 

11 

61 

4 

89 

173 

0 

4 

22 

7 

1 

26 

24 

25 

3 

33 

58 

3 

8 

32 

8 

7 

14 

81 

3 

1 

U.S. CITY TOTAL 8,670 6,936 5,266 4,148 3,524 

San Juan, PR 131 70 74 99 79 

TOTAL 8,801 7,006 5,340 4,247 3,603 

Rates per 100,000 Population 

1994 1995 1996 1997 1998 

0.4 

2.5 

37.8 

9.3 

27.3 

39.6 

4.4 

2.4 

38.0 

22.0 

54.5 

29.3 

0.8 

6.4 

15.0 

22.2 

16.8 

10.7 

14.5 

0.8 

15.1 

0.5 

14.5 

7.6 

15.4 

6.4 

16.7 

4.0 

21.9 

62.1 

8.6 

29.7 

9.9 

19.0 

41.9 

8.6 

20.7 

50.5 

3.9 

26.4 

1.2 

19.6 

1.2 

0.7 

3.7 

19.4 

24.2 

0.8 

4.8 

3.8 

6.1 

0.3 

0.7 

176.8 

2.5 

8.5 

3.5 

7.6 

1.6 

2.4 

30.0 

2.4 

2.6 

0.2 0.0 0.8 0.6 

1.1 0.4 1.7 2.1 

45.7 34.6 28.2 22.6 

2.6 1.3 1.2 2.2 

60.3 82.3 101.8 70.9 

40.1 30.6 16.2 5.5 

7.2 7.5 9.3 4.1 

0.6 1.9 0.6 1.2 

21.6 22.6 7.8 11.3 

19.7 11.7 11.9 11.6 

29.2 8.9 4.0 1.4 

18.8 9.3 4.4 2.2 

0.7 5.3 5.3 5.4 

2.6 0.0 0.6 0.0 

13.7 11.8 7.3 6.2 

42.8 35.5 5.0 1.1 

13.8 2.2 1.6 0.6 

7.7 1.7 0.0 0.8 

12.4 8.4 8.6 14.0 

0.3 1.5 0.4 0.3 

10.9 7.3 2.9 2.0 

0.0 0.3 0.1 0.5 

13.6 4.8 5.7 3.1 

9.1 10.4 8.7 20.3 

7.1 10.3 4.9 2.2 

12.4 4.6 4.1 0.5 

5.5 1.6 0.4 1.3 

3.2 2.5 1.3 1.1 

19.0 15.5 16.0 13.6 

55.1 45.9 39.6 30.0 

2.5 1.9 2.4 1.5 

16.1 17.2 9.2 5.9 

6.3 1.0 3.1 1.0 

18.3 36.2 38.0 39.3 

45.9 35.6 28.1 22.4 

5.0 1.9 1.3 1.1 

15.0 8.8 9.1 9.5 

54.7 39.5 19.2 14.4 

1.3 0.8 0.6 0.9 

24.3 26.0 8.9 13.8 

1.6 0.0 0.2 0.9 

13.3 9.6 7.4 6.1 

1.8 3.4 4.4 6.4 

0.3 0.2 0.4 0.0 

0.8 1.4 0.6 0.8 

18.7 34.6 25.5 11.4 

7.4 5.4 0.8 2.9 

0.5 0.5 0.4 0.1 

3.9 1.9 2.0 2.0 

2.0 1.3 0.8 0.9 

4.4 4.5 7.1 3.4 

0.1 0.2 0.3 0.2 

0.3 0.1 0.7 2.0 

100.6 40.7 18.7 17.0 

2.5 1.1 0.0 1.1 

2.3 0.9 1.3 0.9 

3.7 4.9 3.7 3.5 

4.8 6.6 1.3 1.8 

0.1 1.3 1.5 0.9 

12.7 10.5 2.1 3.6 

20.2 21.5 22.1 15.3 

3.8 3.5 3.6 0.7 

1.0 0.0 1.0 0.5 

12.6 10.1 7.6 6.0 5.1 

15.0 8.0 8.5 11.4 9.1 

12.7 10.0 7.6 6.0 5.1 

STD Surveillance 1998 Syphilis Tables 101 
Table 30. Primary and secondary syphilis — Women – Reported cases and rates in selected cities of >200,000 

population: United States and outlying areas, 1994–1998 

Cases 

City 1994 1995 1996 1997 1998 

0 0 0 2 1 

8 2 1 5 6 

87 110 86 67 62 

29 7 6 3 6 

72 166 240 309 222 

106 109 81 43 15 

8 15 14 19 5 

4 1 1 1 1 

102 61 64 18 36 

287 254 169 145 132 

250 121 39 13 8 

215 128 61 27 15 

2 5 27 30 32 

10 6 0 0 0 

130 135 113 66 46 

53 100 96 15 3 

31 25 6 3 2 

19 19 5 0 0 

72 54 40 45 67 

0 0 3 0 0 

97 73 41 12 9 

0 0 1 0 0 

231 215 84 84 44 

30 34 48 36 87 

52 22 38 12 8 

6 8 3 5 0 

36 15 2 1 2 

140 95 86 32 38 

78 60 57 51 45 

279 238 199 165 134 

69 19 14 16 11 

158 75 76 46 28 

14 14 2 3 2 

49 43 97 97 93 

98 88 70 57 41 

247 180 61 37 18 

25 14 14 12 14 

61 62 51 25 13 

24 8 3 0 5 

51 49 51 15 26 

3 2 0 0 1 

110 72 51 43 30 

7 13 35 31 64 

1 2 0 4 0 

9 1 3 1 1 

18 19 31 21 8 

25 10 6 1 4 

3 2 2 2 0 

37 27 16 12 8 

33 20 11 5 7 

13 5 3 8 4 

3 1 0 0 1 

3 1 0 6 1 

304 165 66 36 25 

3 4 0 0 2 

31 9 2 7 4 

15 19 22 21 20 

19 9 17 3 4 

3 0 5 5 1 

2 23 14 4 6 

72 48 57 58 34 

6 8 6 4 1 

2 1 0 0 1 

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 

U.S. CITY TOTAL 3,952 3,091 2,397 1,789 1,504 

San Juan, PR 65 40 38 41 38 

TOTAL 4,017 3,131 2,435 1,830 1,542 

Rates per 100,000 Population 

1994 1995 1996 1997 1998 

0.0 

3.0 

24.1 

9.0 

19.2 

30.3 

2.8 

2.3 

34.9 

18.7 

54.7 

28.9 

0.4 

6.3 

13.2 

17.8 

12.2 

10.5 

12.9 

0.0 

15.3 

0.0 

15.1 

7.0 

14.4 

5.3 

15.7 

3.3 

22.0 

62.1 

6.5 

32.1 

7.1 

17.7 

37.8 

6.4 

16.4 

53.4 

3.9 

22.5 

1.3 

13.5 

0.6 

0.1 

3.6 

16.4 

19.7 

0.5 

5.6 

2.5 

3.5 

0.4 

0.4 

151.7 

2.1 

6.7 

3.3 

7.9 

0.8 

1.0 

23.8 

2.8 

2.0 

0.0 0.0 0.7 0.4 

0.7 0.4 1.9 2.2 

30.0 23.1 17.8 16.4 

2.1 1.8 0.9 1.7 

45.0 66.9 87.9 63.2 

31.1 23.0 12.3 4.3 

5.2 4.8 6.6 1.7 

0.6 0.6 0.6 0.6 

20.3 20.7 5.7 11.3 

16.6 11.2 9.6 8.8 

26.6 8.7 2.9 1.8 

17.3 8.3 3.7 2.0 

1.0 5.2 5.7 6.1 

3.8 0.0 0.0 0.0 

13.6 11.2 6.4 4.5 

33.7 32.6 5.1 1.0 

9.8 2.4 1.2 0.8 

10.4 2.7 0.0 0.0 

9.8 7.0 7.9 11.7 

0.0 0.9 0.0 0.0 

11.3 6.2 1.8 1.3 

0.0 0.2 0.0 0.0 

13.9 5.4 5.3 2.8 

7.9 11.2 8.5 20.4 

6.1 10.2 3.2 2.1 

7.1 2.7 4.5 0.0 

6.5 0.9 0.4 0.9 

2.2 2.0 0.7 0.9 

16.9 16.1 14.5 12.8 

52.6 44.0 36.4 29.6 

1.8 1.3 1.5 1.0 

15.3 15.8 9.7 5.9 

7.1 1.0 1.5 1.0 

15.4 34.8 34.7 33.3 

34.0 27.5 22.7 16.3 

4.6 1.6 1.0 0.5 

9.2 9.3 8.0 9.4 

55.0 45.1 22.5 11.7 

1.3 0.5 0.0 0.8 

21.6 22.5 6.6 11.4 

0.9 0.0 0.0 0.4 

9.0 6.5 5.5 3.9 

1.1 2.6 2.3 4.7 

0.3 0.0 0.6 0.0 

0.4 1.2 0.4 0.4 

17.6 29.7 20.0 7.6 

7.9 4.8 0.8 3.2 

0.4 0.4 0.3 0.0 

4.0 2.4 1.7 1.2 

1.5 0.8 0.4 0.5 

1.4 0.8 2.2 1.1 

0.1 0.0 0.0 0.1 

0.1 0.0 0.7 0.1 

84.5 34.8 19.4 13.5 

2.8 0.0 0.0 1.4 

1.9 0.4 1.5 0.9 

4.2 4.8 4.5 4.3 

3.8 7.2 1.3 1.7 

0.0 1.3 1.3 0.3 

11.8 7.1 2.0 3.0 

16.2 19.9 20.7 12.1 

3.7 2.7 1.8 0.4 

1.0 0.0 0.0 1.0 

11.2 8.7 6.7 5.0 4.2 

13.6 8.3 7.9 8.5 7.9 

11.2 8.7 6.7 5.0 4.2 

102 Syphilis Tables STD Surveillance 1998 
Table 31. Primary and secondary syphilis — Men – Reported cases and rates in selected cities of >200,000 

