Sexually 

Transmitted 

Disease 

Surveillance 

1999 

Division of STD Prevention 

September 2000 

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 

Statistics and Data Management 

Branch ............................................................Owen J. Devine, Ph.D. 

Chief 

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

Deputy Chief 

Epidemiology and Surveillance 

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

Chief 

Surveillance and Special Studies 

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

Acting 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, 1999. Department of 

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

September 2000. 

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/1999SurvRpt.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, DC, 1997, p.43. 

v 
Preface 

Sexually Transmitted Disease Surveillance, 1999 presents statistics and trends of sexually 

transmitted diseases (STDs) in the United States through 1999. 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, the Jail STD Prevalence Monitoring Projects, the U.S. 

Army, and the Indian Health Service; (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 many of the figures and all of the statistical tables in this publication. These systems are an integral part of program management at all levels of STD prevention 

and control in the United States. 

Sexually Transmitted Disease Surveillance, 1999 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. Included in this section, are figures (A1-A3) that show 

progress made by states in converting from hardcopy aggregate reporting to electronic line-listed 

data. 

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

the Healthy People 2000 (HP2000) national health status objectives for STDs.1 The original 

HP2000 health status objectives were developed in 1989 and revised in 1995. Appendix Table A1 

displays progress made towards the HP2000 Priority Area 19, Objectives 19.1-19.8, for STDs. 

These objectives are used as reference points throughout this edition of Sexually Transmitted Disease Surveillance, 1999. In addition, provisional Healthy People 20102 (HP2010) objectives for the 

rates of gonorrhea, primary and secondary syphilis, congenital syphilis, and the prevalence of 

Chlamydia trachomatis genital infection among specific populations of adolescents and young 

adults are introduced in both the text and in the Appendix. 

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, 

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

Atlanta, Georgia, 30333.
 

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

Revisions. U.S. Government Printing Office, Washington DC, 1995.
 

2U.S. Department of Health and Human Services. Healthy People 2010 (Conference Edition, in Two 

Volumes). U.S. Government Printing Office, Washington, DC, 2000. 

vii 
Acknowledgments 

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

Territorial Health Departments and the Sexually Transmitted Disease Control Programs, the 

Regional Infertility Prevention Programs, the Job Corps, the U.S. Department of Labor, the Indian 

Health Service, the John Hopkins University Chlamydia Research Laboratory, and the U.S. Army, 

who provided 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, Sharon Clanton, Darlene Davis, Owen Devine, Linda Webster 

Dicker, Lyn Finelli, Melinda Flock, LaZetta Grier, Alesia Jester Harvey, Sharon Hixon, Kathleen 

Hutchins, William Levine, Kristen Mertz, Debra Mosure, Raymond Ransom, LuEtta Schneider, 

Maya Sternberg, Emmett Swint, Susan Wang and Akbar Zaidi. 

viii 
Contents 

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

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

Acknowledgments ......................................................... viii
 

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, 1999 ........................... 1
 

National Profile 

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

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

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

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

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

Special Focus Profiles 

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

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

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

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

STDs in Persons Entering Corrections Facilities ................................ 65 
 

STDs in the South ...................................................... 71 
 

Detailed Tables 

National Summary Tables ................................................ 75 
 

Chlamydia Tables....................................................... 78 
 

Gonorrhea Tables ...................................................... 88 
 

Syphillis Tables......................................................... 98 
 

Chancroid Tables...................................................... 120 
 

Appendix 

Sources and Limitations of Data........................................... 123 
 

NETSS Figures A1 - A3 ................................................. 130 
 

Healthy People 2000 Table A1............................................ 132 
 

Contributors.......................................................... 133 
 

ix 
Figures in the National Profile 

Chlamydia 

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

trachomatis infections: United States, 1987–1999 .................... 10 
 

Figure 2. Chlamydia — Reported rates: United States, 1984–1999 .............. 10 
 

Figure 3. Chlamydia — Rates by state: United States and outlying areas, 1999 ..... 11 
 

Figure 4. Chlamydia — Rates by region: United States, 1984–1999.............. 11 
 

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

1984–1999 ................................................. 12 
 

Figure 6. Chlamydia — Rates by gender: United States, 1984–1999 ............. 12 
 

Figure 7. Chlamydia — Age- and gender-specific rates: United States, 1999 ...... 13 
 

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

planning clinics by state, 1999 ................................... 13 
 

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

in family planning clinics by HHS regions, 1988–1999 ................ 14 
 

Gonorrhea 

Figure 10. Gonorrhea — Reported rates: United States, 1970–1999 and the Healthy
 

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

Figure 11. Gonorrhea — Rates by state: United States and outlying areas, 1999 ..... 18 
 

Figure 12. Gonorrhea — Rates by region: United States, 1981–1999 and the
 

Healthy People year 2000 objective .............................. 19 
 

Figure 13. Gonorrhea — Rates in selected U.S. cities of >200,000 population,
 

1981–1999 and the Healthy People year 2000 objective............... 19 
 

Figure 14. Gonorrhea — Rates by gender: United States, 1981–1999 and the
 

Healthy People year 2000 objective .............................. 20 
 

Figure 15. Gonorrhea — Rates by race and ethnicity: United States, 1981–1999
 

and the Healthy People year 2000 objective ........................ 20 
 

Figure 16. Gonorrhea — Age- and gender-specific rates: United States, 1999 ....... 21 
 

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

planning clinics by state, 1999 ................................... 21 
 

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

participating clinics and regional laboratories: United States, 1999 ....... 22 
 

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

tetracycline resistance among GISP isolates, 1999 .................... 22 
 

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

gonorrhoeae isolates with decreased susceptibility or resistance to
 

ciprofloxacin, 1990–1999 ...................................... 23 
 

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

with gonorrhea who had a previous gonorrhea infection within the
 

past year, 1992–1999 ......................................... 23 
 

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

gonorrhoeae isolates obtained from men who have sex with men for
 

STD clinics in nine cities, 1995, 1997 and 1999 ..................... 24 
 

x 
Syphilis 

Figure 23. Syphilis — Reported cases by stage of illness: United States, 1941–1999 . . 29 

Figure 24. Primary and secondary syphilis — Reported rates: United States, 

1970–1999 and the Healthy People year 2000 objective. . . . . . . . . . . . . . . 29 

Figure 25. Primary and secondary syphilis — Rates by state: United States and 

outlying areas, 1999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30 

Figure 26. Primary and secondary syphilis — Counties with rates above and 

counties with rates below the Healthy People year 2000 objective: United 

States, 1999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30 

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

1981–1999 and the Healthy People year 2000 objective. . . . . . . . . . . . . . . 31 

Figure 28. Primary and secondary syphilis — Rates by urban-rural category and 

geographic region, 1999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 

Figure 29. Primary and secondary syphilis — Rates in selected U.S. cities of 

>200,000 population, 1981–1999 and the Healthy People year 2000 

objective . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32 

Figure 30. Primary and secondary syphilis — Rates by gender: United States, 

1981–1999 and the Healthy People year 2000 objective. . . . . . . . . . . . . . . 32 

Figure 31. Primary and secondary syphilis — Rates by race and ethnicity: United 

States, 1981–1999 and the Healthy People year 2000 objective . . . . . . . . . 33 

Figure 32. Primary and secondary syphilis — Age- and gender-specific rates: United 

States, 1999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33 

Figure 33. Congenital syphilis — Reported cases for infants <1 year of age and 

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

1970–1999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34 

Figure 34. Congenital syphilis — Rates for infants <1 year of age: United States, 

1981–1999 and the Healthy People year 2000 objective. . . . . . . . . . . . . . . 34 

Other Sexually Transmitted Diseases 

Figure 35. Chancroid — Reported cases: United States, 1981–1999 . . . . . . . . . . . . . . 36 
 

Figure 36. Genital herpes simplex virus infections — Initial visits to physicians’ 

offices: United States, 1966–1999 and the Healthy People year 2000 

objective . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36 
 

Figure 37. Genital herpes simplex virus type 2 — Percent seroprevalence according 

to age in NHANES* II (1976–1980) and NHANES III (1988–1994) . . . . . . 37 

Figure 38. Human papillomavirus (genital warts) — Initial visits to physicians’ 

offices: United States, 1966–1999 and the Healthy People year 2000 

objective . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37 
 

Figure 39. Nonspecific urethritis — Initial visits to physicians’ offices by men: 

United States, 1966–1999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38 
 

Figure 40. Trichomonal and other vaginal infections — Initial visits to physicians’ 

Offices: United States, 1966–1999. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38 
 

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, 1999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45 

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

areas, 1999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45 

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

States and outlying areas, 1999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46 

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

States and outlying areas, 1999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46 

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

clinics by state, 1999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 

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

clinics by state, 1999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 

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

United States, 1980-1998 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48 

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

of age: United States, 1980–1998 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48 

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

women 15-44 years of age: United States, 1980–1999 and Healthy 

People year 2000 objective . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49 

STDs in Adolescents and Young Adults 

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

age group: Region X, 1988–1999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54 

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

U.S. Job Corps by state of residence, 1999 . . . . . . . . . . . . . . . . . . . . . . . . . 54 

Figure L. Chlamydia — Positivity among 17-37 year-old women entering the 

U.S. Army by state of residence, 1999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55 

Figure M. Chlamydia — Positivity among 17-37 year-old men entering the 

U.S. Army by state of residence, 1999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55 

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

U.S. Job Corps by state of residence, 1999 . . . . . . . . . . . . . . . . . . . . . . . . . 56 

Figure O. Gonorrhea — Positivity among 17-37 year-old men entering the 

U.S. Army by state of residence, 1999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56 

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

United States, 1981–1999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57 

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

United States, 1981–1999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57 

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

10-44 years of age: United States, 1981–1999 . . . . . . . . . . . . . . . . . . . . . . 58 

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

10-44 years of age: United States, 1981–1999 . . . . . . . . . . . . . . . . . . . . . . 58 

xii 
STDs in Racial and Ethnic Minorities 

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

by race and ethnicity: Region X, 1988–1999 . . . . . . . . . . . . . . . . . . . . . . . . 61 

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

Indian Health Service Clinics by IHS regions, 1999 . . . . . . . . . . . . . . . . . . . 61 

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

ethnicity: United States, 1981–1999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62 

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

ethnicity: United States, 1981–1999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62 

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

females by race and ethnicity: United States, 1981–1999 . . . . . . . . . . . . . . 63 

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

males by race and ethnicity: United States, 1981–1999 . . . . . . . . . . . . . . . . 63 

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

and ethnicity: United States, 1991–1999 . . . . . . . . . . . . . . . . . . . . . . . . . . . 64 

STDs in Persons Entering Corrections Facilities 

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

or county jails or juvenile detention centers†, 1999 . . . . . . . . . . . . . . . . . . . 67 

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

county jails or juvenile detention centers†, 1999. . . . . . . . . . . . . . . . . . . . . . 67 

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

facilities†, 1999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68 

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

facilities†, 1999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68 

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

facilities†, 1999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69 

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

facilities†, 1999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69 

STDs in the South 

Figure GG. South — Primary and secondary syphilis case rates by county, 1999 . . . . . 73 

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

syphilis in 1999 compared with 1998 cases, by county . . . . . . . . . . . . . . . . 73 
 

Figure II. South — Chlamydia case rates by county, 1999 . . . . . . . . . . . . . . . . . . . . . 74 
 

Figure JJ. South — Gonorrhea case rates by county, 1999 . . . . . . . . . . . . . . . . . . . . . 74 
 

Sources and Limitations of Data 

Figure A1. Chlamydia — National electronic telecommunications system for 

surveillance (NETSS) transmission status by state, 1999 . . . . . . . . . . . . . . 130 

Figure A2. Gonorrhea — National electronic telecommunications system for 

surveillance (NETSS) transmission status by state, 1999 . . . . . . . . . . . . . . 130 

Figure A3. Primary and secondary syphilis — National electronic telecommunications system for surveillance (NETSS) transmission status by state, 1999 . . 131 

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, 

1941–1999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75 

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

source: United States, 1999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77 

Chlamydia 

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

States, 1996–1999. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78 

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

and race/ethnicity: United States, 1996–1999. . . . . . . . . . . . . . . . . . . . . . . 79 

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

to rates: United States and outlying areas, 1999 . . . . . . . . . . . . . . . . . . . . . 80 

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

in alphabetical order: United States and outlying areas, 1995–1999 . . . . . . 81 

Table 6. Chlamydia — Women – Reported cases and rates by state/area listed in 

alphabetical order: United States and outlying areas, 1995–1999 . . . . . . . . 82 

Table 7. Chlamydia — Men – Reported cases and rates by state/area listed in 

alphabetical order: United States and outlying areas, 1995–1999 . . . . . . . . 83 

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

population, ranked according to rates: United States and outlying 

areas, 1999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84 

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

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

1995–1999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85 

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

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

outlying areas, 1995–1999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86 

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

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

outlying areas, 1995–1999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87 

Gonorrhea 

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

States, 1995–1999. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88 

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

and race/ethnicity: United States, 1995–1999 . . . . . . . . . . . . . . . . . . . . . . . 89 

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

to rates: United States and outlying areas, 1999 . . . . . . . . . . . . . . . . . . . . . 90 

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

in alphabetical order: United States and outlying areas, 1995–1999 . . . . . . 91 

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

in alphabetical order: United States and outlying areas, 1995–1999 . . . . . . 92 

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

alphabetical order: United States and outlying areas, 1995–1999 . . . . . . . . 93 

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

population, ranked according to rates: United States and outlying 

areas, 1999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94 

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

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

1995–1999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95 

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

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

outlying areas, 1995–1999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 96 

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

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

outlying areas, 1995–1999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97 

Syphilis 

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

alphabetical order: United States and outlying areas, 1995–1999 . . . . . . . . 98 

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

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

outlying areas, 1995–1999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99 

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

race/ethnicity: United States, 1995–1999. . . . . . . . . . . . . . . . . . . . . . . . . . 100 

Table 23B. Primary and secondary syphilis — Reported rates per 100,000 population by age, gender, and race/ethnicity: United States, 1995–1999 . . . . . . 101 

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

area, ranked according to rates: United States and outlying areas, 1999 . . 102 

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

area and region listed in alphabetical order: United States and outlying 

areas, 1995–1999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103 

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

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

areas, 1995–1999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104 

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

state/area listed in alphabetical order: United States and outlying areas, 

1995–1999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105 

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, 1999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106 

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

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

and outlying areas, 1995–1999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107 

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

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

States and outlying areas, 1995–1999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 108 

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

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

United States and outlying areas, 1995–1999 . . . . . . . . . . . . . . . . . . . . . . 109 

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

ranked by number of reported cases: United States, 1999** . . . . . . . . . . . 110 

Table 33. Early latent syphilis — Reported cases and rates by state/area listed in 

alphabetical order: United States and outlying areas, 1995–1999 . . . . . . . 111 

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

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

outlying areas, 1995–1999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112 

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

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

1995–1999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113 

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

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

and outlying areas, 1995–1999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 114 

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

age: United States (excluding outlying areas), 1963–1999 . . . . . . . . . . . . . 115 

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, 1999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 116 

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

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

areas, 1995–1999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117 

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, 1999 . . . . . . . . . . . . . . . . . . . . . . 118 

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

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

order: United States and outlying areas, 1995–1999 . . . . . . . . . . . . . . . . . 119 

Chancroid 

Table 42. Chancroid — Reported cases and rates by state/area listed in alphabetical order: United States and outlying areas, 1995–1999. . . . . . . . . . . . 120 

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

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

1995–1999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121 

Appendix 

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

Status . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 132 

xvi 
Geographic Divisions of the United States 

West Midwest Northeast

South 

West Midwest South Northeast 

Alaska Illinois Alabama Connecticut 

Arizona Indiana Arkansas Maine 

California Iowa Delaware Massachusetts 

Colorado Kansas District of Columbia New Hampshire 

Hawaii Michigan Florida New Jersey 

Idaho Minnesota Georgia New York 

Montana Missouri Kentucky Pennsylvania 

Nevada Nebraska Louisiana Rhode Island 

New Mexico North Dakota Maryland Vermont 

Oregon Ohio Mississippi 

Utah South Dakota North Carolina 

Washington Wisconsin Oklahoma 

Wyoming South Carolina 

Tennessee 

Texas 

Virginia 

West Virginia 

xvii 

National Overview of Sexually Transmitted Diseases, 1999 

The logo on the cover of Sexually Transmitted Disease Surveillance, 1999 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 report of the Institute of Medicine, The 

Hidden Epidemic: Confronting Sexually Transmitted Diseases,1 surveillance is a key component of 

our efforts to prevent and control these diseases. 

This overview summarizes national surveillance data on the three diseases for which we have 

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

1999 are worthy of note. 

In 1999, 659,441 cases of infection with genital Chlamydia trachomatis were reported to CDC. 

This case count corresponds to a rate of 254.1 cases per 100,000 persons, an increase of 8.5% compared with the rate of 234.2 in 1998. Rates of reported chlamydial infection among women have 

been increasing annually since the late 1980s when public programs for screening and treatment of 

women were first established to avert pelvic inflammatory disease and related complications. 

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

of sexually active women aged 15 to 25 years of age who are provided care through managed care 

organizations.2 The increase in chlamydia case reports in 1999 most likely represents a continued 

increase in screening for this infection and also increased use of nucleic acid amplification tests 

(NAATs), which are more sensitive than other types of chlamydia screening tests. 

In 1999, the overall reported rate of chlamydial infection among women (404.5 cases per 

100,000 females) was four times the reported rate among men (94.7 cases per 100,000 males), reflecting the large number of women screened for this disease. However, with the increased availability of urine testing with the NAATs, men are increasingly being tested for chlamydial infection. From 

1995 to 1999, the reported chlamydial infection rate in males increased by 64.1% (from 57.7 to 

94.7 cases per 100,000 males) compared with a 27.9% increase in women over this period (from 

316.3 to 404.5 cases per 100,000 females). 