population: United States and outlying areas, 1994–1998 

Cases 

City 1994 1995 1996 1997 1998 

Akron, OH 2 

Albuquerque, NM 5 

Atlanta, GA 174 

Austin, TX 31 

Baltimore, MD 87 

Birmingham, AL 154 

Boston, MA 16 

Buffalo, NY 4 

Charlotte, NC 112 

Chicago, IL 361 

Cincinnati, OH 223 

Cleveland, OH 196 

Columbus, OH 6 

Corpus Christi, TX 10 

Dallas, TX 162 

Dayton, OH 74 

Denver, CO 52 

Des Moines, IA 18 

Detroit, MI 81 

El Paso, TX 5 

Fort Worth, TX 93 

Honolulu, HI 4 

Houston, TX 212 

Indianapolis, IN 32 

Jacksonville, FL 56 

Jersey City, NJ 8 

Kansas City, MO 37 

Los Angeles, CA 206 

Louisville, KY 69 

Memphis, TN 254 

Miami, FL 106 

Milwaukee, WI 121 

Minneapolis, MN 24 

Nashville, TN 51 

New Orleans, LA 105 

New York City, NY 382 

Newark, NJ 35 

Norfolk, VA 61 

Oakland, CA 23 

Oklahoma City, OK 64 

Omaha, NE 2 

Philadelphia, PA 188 

Phoenix, AZ 21 

Pittsburgh, PA 8 

Portland, OR 9 

Richmond, VA 21 

Rochester, NY 34 

Sacramento, CA 6 

San Antonio, TX 25 

San Diego, CA 67 

San Francisco, CA 32 

San Jose, CA 1 

Seattle, WA 8 

St Louis, MO 347 

St Paul, MN 4 

St Petersburg, FL 43 

Tampa, FL 16 

Toledo, OH 16 

Tucson, AZ 9 

Tulsa, OK 7 

Washington, DC 98 

Wichita, KS 4 

Yonkers, NY 3 

1 

4 

210 

10 

251 

155 

25 

1 

64 

328 

131 

135 

2 

2 

133 

144 

43 

8 

76 

2 

67 

0 

202 

40 

28 

19 

9 

176 

68 

239 

32 

75 

10 

54 

133 

184 

29 

68 

8 

57 

5 

127 

30 

2 

3 

18 

8 

3 

23 

33 

27 

1 

4 

196 

3 

11 

14 

13 

1 

25 

64 

8 

1 

0 

1 

161 

3 

313 

121 

28 

5 

71 

174 

37 

69 

27 

0 

123 

105 

5 

1 

52 

7 

54 

2 

67 

37 

37 

7 

5 

127 

47 

198 

24 

82 

2 

96 

99 

77 

11 

41 

7 

63 

0 

90 

54 

2 

4 

35 

7 

4 

9 

25 

30 

3 

1 

76 

3 

6 

22 

13 

5 

26 

59 

9 

0 

2 

4 

137 

5 

359 

64 

33 

1 

30 

201 

21 

34 

24 

2 

82 

13 

5 

0 

49 

3 

27 

1 

96 

35 

24 

4 

1 

76 

56 

178 

33 

38 

9 

106 

75 

60 

14 

19 

7 

24 

1 

65 

87 

1 

2 

28 

1 

2 

15 

18 

44 

5 

5 

28 

0 

4 

13 

3 

7 

4 

59 

12 

2 

2 

5 

101 

9 

244 

21 

18 

3 

33 

206 

4 

15 

23 

0 

80 

3 

1 

3 

85 

2 

17 

4 

55 

78 

8 

1 

4 

58 

46 

126 

20 

26 

2 

117 

64 

63 

13 

20 

6 

35 

3 

59 

109 

0 

3 

14 

3 

1 

18 

17 

21 

2 

32 

33 

1 

4 

12 

4 

6 

8 

47 

2 

0 

U.S. CITY TOTAL 4,685 3,843 2,869 2,358 2,020 

San Juan, PR 66 30 36 58 41 

TOTAL 4,751 3,873 2,905 2,416 2,061 

Rates per 100,000 Population 

1994 1995 1996 1997 1998 

0.8 

2.0 

52.8 

9.6 

26.5 

50.2 

6.1 

2.6 

41.3 

25.4 

54.3 

29.7 

1.2 

6.6 

16.9 

27.0 

21.7 

10.9 

16.2 

1.6 

14.9 

0.9 

14.0 

8.2 

16.3 

7.6 

17.7 

4.8 

21.7 

62.2 

10.9 

27.2 

12.9 

20.4 

46.8 

11.1 

25.5 

47.9 

3.9 

30.5 

1.0 

26.5 

1.8 

1.3 

3.8 

22.9 

28.9 

1.1 

4.0 

5.0 

8.8 

0.1 

1.0 

206.8 

3.0 

10.6 

3.8 

7.3 

2.5 

3.8 

37.0 

1.9 

3.3 

0.4 0.0 0.8 0.8 

1.6 0.4 1.6 1.9 

62.8 47.1 39.6 29.2 

3.0 0.9 1.4 2.6 

77.9 100.1 117.4 79.8 

50.4 39.1 20.8 6.8 

9.3 10.4 12.3 6.7 

0.6 3.2 0.7 2.0 

22.9 24.7 10.1 11.1 

23.1 12.4 14.3 14.6 

32.0 9.1 5.2 1.0 

20.5 10.5 5.2 2.3 

0.4 5.5 4.9 4.7 

1.3 0.0 1.3 0.0 

13.8 12.5 8.2 8.0 

52.6 38.7 4.8 1.1 

17.9 2.1 2.1 0.4 

4.8 0.6 0.0 1.8 

15.2 10.0 9.5 16.4 

0.6 2.1 0.9 0.6 

10.6 8.4 4.1 2.6 

0.0 0.5 0.2 0.9 

13.2 4.3 6.1 3.5 

10.3 9.5 9.0 20.1 

8.2 10.5 6.8 2.3 

18.1 6.6 3.8 0.9 

4.3 2.4 0.5 1.9 

4.1 3.0 1.8 1.4 

21.4 14.8 17.6 14.5 

58.0 48.0 43.1 30.5 

3.3 2.5 3.4 2.0 

17.0 18.8 8.8 6.0 

5.4 1.1 4.8 1.1 

21.4 37.8 41.7 46.1 

59.5 45.0 34.5 29.4 

5.3 2.2 1.7 1.8 

21.3 8.1 10.4 9.6 

54.5 34.3 16.1 16.9 

1.3 1.1 1.1 1.0 

27.1 29.8 11.3 16.5 

2.4 0.0 0.5 1.4 

18.2 13.2 9.6 8.8 

2.5 4.2 6.5 8.2 

0.3 0.3 0.2 0.0 

1.3 1.7 0.8 1.2 

20.0 40.4 32.1 16.0 

6.8 6.0 0.9 2.6 

0.6 0.7 0.4 0.2 

3.7 1.4 2.3 2.8 

2.5 1.9 1.3 1.2 

7.4 8.3 12.2 5.8 

0.1 0.4 0.6 0.2 

0.5 0.1 0.6 4.0 

119.9 47.7 17.9 21.1 

2.3 2.3 0.0 0.8 

2.7 1.5 1.0 1.0 

3.2 5.0 2.9 2.7 

6.0 6.0 1.4 1.9 

0.3 1.3 1.8 1.6 

13.7 14.1 2.1 4.3 

24.8 23.4 23.8 18.9 

3.9 4.2 5.6 0.9 

1.1 0.0 2.2 0.0 

14.1 11.5 8.5 7.0 6.0 

16.8 7.6 9.2 14.8 10.4 

14.1 11.5 8.5 7.1 6.0 

STD Surveillance 1998 Syphilis Tables 103 
Table 32. Primary and secondary syphilis — Counties and independent cities* ranked by number of reported 

cases: United States, 1998 

Rank County/Independent City Cases Rate per 100,000 Population Cumulative Percent 

1 Baltimore (City), MD 456 69.4 7 

2 Cook County, IL (includes Chicago) 364 7.2 12 

3 Shelby County, TN 260 30.0 16 

4 Davidson County, TN 210 39.3 19 

5 Maricopa County, AZ 173 6.4 21 

6 Wayne County, MI 169 7.9 24 

7 Marion County, IN 161 19.8 26 

8 Fulton County, GA 151 20.9 28 

9 Dallas County, TX 126 6.2 30 

10 Los Angeles County, CA 108 1.2 32 

11 Orleans County, LA 105 22.4 33 

12 Harris County, TX 99 3.1 34 

13 Guilford County, NC 98 25.7 36 

14 Jefferson County, KY 91 13.6 37 

15 Philadelphia County, PA 89 6.1 39 

16 Washington, DC 81 15.3 40 

17 Tuscaloosa County, AL 74 46.0 41 

18 Mecklenburg County, NC 73 11.9 42 

19 Oklahoma County, OK 71 11.3 43 

20 St Louis (City), MO 58 17.0 44 

21 Franklin County, OH 56 5.5 45 

22 Forsyth County, NC 54 18.9 45 

23 Prince George’s County, MD 51 6.6 46 

24 Hinds County, MS 51 20.6 47 

25 Milwaukee County, WI 51 5.6 48 

26 Wake County, NC 49 8.9 48 

27 Lancaster County, SC 47 81.2 49 

28 Robeson County, NC 46 40.3 50 

*Accounting for 50% of reported primary and secondary syphilis cases. 

104 Syphilis Tables STD Surveillance 1998 
Table 33. Early latent syphilis — Reported cases and rates by state/area: United States and outlying areas, 

1994–1998 

Cases Rates per 100,000 Population 

State/Area 1994 1995 1996 1997 1998 1994 1995 1996 1997 1998 

Alabama 799 676 801 623 440 18.9 15.9 18.7 14.4 10.2 

Alaska 1 3 0 0 0 0.2 0.5 0.0 0.0 0.0 

Arizona 97 113 129 201 206 2.4 2.7 2.9 4.4 4.5 

Arkansas 656 529 446 237 185 26.7 21.3 17.8 9.4 7.3 

California 1,833 1,426 1,148 961 682 5.8 4.5 3.6 3.0 2.1 

Colorado 51 68 21 13 10 1.4 1.8 0.6 0.3 0.3 

Connecticut 104 92 104 86 37 3.2 2.8 3.2 2.6 1.1 

Delaware 59 57 40 37 44 8.3 7.9 5.5 5.1 6.0 

Florida 2,320 1,484 1,323 1,179 1,092 16.6 10.5 9.2 8.0 7.5 

Georgia 1,639 1,616 1,304 1,085 740 23.2 22.4 17.8 14.5 9.9 

Hawaii 5 0 2 0 0 0.4 0.0 0.2 0.0 0.0 

Idaho 0 1 5 5 0 0.0 0.1 0.4 0.4 0.0 

Illinois 1,685 1,774 917 1,032 641 14.3 15.0 7.7 8.7 5.4 

Indiana 338 377 265 169 121 5.9 6.5 4.5 2.9 2.1 

Iowa 90 77 38 27 20 3.2 2.7 1.3 0.9 0.7 

Kansas 48 40 46 58 39 1.9 1.6 1.8 2.2 1.5 

Kentucky 179 166 126 122 101 4.7 4.3 3.2 3.1 2.6 

Louisiana 2,314 1,598 959 550 446 53.6 36.8 22.1 12.6 10.2 

Maine 5 0 2 2 0 0.4 0.0 0.2 0.2 0.0 

Maryland 651 703 1,152 1,218 848 13.0 13.9 22.8 23.9 16.6 

Massachusetts 200 154 178 127 104 3.3 2.5 2.9 2.1 1.7 

Michigan 589 567 413 354 261 6.2 5.9 4.2 3.6 2.7 

Minnesota 81 55 29 21 8 1.8 1.2 0.6 0.4 0.2 

Mississippi 2,160 2,389 1,484 962 650 80.9 88.6 54.7 35.2 23.8 

Missouri 707 506 259 202 165 13.4 9.5 4.8 3.7 3.1 

Montana 5 9 4 4 0 0.6 1.0 0.5 0.5 0.0 

Nebraska 13 3 5 5 3 0.8 0.2 0.3 0.3 0.2 

Nevada 75 68 32 24 38 5.1 4.4 2.0 1.4 2.3 

New Hampshire 4 3 3 0 1 0.4 0.3 0.3 0.0 0.1 

New Jersey 357 294 303 236 231 4.5 3.7 3.8 2.9 2.9 

New Mexico 17 25 5 8 8 1.0 1.5 0.3 0.5 0.5 

New York 2,682 2,100 1,203 763 679 14.8 11.6 6.6 4.2 3.7 

North Carolina 1,488 1,231 1,071 879 846 21.1 17.1 14.7 11.8 11.4 

North Dakota 1 0 0 0 0 0.2 0.0 0.0 0.0 0.0 

Ohio 1,105 723 508 331 227 10.0 6.5 4.6 3.0 2.0 

Oklahoma 230 280 216 179 158 7.1 8.5 6.6 5.4 4.8 

Oregon 21 17 9 14 7 0.7 0.5 0.3 0.4 0.2 

Pennsylvania 1,897 1,212 883 668 424 15.7 10.0 7.3 5.6 3.5 

Rhode Island 11 14 8 7 0 1.1 1.4 0.8 0.7 0.0 

South Carolina 793 791 581 481 383 21.6 21.5 15.6 12.8 10.2 

South Dakota 0 1 0 2 0 0.0 0.1 0.0 0.3 0.0 

Tennessee 1,289 1,129 957 984 659 24.9 21.5 18.0 18.3 12.3 

Texas 3,869 3,015 2,167 1,863 1,480 21.1 16.1 11.4 9.6 7.6 

Utah 3 7 8 2 3 0.2 0.4 0.4 0.1 0.1 

Vermont 0 0 0 0 2 0.0 0.0 0.0 0.0 0.3 

Virginia 613 546 406 379 230 9.4 8.2 6.1 5.6 3.4 

Washington 35 12 5 13 16 0.7 0.2 0.1 0.2 0.3 

West Virginia 17 11 8 1 2 0.9 0.6 0.4 0.1 0.1 

Wisconsin 382 299 243 169 88 7.5 5.8 4.7 3.3 1.7 

Wyoming 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

U.S. TOTAL1 32,020 26,657 20,187 16,631 12,613 12.3 10.1 7.6 6.2 4.7 

Guam 1 0 0 0 0 0.7 0.0 0.0 0.0 0.0 

Puerto Rico 934 738 631 679 659 25.5 20.0 17.0 17.7 17.2 

Virgin Islands 23 17 6 8 28 21.3 15.5 5.5 7.3 25.5 

OUTLYING AREAS 958 755 637 687 687 24.5 19.1 16.0 16.8 16.8 

TOTAL 32,978 27,412 20,824 17,318 13,300 12.5 10.3 7.7 6.4 4.9 

1

Includes cases reported by Washington, D.C. 