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

been useful in monitoring disease burden and guiding chlamydia screening programs. These data 

show that in many states prevalence of infection remains substantially above the HP2000 goal of 

5% for sexually active women aged 15 to 24 years. In 1999, the median state-specific chlamydia test 

positivity among women aged 15 to 24 years who were screened at selected family planning clinics 

in all states and the Virgin Islands was 5.5% (range, 2.6% to 15.0%) and at selected prenatal clinics 

in 22 states, 7.2% (range, 4.5% to 14.4%). For economically-disadvantaged women aged 16 to 24 

years who entered the U.S. Job Corps in 1999, from 32 states , the District of Columbia and Puerto 

Rico the median state-specific prevalence was 11.1% (range, 5.7% to 18.9%). For women aged 17 

STD Surveillance 1999 Overview 1 
to 37 years entering the U.S. Army, the overall chlamydia prevalence was 9.9% (range, 

4.1%-19.6% by state of residence), and for women aged 15 to 30 years screened at Indian Health 

Service (IHS) clinics in four IHS regions, the prevalence ranged from 5.4% to 10.8%. For adolescent 

women entering juvenile detention centers in 21 U.S. counties, the median chlamydia positivity 

was 13.0% (range, 4.9% to 25.2%). For males entrants to the U.S. Army who were screened in 

1999, the overall chlamydia prevalence was 4.7% (range, 1.1% to 10.3% by state of residence). For 

adolescent men entering juvenile detention centers in 23 counties, the median chlamydia positivity 

was 4.3% (range, 1.5% to 10.0%). Although these data on prevalence are not entirely comparable 

because of differences in the performance characteristics of the screening tests and variations in 

screening criteria, they provide important information on the continuing high burden of disease in 

these populations. 

In parts of the United States where large scale chlamydia screening programs have been instituted, prevalence of disease has often declined substantially. During 1988-1999, 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 62% (from 13.0% to 4.9%). 

After adjusting trends in chlamydia positivity to account for changes in laboratory test methods and 

associated increases in test sensitivity, chlamydia test positivity decreased in five of 10 HHS regions 

from 1998 to 1999, increased in four regions and remained the same in one. Although chlamydia 

positivity has declined in the past year in some regions, most likely due to the effectiveness of 

screening and treating women, continued expansion of screening programs to populations with 

higher prevalence of disease may have contributed to the increases in positivity seen in other 

regions. See the Appendix for a definition of the HHS regions. 

Following a 72% decline in the reported rate of gonorrhea from 1975 to 1997, in 1999 the gonorrhea rate increased for the second year in a row. The gonorrhea rate for 1999 (133.2 cases per 

100,000 persons) was 1.2% higher than the 1998 rate (131.6 cases per 100,000 persons) and 9.2% 

higher than the rate reported in 1997 (122.0 per 100,000 persons). Although screening (usually associated with simultaneous testing for chlamydial infection) and improved reporting may account 

for a portion of the recent increase, true increases in disease in some populations and geographic 

areas also appear to have occurred. The 1999 rate for gonorrhea exceeds the Healthy People 2000 

(HP2000) objective of 100 cases per 100,000 persons. 

The gonorrhea rate in the U.S. among females in 1999 was similar to the rate in 1998 (129.9 and 

130.0 cases per 100,000 females respectively). However, from 1998 to 1999, the gonorrhea rate in 

men increased by 2.5%, from 132.7 to 136.0 cases per 100,000 males. In contrast to the 20 years 

prior to 1998, which generally exhibited decreasing age-specific rates for gonorrhea, for most 

5-year age categories there was little change in the reported rates between 1998 and 1999. Similar 

to chlamydia, rates of gonorrhea in women are particularly high in 15- to 19-year-olds. 

In 1999, new data on gonorrhea prevalence in defined populations were available from several 

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

some parts of the United States. Among 15- to 24-year-old women attending selected family planning clinics in 32 states, the median state-specific gonorrhea prevalence was 1.0% (range, 0% to 

5.2%). For women in this age group attending selected prenatal clinics in 15 states, the median 

prevalence was 1.1% (range, 0% to 4.1%). For 16- to 24-year-old women entering the U.S. Job 

Corps in 14 states in 1999, the median gonorrhea prevalence was 3.6% (range, 0.9% to 9.4%). The 

median gonorrhea prevalence among adolescent women entering juvenile detention centers in 14 

2 Overview STD Surveillance 1999 
counties was 6.4% (range, 1.3% to 14.1%); for adolescent men entering detention facilities in 11 

counties, the median prevalence was 1.9% (range, 0.4% to 3.8%). 

Antimicrobial resistance in Neisseria gonorrhoeae remains a continuing concern, with the most 

recent threat being the increase in fluoroquinolone resistance that has been reported most notably 

from several Asian countries. Ciprofloxacin is a fluoroquinolone antibiotic that has been recommended for treatment of gonorrhea by CDC; this is an oral medication that is inexpensive and effectively treats gonorrhea with a single dose. Although only 0.4% of N. gonorrhoeae isolates tested 

through the Gonococcal Isolate Surveillance Project (GISP) in 1999 demonstrated resistance to 

ciprofloxacin, this was a substantial increase from 1998, when only 0.1% of isolates were reported 

to be resistant. Of note, 14.3% of GISP isolates from Hawaii in 1999 were resistant to ciprofloxacin, 

requiring a change in the gonorrhea treatment recommendations in that state. See Appendix for a 

further description of GISP. 

Data on characteristics of patients in the GISP sample have been used to obtain information on 

the sexual orientation of male STD clinic patients with gonorrhea. In 1999, there was a continuing 

increase in the proportion of GISP isolates from men who have sex with men (MSM). In 1999, the 

proportion of GISP isolates from MSM increased to 13.1% compared with 12.0% in 1998. In 1988 

only 4.0% of isolates were from MSM. The proportional increase in MSM in GISP has corresponded 

to an absolute increase in gonorrhea cases among MSM at STD clinics in several large cities that 

participate in GISP. 

In view of the important role of syphilis in facilitating the transmission of HIV infection, the differential impact of syphilis on racial and ethnic minorities, and the recent cyclical decline in this disease, the National Plan to Eliminate Syphilis from the United States was developed, and 

announced by the Surgeon General in October 19992

. The 6,657 cases of primary and secondary 

(P&S) syphilis reported in 1999 were the fewest cases reported in the United States since 1957. The 

P&S syphilis rate of 2.5 per 100,000 persons (the lowest since national reporting began in 1941) is 

below the HP2000 objective of 4 cases per 100,000 persons, but remains substantially above the 

goal for syphilis elimination of 0.4 cases per 100,000 persons (about 1,000 cases per year).3 

The number of P&S syphilis cases reported in 1999 was 5.4% lower than the 7,035 cases reported in 1998. However, this decline was substantially less than the reductions of approximately 

20% per year since the last major syphilis epidemic peaked in 1990. Although this smaller decline 

may partially reflect improved case finding and reporting, it also reflects the persistence of this disease in some populations and recent outbreaks in several geographic areas, including outbreaks 

among MSM. 

One factor that greatly facilitates syphilis elimination efforts is that this disease continues to be primarily reported only in specific areas of the country. In 1999, 79% of the 3,115 counties in the 

United States reported no cases of P&S syphilis and half of all the cases were reported from only 25 

(0.8%) of the counties. However, 1999 P&S syphilis rates exceeded the HP2000 objective in 265 

counties (9% of the total number of U.S. counties). These 265 counties accounted for 74% of all reported P&S syphilis cases. Ninety-two percent (243 out of 265) of these counties are located in the 

southern United States. In addition, 9 of the 11 states with 1999 reported rates of P&S syphilis 

greater than the HP2000 objective are located in the South. These data suggest that comprehensive 

syphilis prevention efforts focused in the South could markedly reduce the number of syphilis cases 

occurring in the United States. 

STD Surveillance 1999 Overview 3 
Between 1998 and 1999, the national rate of congenital syphilis decreased by 34%, from 21.6 to 

14.3 cases per 100,000 live births. The continuing reduction in congenital syphilis rates, evident 

since the early 1990s, reflects the substantial reduction in the rate of P&S syphilis among women 

over the same period. In 1999, only one state had a reported rate of congenital syphilis that exceeded the HP2000 objective of 40 cases per 100,000 live births. 

Although wide disparities exist in the reported rates of STDs among racial and ethnic groups, 

there has been a reduction in these differences for some diseases over the past five years. For example, the P&S syphilis rate reported for 1999 among African-Americans was 30 times the rate reported among whites, reflecting a substantial decline from 1995, when the rate ratio was 56. 

Although reporting biases likely magnify differences in reported rates by race and ethnicity, these 

factors continue as risk markers among the U.S. population that correlate with other, more fundamental, determinants of health status such as socioeconomic status and access to quality medical 

care. 

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

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

1997. 

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

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

3Division of STD Prevention. The National Plan to Eliminate Syphilis from the United States. National Center 

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

4 Overview STD Surveillance 1999 
National Profile 

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

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

Where relevant, the figures illustrate progress towards specific objectives for the nation published in 

Healthy People 2000: Midcourse Review and 1995 Revisions and towards the provisional 

objectives given in Healthy People 2010: Conference Edition*. 

*See the Appendix for a listing of the Healthy People 2000 and provisional Healthy People 2010 objectives 

for the diseases addressed in this report. 

STD Surveillance 1999 National Profile 5 

Chlamydia 

Infections due to Chlamydia trachomatis are the most commonly reported notifiable disease in 

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

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

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

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

trial of chlamydia screening in a managed care setting suggest that such screening programs can 

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

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

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

neonatal ophthalmia and pneumonia. 

The increase in reported chlamydial infections during the 1990s reflects the expansion of 

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

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

for reporting. However, many women who are at risk for this infection are still not being tested, reflecting the lack of awareness among some health care providers and the limited resources available 

to support screening. Chlamydia screening and reporting are likely to expand further in response to 

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

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

managed care organizations.2 To better monitor trends in disease burden in defined populations 

during the expansion of chlamydia screening activities, data on chlamydia positivity among persons 

screened in a variety of settings are used; in most instances, test positivity serves as a reasonable 

approximation of prevalence.3 In parts of the United States where large scale chlamydia screening 

programs have been instituted, prevalence of the disease has often declined substantially. 

•	 In 1999, 49 states and the District of Columbia had regulations requiring the 

reporting of chlamydia cases to CDC (Figure 1, Table 5). For the state of New 

York, only cases identified in New York City were reported. 

•	 In 1999, 659,441 chlamydial infections were reported to CDC from 49 states, the 

District of Columbia, and New York City (Table 1). This case count corresponds 

to a rate of 254.1 cases per 100,000 persons, an increase of 8.5% compared with 

the rate of 234.2 in 1998. The reported number of chlamydial infections was 

approximately two times greater than the number of reported cases of gonorrhea 

(360,076 gonorrhea cases were reported in 1999, Table 1). 

•	 From 1987 through 1999, the reported rates of chlamydial infection increased 

from 50.8 to 254.1 cases per 100,000 persons (Figure 2, Table 1). The continuing 

increase in reported cases likely represents the further expansion of screening for 

this infection and also increased use of nucleic acid amplification tests, which are 

more sensitive than other types of screening tests. 

•	 For the years 1996-1999, the chlamydia case rate in the Southern region of the 

United States (203.9, 230.1, 268.4, and 289.4 cases per 100,000 persons 

STD Surveillance 1999 National Profile	 Chlamydia 7 
respectively) was higher than in any other region of the country (Table 5, Figures 

3 and 4). The higher rates in this region reflect an expansion of screening activities 

in the South in addition to the high burden of disease in this region. Before 1996, 

reported chlamydia rates were highest in the West and Midwest, where 

substantial public resources had been committed for screening programs, for 

example in family planning clinics. 

•	 Between 1998 and 1999, rates of chlamydial infection reported from selected 

large cities (over 200,000 population) increased by 6% from 361.8 to 382.0 cases 

per 100,000 persons (Figure 5, Table 9). 

•	 In 1999, the overall reported rate of chlamydial infection among women in the 

U.S. (404.5 cases per 100,000 females) was four times higher than the reported 

rate among men (94.7 cases per 100,000 males), reflecting the large number of 

women screened for this disease (Figure 6, Tables 6 and 7). The lower rates 

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

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

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

asymptomatic men are increasingly being diagnosed with chlamydial infection. 

From 1995 to 1999, the reported chlamydial infection rate in males increased by 

64.1% (from 57.7 to 94.7 cases per 100,000 males) compared with a 27.9% 

increase in women over this period (from 316.3 to 404.5 cases per 100,000 

females) (Tables 6 and 7). 

•	 For women, the highest age-specific reported rates of chlamydia in 1999 

occurred among 15- to 19- year-olds (2,483.8 per 100,000 females) and 20- to 

24-year-olds (2,187.1 per 100,000 females). Age-specific reported rates among 

men, while substantially lower than the rates in similarly aged women, 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 1999, the median chlamydia test positivity among 15- to 24-year-old women 

who were screened during visits to selected family planning clinics in all states and 

outlying areas was 5.5% (range, 2.6% to 15.0%) (Figure 8). In many states, the 

chlamydia test positivity exceeded the HP2000 objective of 5% for this 

population, and in nearly all states chlamydia positivity exceeded the HP2010 

provisional objective of 3%.4 

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

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

has been in place for several years. For example, from 1988 to 1999, the 

screening programs in Health and Human Services Region X (Alaska, Idaho, 

Oregon, Washington) family planning clinics demonstrated a decline in 

chlamydia positivity of 62% from 13.0% to 4.9% among 15- to 44-year-old 

women (Figure 9); these positivity values were adjusted for changes in the 

sensitivity of laboratory tests (see Appendix).

5 

8 Chlamydia	 National Profile STD Surveillance 1999 
•	 After adjusting trends in chlamydia positivity to account for changes in laboratory 

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

chlamydia test positivity decreased in five of 10 HHS regions from 1998 to 1999, 

increased in four regions and remained the same in one (Figure 9). Although 

chlamydia positivity has declined in the past year in some regions due to the 

effectiveness of screening and treatment of women, continued expansion of 

screening programs to populations with higher prevalence of disease may have 

contributed to increases in positivity in other regions. 

•	 Additional information on chlamydia screening programs for women of 

reproductive age and chlamydia among adolescents and minority populations 

can be found in the Special Focus Profiles 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. 

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

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

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

Transm Dis 1998;25:251-3. 

4U.S. Department of Health and Human Services. Healthy People 2010 (Conference Edition, in Two 

Volumes). U.S. Government Printing Office, Washington, D.C., 2000. 

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

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

STD Surveillance 1999 National Profile	 Chlamydia 9 
Figure 1. Chlamydia — Number of states that require reporting of Chlamydia trachomatis 

infections: United States, 1987–1999 

No. of states 

50 

40 

30 

20 

10 

0 

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

Figure 2. Chlamydia — Reported rates: United States, 1984–1999 

Rate (per 100,000 population)
 

300
 

240 

180
 

120
 

60
 

0
 

1 9 8 4 8 5 8 6 8 7 8 8 8 9 9 0 9 1 9 2 9 3 9 4 9 5 9 6 9 7 9 8 9 9 

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

10 Chlamydia National Profile STD Surveillance 1999 
Figure 3. Chlamydia — Rates by state: United States and outlying areas, 1999 

Rate per 100,000

population 

<=150 

150.1-300 

>300 

VT 82.1 

NH 82.4 

MA 142.8 

RI 237.2 

CT 226.7 

NJ 153.1 

DE 371.3 

MD 264.2 

Guam 311.0 

Puerto Rico 37.4 Virgin Is. 124.0 

(n=10) 

(n=34) 

(n=9) 

284.4 

307.2 

259.4 231.1 

260.7 273.2 

212.8 

397.4 

265.3 

144.7 

272.9 198.9 

192.5 

231.8 187.4 

380.8 

98.1 

235.4 

157.7 

419.5 

245.6 

179.9 

217.5 176.7 

288.8 

* 

289.0 

148.4 

262.3 

244.9 

186.7 

225.1 

482.3 

209.2 

261.8 

318.6 

105.7 

202.2 

210.3 

100.5 

276.9 

163.6 

*The New York City rate was 360.7 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 250.9 per 100,000 population. For further information on 

chlamydia reporting, see the Appendix. 

Figure 4. Chlamydia — Rates by region: United States, 1984–1999 

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 99
 

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

STD Surveillance 1999 National Profile Chlamydia 11
 
Figure 5. Chlamydia — Rates in selected U.S. cities of >200,000 population, 1984–1999 

Rate (per 100,000 population) 

400 

320 

240 

160 

80 

0 

1 9 8 4 8 5 8 6 8 7 8 8 8 9 9 0 9 1 9 2 9 3 9 4 9 5 9 6 9 7 9 8 9 9 

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

Figure 6. Chlamydia — Rates by gender: United States, 1984–1999 

Rate (per 100,000 population) 

450 

360 

270 

180 

90 

0 

Men 

Women 

1 9 8 4 8 5 8 6 8 7 8 8 8 9 9 0 9 1 9 2 9 3 9 4 9 5 9 6 9 7 9 8 9 9 
 

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

12 Chlamydia National Profile STD Surveillance 1999 
Figure 7. Chlamydia — Age- and gender-specific rates: United States, 1999 

Men Rate (per 100,000 populationpopulationpopulationpopulationpopulationpopulationpopulationpopulationpopulationpopulationpopulationpopulationpopulationpopulationpopulationpopulationpopulationpopulationpopulationpopulationpopulationpopulation) Women 

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

8.9 10-14 147.0

343.7 15-19 2,483.8

503.8 20-24 2,187.1

245.1 25-29 725.9

108.2 30-34 246.5

55.7 35-39 99.0

29.2 40-44 40.4

12.6 45-54 14.4

4.6 55-64 4.0

2.2 65+ 3.0

97.0 Total 403.4

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

clinics by state, 1999 

6.1 

4.5 3.3 3.0 

3.7 4.2 

4.3 2.6 7.2 3.2 

5.0 4.6 VT 2.8 

7.2 

6.1 

3.6 

5.3 4.2 

3.3 4.6 

4.1 

7.2 5.0 

3.7 

5.9 

2.6 

6.5 

6.4 

NH 

MA 

RI 

CT 

NJ 

DE 

6.6 

3.8 

10.5 

3.5 

6.3 

6.3 

8.5 MD 5.9 5.5 DC 5.6 5.5 5.2 5.5 7.1 9.3 

14.6 10.0 7.7 Positivity (%) 

9.0 <4 (n=12) 10.9 4.0 4.0-4.9 (n=8) 5.5 (n=33) >=5 6.1 

Puerto Rico 6.8 Virgin Is. 15.0 

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

during 1999 except for Rhode Island; for Puerto Rico, - chlamydia positivity data were reported 

for August-December only. 