STD Surveillance 1998 Syphilis Tables 105 
Table 34. Early latent syphilis — Reported cases and rates in selected cities of >200,000 population: 

United States and outlying areas, 1994–1998 

Cases 

City 1994 1995 1996 1997 1998 

Akron, OH 5 

Albuquerque, NM 5 

Atlanta, GA 515 

Austin, TX 149 

Baltimore, MD 371 

Birmingham, AL 264 

Boston, MA 94 

Buffalo, NY 19 

Charlotte, NC 243 

Chicago, IL 1,307 

Cincinnati, OH 260 

Cleveland, OH 599 

Columbus, OH 18 

Corpus Christi, TX 45 

Dallas, TX 520 

Dayton, OH 42 

Denver, CO 34 

Des Moines, IA 60 

Detroit, MI 388 

El Paso, TX 42 

Fort Worth, TX 283 

Honolulu, HI 5 

Houston, TX 1,157 

Indianapolis, IN 69 

Jacksonville, FL 128 

Jersey City, NJ 36 

Kansas City, MO 78 

Los Angeles, CA 1,139 

Louisville, KY 109 

Memphis, TN 717 

Miami, FL 686 

Milwaukee, WI 310 

Minneapolis, MN 49 

Nashville, TN 79 

New Orleans, LA 311 

New York City, NY 2,364 

Newark, NJ 56 

Norfolk, VA 82 

Oakland, CA 95 

Oklahoma City, OK 142 

Omaha, NE 9 

Philadelphia, PA 1,708 

Phoenix, AZ 63 

Pittsburgh, PA 10 

Portland, OR 11 

Richmond, VA 60 

Rochester, NY 59 

Sacramento, CA 31 

San Antonio, TX 240 

San Diego, CA 102 

San Francisco, CA 21 

San Jose, CA 5 

Seattle, WA 7 

St Louis, MO 391 

St Paul, MN 14 

St Petersburg, FL 140 

Tampa, FL 100 

Toledo, OH 28 

Tucson, AZ 22 

Tulsa, OK 27 

Washington, DC 502 

Wichita, KS 8 

Yonkers, NY 26 

6 

9 

531 

79 

466 

289 

65 

6 

180 

1,400 

115 

361 

11 

29 

410 

98 

46 

54 

364 

21 

280 

0 

892 

55 

111 

30 

29 

952 

81 

652 

499 

229 

24 

97 

215 

1,945 

77 

110 

55 

140 

3 

1,100 

79 

13 

11 

70 

23 

21 

161 

60 

14 

4 

1 

289 

9 

83 

79 

27 

29 

44 

396 

12 

16 

4 

0 

383 

49 

896 

341 

83 

6 

144 

745 

43 

202 

32 

10 

335 

93 

7 

23 

271 

44 

216 

0 

703 

56 

104 

17 

13 

718 

71 

548 

437 

183 

16 

99 

153 

1,077 

55 

101 

25 

89 

0 

839 

108 

3 

6 

78 

23 

15 

115 

43 

11 

6 

0 

136 

2 

35 

139 

23 

14 

48 

371 

30 

12 

0 

6 

367 

33 

975 

225 

62 

5 

86 

918 

26 

164 

34 

6 

306 

28 

7 

19 

254 

34 

192 

0 

528 

33 

81 

10 

6 

649 

66 

591 

427 

140 

14 

173 

119 

670 

30 

87 

33 

50 

2 

648 

189 

2 

8 

58 

9 

10 

96 

17 

16 

4 

5 

83 

1 

28 

83 

6 

6 

16 

348 

45 

5 

4 

5 

303 

19 

646 

95 

60 

2 

97 

563 

11 

98 

42 

13 

405 

5 

7 

11 

180 

14 

121 

0 

367 

44 

69 

2 

6 

424 

64 

382 

242 

71 

5 

148 

84 

645 

56 

50 

25 

70 

3 

407 

193 

1 

5 

36 

9 

12 

63 

21 

15 

5 

8 

63 

1 

19 

76 

5 

6 

44 

288 

13 

2 

U.S. CITY TOTAL 16,459 13,557 10,449 9,139 6,750 

San Juan, PR 406 313 308 305 300 

TOTAL 16,865 13,870 10,757 9,444 7,050 

Rates per 100,000 Population 

1994 1995 1996 1997 1998 

0.9 

1.0 

74.6 

23.0 

52.8 

40.2 

17.1 

5.8 

43.1 

44.3 

30.0 

42.7 

1.8 

14.5 

26.8 

7.3 

6.9 

17.3 

36.7 

6.3 

22.5 

0.6 

38.0 

8.4 

18.2 

16.5 

17.8 

13.3 

16.2 

83.6 

33.9 

33.0 

12.8 

15.0 

64.2 

32.2 

19.3 

34.0 

7.9 

32.6 

2.1 

112.1 

2.7 

0.8 

2.3 

29.8 

24.2 

2.8 

18.7 

3.9 

2.9 

0.3 

0.4 

106.2 

5.1 

16.1 

11.4 

6.1 

3.0 

7.1 

88.5 

1.9 

13.6 

1.1 0.8 0.0 0.8 

1.7 0.0 1.1 1.0 

75.8 53.6 50.8 41.9 

11.9 7.2 4.8 2.7 

67.4 133.4 148.3 98.3 

43.9 51.6 34.2 14.4 

11.7 14.9 11.1 10.8 

1.8 1.9 1.6 0.6 

31.1 24.2 14.0 15.8 

47.5 25.5 31.5 19.3 

13.3 5.0 3.1 1.3 

25.8 14.5 11.8 7.1 

1.1 3.2 3.3 4.1 

9.3 3.2 1.9 4.1 

20.9 16.8 15.1 20.0 

17.2 16.4 5.0 0.9 

9.3 1.4 1.4 1.4 

15.4 6.5 5.4 3.1 

34.6 24.8 23.3 16.5 

3.1 6.4 4.8 2.0 

21.9 16.6 14.5 9.1 

0.0 0.0 0.0 0.0 

29.0 22.6 16.7 11.6 

6.7 6.9 4.1 5.4 

15.8 14.3 11.1 9.4 

13.8 7.8 4.6 0.9 

6.6 2.9 1.3 1.3 

11.1 8.4 7.6 5.0 

12.0 10.6 9.8 9.5 

75.4 63.4 68.2 44.1 

24.6 21.4 20.9 11.8 

24.6 19.9 15.4 7.8 

6.3 4.2 3.7 1.3 

18.3 18.6 32.4 27.7 

44.6 32.3 25.4 17.9 

26.6 14.7 9.1 8.8 

26.8 19.3 10.5 19.7 

46.3 43.4 37.9 21.8 

4.5 2.0 2.6 2.0 

32.0 20.3 11.3 15.9 

0.7 0.0 0.5 0.7 

73.4 56.9 44.6 28.0 

3.2 4.1 7.0 7.2 

1.0 0.2 0.2 0.1 

2.3 1.2 1.6 1.0 

35.3 40.8 30.1 18.7 

9.5 9.5 3.7 3.7 

1.9 1.3 0.9 1.1 

12.4 8.8 7.2 4.7 

2.3 1.6 0.6 0.8 

1.9 1.5 2.2 2.0 

0.3 0.4 0.2 0.3 

0.1 0.0 0.3 0.5 

80.6 38.9 24.3 18.4 

3.3 0.7 0.4 0.4 

9.5 4.0 3.2 2.2 

8.9 15.5 9.1 8.4 

5.9 5.1 1.3 1.1 

3.9 1.8 0.8 0.8 

11.6 12.6 4.1 11.4 

71.4 68.8 65.8 54.4 

2.9 6.9 10.3 3.0 

8.4 6.3 2.6 1.0 

24.0 19.7 15.1 13.1 9.7 

46.6 35.9 35.3 35.0 34.4 

24.2 19.9 15.3 13.4 10.0 

106 Syphilis Tables STD Surveillance 1998 
Table 35. Late and late latent syphilis — Reported cases and rates by state/area: United States and outlying 

areas, 1994–1998 

Cases Rates per 100,000 Population 

State/Area 1994 1995 1996 1997 1998 1994 1995 1996 1997 1998 

Alabama 453 334 538 419 410 10.7 7.9 12.5 9.7 9.5 

Alaska 18 15 15 11 12 3.0 2.5 2.5 1.8 2.0 

Arizona 256 248 231 255 281 6.3 5.9 5.2 5.6 6.2 

Arkansas 197 217 103 121 183 8.0 8.7 4.1 4.8 7.3 

California 5,105 3,417 2,567 2,319 1,514 16.2 10.8 8.1 7.2 4.7 

Colorado 115 134 112 123 97 3.1 3.6 2.9 3.2 2.5 

Connecticut 122 86 125 175 114 3.7 2.6 3.8 5.4 3.5 

Delaware 47 52 49 52 49 6.6 7.3 6.8 7.1 6.7 

Florida 1,909 1,489 1,128 1,198 1,082 13.7 10.5 7.8 8.2 7.4 

Georgia 683 1,104 931 1,218 749 9.7 15.3 12.7 16.3 10.0 

Hawaii 32 25 25 44 11 2.7 2.1 2.1 3.7 0.9 

Idaho 8 11 14 18 13 0.7 0.9 1.2 1.5 1.1 

Illinois 835 728 549 414 892 7.1 6.2 4.6 3.5 7.5 

Indiana 209 172 197 199 173 3.6 3.0 3.4 3.4 3.0 

Iowa 64 45 25 38 23 2.3 1.6 0.9 1.3 0.8 

Kansas 64 62 62 76 60 2.5 2.4 2.4 2.9 2.3 

Kentucky 134 143 113 141 127 3.5 3.7 2.9 3.6 3.2 

Louisiana 1,409 1,034 902 872 767 32.7 23.8 20.8 20.0 17.6 

Maine 0 2 1 9 3 0.0 0.2 0.1 0.7 0.2 

Maryland 553 394 317 288 616 11.1 7.8 6.3 5.7 12.1 

Massachusetts 326 283 364 524 416 5.4 4.7 6.0 8.6 6.8 

Michigan 325 304 233 252 198 3.4 3.2 2.4 2.6 2.0 

Minnesota 62 85 69 87 57 1.4 1.8 1.5 1.9 1.2 

Mississippi 247 126 10 48 235 9.3 4.7 0.4 1.8 8.6 

Missouri 219 135 123 172 86 4.1 2.5 2.3 3.2 1.6 

Montana 1 0 0 1 0 0.1 0.0 0.0 0.1 0.0 

Nebraska 23 18 16 24 22 1.4 1.1 1.0 1.4 1.3 

Nevada 62 89 89 84 83 4.3 5.8 5.6 5.0 4.9 

New Hampshire 10 29 25 23 11 0.9 2.5 2.2 2.0 0.9 

New Jersey 1,411 893 888 681 402 17.9 11.2 11.1 8.5 5.0 

New Mexico 143 100 70 86 54 8.6 5.9 4.1 5.0 3.1 

New York 5,503 6,005 4,957 4,639 4,291 30.3 33.1 27.3 25.6 23.7 

North Carolina 819 670 516 584 540 11.6 9.3 7.1 7.9 7.3 

North Dakota 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Ohio 377 281 217 202 109 3.4 2.5 1.9 1.8 1.0 

Oklahoma 95 95 62 100 92 2.9 2.9 1.9 3.0 2.8 

Oregon 57 45 52 23 19 1.8 1.4 1.6 0.7 0.6 

Pennsylvania 322 420 335 354 367 2.7 3.5 2.8 2.9 3.1 

Rhode Island 112 72 60 75 54 11.2 7.3 6.1 7.6 5.5 

South Carolina 252 266 259 261 198 6.9 7.2 7.0 6.9 5.3 

South Dakota 6 6 2 4 1 0.8 0.8 0.3 0.5 0.1 

Tennessee 588 540 480 605 515 11.4 10.3 9.0 11.3 9.6 

Texas 3,022 3,152 2,674 2,694 1,930 16.4 16.8 14.0 13.9 9.9 

Utah 36 39 38 49 47 1.9 2.0 1.9 2.4 2.3 

Vermont 1 0 0 1 0 0.2 0.0 0.0 0.2 0.0 

Virginia 492 419 450 485 324 7.5 6.3 6.8 7.2 4.8 

Washington 207 181 114 101 80 3.9 3.3 2.1 1.8 1.4 

West Virginia 152 38 44 17 6 8.3 2.1 2.4 0.9 0.3 

Wisconsin 99 90 74 50 54 1.9 1.8 1.4 1.0 1.0 

Wyoming 3 1 6 1 1 0.6 0.2 1.2 0.2 0.2 

U.S. TOTAL1 27,452 24,295 20,356 20,385 17,570 10.5 9.2 7.7 7.6 6.6 

Guam 4 6 3 1 3 2.7 4.0 2.0 0.6 1.9 

Puerto Rico 753 582 620 640 597 20.6 15.8 16.7 16.7 15.6 

Virgin Islands 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

OUTLYING AREAS 757 588 623 641 600 19.4 14.9 15.6 15.7 14.7 

TOTAL 28,209 24,883 20,979 21,026 18,170 10.7 9.3 7.8 7.7 6.7 

1

Includes cases reported by Washington, D.C. 