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

Centers for Disease Control and Prevention 

STD Surveillance 1999 National Profile Chlamydia 13 
Figure 9. Chlamydia — Trends in positivity among 15-44 year old women tested in family 

planning clinics by HHS regions, 1988–1999 

REGION=VIII REGION=V REGION=II 

REGION=I 

13.0 

10.0 9.5 

8.0 6.7 

5.0 4.7 4.1 3.9 3.9 4.6 4.9 

6.0 5.0 4.6 4.6 5.3 5.4 

94 95 96 97 98 99 

7.5 7.2 

5.6 

97 98 99 

5.7 6.2 6.2 

97 98 99 

6.7 

4.9 4.6 4.1 

96 97 98 99 

88 89 90 91 92 93 94 95 96 97 98 99 REGION=III 

7.4 

6.0 5.3 5.6 6.0 6.2 

REGION=IX 

94 95 96 97 98 99 

5.1 5.2 5.9 6.3 REGION=IV 

8.9 10.1 9.5 

96 97 98 99 REGION=VI 

8.4 8.9 9.7 8.7 

97 98 99 

96 97 98 99 

5.0 4.7 5.4 5.3 

96 97 98 99 

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

sensitivity (see Appendix). No data on laboratory test method available for Region VII in 1995 

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

(HHS) regions. 

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

Centers for Disease Control and Prevention 

14 Chlamydia National Profile STD Surveillance 1999 
Gonorrhea 

Infections due to Neisseria gonorrhoeae, like those resulting from Chlamydia trachomatis, are a 

major cause of pelvic inflammatory disease (PID) in the United States. Occurrence of PID can lead 

to serious outcomes such as tubal infertility, ectopic pregnancy, and chronic pelvic pain. In addition, 

epidemiologic and biological studies provide strong evidence that gonococcal infections facilitate 

the transmission of HIV infection.1 

Following a 72% decline in the reported rate of gonorrhea from 1975 to 1997, in 1999 the 

gonorrhea rate increased for the second year in a row. Although increased screening (usually associated with simultaneous testing for chlamydial infection), use of more sensitive diagnostic tests, and 

improved reporting may account for a portion of the recent increase, true increases in disease in 

some populations and geographic areas also appear to have occurred.2 

As with chlamydial infection, reporting of gonorrhea cases to CDC is incomplete. In addition, reporting practices for gonococcal infections have likely been biased towards reporting of infections in 

persons of minority race or ethnicity who attend public STD clinics.2,3 As a result, for most areas, the 

number of gonorrhea cases reported to CDC reflects many factors, only one of which is the 

occurrence of the infection among the population. For this reason, new data on gonorrhea prevalence in persons screened in a variety of different settings are useful in assessing disease burden in 

selected populations. 

•	 In 1999, 360,076 cases of gonorrhea were reported in the United States (Table 1). 

•	 In 1999, the reported rate of gonococcal infections in the United States (133.2 

cases per 100,000 persons) increased by 1.2% compared with the rate reported 

in 1998 (131.6 cases per 100,000 persons) and 9.2% compared with 1997 

(122.0 cases per 100,000 persons) (Table 14). Prior to this increase, in the period 

from 1977 to 1997, the national gonorrhea rate had been declining following the 

implementation of the national gonorrhea control program in the mid-1970s 

(Table 1). 

•	 In 1999, 26 states and three outlying areas reported gonorrhea rates below the 

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

persons. Eight states and one outlying area had reported rates below the 

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

persons4 (Figure 11 and Table 13). 

•	 The gonorrhea rates in all of the four Census regions of the United States 

(Northeast, West, Midwest, and South) either increased or stayed approximately 

constant between 1998 and 1999. All regions, however, had experienced 

declining rates from 1995 through 1997. As in previous reporting years, the South 

had the highest rate in 1999 (202.9 cases per 100,000 persons) among the four 

regions of the country (Figure 12, Table 14). 

STD Surveillance 1999 National Profile	 Gonorrhea 15 
•	 The overall gonorrhea rate reported from selected large cities, those with 

populations over 200,000 persons, was 230.8 cases per 100,000 persons in 

1999. This rate is slightly lower than that reported for these cities in 1998 (238.0 

cases per 100,000 persons) (Figure 13, Table 18). Fifty-three (83%) of these 64 

cities had rates exceeding the HP2000 objective of 100 cases per 100,000 

persons. All cities, with the exception of San Juan, Puerto Rico, had reported rates 

higher than the HP2010 provisional objective of 19 cases per 100,000 persons 

(Table 17). 

•	 There was no meaningful change in the reported gonorrhea rate among women 

between 1998 and 1999 (130.0 and 129.9 cases per 100,000 females 

respectively). The gonorrhea rate in men, however, increased by 2.5% from 

132.7 to 136.0 cases per 100,000 males from 1998 to 1999. Reported rates in 

1999 among men were greater than the HP2000 objective in 23 states while 1999 

rates among women exceeded the objective in 24 states. State-specific reported 

rates for both men and women were higher than the provisional HP2010 

objective of 19 cases per 100,000 persons in 42 states (Figure 14, Tables 15 and 

16). 

•	 Changes in the reported 1999 gonorrhea rates, relative to those reported in 1998, 

differed depending on racial/ethnic group. For example, the rates among 

Hispanics and Asian/Pacific Islanders were 4% and 6% higher respectively in 

1999 than the corresponding group-specific rates in 1998. The 1999 rate among 

American Indians/Alaska Natives, however, was 7% lower than the rate reported 

in 1998. Rates among non-Hispanic whites and blacks were similar in 1998 and 

1999 (Figure 15 and Table 12B). The 1999 gonorrhea rates for non-Hispanic 

blacks and American Indians/Alaska Natives were above the HP2000 objective. 

In 1999, the reported gonorrhea rate among non-Hispanic blacks was about 30 

times greater than the rate for non-Hispanic whites. 

•	 Between 1998 and 1999, the reported gonorrhea rates among 15- to 19-year-old 

adolescents decreased from 547.0 to 534.0 cases per 100,000 persons. For 20- to 

24-year-old young adults, the reported rate increased from 605.2 to 614.7 cases 

per 100,000 persons between 1998 and 1999 (Table 12B). 

•	 Among women in 1999, 15- to 19-year-olds had the highest reported rate of 

gonorrhea, while among men, 20- to 24-year-olds had the highest rate (Table 

12B and Figure 16). 

•	 In 1999, the median state-specific gonorrhea test positivity among 15 to 24-year 

old women screened in selected family planning clinics in 32 states was 1.0% 

(range, 0% to 5.2%) (Figure 17). 

•	 Antimicrobial resistance remains an important consideration in the treatment of 

gonorrhea.5,6 Overall, 28.1% of isolates collected in 1999 by the Gonococcal 

Isolate Surveillance Project (GISP) were resistant to penicillin, tetracycline, or 

both (Figure 19). 

•	 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 and to 1.1% in 1999 (Figure 20). Resistance to ciprofloxacin was 

first identified in GISP in 1991. From 1991 to 1998, less than 9 

ciprofloxacin-resistant isolates were identified each year and such isolates were 

16 Gonorrhea	 National Profile STD Surveillance 1999 
identified in only a few GISP clinics. However, in 1999, 19 (0.4%) 

ciprofloxacin-resistant GISP isolates were identified in 10 of the 26 GISP clinics. 

Notably, in Honolulu, 14.3% of GISP isolates were ciprofloxacin-resistant 

prompting CDC and the Hawaii Department of Health to no longer recommend 

the use of fluoroquinolone antibiotics for treatment of gonorrhea in that state. 

•	 In 1999, all GISP isolates were susceptible to ceftriaxone and to cefixime. The 

proportion of GISP isolates demonstrating decreased susceptibility to ceftriaxone 

or cefixime has remained very low over time. To date, no cephalosporin 

resistance has been identified in GISP. 

•	 The proportion of GISP isolates demonstrating elevated minimum inhibitory 

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

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

had azithromycin MIC ≥ 0.5 μg/ml compared with 2.9% in 1999. In 1992, there 

were no isolates with azithromycin MIC ≥ 1.0 μg/ml but in 1999, there were 25 

such isolates. 

•	 The percentage of men with gonorrhea who were reported to have had a 

gonorrhea infection in the previous year, as measured by the GISP, decreased 

from 21.5% in 1992 to 17.2% in 1999 (Figure 21), approaching the HP2000 

objective of 15%. 

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

men who have sex with men (MSM).6,7 The proportion of isolates from MSM 

increased from 12.0% in 1998 to 13.1% in 1999; in 1988, only 4.0% of GISP 

isolates were from MSM. Among the nine GISP clinics reporting the majority of 

MSM cases in 1999, the percentage of cases that were in MSM ranged from 

11.3% to 56.8%, with a median of 25.0% (Figure 22). 

•	 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. 

2Centers for Disease Control and Prevention. Gonorrhea – United States, 1998. MMWR 1999;49:538-42. 

3Fox 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. 

4U.S. Department of Health and Human Services. Healthy People 2010 (Conference Edition, in Two 

Volumes). U.S. Government Printing Office, Washington, DC, 2000. 

5Fox KK, Knapp JS, Holmes KK, et al. 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. 

6Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance 1999 Supplement: 

Gonococcal Isolate Surveillance Project (GISP) Annual Report – 1999. U.S. Department of Health and 

Human Services. Atlanta: Centers for Disease Control and Prevention, 1999 (in press). 

7Centers for Disease Control and Prevention. Gonorrhea among men who have sex with men – selected 

sexually transmitted disease clinics, 1993-1996. MMWR 1997;46:889-92. 

STD Surveillance 1999 National Profile	 Gonorrhea 17 
Figure 10. Gonorrhea — Reported rates: United States, 1970–1999 and the Healthy People 

year 2000 objective 

Rate (per 100,000 population) 

Gonorrhea 

2000 Objective 

0 

100 

200 

300 

400 

500 

1970 73 76 79 82 85 88 91 94 97
 

Figure 11. Gonorrhea — Rates by state: United States and outlying areas, 1999
 

Rate per 100,000

population 

<=100 

100.1-200 

>200 

VT 8.8 

NH 9.7 

MA 39.9 

RI 60.8 

CT 101.4 

NJ 96.8 

DE 223.5 

MD 203.1 

Guam 36.9 

Puerto Rico 8.3 Virgin Is. 46.5 

(n=29) 

(n=15) 

(n=9) 

250.2 

49.2 

92.0 127.1 

57.2 63.6 

153.8 

278.0 

38.8 

7.2 

193.1 103.3 

47.7 

101.4 85.1 

301.9 

6.7 

162.0 

59.9 

378.3 

150.5 

6.0 

88.5 74.6 

56.1 

109.1 

257.4 

13.0 

161.8 

120.1 

27.5 

110.8 

392.0 

26.0 

209.3 

166.6 

12.1 

138.4 

37.5 

32.2 

127.5 

8.9 

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

Rico and Virgin Islands) was 131.4 per 100,000 population. The Healthy People year 2000
 

objective is 100 per 100,000 population.
 

18 Gonorrhea National Profile STD Surveillance 1999
 
Figure 12. Gonorrhea — Rates by region: United States, 1981–1999 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 83 85 87 89 91 93 95 97 99
 

Figure 13. Gonorrhea — Rates in selected U.S. cities of >200,000 population, 1981–1999 

and the Healthy People year 2000 objective 

Rate (per 100,000 population)
 

900
 

720
 

540
 

360
 

180
 

0
 

Cities 

2000 Objective 

1981 83 85 87 89 91 93 95 97 99
 

STD Surveillance 1999 National Profile Gonorrhea 19 
Figure 14. Gonorrhea — Rates by gender: United States, 1981–1999 and the Healthy 

People year 2000 objective 

Rate (per 100,000 population) 

600 

480 

360 

240 

120 

0 

Male 

Female 

2000 Objective 

1 9 8 1 8 3 8 5 8 7 8 9 9 1 9 3 9 5 9 7 9 9 
 

Figure 15. Gonorrhea — Rates by race and ethnicity: United States, 1981–1999 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 83 85 87 89 91 93 95 97 99
 

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

Black, White, and Other are non-Hispanic. 

20 Gonorrhea National Profile STD Surveillance 1999 
Figure 16. Gonorrhea — Age- and gender-specific rates: United States, 1999 

Men Rate (per 100,000 populationpopulationpopulationpopulationpopulationpopulationpopulationpopulationpopulationpopulationpopulationpopulationpopulationpopulationpopulationpopulationpopulationpopulationpopulationpopulationpopulationpopulation) Women 

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

8.4 10-14 54.6

341.1 15-19 738.1

585.6 20-24 644.9

352.3 25-29 251.7

206.7 30-34 114.5

144.0 35-39 63.5

98.2 40-44 30.4

51.2 45-54 9.5

19.6 55-64 2.0

5.1 65+ 0.9

136.1 Total 130.0

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

clinics by state, 1999 

0.7 

0.2 

0.7 1.5 VT 0.2 

1.1 NH 0.2 

0.6 0.3 MA 

1.3 

0.7 

0.5 

2.0 0.9 RI 

CT 2.8 

0.7 0.7 0.6 NJ 

DE 

1.6 

MD 1.3 DC 0.8 0.8 1.5 2.2 

Positivity (%) 

5.2 2.8 2.2 

1.7 

3.0 

See * 

<1 

(n=21) 

(n=16) 

1.3 1.0-1.9 (n=9) 

>=2 (n=7) 

0.0 

Puerto Rico Virgin Is. 1.7 

*States reported gonorrhea positivity data on less than 500 women aged 15-24 years during 1999 

except for New Jersey and Virgin Islands submitting gonorrhea positivity data for July-December only. 

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

Centers for Disease Control and Prevention 

STD Surveillance 1999 National Profile Gonorrhea 21 
Figure 18. Gonococcal Isolate Surveillance Project (GISP) — Location of participating 

clinics and regional laboratories: United States, 1999 

Seattle 

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 Miami 

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

resistance among GISP isolates, 1999 

2.1% 

5.8% 

0.4% 

5.7% 

6.0% 

8.1% 

71.9% 

Susceptible 

PPNG 

TRNG 

PPNG/TRNG 

PenR 

TetR 

CMRNG 

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

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

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

chromosomally mediated tetracycline resistant N. gonorrhoeae; CMRNG=chromosomally 

mediated penicillin and tetracycline resistant N. gonorrhoeae. 

22 Gonorrhea National Profile STD Surveillance 1999 
Figure 20. Gonococcal Isolate Surveillance Project (GISP) — Percent of Neisseria 

gonorrhoeae isolates with decreased susceptibility or resistance to 

ciprofloxacin, 1990–1999 

Percent 

1.5 

1.2 

0.9 

0.6 

0.3 

0.0 

Decreased susc. 

Resistance 

1 9 9 0 9 1 9 2 9 3 9 4 9 5 9 6 9 7 9 8 9 9 
 

Note: Resistant isolates have ciprofloxacin MICs ≥ 1 μg/mL. Isolates with decreased 

susceptibility have ciprofloxacin MICs of 0.125 - 0.5 μg/mL. There were forty two (42) 

resistant isolates: one in 1991, one in 1993, two in 1994, eight in 1995, two in 1996, five in 

1997, four in 1998, and nineteen in 1999. Susceptibility to ciprofloxacin was first measured 

in GISP in 1990. 

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

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

1991–1999 

Percent 

50 

40 

30 

20 

10 

0 

Ever* 

Last 12 months** 

1 9 9 1 9 2 9 3 9 4 9 5 9 6 9 7 9 8 9 9 

*Data first collected in 1991. 

**Data first collected in 1992. 

STD Surveillance 1999 National Profile Gonorrhea 23 
Figure 22. Gonococcal Isolate Surveillance Project (GISP) — Percent of Neisseria 

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

in nine cities, 1995, 1997 and 1999 

Percent 

1995 

1997 

1999 

0 

15 

30 

45 

60 

75 

CHI DEN HON LBC ORA POR SDG SEA SFO 

Clinics 

Note: In 1999, these nine clinics reported 83.4% (511/613) 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=Seatle, WA; and SFO=San Francisco, CA. 

24 Gonorrhea National Profile STD Surveillance 1999 
Syphilis 

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 four years preceding pregnancy, may lead to infection of the fetus in over 70% of cases.1 

The rate of primary and secondary (P&S) syphilis reported in the United States is at its lowest 

level since reporting began in 1941. This unprecedented low rate and the concentration of the majority of syphilis cases in a small number of geographic areas have led to the development of the National Plan to Eliminate Syphilis from the United States, which was announced by Surgeon General 

David Satcher in October 1999.2 Collaboration with diverse organizations, public health professionals, the private medical community, and other partners working in STD and HIV will be essential if this effort is to be successful.3 

The rate of P&S syphilis in the United States declined by 88% from 1990 through 1999. Although 

the 5.4% decline in the number of P&S syphilis cases reported in 1999 is less than the declines of 

approximately 20% per year since the last major syphilis epidemic peaked in 1990, it is possible that 

this smaller decline at least partially reflects improved case finding and reporting resulting from the 

national syphilis elimination effort. Syphilis remains an important problem in the South and in 

some urban areas in other regions of the country. In 1999 large outbreaks occurred in several states. 

Recently, outbreaks of syphilis among men who have sex with men (MSM) have been reported, 

possibly reflecting an increase in risk behavior in this population associated with the availability of 

highly active antiretroviral therapy for HIV infection.4,5 

As with the other STDs addressed in this report, the number of syphilis cases reported to CDC is 

less than the actual number of cases occurring among the United States population. As a result, for 

most areas, the number of syphilis cases reported to CDC reflects many factors, only one of which is 

the occurrence of the disease among the population. In addition, differential reporting of syphilis 

cases from public and private sectors may magnify the race and ethnicity differences in the reported 

rates. 

•	 In 1999, 6,657 cases of P&S syphilis were reported to CDC, a decline of 5.4% 

compared with 1998, when 7,035 cases were reported. The number of P&S 

syphilis cases reported in 1999 is the lowest yearly number of cases reported since 

1957 (Table 1). The reported rate of P&S syphilis in the United States in 1999 

(2.5 cases per 100,000 persons) was slightly below the rate reported in 1998 (2.6 

cases per 100,000). The 1999 rate is below the Healthy People 2000 (HP2000) 

national objective of 4.0 cases per 100,000 persons as it has been since 1997 

(Figure 24, Table 1). However, the current reported rate in the United States 

exceeds the new Healthy People 2010 (HP2010) provisional objective of 0.2 

cases per 100,000 persons.6 

STD Surveillance 1999 National Profile	 Syphilis 25 
•	 Since the peak rate in 1990, the rate of early latent syphilis has exceeded the rate 

of P&S syphilis. There were approximately 0.9 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 1999 (Table 1). 