STD Surveillance 1998 Syphilis Tables 107 
Table 36. Late and late latent syphilis — Reported cases and rates in selected cities of >200,000 population: 

United States and outlying areas, 1994–1998 

Cases 

City 1994 1995 1996 1997 1998 

Akron, OH 6 

Albuquerque, NM 69 

Atlanta, GA 130 

Austin, TX 48 

Baltimore, MD 109 

Birmingham, AL 132 

Boston, MA 97 

Buffalo, NY 24 

Charlotte, NC 46 

Chicago, IL 203 

Cincinnati, OH 91 

Cleveland, OH 106 

Columbus, OH 44 

Corpus Christi, TX 18 

Dallas, TX 308 

Dayton, OH 62 

Denver, CO 57 

Des Moines, IA 10 

Detroit, MI 211 

El Paso, TX 126 

Fort Worth, TX 112 

Honolulu, HI 32 

Houston, TX 1,223 

Indianapolis, IN 42 

Jacksonville, FL 51 

Jersey City, NJ 112 

Kansas City, MO 10 

Los Angeles, CA 2,254 

Louisville, KY 59 

Memphis, TN 453 

Miami, FL 573 

Milwaukee, WI 81 

Minneapolis, MN 34 

Nashville, TN 54 

New Orleans, LA 307 

New York City, NY 4,678 

Newark, NJ 346 

Norfolk, VA 41 

Oakland, CA 171 

Oklahoma City, OK 30 

Omaha, NE 14 

Philadelphia, PA 282 

Phoenix, AZ 133 

Pittsburgh, PA 19 

Portland, OR 34 

Richmond, VA 29 

Rochester, NY 78 

Sacramento, CA 86 

San Antonio, TX 179 

San Diego, CA 291 

San Francisco, CA 19 

San Jose, CA 122 

Seattle, WA 106 

St Louis, MO 121 

St Paul, MN 6 

St Petersburg, FL 103 

Tampa, FL 218 

Toledo, OH 16 

Tucson, AZ 67 

Tulsa, OK 15 

Washington, DC 267 

Wichita, KS 9 

Yonkers, NY 35 

1 

26 

207 

87 

191 

78 

88 

23 

41 

141 

26 

108 

13 

24 

334 

50 

65 

11 

192 

115 

60 

22 

1,283 

39 

30 

70 

13 

1,605 

59 

442 

409 

74 

36 

7 

213 

5,291 

232 

31 

91 

32 

11 

329 

142 

10 

27 

14 

59 

54 

174 

252 

37 

68 

87 

60 

12 

63 

156 

3 

47 

13 

201 

14 

43 

4 

31 

190 

30 

73 

149 

130 

8 

31 

100 

46 

40 

3 

19 

217 

66 

48 

5 

144 

60 

63 

23 

1,095 

45 

48 

68 

18 

1,165 

49 

399 

364 

53 

31 

0 

198 

4,455 

256 

24 

96 

20 

1 

255 

143 

11 

32 

27 

31 

34 

231 

143 

105 

59 

58 

43 

12 

42 

115 

10 

35 

18 

125 

13 

21 

0 

41 

289 

57 

81 

136 

191 

13 

19 

NR 

33 

19 

28 

14 

260 

70 

55 

7 

171 

73 

62 

39 

1,128 

21 

89 

61 

4 

806 

56 

473 

367 

42 

27 

36 

208 

4,110 

157 

25 

86 

15 

12 

300 

156 

14 

11 

27 

21 

36 

182 

206 

101 

83 

42 

109 

7 

40 

83 

13 

34 

10 

168 

22 

27 

0 

29 

120 

22 

331 

110 

155 

6 

44 

507 

9 

20 

17 

13 

187 

28 

24 

6 

130 

65 

27 

11 

879 

30 

69 

28 

1 

434 

54 

383 

463 

37 

24 

58 

157 

3,881 

78 

23 

91 

37 

17 

287 

187 

11 

8 

20 

21 

16 

143 

135 

88 

54 

26 

46 

6 

29 

65 

10 

23 

14 

202 

4 

17 

U.S. CITY TOTAL 14,809 13,736 11,428 11,073 10,017 

San Juan, PR 468 309 339 312 293 

TOTAL 15,277 14,045 11,767 11,385 10,310 

Rates per 100,000 Population 

1994 1995 1996 1997 1998 

1.1 

13.4 

18.8 

7.4 

15.5 

20.1 

17.7 

7.3 

8.2 

6.9 

10.5 

7.6 

4.4 

5.8 

15.9 

10.8 

11.5 

2.9 

20.0 

19.0 

8.9 

3.7 

40.2 

5.1 

7.2 

51.3 

2.3 

26.3 

8.8 

52.8 

28.3 

8.6 

8.9 

10.2 

63.4 

63.8 

119.3 

17.0 

14.2 

6.9 

3.3 

18.5 

5.7 

1.4 

7.0 

14.4 

31.9 

7.8 

14.0 

11.1 

2.6 

7.8 

6.7 

32.9 

2.2 

11.9 

24.9 

3.5 

9.2 

4.0 

47.1 

2.1 

18.3 

0.2 0.8 0.0 0.0 

5.0 5.9 7.8 5.5 

29.5 26.6 40.0 16.6 

13.1 4.4 8.2 3.2 

27.6 10.9 12.3 50.4 

11.9 22.5 20.6 16.7 

15.8 23.3 34.3 27.8 

7.1 2.5 4.1 1.9 

7.1 5.2 3.1 7.2 

4.8 3.4 . 17.4 

3.0 5.4 3.9 1.1 

7.7 2.9 1.4 1.4 

1.3 0.3 2.8 1.7 

7.7 6.0 4.4 4.1 

17.0 10.9 12.9 9.2 

8.8 11.7 12.5 5.0 

13.1 9.7 11.0 4.8 

3.1 1.4 2.0 1.7 

18.2 13.2 15.7 11.9 

17.0 8.8 10.4 9.3 

4.7 4.8 4.7 2.0 

2.5 2.6 4.5 1.3 

41.7 35.2 35.7 27.8 

4.8 5.5 2.6 3.7 

4.3 6.6 12.1 9.4 

32.2 31.3 28.0 12.9 

3.0 4.0 0.9 0.2 

18.8 13.7 9.4 5.1 

8.8 7.3 8.4 8.1 

51.1 46.1 54.6 44.2 

20.1 17.9 17.9 22.6 

7.9 5.8 4.6 4.1 

9.4 8.1 7.0 6.3 

1.3 0.0 6.7 10.9 

44.2 41.8 44.3 33.5 

72.4 60.7 56.0 52.9 

80.7 89.6 55.2 27.4 

13.0 10.3 10.9 10.0 

7.5 7.8 6.9 7.3 

7.3 4.6 3.4 8.4 

2.5 0.2 2.7 3.9 

21.9 17.3 20.7 19.8 

5.8 5.5 5.8 6.9 

0.8 0.9 1.1 0.9 

5.6 6.5 2.2 1.6 

7.1 14.1 14.0 10.4 

24.3 12.8 8.7 8.7 

4.9 3.0 3.2 1.4 

13.4 17.6 13.7 10.7 

9.5 5.3 7.6 5.0 

5.1 14.4 13.8 12.0 

4.3 3.7 5.2 3.4 

5.5 3.6 2.6 1.6 

16.7 12.3 31.9 13.5 

4.4 4.4 2.5 2.2 

7.2 4.8 4.6 3.3 

17.6 12.9 9.1 7.1 

0.7 2.2 2.9 2.2 

6.2 4.6 4.4 2.9 

3.4 4.7 2.6 3.6 

36.3 23.2 31.8 38.2 

3.3 3.0 5.0 0.9 

22.4 10.9 14.0 8.8 

21.6 19.9 16.5 15.9 14.4 

53.7 35.4 38.9 35.8 33.6 

22.0 20.1 16.8 16.1 14.6 

*NR = No report (see Appendix). 

108 Syphilis Tables STD Surveillance 1998 
Table 37. Congenital syphilis — Reported cases and rates in infants <1 year of age: United States (excluding 

outlying areas), 1963–1998 

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 7.0 

1986 357 9.5 

1987 444 11.6 

1988 658 16.8 

1989 1,807 44.7 

1990 3,816 91.0 

1991 4,410 107.3 

1992 3,851 94.7 

1993 3,237 80.9 

1994 2,204 55.8 

1995 1,850 47.4 

1996 1,295 33.3 

1997 1,070 27.5 

1998 801 20.6 

Years 1963-1966 are fiscal years.
 

NOTE: The surveillance case definition for congenital syphilis changed in 1988 (see Appendix). As of 1995, cases of congenital syphilis <1 year of
 

age are obtained using case reporting form CDC 73.126.
 

STD Surveillance 1998 Syphilis Tables 109 
Table 38. Congenital syphilis — Reported cases and rates in infants <1 year of age by state/area, ranked 

according to rates: United States and outlying areas, 1998 

Rank State/Area* Cases Rate per 100,000 Live Births 

1 Arkansas 30 82.5 

2 New Jersey 86 75.2 

3 Maryland 44 61.5 

4 Puerto Rico 27 42.8 

YEAR 2000 OBJECTIVE 40.0 

5 Illinois 71 38.8 

6 Florida 71 37.5 

7 South Carolina 19 37.2 

8 Mississippi 15 36.6 

9 Arizona 25 33.2 

10 Oklahoma 15 32.5 

11 Texas 102 30.9 

12 North Carolina 24 23.0 

13 California 119 22.1 

14 New York 56 21.2 

U.S. TOTAL1 801 20.6 

15 Missouri 15 20.3 

16 Alabama 9 14.9 

17 Pennsylvania 21 14.2 

18 Georgia 14 12.3 

19 Louisiana 8 12.3 

20 Tennessee 9 12.2 

21 Michigan 16 12.0 

22 Kentucky 5 9.5 

23 Wisconsin 6 8.9 

24 Virginia 4 4.3 

25 Ohio 4 2.6 

26 Massachusetts 2 2.5 

27 Utah 1 2.4 

28 Colorado 1 1.8 

29 Washington 1 1.3 

30 Alaska 0 0.0 

31 Connecticut 0 0.0 

32 Delaware 0 0.0 

33 Hawaii 0 0.0 

34 Idaho 0 0.0 

35 Indiana 0 0.0 

36 Iowa 0 0.0 

37 Kansas 0 0.0 

38 Maine 0 0.0 

39 Minnesota 0 0.0 

40 Montana 0 0.0 

41 Nebraska 0 0.0 

42 Nevada 0 0.0 

43 New Hampshire 0 0.0 

44 New Mexico 0 0.0 

45 North Dakota 0 0.0 

46 Oregon 0 0.0 

47 Rhode Island 0 0.0 

48 South Dakota 0 0.0 

49 Vermont 0 0.0 

50 West Virginia 0 0.0 

51 Wyoming 0 0.0 

52 Guam 0 0.0 

53 Virgin Islands 0 0.0 

*Mother’s state of residence used to assign case.
 

1

Includes cases reported by Washington, D.C. but excludes outlying areas (Guam, Puerto Rico and Virgin Islands).
 