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

the rate of P&S syphilis. 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 1999 (Table 1). 

•	 In 1999, P&S syphilis rates in 39 states and three outlying areas were below the 

HP2000 national objective of 4.0 cases per 100,000 persons (Figure 25, Table 

24). In addition, 12 states reported 1999 rates equal to or below the HP2010 

provisional objective of 0.2 cases per 100,000 persons. Fourteen states and two 

outlying areas reported five or fewer cases of P&S syphilis in 1999. 

•	 In 1999, 2,473 (79%) of 3,115 counties in the United States reported no cases of 

P&S syphilis compared with 2,430 (78%) counties reporting no cases in 1998. Of 

642 counties reporting at least one case of P&S syphilis in 1999, 377 (59%) 

reported rates below the HP2000 objective of 4.0 cases per 100,000 persons. 

Alternatively, rates of P&S syphilis were above the HP2000 objective for 265 

counties in 1999 (Figure 26). These 265 counties (9% of the total number of 

counties in the U.S.) accounted for approximately 74% of the total P&S syphilis 

cases reported in 1999. 

•	 In 1999, 2,495 (80%) of the 3,115 United States counties reported P&S syphilis 

rates equal to or less than the provisional HP2010 objective of 0.2 cases per 

100,000 persons. 

•	 In 1999, the largest numbers of cases of P&S syphilis were reported from 22 

counties, and the three independent cities of Baltimore, MD, Danville, VA, and 

St. Louis, MO (Table 32). These 25 areas account for half of the total number of 

P&S syphilis cases that were reported in the United States in 1999. 

•	 In 1999, the reported rate of P&S syphilis among men (2.9 cases per 100,000 

males) was 1.5 times greater than the rate among women (2.0 cases per 100,000 

females). The overall male to female rate ratio has risen steadily since 1994 when 

it was 1.1. The male to female rate ratio has increased since 1994 in all racial 

ethnic groups except American Indian/Alaska Natives. The change in the male to 

female rate ratio was most notable in Hispanics, where it increased from 1.8 in 

1994 to 2.9 in 1999. The male to female ratio of P&S syphilis rates was greater in 

1999, as compared to the ratio in 1998, for 16 (59%) of the 26 states and the 

District of Columbia that reported 25 or more cases in 1998 (Tables 25-27). In 

Seattle, and possibly in other cities, the increase in the male to female rate ratio in 

1999 corresponded to an increase in syphilis among MSM.5 

•	 The P&S syphilis rate for 1999 in the southern region of the United States (4.5 

cases per 100,000 persons) was higher than the rate reported in any other region 

of the country. In addition, the 1999 rate in the South exceeds the HP2000 

objective (Figure 27, Table 25). The rates in the other three regions of the country 

(Northeast, Midwest, and West) in 1999 were below the HP2000 objective. The 

26 Syphilis	 National Profile STD Surveillance 1999 
1999 reported rates in all regions exceeded the HP2010 provisional objective of 

0.2 cases per 100,000 persons. 

•	 Reported rates and case counts for P&S syphilis were calculated within each of 

the four geographic regions of the United States (Northeast, Midwest, South, and 

West) and for each of four categories representing the level of urbanization 

(urban, peri-urban, peri-rural, rural) (see Figure 28 and the Appendix for 

definitions of the categories). Reported P&S syphilis rates in the South were 

higher than the other regions of the country for all urbanization categories. Of the 

6,606 cases of P&S syphilis reported at the county level in 1999, that is, those 

cases that could be classified into a location/urbanization category, 65% occurred 

in the South. 

•	 The overall 1999 rate of P&S syphilis reported for selected large cities with 

populations of 200,000 persons or more (5.1 per 100,000 persons) was the same 

as the rate reported for these cities in 1998 (Figure 29, 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. Rates exceeded the provisional 

HP2010 objective of 0.2 cases per 100,000 persons in 57 (89%) of the 64 

selected cities (Table 28). 

•	 In 1999, the rate of P&S syphilis reported in African-Americans (15.2 cases per 

100,000 persons) was 30.4 times greater than the rate reported in whites (0.5 

cases per 100,000 persons). However, this differential was substantially less than 

in 1995, when the rate of P&S syphilis among African-Americans was 56.1 times 

greater than the rate reported among whites (Table 23B). 

•	 During the period from 1995 to 1998, the rates of P&S syphilis within racial and 

ethnic groups have generally declined. However, these group-specific rates 

remained relatively constant between 1998 and 1999 with the exception of the 

rate among non-Hispanic blacks, which decreased 10% in 1999 from the 1998 

value (Figure 31, Table 23B). The 1999 reported rate for non-Hispanic blacks 

(15.2 cases per 100,000 persons) was 30 times greater than the rate for 

non-Hispanic whites. 

•	 Between 1998 and 1999, the overall rate of congenital syphilis decreased by 34% 

in the United States from 21.6 to 14.3 cases per 100,000 live births (Figure 34, 

Table 37). In addition, among the 24 states and outlying areas with five or more 

reported cases of congenital syphilis in 1999, 18 had rates that decreased from 

the 1998 value. Eleven of these states and Puerto Rico had decreases of 30% or 

more between the 1998 and 1999 reported rates (Table 39). 

•	 The continuing decrease in the rate of congenital syphilis likely reflects the 

substantial reduction in the rate of P&S syphilis among women that has occurred 

in the last decade (Figure 33).7 During the period from 1991 through 1999, the 

average yearly percentage decrease in the congenital syphilis rate was 22% 

(Table 37) which is equal to the average yearly percentage decrease in the rate of 

P&S syphilis reported among women for the years 1990 though 1998. 

•	 In 1999, only one state or outlying area (New Jersey) had a reported rate of 

congenital syphilis that exceeded the HP2000 objective of 40 cases per 100,000 

live births. Twenty-eight states and one outlying area, however, had reported 

congenital syphilis rates in 1999 that exceeded the HP2010 provisional objective 

of 1 case per 100,00 live births6 (Table 38). 

STD Surveillance 1999 National Profile	 Syphilis 27 
•	 The HP2000 congenital syphilis objective of 40 cases per 100,000 live births was 

exceeded in 18 (28%) of the 64 selected cities with populations of 200,000 or 

more persons (Table 40). Six of these cities (Newark, Baltimore, Detroit, St. 

Louis, Chicago, and Atlanta) had reported rates that were more than twice the 

HP2000 objective. Thirty-seven of the selected cities reported congenital syphilis 

rates in 1999 that exceeded the provisional HP2010 objective of 1 case per 

100,000 live births.6 

•	 Additional information on syphilis and congenital syphilis can be found in the 

Special Focus Profiles section. 

1Ingraham NR. The value of penicillin alone in the prevention and treatment of congenital syphilis. Acta 

Derm Venereol 31 (suppl 24): 60, 1951. 

2Division of STD Prevention. The National Plan to Eliminate Syphilis from the United States. National Center 

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

3Centers for Disease Control and Prevention. Primary and secondary syphilis – United States, 1998. MMWR 

1999;48:873-8. 

4Centers for Disease Control and Prevention. Resurgent bacterial sexually transmitted disease among men 

who have sex with men – King County, Washington, 1997-1999. MMWR 1999;48:773-7. 

5Miller M, Meyer L, Boufassa F, et al. Sexual behavior changes and protease inhibitor therapy. AIDS 

1999;14:F33-9. 

6U.S. Department of Health and Human Services. Healthy People 2010 (Conference Edition, in Two 

Volumes). U.S. Government Printing Office, Washington, DC, 2000. 

7Centers for Disease Control and Prevention. Congenital Syphilis – United States, 1998. MMWR 

1998;48:757-61. 

28 Syphilis	 National Profile STD Surveillance 1999 
Figure 23. Syphilis — Reported cases by stage of illness: United States, 1941–1999 

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 24. Primary and secondary syphilis — Reported rates: United States, 1970–1999 

and the Healthy People year 2000 objective 

Rate (per 100,000 population)
 

25
 

20
 

15
 

10
 

5
 

0
 

P&S Syphilis 

2000 Objective 

1970 73 76 79 82 85 88 91 94 97
 

STD Surveillance 1999 National Profile Syphilis 29 
Figure 25. Primary and secondary syphilis — Rates by state: United States and outlying areas, 

1999 

1.4 

0.1 0.0 0.0 

0.2 0.2 

0.1 0.8 0.0 0.8

0.0 2.5 VT 0.5 0.3 0.7 NH 0.1 0.4 0.3 0.8 MA 0.6 0.1 7.6 3.5 RI 0.3 0.9 0.2 0.3 2.3 CT 0.5 0.5 1.8 2.6 NJ 0.8 

DE 1.3 6.1 11.8 MD 6.7 4.5 5.6 0.7 3.4 7.0 Rate per 100,000 Guam 1.3 5.6 population 4.6 7.0 

2.4 <=4 (n=42) 

0.2 7.0 4.1-8 (n=10)

>8 2.6 (n=1)

0.3 

Puerto Rico 3.8 Virgin Is. 0.9 

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

(including Guam, Puerto Rico and Virgin Islands) was 2.5 per 100,000 population. The Healthy 

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

Figure 26. Primary and secondary syphilis — Counties with rates above and counties with 

rates below the Healthy People year 2000 objective: United States, 1999 

Rates per 100,000

Population 

<=4(n=2,850) 

>4 (n=265) 

30 Syphilis National Profile STD Surveillance 1999 
Figure 27. Primary and secondary syphilis — Rates by region: United States, 1981–1999 

and the Healthy People year 2000 objective 

Rate (per 100,000 population) 

West 

Midwest 

Northeast 

South 

2000 Objective 

0 

10 

20 

30 

40 

50 

1981 83 85 87 89 91 93 95 97 99
 

Figure 28. Primary and secondary syphilis — Rates by urban-rural category and
 

geographic region, 1999
 

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. 

STD Surveillance 1999 National Profile Syphilis 31
 
Figure 29. Primary and secondary syphilis — Rates in selected U.S. cities of >200,000 

population, 1981–1999 and the Healthy People year 2000 objective 

Rate (per 100,000 population) 

50 

40 

30 

20 

10 

0 

Cities 

2000 Objective 

1 9 8 1 8 3 8 5 8 7 8 9 9 1 9 3 9 5 9 7 9 9 
 

Figure 30. Primary and secondary syphilis — Rates by gender: United States, 1981–1999 

and the Healthy People year 2000 objective 

Rate (per 100,000 population) 

25 

20 

15 

10 

5 

0 

Male 

Female 

2000 Objective 

1 9 8 1 8 3 8 5 8 7 8 9 9 1 9 3 9 5 9 7 9 9 
 

32 Syphilis National Profile STD Surveillance 1999 
Figure 31. Primary and secondary syphilis — Rates by race and ethnicity: United States, 

1981–1999 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 83 85 87 89 91 93 95 97 99 

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

Black, White, and Other are non-Hispanic. 

Figure 32. Primary and secondary syphilis — Age- and gender-specific rates: United 

States, 1999 

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

0.0 10-14

1.8

5.7

5.5

6.0

6.1

5.0

3.4

1.7

0.5

2.9

0.2

3.6

5.2

5.2

4.9

4.2

2.5

1.0

0.3

0.0

2.0

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

0.0 10-14

1.8

5.7

5.5

6.0

6.1

5.0

3.4

1.7

0.5

2.9

0.2

3.6

5.2

5.2

4.9

4.2

2.5

1.0

0.3

0.0

2.0

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

0.0 10-14

1.8

5.7

5.5

6.0

6.1

5.0

3.4

1.7

0.5

2.9

0.2

3.6

5.2

5.2

4.9

4.2

2.5

1.0

0.3

0.0

2.0

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

0.0 10-14

1.8

5.7

5.5

6.0

6.1

5.0

3.4

1.7

0.5

2.9

0.2

3.6

5.2

5.2

4.9

4.2

2.5

1.0

0.3

0.0

2.0

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

0.0 10-14

1.8

5.7

5.5

6.0

6.1

5.0

3.4

1.7

0.5

2.9

0.2

3.6

5.2

5.2

4.9

4.2

2.5

1.0

0.3

0.0

2.0

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

0.0 10-14

1.8

5.7

5.5

6.0

6.1

5.0

3.4

1.7

0.5

2.9

0.2

3.6

5.2

5.2

4.9

4.2

2.5

1.0

0.3

0.0

2.0

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

0.0 10-14

1.8

5.7

5.5

6.0

6.1

5.0

3.4

1.7

0.5

2.9

0.2

3.6

5.2

5.2

4.9

4.2

2.5

1.0

0.3

0.0

2.0

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

0.0 10-14

1.8

5.7

5.5

6.0

6.1

5.0

3.4

1.7

0.5

2.9

0.2

3.6

5.2

5.2

4.9

4.2

2.5

1.0

0.3

0.0

2.0

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

0.0 10-14

1.8

5.7

5.5

6.0

6.1

5.0

3.4

1.7

0.5

2.9

0.2

3.6

5.2

5.2

4.9

4.2

2.5

1.0

0.3

0.0

2.0

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

0.0 10-14

1.8

5.7

5.5

6.0

6.1

5.0

3.4

1.7

0.5

2.9

0.2

3.6

5.2

5.2

4.9

4.2

2.5

1.0

0.3

0.0

2.0

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

0.0 10-14

1.8

5.7

5.5

6.0

6.1

5.0

3.4

1.7

0.5

2.9

0.2

3.6

5.2

5.2

4.9

4.2

2.5

1.0

0.3

0.0

2.0

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

0.0 10-14

1.8

5.7

5.5

6.0

6.1

5.0

3.4

1.7

0.5

2.9

0.2

3.6

5.2

5.2

4.9

4.2

2.5

1.0

0.3

0.0

2.0

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

0.0 10-14

1.8

5.7

5.5

6.0

6.1

5.0

3.4

1.7

0.5

2.9

0.2

3.6

5.2

5.2

4.9

4.2

2.5

1.0

0.3

0.0

2.0

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

0.0 10-14

1.8

5.7

5.5

6.0

6.1

5.0

3.4

1.7

0.5

2.9

0.2

3.6

5.2

5.2

4.9

4.2

2.5

1.0

0.3

0.0

2.0

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

0.0 10-14

1.8

5.7

5.5

6.0

6.1

5.0

3.4

1.7

0.5

2.9

0.2

3.6

5.2

5.2

4.9

4.2

2.5

1.0

0.3

0.0

2.0

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

0.0 10-14

1.8

5.7

5.5

6.0

6.1

5.0

3.4

1.7

0.5

2.9

0.2

3.6

5.2

5.2

4.9

4.2

2.5

1.0

0.3

0.0

2.0

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

0.0 10-14

1.8

5.7

5.5

6.0

6.1

5.0

3.4

1.7

0.5

2.9

0.2

3.6

5.2

5.2

4.9

4.2

2.5

1.0

0.3

0.0

2.0

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

0.0 10-14

1.8

5.7

5.5

6.0

6.1

5.0

3.4

1.7

0.5

2.9

0.2

3.6

5.2

5.2

4.9

4.2

2.5

1.0

0.3

0.0

2.0

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

0.0 10-14

1.8

5.7

5.5

6.0

6.1

5.0

3.4

1.7

0.5

2.9

0.2

3.6

5.2

5.2

4.9

4.2

2.5

1.0

0.3

0.0

2.0

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

0.0 10-14

1.8

5.7

5.5

6.0

6.1

5.0

3.4

1.7

0.5

2.9

0.2

3.6

5.2

5.2

4.9

4.2

2.5

1.0

0.3

0.0

2.0

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

0.0 10-14

1.8

5.7

5.5

6.0

6.1

5.0

3.4

1.7

0.5

2.9

0.2

3.6

5.2

5.2

4.9

4.2

2.5

1.0

0.3

0.0

2.0

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 

0.0 10-14

1.8 

5.7 

5.5 

6.0 

6.1 

5.0 

3.4 

1.7 

0.5 

2.9 

0.2 

3.6 

5.2 

5.2 

4.9 

4.2 

2.5 

1.0 

0.3 

0.0 

2.0 

STD Surveillance 1999 National Profile Syphilis 33 
Figure 33. Congenital syphilis — Reported cases for infants <1 year of age and rates of 

primary and secondary syphilis among women: United States, 1970–1999 

Congenital

Syphilis

P&S rate (per 100,000 population) CS cases (in thousands) 

20 

16 

12 

8 

4 

0 

Kaufman Criteria 

CDC Surveillance Definition 

P&S Syphilis 

7.5 

6.0 

4.5 

3.0 

1.5 

0.0 

1970 75 80 85 90 95 

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

Case counts for congenital syphilis shown in this graph correspond to those listed in 

Table 37. 

Figure 34. Congenital syphilis — Rates for infants <1 year of age: United States, 

1981–1999 and the Healthy People year 2000 objective 

Rate (per 100,000 live births) 

Cong. Syphilis 

2000 Objective 

0 

25 

50 

75 

100 

125 

1 9 8 1 8 3 8 5 8 7 8 9 9 1 9 3 9 5 9 7 9 9 

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

34 Syphilis National Profile STD Surveillance 1999 
Other Sexually Transmitted Diseases 

Since 1987, reported cases of chancroid have declined steadily (Table 1, Figure 35). In 1999, a 

total of 143 cases of chancroid were reported from the United States. Only sixteen states and one 

outlying area reported one or more cases of chancroid in 1999 and three of these states (New York, 

South Carolina and Texas) accounted for nearly 72% of the 143 reported cases. Although the decline in reported chancroid cases most likely reflects a decline in the incidence of this disease, these 

data should be interpreted in view of the fact that Haemophilus ducreyi, the causative organism of 

chancroid, is difficult to culture and, as a result, this condition may be substantially 

underdiagnosed.1,2 

Comprehensive surveillance data for genital herpes simplex virus (HSV), human papillomavirus, 

non-gonococcal urethritis, 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 36 and 38-40). 

Serious consequences of genital herpes simplex virus infection include painful recurrent episodes 

of genital lesions, increased likelihood of HIV transmission and acquisition, and, for women who acquire genital herpes in pregnancy, potentially fatal neonatal infection.3 Data on 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 37).4 

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. Infect Dis 1998;178:1795-8. 

3Handsfield JJ, Stone KM, Wasserheit JN. Prevention agenda for genital herpes. Sex Transm Dis 1999; 

26:228-231. 