110 Syphilis Tables STD Surveillance 1998 
Table 39. Congenital syphilis — Reported cases and rates in infants <1 year of age by state/area: 

United States and outlying areas, 1994–1998 

Cases Rates per 100,000 Live Births 

State/Area* 1994 1995 1996 1997 1998 1994 1995 1996 1997 1998 

Alabama 18 18 23 31 9 29.5 29.8 38.0 51.2 14.9 

Alaska 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Arizona 16 10 6 12 25 22.6 13.8 8.0 15.9 33.2 

Arkansas 29 29 32 40 30 83.5 82.4 88.0 110.0 82.5 

California 194 344 195 159 119 34.2 62.3 36.1 29.5 22.1 

Colorado 4 1 3 0 1 7.4 1.8 5.4 0.0 1.8 

Connecticut 6 6 2 2 0 13.1 13.5 4.5 4.5 0.0 

Delaware 5 1 0 2 0 48.0 9.7 0.0 19.7 0.0 

Florida 74 109 93 72 71 38.8 57.8 49.1 38.0 37.5 

Georgia 42 45 29 17 14 37.8 40.1 25.4 14.9 12.3 

Hawaii 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Idaho 0 0 1 0 0 0.0 0.0 5.4 0.0 0.0 

Illinois 258 184 104 73 71 136.3 99.0 56.8 39.9 38.8 

Indiana 11 0 6 3 0 13.3 0.0 7.2 3.6 0.0 

Iowa 6 0 0 0 0 16.2 0.0 0.0 0.0 0.0 

Kansas 2 1 0 2 0 5.4 2.7 0.0 5.5 0.0 

Kentucky 13 7 5 5 5 24.5 13.4 9.5 9.5 9.5 

Louisiana 87 36 15 22 8 128.3 54.8 23.0 33.7 12.3 

Maine 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Maryland 9 28 36 58 44 12.2 38.7 50.3 81.1 61.5 

Massachusetts 6 0 6 1 2 7.2 0.0 7.5 1.2 2.5 

Michigan 28 28 22 29 16 20.3 20.8 16.5 21.7 12.0 

Minnesota 2 2 2 0 0 3.1 3.2 3.1 0.0 0.0 

Mississippi 56 65 54 41 15 133.5 157.2 131.7 100.0 36.6 

Missouri 72 40 15 10 15 97.9 54.8 20.3 13.5 20.3 

Montana 0 0 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 0.0 

Nevada 3 0 1 0 0 12.5 0.0 3.8 0.0 0.0 

New Hampshire 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

New Jersey 178 94 99 84 86 151.5 81.9 86.6 73.5 75.2 

New Mexico 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

New York 388 326 155 105 56 139.4 120.1 58.7 39.8 21.2 

North Carolina 44 33 31 18 24 43.4 32.5 29.7 17.2 23.0 

North Dakota 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Ohio 71 38 15 10 4 45.5 24.7 9.9 6.6 2.6 

Oklahoma 15 17 10 9 15 32.8 37.2 21.6 19.5 32.5 

Oregon 0 0 0 1 0 0.0 0.0 0.0 2.3 0.0 

Pennsylvania 115 68 58 37 21 73.2 44.8 39.1 24.9 14.2 

Rhode Island 2 0 0 0 0 14.9 0.0 0.0 0.0 0.0 

South Carolina 100 42 44 18 19 192.1 82.5 86.1 35.2 37.2 

South Dakota 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Tennessee 57 29 34 32 9 77.9 39.6 46.1 43.4 12.2 

Texas 224 199 164 149 102 69.8 61.7 49.6 45.1 30.9 

Utah 0 0 0 0 1 0.0 0.0 0.0 0.0 2.4 

Vermont 0 0 1 0 0 0.0 0.0 14.8 0.0 0.0 

Virginia 18 25 16 7 4 18.9 27.0 17.3 7.6 4.3 

Washington 3 1 1 0 1 3.9 1.3 1.3 0.0 1.3 

West Virginia 2 0 0 1 0 9.4 0.0 0.0 4.8 0.0 

Wisconsin 18 11 3 9 6 26.4 16.3 4.5 13.4 8.9 

Wyoming 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

U.S. TOTAL1 2,204 1,850 1,295 1,070 801 55.8 47.4 33.3 27.5 20.6 

Guam 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Puerto Rico 20 14 10 9 27 31.1 22.1 15.8 14.3 42.8 

Virgin Islands 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

OUTLYING AREAS 20 14 10 9 27 28.2 20.1 14.4 13.0 39.0 

TOTAL 2,224 1,864 1,305 1,079 828 55.3 47.0 32.9 27.2 20.9 

*Mother’s state of residence used to assign case.
 

1

Includes cases reported by Washington, D.C.
 

NOTE: As of 1995, cases of congenital syphilis <1 year of age are obtained using case reporting form CDC 73.126.
 

STD Surveillance 1998 Syphilis Tables 111 
5

10

15

20

25

30

35

40

45

50

55

60

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

>200,000 population, ranked according to rates: United States and outlying areas, 1998 

Rank City* Cases Rate per 100,000 Live Births 

1 Newark, NJ 26 510.5 

2 Baltimore, MD 29 279.7 

3 Miami, FL 37 246.5 

4 Oklahoma City, OK 10 136.6 

Houston, TX 52 124.8 

6 Washington, DC 8 95.4 

7 Chicago, IL 49 92.7 

8 Philadelphia, PA 21 92.1 

9 Phoenix, AZ 19 81.1 

Memphis, TN 9 81.0 

11 Dallas, TX 17 76.4 

12 Jersey City, NJ 3 74.5 

13 Birmingham, AL 3 72.4 

14 Detroit, MI 12 72.3 

Yonkers, NY 2 70.8 

16 Richmond, VA 2 68.1 

17 Atlanta, GA 5 61.6 

18 Louisville, KY 4 58.9 

19 Tampa, FL 4 58.0 

Los Angeles, CA 40 56.6 

21 Milwaukee, WI 6 53.4 

22 St Louis, MO 3 51.2 

23 Tulsa, OK 3 50.5 

24 Rochester, NY 2 49.0 

YEAR 2000 OBJECTIVE 40.0 

San Diego, CA 7 35.6 

26 New York City, NY 43 35.0 

27 Cleveland, OH 3 32.3 

28 New Orleans, LA 2 26.4 

29 Boston, MA 2 25.8 

San Antonio, TX 5 23.3 

31 Corpus Christi, TX 1 21.9 

32 Sacramento, CA 2 18.5 

33 Oakland, CA 1 15.6 

34 San Juan, PR 1 14.3 

San Francisco, CA 1 11.9 

36 Denver, CO 1 10.9 

37 Fort Worth, TX 1 10.7 

38 Columbus, OH 1 9.1 

39 Tucson, AZ 0 0.0 

San Jose, CA 0 0.0 

41 Jacksonville, FL 0 0.0 

42 St Petersburg, FL 0 0.0 

43 Honolulu, HI 0 0.0 

44 Indianapolis, IN 0 0.0 

Des Moines, IA 0 0.0 

46 Wichita, KS 0 0.0 

47 Minneapolis, MN 0 0.0 

48 St Paul, MN 0 0.0 

49 Kansas City, MO 0 0.0 

Omaha, NE 0 0.0 

51 Albuquerque, NM 0 0.0 

52 Buffalo, NY 0 0.0 

53 Charlotte, NC 0 0.0 

54 Akron, OH 0 0.0 

Cincinnati, OH 0 0.0 

56 Dayton, OH 0 0.0 

57 Toledo, OH 0 0.0 

58 Portland, OR 0 0.0 

59 Pittsburgh, PA 0 0.0 

Nashville, TN 0 0.0 

61 Austin, TX 0 0.0 

62 El Paso, TX 0 0.0 

63 Norfolk, VA 0 0.0 

64 Seattle, WA 0 0.0 

*Mother’s city of residence used to assign case. 

112 Syphilis Tables STD Surveillance 1998 
Table 41. Congenital syphilis — Reported cases and rates in infants <1 year of age in selected cities of 

>200,000 population: United States and outlying areas, 1994–1998 

Cases 

City* 1994 1995 1996 1997 1998 

Akron, OH 0 

Albuquerque, NM 0 

Atlanta, GA 11 

Austin, TX 3 

Baltimore, MD 1 

Birmingham, AL 7 

Boston, MA 4 

Buffalo, NY 1 

Charlotte, NC 3 

Chicago, IL 177 

Cincinnati, OH 15 

Cleveland, OH 44 

Columbus, OH 1 

Corpus Christi, TX 0 

Dallas, TX 10 

Dayton, OH 5 

Denver, CO 3 

Des Moines, IA 2 

Detroit, MI 19 

El Paso, TX 10 

Fort Worth, TX 7 

Honolulu, HI 0 

Houston, TX 86 

Indianapolis, IN 3 

Jacksonville, FL 1 

Jersey City, NJ 9 

Kansas City, MO 7 

Los Angeles, CA 190 

Louisville, KY 10 

Memphis, TN 35 

Miami, FL 14 

Milwaukee, WI 15 

Minneapolis, MN 1 

Nashville, TN 1 

New Orleans, LA 23 

New York City, NY 329 

Newark, NJ 55 

Norfolk, VA 2 

Oakland, CA 0 

Oklahoma City, OK 12 

Omaha, NE 0 

Philadelphia, PA 106 

Phoenix, AZ 13 

Pittsburgh, PA 1 

Portland, OR 0 

Richmond, VA 0 

Rochester, NY 4 

Sacramento, CA 0 

San Antonio, TX 10 

San Diego, CA 0 

San Francisco, CA 4 

San Jose, CA 0 

Seattle, WA 2 

St Louis, MO 49 

St Paul, MN 0 

St Petersburg, FL 0 

Tampa, FL 4 

Toledo, OH 0 

Tucson, AZ 3 

Tulsa, OK 1 

Washington, DC 28 

Wichita, KS 0 

Yonkers, NY 8 

0 

0 

16 

0 

15 

9 

0 

1 

1 

121 

6 

18 

0 

1 

10 

7 

0 

0 

21 

4 

9 

0 

99 

0 

1 

9 

2 

125 

4 

25 

47 

11 

2 

1 

0 

281 

40 

7 

23 

13 

0 

68 

6 

0 

0 

1 

4 

6 

9 

6 

1 

4 

0 

24 

0 

2 

9 

0 

1 

0 

13 

0 

3 

0 

0 

15 

0 

30 

11 

2 

2 

2 

66 

1 

5 

0 

0 

2 

7 

1 

0 

15 

4 

5 

0 

98 

0 

1 

2 

0 

68 

3 

26 

37 

3 

1 

1 

0 

131 

35 

5 

8 

4 

0 

58 

2 

0 

0 

0 

1 

3 

7 

5 

2 

2 

0 

8 

0 

1 

16 

0 

2 

3 

14 

0 

0 

0 

0 

12 

0 

56 

6 

0 

3 

0 

50 

0 

6 

1 

0 

3 

0 

0 

0 

25 

2 

6 

0 

101 

0 

0 

4 

1 

50 

3 

28 

31 

9 

0 

0 

4 

84 

26 

1 

2 

5 

0 

37 

10 

0 

1 

1 

0 

5 

4 

13 

2 

1 

0 

5 

0 

0 

7 

0 

0 

1 

11 

2 

0 

0 

0 

5 

0 

29 

3 

2 

0 

0 

49 

0 

3 

1 

1 

17 

0 

1 

0 

12 

0 

1 

0 

52 

0 

0 

3 

0 

40 

4 

9 

37 

6 

0 

0 

2 

43 

26 

0 

1 

10 

0 

21 

19 

0 

0 

2 

2 

2 

5 

7 

1 

0 

0 

3 

0 

0 

4 

0 

0 

3 

8 

0 

2 

U.S. CITY TOTAL 1,349 1,086 715 619 436 

San Juan, PR 10 0 1 3 1 

TOTAL 1,359 1,086 716 622 437 

Rates per 100,000 Live Births 

1994 1995 1996 1997 1998 

0.0 

0.0 

129.3 

31.6 

8.6 

164.6 

47.2 

17.7 

42.4 

308.7 

249.0 

446.6 

9.6 

0.0 

47.0 

164.4 

34.8 

58.0 

98.0 

71.0 

79.8 

0.0 

214.8 

22.0 

9.1 

213.5 

107.3 

258.5 

160.5 

302.1 

86.4 

127.7 

16.9 

12.5 

264.6 

257.7 

985.8 

43.7 

0.0 

167.9 

0.0 

406.8 

60.8 

21.1 

0.0 

0.0 

81.1 

0.0 

47.2 

0.0 

44.1 

0.0 

27.6 

729.1 

0.0 

0.0 

53.5 

0.0 

33.7 

16.3 

282.0 

0.0 

279.8 

0.0 0.0 0.0 0.0 

0.0 0.0 0.0 0.0 

196.4 184.7 147.7 61.6 

0.0 0.0 0.0 0.0 

140.9 289.3 540.0 279.7 

219.0 265.3 144.7 72.4 

0.0 25.8 0.0 25.8 

19.4 41.6 62.5 0.0 

12.5 23.7 0.0 0.0 

221.9 124.9 94.6 92.7 

105.4 17.3 0.0 0.0 

189.6 53.8 64.5 32.3 

0.0 0.0 9.1 9.1 

21.2 0.0 0.0 21.9 

46.2 9.0 13.5 76.4 

239.0 246.1 0.0 0.0 

0.0 10.9 0.0 10.9 

0.0 0.0 0.0 0.0 

119.4 90.4 150.7 72.3 

28.8 29.7 14.8 0.0 

98.8 53.3 64.0 10.7 

0.0 0.0 0.0 0.0 

244.5 235.2 242.4 124.8 

0.0 0.0 0.0 0.0 

9.2 9.0 0.0 0.0 

225.2 49.7 99.4 74.5 

29.3 0.0 13.7 0.0 

175.5 96.2 70.7 56.6 

62.2 44.2 44.2 58.9 

225.8 234.1 252.1 81.0 

302.7 246.5 206.5 246.5 

98.4 26.7 80.1 53.4 

34.9 17.2 0.0 0.0 

12.4 12.4 0.0 0.0 

0.0 0.0 52.7 26.4 

222.9 106.5 68.3 35.0 

740.3 687.2 510.5 510.5 

160.1 122.2 24.4 0.0 

357.2 124.7 31.2 15.6 

183.2 54.6 68.3 136.6 

0.0 0.0 0.0 0.0 

281.0 254.4 162.3 92.1 

27.0 8.5 42.7 81.1 

0.0 0.0 0.0 0.0 

0.0 0.0 14.0 0.0 

34.7 0.0 34.0 68.1 

89.9 24.5 0.0 49.0 

52.8 27.7 46.2 18.5 

42.9 32.6 18.6 23.3 

30.0 25.5 66.2 35.6 

11.6 23.9 23.9 11.9 

25.3 12.3 6.2 0.0 

0.0 0.0 0.0 0.0 

398.1 136.7 85.4 51.2 

0.0 0.0 0.0 0.0 

59.6 29.2 0.0 0.0 

123.5 232.2 101.6 58.0 

0.0 0.0 0.0 0.0 

11.8 22.9 0.0 0.0 

0.0 50.5 16.8 50.5 

144.2 166.9 131.1 95.4 

0.0 0.0 33.8 0.0 

110.8 0.0 0.0 70.8 

162.7 134.4 89.1 77.2 54.3 

110.8 0.0 14.3 42.9 14.3 

162.1 132.9 88.5 76.9 54.0 

*Mother’s city of residence used to assign case. 

NOTE: As of 1995, cases of congenital syphilis <1 year of age are obtained using case reporting form CDC 73.126. 

STD Surveillance 1998 Syphilis Tables 113 
Table 42. Chancroid — Reported cases and rates by state/area: United States and outlying areas, 1994–1998 

Cases Rates per 100,000 Population 

State/Area 1994 1995 1996 1997 1998 1994 1995 1996 1997 1998 

Alabama 24 7 0 1 1 0.6 0.2 0.0 0.0 0.0 

Alaska 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Arizona 3 2 2 0 2 0.1 0.0 0.0 0.0 0.0 

Arkansas 0 1 1 1 7 0.0 0.0 0.0 0.0 0.3 

California 31 8 8 19 8 0.1 0.0 0.0 0.1 0.0 

Colorado 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Connecticut 0 0 0 0 2 0.0 0.0 0.0 0.0 0.1 

Delaware 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Florida 20 24 3 3 3 0.1 0.2 0.0 0.0 0.0 

Georgia 0 2 0 1 2 0.0 0.0 0.0 0.0 0.0 

Hawaii 0 0 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 0.0 

Illinois 38 21 20 5 0 0.3 0.2 0.2 0.0 0.0 

Indiana 0 0 1 0 1 0.0 0.0 0.0 0.0 0.0 

Iowa 1 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Kansas 5 2 2 0 1 0.2 0.1 0.1 0.0 0.0 

Kentucky 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Louisiana 209 129 58 3 1 4.8 3.0 1.3 0.1 0.0 

Maine 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Maryland 0 0 2 1 0 0.0 0.0 0.0 0.0 0.0 

Massachusetts 1 7 2 4 0 0.0 0.1 0.0 0.1 0.0 

Michigan 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Minnesota 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Mississippi 0 0 1 1 3 0.0 0.0 0.0 0.0 0.1 

Missouri 2 0 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 0.0 

Nebraska 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Nevada 0 2 0 2 0 0.0 0.1 0.0 0.1 0.0 

New Hampshire 0 0 1 0 0 0.0 0.0 0.1 0.0 0.0 

New Jersey 0 4 4 0 0 0.0 0.1 0.0 0.0 0.0 

New Mexico 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

New York 365 336 182 119 82 2.0 1.9 1.0 0.7 0.5 

North Carolina 10 18 14 9 9 0.1 0.3 0.2 0.1 0.1 

North Dakota 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Ohio 8 5 6 3 3 0.1 0.0 0.1 0.0 0.0 

Oklahoma 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Oregon 5 0 0 1 0 0.2 0.0 0.0 0.0 0.0 

Pennsylvania 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Rhode Island 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

South Carolina 0 0 8 15 19 0.0 0.0 0.2 0.4 0.5 

South Dakota 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Tennessee 3 2 2 1 0 0.1 0.0 0.0 0.0 0.0 

Texas 51 26 65 53 34 0.3 0.1 0.3 0.3 0.2 

Utah 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Vermont 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Virginia 0 2 1 1 7 0.0 0.0 0.0 0.0 0.1 

Washington 1 5 1 2 1 0.0 0.1 0.0 0.0 0.0 

West Virginia 0 1 0 0 0 0.0 0.1 0.0 0.0 0.0 

Wisconsin 2 3 2 0 2 0.0 0.1 0.0 0.0 0.0 

Wyoming 0 0 0 1 1 0.0 0.0 0.0 0.2 0.2 

U.S. TOTAL1 779 607 386 246 189 0.3 0.2 0.1 0.1 0.1 

Guam 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Puerto Rico 32 1 2 1 2 0.9 0.0 0.1 0.0 0.1 

Virgin Islands 1 2 0 0 0 0.9 1.8 0.0 0.0 0.0 

OUTLYING AREAS 33 3 2 1 2 0.8 0.1 0.1 0.0 0.0 

TOTAL 812 610 388 247 191 0.3 0.2 0.1 0.1 0.1 

1

Includes cases reported by Washington, D.C. 

114 Chancroid Tables STD Surveillance 1998 
Table 43. Chancroid — Reported cases and rates in selected cities of >200,000 population: United States and 

outlying areas, 1994–1998 

Cases 

City 1994 1995 1996 1997 1998 

Akron, OH 0 0 0 0 0 

Albuquerque, NM 0 0 0 0 0 

Atlanta, GA 0 0 0 1 1 

Austin, TX 5 0 0 0 0 

Baltimore, MD 0 0 1 0 0 

Birmingham, AL 0 0 0 0 0 

Boston, MA 0 2 0 3 0 

Buffalo, NY 0 0 0 0 0 

Charlotte, NC 0 3 4 1 0 

Chicago, IL 36 21 20 5 0 

Cincinnati, OH 3 1 0 0 0 

Cleveland, OH 2 0 0 0 2 

Columbus, OH 0 0 0 3 1 

Corpus Christi, TX 0 1 0 0 0 

Dallas, TX 0 12 13 13 6 

Dayton, OH 3 1 1 0 0 

Denver, CO 0 0 0 0 0 

Des Moines, IA 1 0 0 0 0 

Detroit, MI 0 0 0 0 0 

El Paso, TX 1 0 1 2 4 

Fort Worth, TX 0 0 0 1 0 

Honolulu, HI 0 0 0 0 0 

Houston, TX 38 0 25 23 20 

Indianapolis, IN 0 0 0 0 0 

Jacksonville, FL 0 0 0 0 0 

Jersey City, NJ 0 0 0 0 0 

Kansas City, MO 0 0 0 0 0 

Los Angeles, CA 20 4 2 12 1 

Louisville, KY 0 0 0 0 0 

Memphis, TN 3 2 2 0 0 

Miami, FL 0 0 0 0 0 

Milwaukee, WI 0 0 1 0 2 

Minneapolis, MN 0 0 0 0 0 

Nashville, TN 0 0 0 0 0 

New Orleans, LA 201 125 52 3 0 

New York City, NY 357 334 181 119 82 

Newark, NJ 0 1 0 0 0 

Norfolk, VA 0 1 0 0 0 

Oakland, CA 0 2 0 1 0 

Oklahoma City, OK 0 0 0 0 0 

Omaha, NE 0 0 0 0 0 

Philadelphia, PA 0 0 0 0 0 

Phoenix, AZ 3 0 1 0 2 

Pittsburgh, PA 0 0 0 0 0 

Portland, OR 2 0 0 0 0 

Richmond, VA 0 0 0 0 0 

Rochester, NY 0 0 0 0 0 

Sacramento, CA 0 0 0 0 0 

San Antonio, TX 0 0 0 0 0 

San Diego, CA 2 2 2 0 0 

San Francisco, CA 2 0 1 3 4 

San Jose, CA 0 0 0 0 0 

Seattle, WA 0 4 0 1 0 

St Louis, MO 1 0 0 0 0 

St Paul, MN 0 0 0 0 0 

St Petersburg, FL 0 0 0 0 0 

Tampa, FL 0 0 0 0 0 

Toledo, OH 0 0 0 0 0 

Tucson, AZ 0 0 1 0 0 

Tulsa, OK 0 0 0 0 0 

Washington, DC 0 0 0 0 0 

Wichita, KS 0 0 1 0 0 

Yonkers, NY 0 0 0 0 0 

U.S. CITY TOTAL 680 516 309 191 125 

San Juan, PR 10 0 1 0 1 

TOTAL 690 516 310 191 126 

Rates per 100,000 Population 

1994 1995 1996 1997 1998 

0.0 

0.0 

0.0 

0.8 

0.0 

0.0 

0.0 

0.0 

0.0 

1.2 

0.3 

0.1 

0.0 

0.0 

0.0 

0.5 

0.0 

0.3 

0.0 

0.2 

0.0 

0.0 

1.2 

0.0 

0.0 

0.0 

0.0 

0.2 

0.0 

0.3 

0.0 

0.0 

0.0 

0.0 

41.5 

4.9 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.1 

0.0 

0.4 

0.0 

0.0 

0.0 

0.0 

0.1 

0.3 

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 0.0 0.0 0.0 

0.0 0.0 0.1 0.1 

0.0 0.0 0.0 0.0 

0.0 0.1 0.0 0.0 

0.0 0.0 0.0 0.0 

0.4 0.0 0.5 0.0 

0.0 0.0 0.0 0.0 

0.5 0.7 0.2 0.0 

0.7 0.7 0.2 0.0 

0.1 0.0 0.0 0.0 

0.0 0.0 0.0 0.1 

0.0 0.0 0.3 0.1 

0.3 0.0 0.0 0.0 

0.6 0.7 0.6 0.3 

0.2 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 0.0 0.0 

0.0 0.1 0.3 0.6 

0.0 0.0 0.1 0.0 

0.0 0.0 0.0 0.0 

0.0 0.8 0.7 0.6 

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 0.0 0.0 0.0 

0.2 0.2 0.0 0.0 

0.0 0.0 0.0 0.0 

0.0 0.1 0.0 0.2 

0.0 0.0 0.0 0.0 

0.0 0.0 0.0 0.0 

25.9 11.0 0.6 0.0 

4.6 2.5 1.6 1.1 

0.3 0.0 0.0 0.0 

0.4 0.0 0.0 0.0 

0.2 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 0.1 

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 

0.1 0.1 0.0 0.0 

0.0 0.1 0.4 0.5 

0.0 0.0 0.0 0.0 

0.3 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 0.1 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 

1.0 0.7 0.4 0.3 0.2 

1.1 0.0 0.1 0.0 0.1 

1.0 0.7 0.4 0.3 0.2 

STD Surveillance 1998 Chancroid Tables 115 

Sources and Limitations of Data 

CDC Surveillance Data 

Much of the information in this document was based on cases of sexually transmitted diseases 

(STDs) reported to the Division of STD Prevention (DSTD), 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, 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 U.S.” in selected tables and figures. 

At present, STD data are submitted to CDC on a variety of hardcopy summary reports (monthly, 

quarterly, and annually) and electronically either in summary or individual case-listed format via 

the National Electronic Telecommunications System for Surveillance (NETSS) — the system that 

provides notifiable disease information that is published in the Morbidity and Mortality Weekly 

Report, or MMWR. DSTD is currently working with project areas on converting from hardcopy reporting of summary data to electronic submission of line-listed (i.e., case-specific) data through 

NETSS. As of 1998, 29 states have been notified to discontinue hardcopy reporting and are sending 

primary and secondary syphilis, chlamydia and gonorrhea as line-listed extended, electronic data. 

See Figures A1-A3 in this Appendix for type of reporting by state and disease. “Summary” refers to 

aggregate electronic data. “Case” refers to case-specific, 60-byte core records. “Extended case” 

refers to case-specific, 60-byte core records plus STD-specific information beyond the core 60-byte 

record. “Discontinue hardcopy” refers to those states that sent consistent, quality case-extended 

data and were notified to discontinue hardcopy reporting. 