4Fleming 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 1999 National Profile Other Sexually Transmitted Diseases 35 
Figure 35. Chancroid — Reported cases: United States, 1981–1999 

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 99 

Figure 36. Genital herpes simplex virus infections — Initial visits to physicians’ offices: 

United States, 1966–1999 and the Healthy People year 2000 objective 

Visits (in thousands) 

250 

200 

150 

100 

50 

0 

Genital herpes 

2000 Objective 

1 9 6 6 6 9 7 2 7 5 7 8 8 1 8 4 8 7 9 0 9 3 9 6 9 9 
 

Note: See Appendix.
 

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

36 Other Sexually Transmitted Diseases National Profile STD Surveillance 1999 
Figure 37. Genital herpes simplex virus type 2 — Percent seroprevalence according to age 

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

Percent 

40 

32 

24 

16 

8 

0 

NHANES II 

NHANES III 

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

Age Group 

Note: Bars indicate 95% confidence intervals. 

*National Health and Nutrition Examination Survey 

Figure 38.	 Human papillomavirus (genital warts) — Initial visits to physicians’ offices: 

United States, 1966–1999 and the Healthy People year 2000 objective 

Visits (in thousands)
 

400
 

320
 

240
 

160
 

80
 

0
 

Genital warts 

2000 Objective 

1966 69 72 75 78 81 84 87 90 93 96 99
 

Note: See Appendix.
 

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

STD Surveillance 1999 National Profile Other Sexually Transmitted Diseases 37 
Figure 39. Nonspecific urethritis — Initial visits to physicians’ offices by men: 

United States, 1966–1999 

Visits (in thousands) 

400 

320 

240 

160 

80 

0 

1 9 6 6 6 9 7 2 7 5 7 8 8 1 8 4 8 7 9 0 9 3 9 6 9 9 
 

Note: See Appendix.
 

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

Figure 40. Trichomonal and other vaginal infections — Initial visits to physicians’ offices: 

United States, 1966–1999 

Visits (in thousands) 

4,500 

3,600 

2,700 

1,800 

900 

0 

Trichomonal 

Other Vaginitis 

1966 69 72 75 78 81 84 87 90 93 96 99
 

Note: See Appendix.
 

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

38 Other Sexually Transmitted Diseases National Profile STD Surveillance 1999 
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-JJ) that highlight specific points made in the text. 

STD Surveillance 1999 Special Focus Profiles 39 

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 such as ectopic 

pregnancy and tubal factor infertility. If not adequately treated, 20% to 40% of women infected with 

chlamydia1 and 10% to 40% of women infected with gonorrhea2 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 asymptomatic.4-6 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 pregnancy.7 Data from a randomized controlled trial of chlamydia screening in a managed care setting 

suggest that such screening programs can reduce the incidence of PID by as much as 60%.8 

Gonorrhea and chlamydia can also result in adverse outcomes of pregnancy, including neonatal 

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

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

requires antenatal detection and treatment. 

Genital infections with human papillomavirus (HPV) in women are a major concern because 

specific types (e.g., types 16, 18, 31, 33, and 35), are causally related to cervical cancer; these types 

also cause Pap smear abnormalities. Other types (e.g., types 6 and 11) cause genital warts and, in 

child-bearing women, can cause recurrent respiratory papillomatosis in infants.9 

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 care.10 

Observations 

•	 Between 1998 and 1999, the reported case rate of chlamydial infections in 

women increased from 377.6 to 404.5 per 100,000 females (Figure 6, Table 6). 

This increase most likely reflects a variety of different factors, including increased 

screening activities, the use of more sensitive diagnostic tests and changes to 

information systems to incorporate laboratory reporting rather than an increase 

in the number of new cases of chlamydia occurring among women; even as 

reported cases of chlamydia have increased each year, the prevalence among 

women screened in the United States has generally declined (see section on 

Chlamydia). Despite considerable under-reporting, it is important to note that 

STD Surveillance 1999	 Special Focus Profiles STDs in Women and Infants 41 
female chlamydia rates exceed gonorrhea rates among women in many states 

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

•	 In 1999, the median state-specific chlamydia test positivity among 15- to 24­

year-old women screened in selected prenatal clinics in 22 states was 7.2% 

(range, 4.5% to 14.4%) (Figure E). 

•	 Gonorrhea rates among women exceeded the HP2000 objective of 100 cases per 

100,000 persons in 24 states in 1999 (Figure B, Table 15), the same number as in 

1998. Forty-two states had gonorrhea rates among women in 1999 that 

exceeded the provisional HP2010 objective of 19 cases per 100,000 persons.11 

As in previous years, the highest rates of gonorrhea among women in 1999 

occurred in the South (Figure B). 

•	 Like chlamydia, gonorrhea is often asymptomatic in women and can only be 

identified through screening. Large-scale screening programs for gonorrhea in 

women began in the late 1970s. After an initial increase in cases detected through 

screening, gonorrhea rates for both women and men declined steadily 

throughout the 1980s and early 1990s (Figure 14, Tables 15 and 16). However, 

the gonorrhea rate for women in 1999 (129.9 per 100,000 females) was similar to 

the 1998 rate of 130.0 cases per 100,000 females. The gonorrhea rate among 

men increased between 1998 and 1999, from 132.7 to 136.0 cases per 100,000 

males. 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. As with chlamydia, trends in reported gonorrhea rates among women 

are likely to be more reflective of screening practices rather than the actual burden 

of disease. 

•	 In 1999, the median state-specific gonorrhea test positivity among 15- to 24-yearold women screened in selected prenatal clinics in 15 states was 1.1% (range, 

0.0% to 4.1%) (Figure F). 

•	 The HP2000 objective for primary and secondary (P&S) syphilis is 4.0 cases per 

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

HP2000 objective in 9 southern states (Alabama, Georgia, Louisiana, Maryland, 

Mississippi, North Carolina, Oklahoma, South Carolina, and Tennessee) and in 

the state of Indiana (Table 26). The HP2010 objective for P&S syphilis is 0.2 

cases per 100,000 persons. Thirty-eight states and two outlying areas had 1999 

P&S syphilis rates among women that exceeded the HP2010 objective. For 

congenital syphilis, the HP2000 objective is 40 cases per 100,000 live births. Only 

one state had a 1999 rate that exceeded this objective (Figure D, Table 38). The 

HP2010 objective for congenital syphilis is 1 case per 100,000 live births. 

Twenty-eight states and one outlying area had reported rates higher than this 

objective in 1999. 

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

(Figure 33). 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 87% to 14.3 cases per 100,000 live births 

in 1999 (Figure 34, Table 37). The rate of P&S syphilis in women peaked at 17.3 

cases per 100,000 females in 1990 and declined 88% to 2.0 cases per 100,000 

females in 1999 (Figure 33, Table 26). 

42 STDs in Women and Infants Special Focus Profiles	 STD Surveillance 1999 
•	 Although the 1999 reported rate of congenital syphilis for the United States, 14.3 

cases per 100,000 live births, is below the HP2000 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 eliminated.12 The 1999 reported rate is well above the HP2010 

provisional objective of 1 case per 100,000 live births. 

•	 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 

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 outpatient facilities during the 1990s. Trends in hospitalized 

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

remained relatively constant from 1995 through 1998 (Figure H). 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 inpatient to outpatient) rather than true trends in disease.13 

•	 The reported number of initial visits to physicians= offices for PID through the 

National Disease and Therapeutic Index (NDTI) has generally declined from 

1993 through 1999. However, the reported number of visits in 1999 was slightly 

greater than the number of initial visits reported in 1998 (Figure I). In 1998, an 

estimated 238,000 cases of PID were diagnosed in emergency departments 

among women 15 to 44 years of age (National Hospital Ambulatory Medical 

Care Survey, NCHS). This estimated number has a relative standard error of 

18%. 

•	 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. Beginning in 1989, hospitalizations for ectopic pregnancy began to 

decline. However, the number of reported hospitalizations for ectopic pregnancy 

increased in 1998 relative to the number reported in 1997 with the 1998 level 

similar to that reported in 1995 (Figure G). Data from outpatient care surveys 

suggest that nearly half of all ectopic pregnancies are treated on an outpatient 

basis.14 

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;9:185-92. 

STD Surveillance 1999	 Special Focus Profiles STDs in Women and Infants 43 
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. 

9Division of STD Prevention. Prevention of Genital HPV Infection and Sequelae: Report of an External Consultants’ Meeting. National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, December 1999. 

10Centers for Disease Control. Guidelines for prevention and control of congenital syphilis. MMWR 

1988;37(No.S-1). 

11U.S. Department of Health and Human Services. Healthy People 2010 (Conference Edition, in Two 

Volumes). U.S. Government Printing Office, Washington, D.C., 2000. 

12Division of STD/HIV Prevention. Healthy People 2000: National Health Promotion and Disease Objectives. 

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

13Rolfs 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. 

14Centers for Disease Control and Prevention. Ectopic pregnancy in the United States, 1990-1992. MMWR 

1995;44:46-8. 

44 STDs in Women and Infants Special Focus Profiles STD Surveillance 1999 
Figure A. Chlamydia — Rates for women by state: United States and outlying areas, 1999 

310.4 

269.2 155.4 212.1 

268.6 228.1 

212.5 318.4 422.5 * 271.4 374.3 VT 137.8 

291.4 341.8 286.5 

403.7 

360.6 NH 

MA 

127.7 

218.6 153.2 414.7 310.7 RI 344.6 405.9 408.0 376.6 410.5 290.7 

168.9 332.6 CT 

NJ 

359.1 

265.8 

DE 593.7 

394.4 473.9 MD 429.9 402.5 393.4 473.4 351.9 838.8 

Guam 575.1 

694.5 509.0 629.1 

Rate per 100,000

population 

520.0 <=150 (n=3) 

499.0 584.0 150.1-300 (n=15) 

341.6 >300 (n=35) 

429.9 

Puerto Rico 57.1 Virgin Is. 196.2 

*The New York City rate was 607.8 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 399.4 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, 1999 

35.3 

7.9 6.3 14.3 

26.1 62.4 

6.8 144.0 31.2 112.8

10.9 154.2 VT 7.3 51.7 118.0 NH 10.1 95.8 56.0 167.6 MA 37.9 9.5 107.4 189.5 RI 72.3 54.5 63.5 38.0 131.4 CT 106.6 117.7 159.0 80.2 NJ 91.4 

DE 238.8 233.9 176.7 MD 179.9 74.6 130.8 59.8 120.1 295.6 Rate per 100,000 Guam 37.3 257.2 population 241.2 428.2 

168.0 <=100 (n=29) 

52.4 295.3 100.1-175 (n=14)

>175 143.8 (n=10)

42.2 

Puerto Rico 6.6 Virgin Is. 66.0 

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

Puerto Rico and Virgin Islands) was 128.0 per 100,000 population. The Healthy People year 

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

STD Surveillance 1999 Special Focus Profiles STDs in Women and Infants 45 
Figure C. Primary and secondary syphilis — Rates for women by state: United States and 

outlying areas, 1999 

0.1 

0.0 0.0 0.0 

0.3 0.2 

0.0 0.0 0.7 0.4 

0.0 1.9 VT 0.7 

0.3 0.4 0.4 

0.7 

0.4 NH 

MA 

0.2 

0.5 0.0 2.9 7.4 RI 0.2 0.5 0.3 0.6 1.7 2.2 

0.3 2.0 CT 

NJ 

0.4 

0.8 

DE 0.3 

10.1 5.2 MD 6.2 2.8 4.5 0.3 3.4 5.9 

Guam 0.0 

6.5 4.5 4.1 

Rate per 100,000

population 

1.8 <=4 (n=43) 

0.0 6.7 4.1-8 (n=9) 

2.1 >8 (n=1) 

0.3 

Puerto Rico 3.6 Virgin Is. 1.7 

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 2.0 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, 1999 

0.0 

0.0 0.0 0.0 

0.0 0.0 

0.0 10.5 9.8 16.7

0.0 15.0 VT 0.0 0.0 4.9 NH 7.0 0.0 0.0 3.9 MA 0.0 0.0 8.4 29.3 RI 0.0 16.8 1.8 0.0 3.3 CT 2.3 0.0 12.2 0.0 NJ 40.6 

DE 0.0 17.8 9.4 MD 38.5 31.7 16.6 0.0 38.4 36.4 Rate per 100,000 Guam 0.0 live births 9.8 12.7 28.9 

20.4 <1 (n=24) 

0.0 18.2 1-40 (n=28)

>40 16.6 (n=1)

0.0 

Puerto Rico 26.5 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 14.5 per 100,000 live births. The 

Healthy People year 2000 objective is 40.0 per 100,000 live births. 

46 STDs in Women and Infants Special Focus Profiles STD Surveillance 1999 
Figure E. Chlamydia — Positivity among 15-24 year old women tested in prenatal 

clinics by state, 1999 

6.1 

6.4 

VT 

4.9 NH 

5.6 6.1 MA 

RI 7.7 CT 

6.7 4.5 5.3 

8.0 NJ 

DE 

5.9 

7.2 

9.0 MD 4.9 7.5 DC 7.3 8.7 8.7 9.2 

Positivity (%) 

14.4 See * (n=31) 

14.0 <5 (n=3) 

7.1 5.0-9.9 

>=10 

(n=17) 

(n=2) 

Puerto Rico Virgin Is. 

*States not reporting chlamydia positivity data in prenatal clinics.
 

Note: States reported chlamydia positivity data on at least 100 women aged 15-24 years during 1999.
 

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, 1999 

VT 

NH 

0.7 MA 0.0 RI 1.2 CT 

1.1 NJ 0.0 0.7 0.7 DE 

MD 1.8 DC 0.8 0.3	 1.5 1.9 

Positivity (%) 

4.1 See * (n=38) 

<1 (n=7) 3.8 

1.0-1.9 (n=6) 1.1 

>=2 (n=2) 

Puerto Rico Virgin Is. 

*States not reporting gonorrhea positivity data in prenatal clinics. 

Note: States reported gonorrhea positivity data on at least 100 women aged 15-24 years during 1999. 

New Jersey reported gonorrhea positivity data for July-December only. 

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

Centers for Disease Control and Prevention 

STD Surveillance 1999 Special Focus Profiles STDs in Women and Infants 47 
Figure G. Ectopic pregnancy — Hospitalizations of women 15-44 years of age: United 

States, 1980-1998 

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 98 

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, 1980–1998 

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 98 

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) 

48 STDs in Women and Infants Special Focus Profiles STD Surveillance 1999 
Figure I.	 Pelvic inflammatory disease — Initial visits to physicians’ offices by women
 

15-44 years of age: United States, 1980–1999 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 1999 Special Focus Profiles STDs in Women and Infants 49
 

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, for example Chlamydia trachomatis, adolescent women 

may have a physiologically increased susceptibility to infection due to increased cervical ectopy. 

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 risk.1-3 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 infection4,5. The 

Regional Infertility Prevention Projects that perform large-scale screening for 

chlamydial infections 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 1988 (Figure J). 

•	 Among women, 15- to 19-year-olds had the highest rate of gonorrhea in 1999 

compared to all other age categories (Figure P, Table 12B). In addition, 20- to 

29-year-old women had the highest rates of primary and secondary syphilis in 

1999 (Figure R, 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 Q 

and S, Tables 12B and 23B). 

•	 Rates of gonorrhea among male adolescents generally decreased between the 

years 1995 and 1999 (Table 12B). In the 10- to 14-year-old group, the rate for 

young men remained stable at 8.4 cases per 100,000 males between 1998 and 

1999. In the 15- to 19-year-old group, the rate declined from 503.2 cases per 

100,000 males in 1995 to 341.1 cases per 100,000 males in 1999, a 32% 

decrease. The 1999 rate for this male adolescent age group was slightly less than 

the rate of 347.0 cases per 100,000 males reported in 1998. Among young adult 

men in the 20- to 24-year-old group, the rate of gonorrhea increased between 

1998 and 1999 (576.4 and 585.6 cases per 100,000 males respectively). 

However, the rate in this age group in 1999 is 10% lower than the rate of 653.8 

cases per 100,000 males reported for men aged 20- to 24-years in 1995. 

STD Surveillance 1999 Special Focus Profiles STDs in Adolescents and Young Adults 51 
•	 Gonorrhea among female adolescents and young adults aged 10- to 19-years 

also decreased between 1995 and 1999 (Table 12B). In the 10- to 14-year-old 

group, the rate for females decreased 24% during this period from 71.7 cases per 

100,000 females in 1995 to 54.6 cases per 100,000 females in 1999. In the 15- to 

19-year-old group, the rate declined by 22% from 847.8 to 738.1 cases per 

100,000 females between 1995 and 1999. In addition, the rates for female 

adolescents in these age groups decreased between the years 1998 and 1999. 

Among young adult women in the 20- to 24-year-old group, the rate of gonorrhea 

increased by 1.5% from 635.1 to 644.9 cases per 100,000 females between 1998 

and 1999. The 1999 rate for women in this age group was 5% greater than the 

age-group specific rate of 611.6 cases per 100,000 females reported in 1995. 

•	 In 1999, the highest age-specific gonorrhea rates among women and the third 

highest rates among men were in the 15- to 19-year-old group (Figure 16). 

•	 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 economically disadvantaged youth aged 16 through 24 

years. Among women entering the Job Corps from 32 states, the District of 

Columbia, and Puerto Rico, in 1999, based on their place of residence just before 

program entry, the median state-specific chlamydia prevalence was 11.1% 

(range, 5.7% to 18.9%) (Figure K). Chlamydial infection is widespread 

geographically and highly prevalent among these economically disadvantaged 

young women. 

•	 Since 1996, approximately 25,000 female recruits have been screened at entry in 

the U.S. Army at basic training in Fort Jackson, South Carolina.6 All tests are 

performed at the Johns Hopkins University Chlamydia Research Laboratory on 

urine specimens. Among women aged 17 to 37 years entering the Army in 1999, 

based on their state of residence before entry, the overall state-specific chlamydia 

prevalence was 9.9%. State-specific prevalence ranged from 4.1% to 19.6% 

(Figure L). 

•	 Among men aged 17 to 37 years entering the Army in 1999, based on their state 

of residence before entry, the overall chlamydia prevalence was 4.7%. 

State-specific chlamydia prevalence ranged from 1.1% to 10.3% (Figure M). 

•	 Data from Job Corps centers submitting gonorrhea specimens to the national 

contract laboratory from female students aged 16 to 24 years indicate a high 

prevalence of gonococcal infection in this population. Specimens from at least 

100 students from each of 14 states were tested by the contract laboratory; the 

median state-specific gonorrhea prevalence was 3.6% (range, 0.9% to 9.4%) in 

1999 (Figure N). 