The data used in this report are based on a combination of aggregated NETSS data and summary 

hardcopy reports. Monthly reports included summary data for syphilis by county and state. 

Quarterly reports included summary data for syphilis, gonorrhea, chlamydia, and other STDs by 

gender and source of report (STD clinic or non-STD clinic) for the 50 states, 64 large cities (most 

with a population over 200,000 in 1980), and outlying areas of the United States. Annual reports included summary data for P&S syphilis, gonorrhea, and chlamydia by age, race, and gender for the 

50 states and six large cities. In addition, data on antimicrobial susceptibility in Neisseria 

gonorrhoeae were collected through the Gonococcal Isolate Surveillance Project (GISP), a sentinel 

system of 28 STD clinics and five regional laboratories located throughout the United States. Provisional data on syphilis, gonorrhea, and chlamydia reported to CDC weekly by states for inclusion in 

the Morbidity and Mortality Weekly Report were not included in this document. 

Areas differ in their ability to resolve differences in total cases derived from hardcopy monthly, 

quarterly, and annual reports (as well as electronically submitted case-listed data). Thus, depending 

on the database used, there may be discrepancies in total cases in the tables and figures. In most 

instances, these discrepancies are less than 5% of total reported cases and have minimal impact on 

national total cases and rates. However, for a specific area, the discrepancies may be larger. 

STD Surveillance 1998 Appendix Sources and Limitations of Data 117 
Reports and corrections sent to CDC on hardcopy forms through June 15, 1999 and for NETSS 

electronic data through July 19, 1999 have been included. Hardcopy data received after these 

dates will appear in subsequent issues. The data in the tables and figures in this document supersede 

those in all earlier publications. 

Population Denominators and Rate Calculations 

Crude incidence rates (new cases/population) were calculated on an annual basis per 100,000 

population. 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: US Government Printing 

Office, 1990; and United States Population Estimates by Age, Sex and Race: 1989 [Series P-25, No. 

1057]; Washington: US 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). Rates for 

1991-1997 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; 1991-1997 Estimates of the 

Population of Counties by Age, Sex and Race/Hispanic Origin: 1990 to 1997; machine-readable 

data files). Rates for 1998 use population estimates for 1997. 

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 counties in 

which the city is located. For the remaining cities, incidence rates were calculated by using 

population estimates based on the Bureau of the Census (Irwin R, see above) and a marketing 

survey (Market Statistics, Inc; Sales and Marketing Management; New York: Bill Communications, 

Inc, August 1989). 

1980-1988 population estimates 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: US 

Government Printing Office, 1989). After 1988, population estimates for outlying areas were 

obtained directly from the health departments in these areas. For Puerto Rico and Virgin Islands, 

current population estimates through 1997 were obtained from their area’s data centers. Rates for 

1998 were based on the 1997 population estimates. Population estimates for Guam were updated 

through 1995 and were used to calculate rates for 1995-1998. 

The percentage of cases for which race/ethnicity and age were unknown or unspecified differed 

considerably by year and area. States were excluded from analysis if race/ethnicity and age were not 

reported for the majority of cases. Otherwise, if race/ethnicity or age was unknown or unspecified, 

cases were distributed according to the distribution of cases for which these data were available. In 

this edition, 1981 through 1998 age- and race-specific rates (for chlamydia (1996-98 only), gonorrhea, and syphilis in the National Profile, Special Focus Profiles and Detailed Tables) are 

calculated from estimates based on this redistribution. 

118 Sources and Limitations of Data Appendix STD Surveillance 1998 
Rates of congenital syphilis for 1989-1998 were calculated using live births from the National 

Center for Health Statistics (NCHS) (Vital Statistics: Natality Tapes 1989-1996 or Vital Statistics 

Reports, United States 1998, Vol. 46 No.12—Natality). Race-specific rates for 1996-1998 were 

calculated using live births for 1996. Rates before 1989 were calculated using published live birth 

data (NCHS; Vital Statistics Report, United States, 1988 [Vol.1—Natality]). 

Case Definitions and Reporting Practices 

Although most areas generally adhere to the case definitions for STDs found in Case Definitions 

for Infectious Conditions Under Public Health Surveillance (MMWR 1997;46(RR-10):1-56), there 

are differences between individual areas in case definitions as well as in the policies and systems for 

collecting surveillance data. Thus, comparisons of case numbers and rates between 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. In many areas, reporting from 

publicly supported institutions (e.g., STD clinics) was more complete than from other sources (e.g., 

private practitioners). Thus, the trends may not be representative of all segments of the population. 

Military cases are not reported as a separate category. 

Reporting of Congenital Syphilis Cases 

In 1988, a new surveillance case definition for congenital syphilis was introduced. The new case 

definition has greater sensitivity than the former definition. In addition, many areas greatly 

enhanced active case finding for congenital syphilis during this time. For these reasons, the number 

of reported cases increased dramatically during 1989-1991. As is true of any change, 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 after 

January 1, 1992. Therefore, the reliability of trends is expected to have stabilized after this date. 

In addition to changing the case definition, 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 collects individual case information 

which allows more thorough analysis of cases. For the purposes of these analyses 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 have been reported by state and city of residence of the mother for 

1995-1998. 

Reporting of Syphilis Cases 

Cases of unknown duration have been counted with late and late latent syphilis. 

Reporting of Gonorrhea Cases 

In 1994, Georgia reported gonorrhea cases to CDC for only part of a year. Therefore, Georgia 

cases and population were excluded from gonorrhea figures and tables for 1994. The city of Atlanta 

was also excluded from city gonorrhea figures and tables for 1994. 

STD Surveillance 1998 Appendix Sources and Limitations of Data 119 
For more details on GISP gonorrhea cases, refer to the following annual publication: Division of 

STD Prevention. Sexually Transmitted Disease Surveillance 1997 Supplement: Gonococcal Isolate 

Surveillance Project (GISP) Annual Report 1997, U.S. Department of Health and Human Services, 

Public Health Service. Atlanta: Centers for Disease Control and Prevention, October 1998. 

Reporting of Chlamydia Cases 

In 1998, New York was the only state that did not yet have laws or policies for uniform reporting of 

Chlamydia trachomatis cases. Chlamydia cases for New York were exclusively based on cases 

reported by New York City (i.e., no cases were reported outside of New York City). When calculating 

U.S. total rates, the population denominators were adjusted to include only the New York City 

population. Trends in many areas were more representative of increases in reporting of cases rather 

than actual trends in disease. Cases and rates of chlamydia reported in gender-specific tables are 

underestimated due to some reported cases with unknown gender. Despite problems with under-reporting, it is important to publish the 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. 

Chlamydia test positivity was calculated by dividing the number of women testing positive for 

chlamydia (numerator) by the total number of women tested for chlamydia (denominator) and was 

expressed as a percentage. While not common, the denominator may contain multiple tests from 

the same individual if that person was tested more than once during a year. Various chlamydia test 

methods were used and no adjustments of test positivity were made based on test type. Chlamydia 

testing data for region- and state-specific figures were published with permission from the HHS 

Regional Infertility Prevention Programs, selected state STD prevention programs, and the Job 

Corps, U.S. Department of Labor. Health and Human Services (HHS) regions 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. 

For more details on chlamydia prevalence, refer to the following annual publication: Division of 

STD Prevention. Sexually Transmitted Disease Surveillance 1997 Supplement: Chlamydia Prevalence Monitoring Project Annual Report 1997, U.S. Department of Health and Human Services, Public Health Service. Atlanta: Centers for Disease Control and Prevention. 

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 1966-1998). For more information on this database, contact IMS America, Ltd., 660 West Germantown Pike, Plymouth Meeting, PA 19462; 

Telephone: (610) 834-5000. 

120 Sources and Limitations of Data Appendix STD Surveillance 1998 
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 1980-1997), 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; 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 1995-1997) 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 Year 2000 Revisions 

In 1995, the Healthy People year 2000 objectives were revised1. The year 2000 objectives for the 

diseases in this report were revised as follows: primary and secondary syphilis—10 per 100,000 

population to 4; congenital syphilis—50 per 100,000 livebirths to 40; and gonorrhea —225 per 

100,000 population to 100. 

Urban Rural Categorization Method 

Aggregate county-specific case report data on P&S syphilis are submitted monthly by state health 

departments (via Form CDC-73. 998) to the Centers for Disease Control and Prevention (CDC). 

These P&S syphilis case report data were summarized using urban-to-rural continuum codes for 

metro and nonmetro counties that were developed by the U.S. Department of Agriculture (USDA)2 

and incorporated the Office of Management and Budget’s (OMB) official metro status based on the 

results of the 1990 Population Census3

. The 1993 urban-rural continuum codes form a classification scheme that distinguishes metropolitan counties by size, and nonmetropolitan counties by degree of urbanization and proximity to metro areas. The standard Office of Management and Budget 

(OMB) metro and nonmetro categories have been subdivided into four metro and six nonmetro 

categories2

. The county-specific USDA codes used to place counties into urban-to-rural categories 

are as follows: 

U.S. Department of Agriculture Urban-to-Rural Continuum Codes for Metro and 

Nonmetro Counties (as of June 1993) 

Code Metro Counties: 

0 Central counties of metro areas of 1 million population or more 

1 Fringe counties of metro areas of 1 million population or more 

2 Counties in metro areas of 250,000 to 1 million population 

3 Counties in metro areas of fewer than 250,000 population 

Nonmetro Counties: 

4 Urban population of 20,000 or more, adjacent to a metro area 

5 Urban population of 20,000 or more, not adjacent to a metro area 

6 Urban population of 2,500 to 19,999, adjacent to a metro area 

7 Urban population of 2,500 to 19,999, not adjacent to a metro area 

8 Completely rural or fewer than 2,500 urban population, adjacent to a metro area 

9 Completely rural or fewer than 2,500 urban population, not adjacent to a metro area 

STD Surveillance 1998 Appendix Sources and Limitations of Data 121 
An aggregate urban category (codes 0, 2, and 3) was defined to include central counties with at 

least one million or more persons (code 0) and non-fringe counties in metro areas (codes 2 and 3). 

Fringe metro counties (code 1) were combined with the non-metro counties adjacent to a metro 

area and with an urban population of at least 2,500 population (codes 4 and 6) to form an aggregate 

category designated as peri-urban (codes 1, 4, and 6). An aggregate peri-rural category was defined 

to include nonmetro counties not adjacent to a metro area and with an urban population of at least 

2,500 population (codes 5 and 7), and an aggregate rural (codes 8 and 9) category was defined to 

include nonmetro counties that were completely rural or had fewer than 2,500 urban population. 

1Department of Health and Human Services. Healthy People 2000: Midcourse Review and 1995 Revisions. 

U.S. Department of Health and Human Services, Public Health Service. U.S. Government Printing Office, 

Washington, D.C., 1995. 

2Rural-Urban Continuum Codes for Metro and Nonmetro Counties, 1993. Butler MA, Beal CL, Agriculture 

and Rural Economy Division, Economic Research Service, U.S. Department of Agriculture. Staff Report No. 

AGES 9425, September 1994. 

3Federal Register, Part IV, Office of Management and Budget, Revised Standards for Defining Metropolitan 

Areas in the 1990’s. Vol .55 No.62, Friday March 30, 1990. 

122 Sources and Limitations of Data Appendix STD Surveillance 1998 
Figure A1. Chlamydia — National electronic telecommunications surveillance system (NETSS) 

transmission status by state, 1998 

* 

Guam NETSS Data: 

Summary 

Case 

Case Extended 

Discontinued 

Hardcopy 

Puerto Rico* Virgin Is.* 

*Upstate New York (New York City reports summary chlamydia records to NETSS), Washington, DC, 

Puerto Rico and Virgin Islands did not report. 

Note: Unless noted, large city projects transmit records in the same format as states. San Francisco 

and Los Angeles, CA projects report case extended chlamydia records to NETSS. 

Figure A2. Gonorrhea — National electronic telecommunications surveillance system (NETSS) 

transmission status by state, 1998 

Guam NETSS Data: 

Summary 

Case 

Case Extended 

Discontinued 

Hardcopy 

Puerto Rico Virgin Is.* 

* Virgin Islands did not report. 

Note: Unless noted, large city projects transmit records in the same format as states. San Francisco 

and Los Angeles, CA projects report case extended gonorrhea records to NETSS. New York 

City and Washington, DC projects report summary gonorrhea records to NETSS. 