1Centers for Disease Control and Prevention. Premarital sexual experience among adolescent women – 

United States, 1970-1988. MMWR 1991;39:929-32. 

2Centers for Disease Control and Prevention. 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. 

52 STDs in Adolescents and Young Adults Special Focus Profiles STD Surveillance 1999 
3Forrest JD. Timing of reproductive life stages. Obstet Gynecol 1993;82(1). 

4Centers for Disease Control and Prevention. 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. 

6Gaydos CA, Howel MR, Pare B, et al. Chlamydia trachomatis infection in female military recruits. N Engl J 

Med 1998;339:739-44. 

STD Surveillance 1999 Special Focus Profiles STDs in Adolescents and Young Adults 53 
Figure J.	 Chlamydia — Positivity among women tested in family planning clinics by 

age group: Region X, 1988–1999 

Percent 

15 

12 

9 

6 

3 

0 

<18 Years 

18-19 Years 

20-24 Years 

25-29 Years 

30+ Years 

1 9 8 8 8 9 9 0 9 1 9 2 9 3 9 4 9 5 9 6 9 7 9 8 9 9 
 

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

laboratory test method in 1994 and 1999 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, 1999 

Prevalence (%) 

See * 

<10 

10.0-14.9 

>=15 

VT 

NH 

MA 10.3 

RI 

CT 8.4 

NJ 12.0 

DE 

MD 8.1 

DC 14.7 

Puerto Rico 9.6 Virgin Is. 

(n=19) 

(n=11) 

(n=16) 

(n=7) 

16.3 

6.7 

11.7 18.9 

8.6 

15.9 

16.1 

15.4 12.1 

9.1 8.4 

17.8 

12.3 

17.6 

9.3 

10.5 

10.5 

13.0 

12.0 

10.3 

5.7 

10.0 

13.2 

6.3 

12.7 

12.0 

7.9 

10.4 

*Fewer than 100 women residing in these states and entering the U.S. Job Corps were screened for 

chlamydia in 1999. 

Note: The overall chlamydia prevalence among female students entering the U.S. Job Corps in 1999 

was 11.5%. 

SOURCE: U.S. Department of Labor 

54 STDs in Adolescents and Young Adults Special Focus Profiles STD Surveillance 1999 
Figure L. Chlamydia — Positivity among 17-37 year-old women entering the U.S. Army by 

state of residence, 1999 

7.8 

12.9 VT . 4.1 NH 

10.1 MA 

7.1 RI 5.6 13.5 CT 

NJ 10.8 

DE 14.9 MD 5.8 

DC 16.5 

Positivity (%) 

19.6 18.1 14.9 

11.7 

15.1 

See * 

<5 

(n=36) 

(n=1) 

11.3 5.0-9.9 (n=4) 

>=10 (n=12) 

Puerto Rico Virgin Is. 

*Fewer than 100 women residing in these states and entering the U.S. Army were screened for 

chlamydia in 1999. 

Note: Screening female recruits from January - July only. Overall positivity was 9.9%. 

SOURCE: Johns Hopkins University Chlamydia Research Laboratory (funding initiative: Office of Defense Women’s 

Health Research) 

Figure M. Chlamydia — Positivity among 17-37 year-old men entering the U.S. Army by 

state of residence, 1999 

4.3 

VT . 5.0 NH 

3.6 MA 

3.9 RI 1.1 4.1 CT 

NJ 

DE 6.9 MD 5.4 

DC 7.7 

Positivity (%) 7.6 10.3 

7.2 

8.0 

See * 

<5 

(n=39) 

(n=6) 

4.6 5.0-9.9 (n=7) 

>=10 (n=1) 

Puerto Rico Virgin Is. 

*Fewer than 100 men residing in these states and entering the U.S. Army were screened for 

chlamydia in 1999. 

Note: Screening male recruits from January - February and August - November only. Overall 

positivity was 4.7%. 

SOURCE: Johns Hopkins University Chlamydia Research Laboratory (funding initiative: Aberdeen Proving Ground) 

STD Surveillance 1999 Special Focus Profiles STDs in Adolescents and Young Adults 55 
Figure N. Gonorrhea — Prevalence among 16-24 year-old women entering the U.S. Job 

Corps by state of residence, 1999 

2.9 

VT 

NH 3.3 MA 3.3 

0.9 

9.4 4.5 

4.4 

RI 

CT 

NJ 6.8 DE 

MD 2.0 DC 2.4 5.0 

Prevalence (%) 

8.1 2.5 

See * (n=39) 

<2 (n=1) 

3.8 2.0-4.9 (n=9) 

>=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 1999. 

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. 

Figure O. Gonorrhea — Positivity among 17-37 year-old men entering the U.S. Army by state 

of residence, 1999 

0.4 

VT 

NH . 0.0 MA 1.1 RI 0.7 CT 0.0 0.0 NJ 

DE 

MD 0.0 0.7 DC 

1.0 

Positivity (%) 0.8 1.4

See * (n=39) 0.3 <.5 (n=7) 0.9 

0.5-0.9 (n=4) 0.0 

>=1 (n=3) 

Puerto Rico Virgin Is. 

*Fewer than 100 men residing in these states and entering the U.S. Army were screened for chlamydia 

in 1999. 

Note: Screening male recruits from January - February and August - November only. Overall positivity 

was 0.4%. 

SOURCE: Johns Hopkins University Chlamydia Research Laboratory (funding initiative: Aberdeen Proving Ground) 

56 STDs in Adolescents and Young Adults Special Focus Profiles STD Surveillance 1999 
Figure P. Gonorrhea — Age-specific rates among women 10-44 years of age: United 

States, 1981–1999 

Rate (per 100,000 population) 

1,500 

1,200 

900 

600 

300 

0 

10-14 

15-19 

20-24 

25-29 

30-34 

35-39 

40-44 

1981 83 85 87 89 91 93 95 97 99
 

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

1981–1999 

Rate (per 100,000 population)
 

2,000
 

1,600
 

1,200
 

800
 

400
 

0
 

10-14 

15-19 

20-24 

25-29 

30-34 

35-39 

40-44 

1981 83 85 87 89 91 93 95 97 99
 

STD Surveillance 1999 Special Focus Profiles STDs in Adolescents and Young Adults 57 
Figure R. Primary and secondary syphilis — Age-specific rates among women 10-44 

years of age: United States, 1981–1999 

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 

1 9 8 1 8 3 8 5 8 7 8 9 9 1 9 3 9 5 9 7 9 9 
 

Figure S. Primary and secondary syphilis — Age-specific rates among men 10-44 years of 

age: United States, 1981–1999 

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 

1 9 8 1 8 3 8 5 8 7 8 9 9 1 9 3 9 5 9 7 9 9 
 

58 STDs in Adolescents and Young Adults Special Focus Profiles STD Surveillance 1999 
STDs in Racial and Ethnic Minorities
 

Public Health Impact 

Surveillance data show higher reported rates of STDs among some minority racial or ethnic 

groups when compared with rates among whites. Race and ethnicity in the United States are risk 

markers that correlate with other more fundamental determinants of health status such as poverty, 

access to quality health care, health care seeking behavior, illicit drug use, and living in communities 

with high prevalence of STDs. Acknowledging the disparity in STD rates by race or ethnicity is one 

of the first steps in empowering affected communities to organize and focus on this problem. 

Surveillance data are based on cases of STDs reported to state and local health departments (see 

Appendix). In many areas, reporting from public sources, for example STD clinics, is more complete than reporting from private sources. Since minority populations may utilize public clinics more 

than whites, differences in rates between minorities and whites may be increased by this reporting 

bias. 

Observations 

•	 Although chlamydia is a widely distributed STD among all racial and ethnic 

groups, trends in positivity in women screened in Health and Human Services 

Region X (Alaska, Idaho, Oregon, and Washington) show consistently higher 

chlamydia positivity among minorities (Figure T). 

•	 In 1999, chlamydia positivity among sexually active 15- to 30-year old women 

screened at clinics of the Indian Health Service (IHS) in four IHS regions ranged 

from 5.4% to 10.8% (Figure U). 

•	 In 1999, 77% of the total number of cases of gonorrhea reported to CDC 

occurred among African-Americans (Table 12A). The reported rate of gonorrhea 

among African-Americans in 1999 was 848.8 cases per 100,000 persons. Among 

Hispanics, the 1999 reported gonorrhea rate was 75.3 cases per 100,000 

persons. These rates are 30 and 3 times higher than the rate reported among 

non-Hispanic whites in 1999 of 27.9 cases per 100,000 persons (Figure 15, Table 

12B). 

•	 Gonorrhea rates were highest in 1999 among all racial, ethnic, and age categories 

for African-Americans aged 15 to 24 years. In 1999, African-American women 

aged 15 to 19 years had a gonorrhea rate of 3,691.0 cases per 100,000 females. 

This rate is 19 times greater than the 1999 rate among non-Hispanic white 

females of similar age. African-American men in the 15- to 19-year old age 

category had a 1999 gonorrhea rate of 1,996.5 cases per 100,000 males, which 

was 52 times higher than the rate among 15- to 19-year old white males (Table 

12B). Among 20- to 24-year-olds in 1999, the gonorrhea rate among 

STD Surveillance 1999 Special Focus Profiles STDs in Racial and Ethnic Minorities 59 
African-Americans was 27 times greater than that among non-Hispanic whites 

(3,425.8 and 126.3 cases per 100,000 persons respectively) (Table 12B). 

•	 Despite declines in gonorrhea rates for most age and race/ethnic groups during 

the 1980s, African-American adolescent females aged 15 to 19 years did not 

show a decline in rates until 1991 (Figure V). Similarly, declines among 

African-American adolescent males did not begin until 1992 (Figure W). 

However, from 1998 to 1999 gonorrhea rates among African-Americans 

declined by only 0.3% (851.2 and 848.8 cases per 100,000 persons respectively). 

During the same period, gonorrhea rates increased by 4% among Hispanics and 

6% among Asian/Pacific Islanders while decreasing by 7% among American 

Indians/Alaska Natives (Table 12B). 

•	 The most recent epidemic of syphilis was largely an epidemic in heterosexual, 

minority populations.1 Since 1990, rates of primary and secondary (P&S) syphilis 

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 1999, 75% of all cases of P&S syphilis 

reported to CDC occurred among African-Americans (Table 23A). Although the 

rate for African-Americans declined from 16.9 to 15.2 cases per 100,000 persons 

between 1998 and 1999, the 1999 rate was 30 times greater than the rate of 0.5 

per 100,000 persons among non-Hispanic whites. Between 1998 and 1999, P&S 

syphilis rates for African-American females aged 15 to 19 years declined by 17%, 

and for African-American males in this age group by 15% (Figures X and Y, Table 

23B). Similarly, the P&S syphilis rate declined about 14% between 1998 and 

1999 among young African-American adults aged 20 to 24 years. The 1999 rate 

of P&S syphilis among Hispanics was 1.8 cases per 100,000 persons, which is 4 

times greater than the rate among non-Hispanic whites (Table 23B). 

•	 In 1999, the rate of congenital syphilis was 57.9 cases per 100,000 live births 

among African-Americans and 20.4 cases per 100,000 live births among 

Hispanics. These rates are 29 and 10 times greater than the 1999 rate of 2 cases 

per 100,000 live births among non-Hispanic whites respectively (Figure Z). 

Compared with 1998, the 1999 rate of congenital syphilis decreased by 36% 

among African-Americans and by 29% among 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. 

60 STDs in Racial and Ethnic Minorities Special Focus Profiles STD Surveillance 1999 
Figure T.	 Chlamydia — Positivity among women tested in family planning clinics 

by race and ethnicity: Region X, 1988–1999 

Percent 

15 

White 

Black 

Hispanic 

12 Asian/Pac Isl 

Nat Am/AK Nat 

9 

6 

3 

0 

1988 89 90 91 92 93 94 95 96 97 98 99 

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

laboratory test method in 1994 and 1999 and associated increases in test sensitivity. 

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

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

Service Clinics by IHS regions, 1999 

Alaska* 

Billings 

10.8 Aberdeen 

Portland* 8.4 

Bemidj* 

Phoenix* 

Nashville* 

Oklahoma 

California* 

5.4 

Tucson* 

Navajo* 

Albuquerque 

5.5 

*IHS regions not reporting chlamydia positivity data during 1999.
 

Note: Albuquerque - chlamydia positivity data reported for April-December only.
 

SOURCE: Indian Health Service
 

STD Surveillance 1999 Special Focus Profiles STDs in Racial and Ethnic Minorities 61 
Figure V. Gonorrhea — Reported rates for 15-19 year old females by race and ethnicity: 

United States, 1981–1999 

Rate (per 100,000 population) 

White 

Black 

Hispanic 

Other 

0 

1,400 

2,800 

4,200 

5,600 

7,000 

1981 83 85 87 89 91 93 95 97 99
 

Note: Black, White, and Other are non-Hispanic. 

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

United States, 1981–1999 

Rate (per 100,000 population) 

White 

Black 

Hispanic 

Other 

0 

1,400 

2,800 

4,200 

5,600 

7,000 

1981 83 85 87 89 91 93 95 97 99
 

Note: Black, White, and Other are non-Hispanic. 

62 STDs in Racial and Ethnic Minorities Special Focus Profiles STD Surveillance 1999
 
Figure X. Primary and secondary syphilis — Reported rates for 15-19 year old females by 

race and ethnicity: United States, 1981–1999 

Rate (per 100,000 population) 

250 

200 

150 

100 

50 

0 

White 

Black 

Hispanic 

Other 

1981 83 85 87 89 91 93 95 97 99
 

Note: Black, White, and Other are non-Hispanic. 

Figure Y. Primary and secondary syphilis — Reported rates for 15-19 year old males by 

race and ethnicity: United States, 1981–1999 

Rate (per 100,000 population) 

125 

100 

75 

50 

25 

0 

White 

Black 

Hispanic 

Other 

1981 83 85 87 89 91 93 95 97 99
 

Note: Black, White, and Other are non-Hispanic. 

STD Surveillance 1999 Special Focus Profiles STDs in Racial and Ethnic Minorities 63 
Figure Z. Congenital syphilis — Rates for infants <1 year of age by mother’s race and 

ethnicity: United States, 1991–1999 

Rate (per 100,000 live births) 

White 

Black 

Hispanic 

Other 

2000 Objective 

0 

90 

180 

270 

360 

450 

1 9 9 1 9 2 9 3 9 4 9 5 9 6 9 7 9 8 9 9 
 

Note: Less than 5% of cases had missing race/ethnicity information and were excluded. Black, 

White, and Other are non-Hispanic. 

64 STDs in Racial and Ethnic Minorities Special Focus Profiles STD Surveillance 1999
 
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 jails.1 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 1999, 10 states reported chlamydia, gonorrhea, or syphilis data to CDC as part 

of the Jail STD Prevalence Monitoring Project, three states reported syphilis data 

as part of the Innovations in Syphilis Prevention Project, 14 additional states 

reported data (at least 100 test results) from corrections facilities as part of the 

Regional Infertility Prevention Project, and three additional states reported data 

in response to CDC’s request for data. 

•	 The maps shown below represent approximately 282,000 syphilis tests for men 

and 61,000 syphilis tests for women, 40,000 chlamydia tests for men and 42,000 

chlamydia tests for women, and 107,000 gonorrhea tests for men and 38,000 

gonorrhea tests for women. 

•	 The median percentage of reactive syphilis tests was 8.5% (range, 0.3% to 

25.1%) for women entering 19 adult jails and 0.8% (range, 0.6% to 2.8%) for 

adolescent women entering three juvenile detention centers (Figure AA). The 

median percentage of reactive tests was 3.9% (range, 1.0% to 7.7%) for men at 

18 adult jails and 0.4% (range, 0.2% to 1.6%) at three juvenile facilities. The 

percentage of reactive syphilis tests was higher for women than for men in 19 

(95%) of 20 adult and juvenile facilities reporting syphilis test results for both 

sexes (Figures AA, BB). 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 median positivity for chlamydia was 13% (range, 4.9% to 25.2%); 

positivity was greater than 10% in 16 (76%) of 21 counties reporting data (Figure 

CC). The median positivity for gonorrhea in women was 6.4% (range, 1.3% to 

14.1%); positivity was greater than 5% in 8 (57%) of 14 juvenile facilities (Figure 

EE). 

•	 The median positivity for chlamydial infection in men entering juvenile facilities in 

23 counties was 4.3% (range, 1.5% to 10.0%) (Figure DD). The median positivity 

STD Surveillance 1999 Special Focus Profiles STDs in Persons Entering Corrections Facilities 65 
for gonorrhea among men entering juvenile facilities in 11 counties was 1.9% 

(range, 0.4% to 3.8%) (Figure FF). 

1CDC. Syphilis screening among women arrestees at the Cook County Jail – Chicago, 1996. MMWR 

1998;47:432-3. 

66 STDs in Persons Entering Corrections Facilities Special Focus Profiles STD Surveillance 1999 
Figure AA. Syphilis serologic tests — Percent seroreactivity in women entering city or county 

jails or juvenile detention centers†

, 1999 

†

From facilities reporting >100 test results. 

SOURCE: Local and State STD Control Programs; Regional Infertility Prevention Programs; Centers for Disease Control and 

Prevention 

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

jails or juvenile detention centers†

, 1999 

†

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 1999 Special Focus Profiles STDs in Persons Entering Corrections Facilities 67 
Figure CC. Chlamydia — Positivity in women entering juvenile and adult corrections 

facilities†

, 1999 

†

From facilities reporting >100 test results. 

SOURCE: Local and State STD Control Programs; Regional Infertility Prevention Programs; Centers for Disease Control and 

Prevention 

Figure DD. Chlamydia — Positivity in men entering juvenile and adult corrections facilities†, 

1999 

†

From facilities reporting >100 test results. 

SOURCE: Local and State STD Control Programs; Regional Infertility Prevention Programs; Centers for Disease Control and 

Prevention 

68 STDs in Persons Entering Corrections Facilities Special Focus Profiles STD Surveillance 1999 
Figure EE. Gonorrhea — Positivity in women entering juvenile and adult corrections 

facilities†

, 1999 

†

From facilities reporting >100 test results. 