STD Surveillance 1998 Appendix NETSS 123 
Figure A3. Primary and secondary syphilis — National electronic telecommunications 

surveillance system (NETSS) transmission status by state, 1998 

Guam NETSS Data: 

Summary 

Case 

Case Extended 

Discontinued 

Hardcopy 

Puerto Rico Virgin Is.* 

*Virgin Islands did not report.
 

Note: Large city projects transmit records in the same format as states.
 

124 NETSS Appendix STD Surveillance 1998 
Table A1. Healthy People 2000 Sexually Transmitted Diseases Objective 19.1–19.8 Status 

Baseline 

Objective Year Baseline 1994 1995 1996 1997 1998 2000 

19.1 Gonorrhea (per 100,000 persons) 1989 300 166 149 123 122 133 100 

a. Black (non-Hispanic) 1989 1,990 1,163 1,046 817 802 862 650 

b. Adolescents 15-19 years 1989 1,123 734 671 544 522 561 375 

c. Female 15-44 years 1989 501 315 299 259 261 292 175 

19.2 Chlamydia prevalence among females 15-24 

years 

Female 15-19 years 1988 12.2% —­ 6.7% 5.4% —­ 6.9%* 5% 

Female 20-24 years 1988 8.5% —­ 4.2% 3.4% —­ 4.4%* 5% 

19.3 Primary and secondary syphilis (per 100,000 1989 18.1 7.9 6.3 4.3 3.2 2.6 4 

persons) 

a. Black 1989 118 57 45 30 22 17 30 

19.4 Congenital syphilis (per 100,000 live births) 1990 91.0 55.8 47.4 33.3 27.5 20.6 40 

a. Black 1992 a

417.8 249.6 213.2 150.5 122.7 87.0 175 

b. Hispanic 1992 a

134.6 73.8 61.2 38.9 33.5 27.9 50 

19.5 Annual number of first time consultations1 

Genital herpes 1988 163,000 142,000 160,000 208,000 176,000 188,000 138,500 

Genital warts 1988 290,000 238,000 253,000 191,000 145,000 211,000 246,500 

19.6 Pelvic inflammatory disease 

Hospitalizations per 100,000 females 15-44 years 1988 311 177 162 164 157 —­ 100 

Initial visits to physicians (number of visits)1 1988 430,800 332,000 262,000 286,000 261,000 234,000 290,000 

Hospitalizations per 100,000 females 

a. Black 15-44 years 1988 655 378 296 320 281 —­ 150 

b. Adolescents 15-19 years 1988 342 184 141 168 186 —­ 110 

19.7** Sexually transmitted Hepatitis B (number of cases) 1987 47,593 35,077 2

29,446 —­ —­ —­ 30,500 

19.8 Repeat gonorrhea infection in last 12 months 1987 20% 18.6% 18.4% 18.5% 17.0% 17.5% 15% 

a. Black 1992 21.3% 20.3% 20.1% 19.8% 18.3% 18.6% 17% 

—-Data not available.
 

a

Baseline has been revised.
 

1

As measured by first-time visits to physicians’ offices.
 

2

Data are provisional.
 

NOTE: Data include revisions and, therefore, may differ from data previously published in these reports and other publications. 

Data Sources 

Objective number Data Source 

19.1,19a-c Sexually Transmitted Disease Surveillance System, CDC, NCHSTP. 

19.2 Sexually Transmitted Disease Surveillance System, CDC, NCHSTP. 

19.3, 19.3a Sexually Transmitted Disease Surveillance System, CDC, NCHSTP. 

19.4 Sexually Transmitted Disease Surveillance System, CDC, NCHSTP. 

19.5 National Disease and Therapeutic Index, IMS America, Ltd. 

19.6, 19.6a-b For hospitalizations, National Hospital Discharge Survey, CDC, NCHS. 

For number of visits, National Disease and Therapeutic Index, IMS America, Ltd. 

19.7** Viral Hepatitis Surveillance System, CDC, NCID. 

19.8 Gonococcal Isolate Surveillance Project, CDC, NCHSTP. 

*Positivity not adjusted for changes in laboratory test method in 1998 and associated increases in test sensitivity. 

**Duplicate Objective. 

STD Surveillance 1998 Appendix Healthy People 2000 125 
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 24, 1999. 

Project Directors 

Alabama Charles H. Woernle, M.D., M.P.H. 

Alaska John P. Middaugh, M.D. 

Arizona Chris Brown 

Arkansas Martha Hiett 

California Gail Bolan, M.D. 

Los Angeles Robert H. Settlage, M.D. (acting) 

San Francisco Jeffrey Klausner, M.D. 

Colorado Ellen Mangione, M.D., M.P.H. 

Connecticut James L. Hadler, M.D., M.P.H. 

Delaware James C. Welch, R.N. 

District of Columbia M. Ricardo Calderon, M.D., M.P.H. 

Florida Landis Crockett, M.D., M.P.H. 

Georgia William C. Fields 

Hawaii Peter Whiticar 

Idaho Roger Perotto 

Illinois Charlie Rabins, M.P.H. 

Chicago Christine Kosmos 

Indiana Lori Phillips (acting) 

Iowa Mary Weaver, R.N., M.S.N. 

Kansas Gianfranco Pezzino, M.D., M.P.H. 

Kentucky Clarkson Palmer, M.D., M.P.H. 

Louisiana Thomas Farley, M.D., M.P.H. 

Maine Sally Lou Patterson 

Maryland Rafiq Miazad, M.D., M.P.H. 

Baltimore David C. Rose, M.D., F.A.A.P. 

Massachusetts Paul Etkind, M.P.H. 

Michigan David R. Johnson, M.D. 

Minnesota Jill M. DeBoer, M.P.H. 

Mississippi Robert Hotchkiss, M.D. 

Missouri Mahree Skala, M.A. 

Montana Kathleen Martin 

Nebraska Christine M. Newlon 

Nevada Yvonne Silva 

New Hampshire David R. Ayotte, M.S.P.H. 

New Jersey Janet DeGraaf, M.P.A. 

New Mexico Susan Eastman 

New York F. Bruce Coles, D.O. 

New York City Isaac Weisfuse, M.D., M.P.H. 

North Carolina Evelyn M. Foust, M.P.H. 

North Dakota Fred F. Heer 

Ohio J. Nick Baird, M.D. 

Oklahoma William R. Pierson, M.B.A. 

Oregon David W. Fleming, M.D. 

Pennsylvania Michelle Patrick, M.P.A. 

Philadelphia Robert Levenson 

Rhode Island Tom Bertrand 

South Carolina Lynda Kettinger, M.P.H. 

South Dakota John N. Jones 

Tennessee William L. Moore, Jr., M.D. 

Texas Charles E. Bell, M.D. 

Utah Craig R. Nichols, M.P.A. 

Vermont Peter D. Galbraith, D.M.D., M.P.H. 

Virginia Grayson B. Miller, Jr., M.D., M.P.H. 

Washington Larry Klopfenstein 

West Virginia Loretta E. Haddy, M.S., M.A. 

Wisconsin Herb Bostrom 

Wyoming Jimm Murray 

American Samoa Joseph Tufa, D.S.M., M.P.H. 

Federated States of 

Micronesia Eliuel K. Pretrick, M.O., M.P.H. 

Government of the 

Marshall Islands Donald F. Copelle 

Guam Dennis Rodriguez 

Puerto Rico Orlando Lopez, M.D. 

Republic of Palau Anthony Pollai, M.D. 

Virgin Islands Wilbur K. Callender, M.D. 

126 Contributors 

Program Managers 

Mike O’Cain 

Wendy Craytor 

Frank Slaughter 

Gary Horton 

Tom Ault 

A. Michael Lawrence, M.P.A. 

Wendy Wolf, M.P.A. 

Nancy Spencer, M.P.H. 

Heidi Jenkins 

Paulette Jackson 

Peter Moore 

Jack E. Wroten 

Mark Schrader 

Roy Ohye 

Anne Williamson, M.H.E. 

Charlie Rabins, M.P.H. 

Janice M. Johnson 

Jim Beall 

John Katz 

R. Allen Mayer 

David Raines 

Jim Scioneaux 

Bob Woods 

Dave Akers 

Wayne Brathwaite 

Paul Etkind, M.P.H. 

Mark A. Miller 

Jill M. DeBoer, M.P.H. 

Mike Cassell 

Mary Menges 

Sally Klein, R.N. 

Dan Harrah 

Robert Nellis 

David R. Ayotte, M.S.P.H. 

Jerry Carolina 

Al Chowning 

F. Bruce Coles, D.O. 

Steve Rubin 

Paul Esbrandt 

Kirby Kruger 

J. Nick Baird, M.D. 

Mark Turner, M.P.H. 

Doug Harger 

Ed Powers 

Martin Goldberg 

Tom Bertrand 

Tim Lindman 

David Morgan 

Chris Freeman 

Casey S. Blass 

Cristie Chesler 

Marilyn Richards 

Casey Riley 

Larry Klopfenstein 

Robert Johnson 

Anthony Wade 

Roger Burr 

Tai Ripley, R.N. 

Kidsen K. Iohp, M.P.H. 

Peter Bien 

Josie O’Mallen 

Nelson Colon-Cartagena 

Caleb T. Otto, M.D. 

Paul Arguin, M.D. 

Epidemiologists 

J.P. Lofgren, M.D.
 

John P. Middaugh, M.D.
 

Lee A. Bland, M.A., M.P.H.
 

Thomas McChesney, D.V.M.
 

Duc J. Vugia, M.D., M. P.H.
 

Duc J. Vugia, M.D., M. P.H.
 

Duc J. Vugia, M.D., M. P.H.
 

Richard E. Hoffman, M.D., M.P.H.
 

James L. Hadler, M.D., M.P.H.
 

A. LeRoy Hathcock, Ph.D.
 

Martin E. Levy, M.D., M.P.H.
 

Richard S. Hopkins, M.D., M.S.P.H.
 

Kathleen E. Toomey, M.D., M.P.H.
 

Paul Effler, M.D., M.P.H.
 

Christine G. Hahn, M.D.
 

Shari L. Bornstein, M.D., M.P.H.
 

Shari L. Bornstein, M.D., M.P.H.
 

Robert Teclaw, D.V.M., Ph.D., M.P.H.
 

Patricia Quinlisk, M.D., M.P.H.
 

Gianfranco Pezzino, M.D., M.P.H.
 

Glyn G. Caldwell, M.D.
 

Louise McFarland, Dr.P.H.
 

Kathleen F. Gensheimer, M.D., M.P.H.
 

Diane M. Dwyer, M.D.
 

Diane M. Dwyer, M.D.
 

Alfred DeMaria, Jr., M.D.
 

Matthew L. Boulton, M.D., M.P.H.
 

Richard Danila, Ph.D., M.P.H.
 

Mary Currier, M.D., M.P.H.
 

Denny H. Donnell, Jr., M.D., M.P.H.
 

Todd A. Damrow, Ph.D., M.P.H.
 

Thomas J. Safranek, M.D.
 

Randall Todd, Dr.P.H.
 

Jesse Greenblatt, M.D., M.P.H.
 

Eddy A. Bresnitz, M.D., M.S.
 

Mack C. Sewell, Dr.P.H., M.S.
 

Perry F. Smith, M.D.
 

Perry F. Smith, M.D.
 

Newton J. MacCormack, M.D., M.P.H.
 

Larry Shireley, M.S., M.P.H.
 

Forrest W. Smith, M.D.
 

Michael Crutcher, M.D., M.P.H.
 

David W. Fleming, M.D.
 

James T. Rankin, Jr., D.V.M., Ph.D., M.P.H.
 

James T. Rankin, Jr., D.V.M., Ph.D., M.P.H.
 

Utpala Bandy, M.D., M.P.H.
 

James Jerome Gibson, M.D., M.P.H.
 

Sarah L. Patrick, M.P.H., Ph.D.
 

William L. Moore, Jr., M.D.
 

Dennis M. Perrotta, Ph.D.
 

Craig R. Nichols, M.P.A.
 

Peter D. Galbraith, D.M.D., M.P.H.
 

Robert B. Stroube, M.D., M.P.H.
 

Juliet VanEenwyk, Ph.D.
 

Loretta E. Haddy, M.S., M.A.
 

Jeffrey P. Davis, M.D.
 

Karl Musgrave, D.V.M., M.P.H.
 

Joseph Tufa, D.S.M., M.P.H.
 

Jean Paul Chaine
 

Tom D. Kijiner
 

Robert L. Haddock, D.V.M., M.P.H.
 

Carmen Deseda, M.D.
 

Jill McCready, M.S., M.P.H.
 

Jose Poblete, M.D., SACS, FICA
 

STD Surveillance 1998