SOURCE: Local and State STD Control Programs; Regional Infertility Prevention Programs; Centers for Disease Control and 

Prevention 

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

facilities†

, 1999 

†

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 1999 Special Focus Profiles STDs in Persons Entering Corrections Facilities 69 

STDs in the South
 

Public Health Impact 

The southern region of the United States consists of the District of Columbia and 16 states: 

Alabama, Arkansas, Delaware, Florida, Georgia, Kentucky, Louisiana, Maryland, Mississippi, 

North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Virginia, and West Virginia. This 

region has consistently had higher reported rates of chlamydia, gonorrhea and primary and 

secondary (P&S) syphilis than the other regions of the country (Northeast, Midwest, and West). The 

reasons for these higher rates in the South 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. Regional differences in STD rates are particularly disturbing in light of the fact that STDs 

can increase the risk of HIV transmission by two to five fold. The high HIV prevalence among childbearing women living in the South may be due, in part, to the high rates of these other STDs in the 

region.1 Data from a randomized controlled trial evaluating the use of STD treatment to prevent HIV 

suggest that the risk of HIV infection may be reduced by as much as 40% in areas with high STD 

rates.2 

Observations 

•	 The South has consistently had higher rates of gonorrhea and P&S syphilis 

compared with other regions throughout the 1980s and 1990s (Figures 12, and 

27, Tables 14 and 25). From 1996 through 1999, the South also had a higher 

reported rate of chlamydia (Table 5) than the other regions of the country. 

•	 In 1999, seven of the 10 states with the highest chlamydia rates were in the South 

(Figure 3, Table 4). Similarly, nine of the 10 states with the highest rates of 

gonorrhea were located in the South (Figure 11, Table 13). Nine of the 11 states 

with 1999 reported rates of P&S syphilis that exceeded the Healthy People Year 

2000 (HP2000) objective of 4.0 cases per 100,000 persons were located in the 

South (Figure 25, Table 24). Six of these southern states had reported P&S 

syphilis rates in 1999 that were at least 1.5 times greater than the HP2000 

objective (Figure 25, Table 24). 

•	 In 1999, 243 (92%) of 265 counties with P&S syphilis rates above the HP2000 

objective were located in the South (Figure 26 and Figure GG). 

•	 Of the 243 counties in the South that had reported P&S syphilis rates in 1999 

above HP2000 objective, 157 (65%) had an increase in the rate from 1998 to 

1999 (Figures GG and HH). 

•	 County-specific rates of chlamydia and gonorrhea in 1999 were produced for 

those southern states submitting county level data (Figures II and JJ). 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, Florida, Kentucky, 

STD Surveillance 1999	 Special Focus Profiles STDs in the South 71 
Oklahoma, Texas, and Virginia where hardcopy reports have been discontinued 

based on consistent, high quality, and timely submissions of NETSS data. 

1Koumans EH, Sternberg M, Gwinn M, Swint E, Zaidi A, St. Louis M. Geographic variation of HIV infection in 

childbearing women with syphilis in the United States. AIDS 2000;14:279-87. 

2Grosskurth 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. 

72 STDs in the South Special Focus Profiles STD Surveillance 1999 


Table 1. Cases of sexually transmitted diseases reported by state health departments and rates per 100,000 

civilian population: United States, 1941–1999 

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 1999 National Summary Tables 75 
Table 1. Cases of sexually transmitted diseases reported by state health departments and rates per 100,000 

civilian population: United States, 1941–1999 (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 69,353 26.4 16,543 6.3 26,657 10.1 24,296 9.2 1,857 0.7 478,577 190.4 392,651 149.4 607 0.2 0 0.0 188 0.1 

1996 53,218 20.1 11,388 4.3 20,187 7.6 20,364 7.7 1,279 0.5 490,615 192.9 326,805 123.2 386 0.1 10 0.0 72 0.0 

1997 46,708 17.5 8,556 3.2 16,631 6.2 20,446 7.6 1,075 0.4 531,744 207.0 326,564 122.0 246 0.1 8 0.0 114 0.0 

1998 38,366 14.2 7,035 2.6 12,741 4.7 17,752 6.6 838 0.3 607,752 234.2 355,728 131.6 189 0.1 3 0.0 86 0.0 

1999 35,628 13.2 6,657 2.5 11,677 4.3 16,738 6.2 556 0.2 659,441 254.1 360,076 133.2 143 0.1 19 0.0 62 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 in hardcopy and electronic format based on case reporting form CDC 73.126. 

Note: Adjustments to the number of cases reported from state health departments were made for hardcopy forms and for electronic data submissions 

through August 4, 2000 (see Appendix). The number of cases and the rates shown here supersede those published in previous reports. Cases and rates 

shown in this table exclude the outlying areas of Guam, Puerto Rico and Virgin Islands. 

76 National Summary Tables STD Surveillance 1999 
Table 2. Reported cases of sexually transmitted disease by gender and reporting source: United States,

1999

Non-STD Clinic STD Clinic Total †

Disease* Male Female Total Male Female Total Male Female Total

Total Chlamydia Trachomatis 65,297 426,550 493,829 54,773 110,410 165,545 120,094 537,003 659,441

Chlamydial PID‡ NA 2,555 2,558 NA 478 479 NA 3,033 3,037

Ophthalmia Neonatorum 115 152 267 11 16 28 126 168 295

Total Gonorrhea 80,506 126,471 207,803 99,038 53,051 152,241 179,564 179,534 360,076

Gonococcal PID NA 2,360 2,362 NA 1,379 1,381 NA 3,739 3,743

Ophthalmia Neonatorum 15 21 36 3 2 5 18 23 41

Total Syphilis NA NA NA NA NA NA 18,771 16,803 35,628

Primary 645 215 860 1,156 295 1,452 1,801 510 2,312

Secondary 974 1,144 2,120 1,080 1,142 2,224 2,055 2,286 4,345

Early Latent 2,915 3,166 6,087 2,893 2,697 5,590 5,808 5,863 11,677

Late and Late Latent+ 4,884 4,766 9,657 3,947 3,129 7,081 8,831 7,895 16,738

Neurosyphilis§ 227 93 320 16 5 21 243 98 341

Congenital <1 year¥ NR NR NR NR NR NR 276 249 556

Chancroid 21 25 46 69 26 95 91 51 143

Granuloma Inguinale 1 0 1 14 4 18 15 4 19

Lymphogranuloma Venereum 6 12 18 33 11 44 39 23 62

Genital Herpes¤ 858 2,515 3,389 3,605 3,154 6,763 4,463 5,669 10,149

Other and Nonspecified PID NA 1,042 1,042 NA 1,880 1,880 NA 2,922 2,922

Nonspecific Urethritis in Men 2,704 NA 2,704 26,027 NA 26,027 28,731 NA 28,731

*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 but are included in the late and late latent 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 1999 National Summary Tables 77
Table 3A. Chlamydia — Reported cases by age, gender, and race/ethnicity: United States, 1996–1999 

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 10,432 36,660 

19,730 5,181 14,549 

9,350 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 12,566 37,808 

20,698 6,260 14,438 

9,597 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 11,198 617 10,581 2,975 89 2,886 6,145 377 5,768 1,656 127 1,529 140 11 129 282 13 269 

15-19 198,781 24,299 174,482 63,955 5,285 58,670 97,036 13,870 83,166 30,894 4,319 26,575 3,024 360 2,664 3,872 465 3,407 

20-24 164,663 31,609 133,054 51,159 8,427 42,732 76,759 16,149 60,610 30,455 5,999 24,456 3,146 535 2,611 3,144 499 2,645 

199825-29 

30-34 

35-39 

64,341 15,975 48,366 

25,601 7,719 17,882 

12,586 4,378 8,208 

17,846 4,119 13,727 

6,773 2,119 4,654 

3,489 1,145 2,344 

29,274 8,163 21,111 

11,343 3,857 7,486 

5,650 2,305 3,345 

14,235 

6,048 

2,636 

3,146 

1,497 

715 

11,089 

4,551 

1,921 

1,671 348 1,323 

765 159 606 

455 133 322 

1,315 199 1,116 

672 87 585 

356 80 276 

40-44 5,306 2,032 3,274 1,582 607 975 2,361 1,096 1,265 993 251 742 209 46 163 161 32 129 

45-54 3,185 1,345 1,840 1,032 452 580 1,373 702 671 543 137 406 119 42 77 118 12 106 

55-64 659 304 355 174 83 91 320 174 146 114 33 81 28 8 20 23 6 17 

65+ 1,045 251 794 306 88 218 553 124 429 150 34 116 24 5 19 12 0 12 

TOTAL 489,252 89,081 400,171 149,787 22,572 127,215 231,717 47,067 184,650 88,137 16,383 71,754 9,613 1,655 7,958 9,998 1,404 8,594 

10-14 12,545 753 11,792 3,200 117 3,083 7,015 449 6,566 1,899 162 1,737 158 12 146 273 13 260 

15-19 231,999 29,663 202,336 73,159 6,410 66,749 115,008 17,106 97,902 35,970 5,173 30,797 3,656 454 3,202 4,206 520 3,686 

20-24 201,482 38,948 162,534 62,178 10,762 51,416 95,429 20,130 75,299 36,552 6,919 29,633 3,947 641 3,306 3,376 496 2,880 

199925-29 

30-34 

35-39 

77,036 19,346 57,690 

30,349 9,171 21,178 

14,825 5,315 9,510 

20,688 4,885 15,803 

7,611 2,359 5,252 

4,051 1,466 2,585 

35,495 9,981 25,514 

13,687 4,700 8,987 

6,619 2,811 3,808 

17,192 

7,426 

3,293 

3,727 

1,759 

822 

13,465 

5,667 

2,471 

2,146 489 1,657 

970 216 754 

493 130 363 

1,515 264 1,251 

655 137 518 

369 86 283 

40-44 6,461 2,685 3,776 1,877 799 1,078 2,855 1,408 1,447 1,282 350 932 266 86 180 181 42 139 

45-54 3,957 1,806 2,151 1,128 536 592 1,708 941 767 806 235 571 182 66 116 133 28 105 

55-64 823 419 404 250 160 90 371 193 178 128 41 87 46 13 33 28 12 16 

65+ 777 265 512 268 100 168 294 98 196 124 31 93 32 19 13 59 17 42 

TOTAL 582,207 108,967 473,240 174,921 27,750 147,171 279,529 58,121 221,408 105,007 19,337 85,670 11,932 2,137 9,795 10,818 1,622 9,196 

NOTE: These tables should be used only for race/ethnicity and age comparisons, not for overall totals or gender totals. This is because, 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); 1999 (Colorado, District of Columbia, Michigan, New Jersey and New York). Cases and population denominators have been excluded for these states/areas. Differences between total 

cases from this table and others in the report are due to different reporting forms and above listed exclusions. The 0 to 9 year age group is not shown 

because some of these may not be due to sexual transmission; however, they are included in the totals. 

78 Chlamydia Tables STD Surveillance 1999 
Table 3B. Chlamydia — Reported rates per 100,000 population by age, gender, and race/ethnicity: United 

States, 1996–1999 

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 72.8 7.8 141.1 29.3 1.7 58.5 282.6 34.2 538.7 73.7 11.1 139.3 22.7 3.5 42.9 150.6 13.7 291.8 

15-19 1,269.0 301.4 2,295.6 618.4 99.2 1,170.2 4,369.9 1,227.8 7,623.6 1,334.8 357.6 2,401.2 494.4 116.2 882.4 2,206.6 529.1 3,890.0 

20-24 1,162.1 436.8 1,919.0 550.0 176.8 942.1 3,999.9 1,698.9 6,258.3 1,368.6 517.5 2,294.1 541.7 185.2 894.3 2,201.0 696.1 3,716.6 

25-29 

30-34 

35-39 

434.7 

160.2 

70.2 

216.3 652.2 

97.2 222.5 

49.0 91.4 

179.8 82.9 276.8 

61.8 38.7 84.8 

27.0 17.7 36.4 

1,560.9 910.9 2,155.8 

582.1 422.8 722.4 

272.2 236.8 303.5 

658.8 

271.3 

126.3 

279.1 1,072.6 

128.6 427.3 

66.2 190.9 

240.1 107.6 355.3 

108.3 48.4 160.3 

64.2 39.4 86.6 

916.3 271.5 1,589.7 

1998

499.5 129.5 868.7 

253.6 115.5 388.1 

40-44 30.6 23.6 37.6 12.3 9.4 15.2 122.0 120.8 123.1 57.7 28.6 87.8 31.2 14.6 45.9 123.2 50.7 191.1 

45-54 11.7 10.1 13.2 4.9 4.3 5.4 51.7 58.0 46.4 24.1 12.4 35.5 11.9 9.1 14.4 60.8 12.9 105.0 

55-64 3.7 3.6 3.8 1.2 1.2 1.2 20.1 25.1 16.2 8.8 5.5 11.8 5.0 3.1 6.6 19.9 11.1 27.6 

65+ 3.8 2.2 5.0 1.3 0.9 1.6 27.4 15.6 35.0 10.3 5.5 13.9 3.8 1.9 5.2 9.3 0.0 16.0 

TOTAL 227.9 84.7 365.3 96.9 29.8 161.4 937.6 400.6 1,424.2 345.5 126.8 569.6 118.8 42.7 188.7 549.0 156.9 927.9 

10-14 76.3 8.9 147.0 29.2 2.1 57.7 294.2 37.1 559.2 83.8 14.0 156.8 25.2 3.7 47.7 144.0 13.5 278.5 

15-19 1,382.8 343.7 2,483.8 653.1 111.1 1,228.5 4,718.9 1,381.2 8,167.3 1,539.8 424.4 2,756.9 585.8 143.7 1,038.8 2,363.5 583.3 4,150.9 

20-24 1,328.8 503.8 2,187.1 617.0 208.7 1,044.7 4,541.4 1,939.6 7,080.4 1,627.9 591.6 2,754.4 665.0 217.2 1,107.6 2,325.4 680.6 3,983.2 

25-29 

30-34 

35-39 

486.3 

177.8 

77.5 

245.1 725.9 

108.2 246.5 

55.7 99.0 

192.4 90.9 293.8 

64.3 40.0 88.5 

29.1 21.0 37.3 

1,728.3 1,019.2 2,374.8 

644.9 473.9 794.9 

292.0 264.9 315.9 

788.7 

330.3 

156.5 

328.0 1,290.2 

149.9 527.4 

75.5 243.4 

302.5 148.3 436.4 

134.6 64.5 195.6 

68.2 37.8 95.7 

1,038.3 354.0 1,753.6 

1999

478.4 200.2 756.2 

258.5 122.1 391.3 

40-44 34.8 29.2 40.4 13.5 11.5 15.6 134.5 141.7 128.2 73.8 39.6 109.3 39.0 26.8 49.8 136.0 65.2 202.4 

45-54 13.5 12.6 14.4 4.9 4.7 5.1 58.4 70.7 48.1 35.4 21.0 49.4 17.9 14.0 21.2 67.1 29.4 102.0 

55-64 4.3 4.6 4.0 1.6 2.1 1.1 21.1 25.3 17.9 9.8 6.8 12.5 8.0 4.9 10.6 23.7 21.7 25.5 

65+ 2.7 2.2 3.0 1.1 1.0 1.2 13.1 11.1 14.4 8.4 5.0 11.0 5.0 7.1 3.5 44.7 30.5 55.0 

TOTAL 253.5 97.0 403.4 104.9 34.0 172.9 1,030.4 451.3 1,553.6 407.9 148.4 673.9 144.6 54.1 227.8 584.6 178.3 977.3 

NOTE: These tables should be used only for race/ethnicity and age comparisons, not for overall totals or gender totals. This is because, 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); 1999 (Colorado, District of Columbia, Michigan, New Jersey and New York). Cases and population denominators have been excluded for these states/areas. 

Differences between total cases from this table and others in the report are due to different reporting forms and above listed exclusions. The 0 to 9 

year age group is not shown because some of these may not be due to sexual transmission; however, they are included in the totals. 

STD Surveillance 1999 Chlamydia Tables 79 
Table 4. Chlamydia — Reported cases and rates by state/area, ranked according to rates: United States and 

outlying areas, 1999 

Rank State/Area Cases Rate per 100,000 Population 

1 South Carolina 18,499 482.3 

2 Mississippi 11,545 419.5 

3 Georgia 30,368 397.4 

4 Louisiana 16,635 380.8 

5 Delaware 2,761 371.3 

6 New York1 26,766 360.7 

7 Texas 62,958 318.6 

8 Guam 497 311.0 

9 Alaska 1,886 307.2 

10 North Carolina 21,812 289.0 

11 New Mexico 5,017 288.8 

12 Alabama 12,375 284.4 

13 Wisconsin 14,462 276.9 

14 Colorado 10,848 273.2 

15 Illinois 32,870 272.9 

16 Hawaii 3,165 265.3 

17 Maryland 13,568 264.2 

18 Ohio 29,398 262.3 

19 Tennessee 14,216 261.8 

20 California 85,156 260.7 

21 Arizona 12,111 259.4 

U.S. TOTAL2 659,441 254.1 

22 Missouri 13,355 245.6 

23 Oklahoma 8,195 244.9 

24 Rhode Island 2,345 237.2 

25 Michigan 23,107 235.4 

26 Kansas 6,093 231.8 

27 Arkansas 5,865 231.1 

28 Connecticut 7,422 226.7 

29 Pennsylvania 27,019 225.1 

30 Nebraska 3,616 217.5 

31 Florida 31,743 212.8 

32 Washington 11,964 210.3 

33 South Dakota 1,544 209.2 

34 Virginia 13,735 202.2 

35 Indiana 11,734 198.9 

36 Iowa 5,511 192.5 

37 Kentucky 7,378 187.4 

38 Oregon 6,127 186.7 

39 Montana 1,584 179.9 

40 Nevada 3,086 176.7 

41 Wyoming 787 163.6 

42 Minnesota 7,450 157.7 

43 New Jersey 12,424 153.1 

44 North Dakota 947 148.4 

45 Idaho 1,778 144.7 

46 Massachusetts 8,776 142.8 

47 Virgin Islands 136 124.0 

48 Utah 2,219 105.7 

49 West Virginia 1,820 100.5 

50 Maine 1,220 98.1 

51 New Hampshire 976 82.4 

52 Vermont 485 82.1 

53 Puerto Rico 1,445 37.4 

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). 

80 Chlamydia Tables STD Surveillance 1999 
Table 5. Chlamydia — Reported cases and rates by state/area and region listed in alphabetical order: United 

States and outlying areas, 1995–1999 

Cases* Rates per 100,000 Population 

State/Area 1995 1996 1997 1998 1999 1995 1996 1997 1998 1999 

Alabama 3,188 8,306 8,704 10,065 12,375 75.0 193.7 201.5 231.3 284.4 

Alaska NR 1,360 1,616 1,907 1,886 . 224.8 265.2 310.6 307.2 

Arizona 10,061 10,692 10,783 11,489 12,111 238.5 241.1 236.7 246.1 259.4 

Arkansas 680 2,111 2,503 4,123 5,865 27.4 84.2 99.2 162.4 231.1 

California 61,802 61,593 68,737 76,519 85,156 195.6 193.3 213.0 234.2 260.7 

Colorado 6,650 7,282 7,749 9,113 10,848 177.5 190.8 199.1 229.5 273.2 

Connecticut 6,440 6,269 6,377 6,977 7,422 196.7 191.9 195.0 213.1 226.7 

Delaware 2,701 2,271 2,613 2,608 2,761 376.6 313.9 357.2 350.7 371.3 

Florida 22,294 24,763 26,788 24,949 31,743 157.4 171.7 182.8 167.3 212.8 

Georgia 11,193 13,555 15,911 25,250 30,368 155.4 184.8 212.5 330.4 397.4 

Hawaii 2,135 1,816 1,829 2,604 3,165 179.9 153.5 154.1 218.3 265.3 

Idaho 1,739 1,524 1,709 2,035 1,778 149.5 128.3 141.2 165.6 144.7 

Illinois 24,645 24,430 23,024 26,363 32,870 208.3 206.2 193.5 218.9 272.9 

Indiana 9,102 10,334 9,600 10,801 11,734 156.8 177.3 163.7 183.1 198.9 

Iowa 5,089 4,165 4,907 5,174 5,511 179.1 146.2 172.0 180.8 192.5 

Kansas 5,314 4,449 4,627 5,587 6,093 207.1 172.5 178.3 212.5 231.8 

Kentucky 6,904 6,805 6,332 6,441 7,378 178.9 175.3 162.0 163.6 187.4 

Louisiana 9,111 11,020 11,545 15,188 16,635 209.8 253.9 265.3 347.6 380.8 

Maine 1,144 967 1,066 1,073 1,220 92.2 78.1 85.8 86.2 98.1 

Maryland 10,378 11,901 13,978 13,097 13,568 205.8 235.2 274.4 255.1 264.2 

Massachusetts 7,402 6,837 7,984 8,363 8,776 121.9 112.4 130.5 136.0 142.8 

Michigan 21,666 19,865 21,399 22,156 23,107 226.9 204.1 218.9 225.7 235.4 

Minnesota 6,032 5,607 6,631 6,970 7,450 130.9 120.6 141.5 147.5 157.7 

Mississippi 912 4,848 10,020 10,614 11,545 33.8 178.8 367.0 385.7 419.5 

Missouri 12,110 11,959 12,257 12,670 13,355 227.5 223.0 226.9 233.0 245.6 

Montana 1,198 1,124 1,146 1,412 1,584 137.7 128.2 130.4 160.4 179.9 

Nebraska 2,873 2,478 2,766 2,911 3,616 175.5 150.3 166.9 175.1 217.5 

Nevada 3,049 2,847 2,887 3,320 3,086 199.3 177.8 172.2 190.1 176.7 

New Hampshire 898 732 816 960 976 78.2 63.1 69.6 81.0 82.4 

New Jersey 4,056 12,273 10,339 11,686 12,424 51.0 153.4 128.4 144.0 153.1 

New Mexico 4,285 4,007 4,021 3,793 5,017 254.2 234.2 232.5 218.4 288.8 

New York1 26,686 26,455 28,468 26,218 26,766 365.0 360.7 387.7 353.3 360.7 

North Carolina 15,780 15,078 17,108 22,197 21,812 219.3 206.3 230.4 294.1 289.0 

North Dakota 1,324 1,016 902 1,036 947 206.4 158.1 140.7 162.3 148.4 

Ohio 29,124 20,653 22,827 27,786 29,398 261.2 185.0 204.1 247.9 262.3 

Oklahoma 5,065 7,379 7,419 9,393 8,195 154.5 223.9 223.7 280.7 244.9 

Oregon 5,465 5,457 5,270 5,855 6,127 174.0 170.7 162.5 178.4 186.7 

Pennsylvania 22,961 19,275 19,838 24,629 27,019 190.2 160.1 165.0 205.2 225.1 

Rhode Island 1,902 1,833 2,069 2,307 2,345 192.2 185.5 209.5 233.4 237.2 

South Carolina 8,591 9,391 12,511 18,510 18,499 233.9 252.7 332.7 482.5 482.3 

South Dakota 1,313 1,538 1,439 1,572 1,544 180.1 208.5 195.0 213.0 209.2 

Tennessee 13,154 13,125 12,502 13,717 14,216 250.3 247.3 232.9 252.6 261.8 

Texas 44,627 43,003 50,675 60,436 62,958 238.3 225.3 260.7 305.9 318.6 

Utah 1,676 1,598 1,774 2,209 2,219 85.9 79.2 86.2 105.2 105.7 

Vermont 462 398 434 413 485 79.0 67.9 73.7 69.9 82.1 

Virginia 12,285 11,756 11,955 13,561 13,735 185.6 176.4 177.5 199.7 202.2 

Washington 9,462 9,236 9,523 10,998 11,964 174.2 167.3 169.7 193.3 210.3 

West Virginia 2,326 2,325 3,108 2,791 1,820 127.2 127.7 171.2 154.1 100.5 

Wisconsin 8,955 10,290 9,554 13,999 14,462 174.8 200.0 184.8 268.0 276.9 

Wyoming 703 621 635 725 787 146.4 129.4 132.4 150.8 163.6 

U.S. TOTAL2 478,577 490,615 531,744 607,752 659,441 190.4 192.9 207.0 234.2 254.1 

Northeast 71,951 75,039 77,391 82,626 87,433 177.0 184.4 189.7 201.7 213.4 

Midwest 127,547 116,784 119,933 137,025 150,087 206.4 187.8 192.0 217.9 238.7 

South 170,854 189,635 216,741 256,122 276,193 185.9 203.9 230.1 268.4 289.4 

West 108,225 109,157 117,679 131,979 145,728 189.9 186.6 198.1 219.0 241.8 

Guam 461 304 368 410 497 308.9 199.1 235.6 256.5 311.0 

Puerto Rico 2,305 2,481 2,123 1,685 1,445 62.4 66.7 55.5 43.7 37.4 

Virgin Islands 17 11 14 10 136 15.5 10.0 12.8 9.1 124.0 

OUTLYING AREAS 2,783 2,796 2,505 2,105 2,078 70.4 70.2 61.2 51.0 50.3 

TOTAL 481,360 493,411 534,249 609,857 661,519 188.6 191.0 204.7 231.3 250.9 

*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 1999 Chlamydia Tables 81 
Table 6. Chlamydia — Women – Reported cases and rates by state/area listed in alphabetical order: United 

States and outlying areas, 1995–1999 

Cases* Rates per 100,000 Population 

State/Area 1995 1996 1997 1998 1999
 1995 1996 1997 1998 1999
 

Alabama 2,888 7,623 7,957 9,197 11,524 130.5 342.4 354.9 406.2 509.0 

Alaska NR 1,071 1,291 1,479 1,456 . 373.4 446.6 506.9 499.0 

Arizona 8,315 8,635 8,597 9,015 9,497 389.8 385.9 374.3 382.0 402.5 

Arkansas 596 1,933 2,346 3,850 4,618 46.4 149.4 180.3 293.4 351.9 

California 50,314 49,158 53,536 59,747 66,334 318.6 309.1 332.4 365.6 405.9 

Colorado NG 5,692 5,958 6,979 8,172 . 295.9 303.8 348.5 408.0 

Connecticut 5,624 5,321 5,282 5,828 6,053 333.2 316.8 314.4 345.8 359.1 

Delaware 2,295 1,877 2,070 2,117 2,268 623.4 506.0 551.9 554.2 593.7 

Florida 18,251 20,160 21,953 20,171 26,231 249.9 271.8 291.5 262.7 341.6 

Georgia 10,263 11,744 13,927 21,156 24,685 277.4 312.3 363.1 539.2 629.1 

Hawaii 1,878 1,568 1,548 2,209 2,557 320.2 267.5 262.4 371.4 429.9 

Idaho 1,370 1,177 1,336 1,553 1,308 235.1 198.1 220.8 252.3 212.5 

Illinois 20,443 21,111 17,302 21,845 25,593 336.6 348.2 284.4 353.9 414.7 

Indiana 7,564 8,592 7,819 8,823 9,410 253.5 287.5 260.2 291.3 310.7 

Iowa 4,210 3,443 3,900 4,077 4,208 288.4 235.9 267.0 277.6 286.5 

Kansas 4,453 3,744 3,840 4,649 5,034 341.6 285.8 291.5 347.8 376.6 

Kentucky 5,995 5,604 5,128 5,126 5,891 301.4 280.8 255.3 253.0 290.7 

Louisiana 7,569 9,490 9,414 12,169 13,247 335.8 422.0 417.6 536.5 584.0 

Maine 1,024 829 898 899 991
 160.7 130.8 141.4 141.0 155.4 

Maryland 9,150 10,249 12,180 11,093 11,351 352.9 394.6 466.0 420.2 429.9 

Massachusetts 6,237 5,783 6,522 6,812 6,959 198.1 183.7 206.2 214.0 218.6 

Michigan 18,750 16,851 18,289 18,769 18,869 382.3 337.7 365.1 372.4 374.3 

Minnesota 4,681 4,328 4,953 5,119 5,469 199.9 183.7 208.7 213.5 228.1 

Mississippi 849 4,100 8,590 9,185 9,953 60.5 291.0 605.6 640.9 694.5 

Missouri 10,866 10,578 10,749 11,063 11,515 395.0 382.7 386.5 394.4 410.5 

Montana 995 899 941 1,131 1,192
 227.5 204.4 213.5 255.4 269.2 

Nebraska 2,346 2,020 2,288 2,390 2,903 280.2 240.2 270.9 281.4 341.8 

Nevada 2,649 2,463 2,484 2,820 2,500 352.6 313.9 302.3 328.8 291.4 

New Hampshire 725 578 639 726 769
 124.0 98.1 107.4 120.6 127.7 

New Jersey 3,902 11,463 9,641 10,735 11,123 95.2 278.2 232.6 256.6 265.8 

New Mexico 3,721 3,417 3,503 3,204 4,177 435.2 394.1 399.5 363.1 473.4 

New York1 24,600 24,375 25,706 23,449 23,896 635.4 628.7 662.8 596.4 607.8 

North Carolina 13,589 13,072 14,553 18,646 18,416 366.8 347.9 381.5 479.8 473.9 

North Dakota 1,025 714 684 755 680
 318.6 221.9 212.9 235.5 212.1 

Ohio 24,883 18,050 19,727 23,248 23,380 431.6 313.4 342.0 401.4 403.7 

Oklahoma 4,467 6,269 6,269 7,696 6,737 266.2 372.4 370.1 449.4 393.4 

Oregon 4,145 4,095 3,848 4,307 4,462 260.4 253.3 234.8 259.3 268.6 

Pennsylvania 20,290 17,227 17,257 20,878 22,470 323.5 275.9 277.0 335.0 360.6 

Rhode Island 1,598 1,600 1,738 1,779 1,769 310.8 312.0 339.4 346.5 344.6 

South Carolina 6,932 7,918 11,120 16,489 16,669 364.8 412.2 572.2 829.7 838.8 

South Dakota 1,039 1,184 1,021 1,171 1,194 280.8 316.6 272.9 312.2 318.4 

Tennessee 10,517 10,004 9,605 10,552 11,084 386.5 365.0 346.4 375.5 394.4 

Texas 38,517 37,240 42,750 49,940 52,071 405.9 385.6 435.0 498.7 520.0 

Utah 1,316 1,229 1,357 1,616 1,618 134.2 121.4 131.3 153.0 153.2 

Vermont 408 336 379 357 414
 137.2 112.9 126.9 118.9 137.8 

Virginia 11,253 10,630 10,452 11,567 11,556 333.0 312.7 304.2 332.9 332.6 

Washington 7,508 7,194 7,331 8,377 8,880 274.6 259.7 260.5 292.8 310.4 

West Virginia 1,961 1,894 2,590 2,340 1,585 206.9 201.1 275.8 249.3 168.9 

Wisconsin 6,860 8,170 7,459 10,846 11,225 262.9 312.5 284.2 408.2 422.5 

Wyoming 560 521 536 595 649
 234.7 218.6 225.1 248.8 271.4 

U.S. TOTAL2 400,840 414,987 441,921 501,266 537,003 316.3 319.4 337.1 377.6 404.5 

Guam 393 260 325 351 432
 560.3 362.3 442.6 467.3 575.1 

Puerto Rico 1,905 1,989 1,722 1,327 1,147 99.8 103.4 86.5 66.1 57.1 

Virgin Islands 9 11 13 10 113
 15.8 19.3 22.8 17.4 196.2 

OUTLYING AREAS 2,307 2,260 2,060 1,688 1,692 113.3 110.1 97.1 78.9 79.1 

TOTAL 403,147 417,247 443,981 502,954 538,695 313.1 316.2 333.3 372.9 399.4 

*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.
 

82 Chlamydia Tables STD Surveillance 1999
 
Table 7. Chlamydia — Men – Reported cases and rates by state/area listed in alphabetical order: United 

States and outlying areas, 1995–1999 

Cases* Rates per 100,000 Population 

State/Area 1995 1996 1997 1998 1999 1995 1996 1997 1998 1999 

Alabama 285 662 708 844 795 14.0 32.1 34.1 40.4 38.1 

Alaska NR 289 325 428 430 . 90.8 101.5 132.8 133.4 

Arizona 1,746 2,057 2,186 2,474 2,614 83.7 93.6 96.8 107.1 113.2 

Arkansas 79 178 143 267 1,247 6.6 14.7 11.7 21.8 101.7 

California 11,248 12,157 14,875 16,525 18,236 71.2 76.2 92.0 101.2 111.7 

Colorado NG 1,585 1,784 2,115 2,666 . 83.7 92.4 107.5 135.5 

Connecticut 816 948 1,095 1,149 1,369 51.4 59.7 68.9 72.3 86.2 

Delaware 406 394 543 491 493 116.3 111.8 152.3 135.8 136.3 

Florida 4,043 4,603 4,835 4,363 5,384 58.9 65.7 67.9 60.3 74.4 

Georgia 930 1,811 1,962 3,932 5,462 26.6 50.7 53.7 105.7 146.9 

Hawaii 257 248 281 395 583 42.8 41.6 47.1 66.0 97.5 

Idaho 369 347 373 482 446 63.6 58.5 61.6 78.6 72.7 

Illinois 4,202 3,319 5,722 4,518 7,263 73.0 57.4 98.5 76.9 123.7 

Indiana 1,537 1,742 1,773 1,968 2,313 54.5 61.3 62.0 68.6 80.6 

Iowa 879 722 1,007 1,096 1,302 63.6 52.0 72.4 78.6 93.4 

Kansas 860 705 787 938 1,059 68.2 55.5 61.6 72.6 81.9 

Kentucky 909 1,201 1,182 1,093 1,328 48.6 63.7 62.2 57.2 69.5 

Louisiana 1,542 1,530 2,131 3,019 3,388 73.8 73.1 101.6 143.7 161.3 

Maine 120 138 168 174 229 19.9 22.8 27.7 28.7 37.8 

Maryland 1,228 1,652 1,798 1,973 2,196 50.1 67.1 72.5 79.1 88.0 

Massachusetts 1,165 1,054 1,462 1,551 1,817 39.8 35.9 49.5 52.3 61.3 

Michigan 2,916 3,014 3,110 3,387 4,237 62.8 63.6 65.3 70.9 88.7 

Minnesota 1,351 1,279 1,678 1,851 1,981 59.6 55.8 72.6 79.5 85.1 

Mississippi 63 703 1,180 1,355 1,450 4.9 54.0 89.9 102.7 109.9 

Missouri 1,244 1,381 1,508 1,607 1,840 48.4 53.1 57.5 61.0 69.9 

Montana 203 180 198 281 392 46.9 41.2 45.2 64.2 89.6 

Nebraska 526 452 473 520 712 65.8 56.0 58.2 63.9 87.5 

Nevada 400 384 403 498 586 51.4 47.0 47.1 56.0 65.9 

New Hampshire 173 154 177 234 207 30.7 27.0 30.6 40.1 35.5 

New Jersey 154 801 689 944 1,281 4.0 20.6 17.6 24.0 32.6 

New Mexico 564 590 518 589 839 67.9 69.9 60.7 68.9 98.2 

New York1 2,086 2,080 2,762 2,669 2,846 60.6 60.2 79.7 76.5 81.6 

North Carolina 2,191 2,006 2,555 3,551 3,396 62.8 56.5 70.8 97.0 92.8 

North Dakota 299 302 218 281 267 93.5 94.1 68.2 88.5 84.1 

Ohio 4,048 2,405 2,884 4,211 5,604 75.2 44.5 53.2 77.7 103.4 

Oklahoma 598 1,110 1,150 1,697 1,458 37.4 68.9 70.8 103.8 89.2 

Oregon 1,320 1,362 1,422 1,548 1,665 85.2 86.2 88.6 95.5 102.7 

Pennsylvania 2,671 2,048 2,581 3,751 4,549 46.1 35.3 44.6 65.0 78.8 

Rhode Island 304 233 331 528 576 63.9 49.0 69.6 111.1 121.2 

South Carolina 813 881 1,215 1,837 1,679 45.9 49.1 66.9 99.4 90.8 

South Dakota 274 354 417 400 348 76.3 97.4 114.6 110.2 95.8 

Tennessee 2,637 3,121 2,897 3,165 3,132 104.0 121.6 111.6 120.8 119.5 

Texas 6,110 5,763 7,925 10,301 10,597 66.2 61.1 82.5 105.7 108.7 

Utah 360 368 417 593 601 37.1 36.6 40.7 56.8 57.6 

Vermont 54 62 55 56 71 18.8 21.5 19.0 19.3 24.4 

Virginia 989 1,109 1,379 1,988 2,177 30.5 33.9 41.8 59.9 65.6 

Washington 1,954 2,042 2,192 2,621 3,084 72.5 74.3 78.4 92.7 109.0 

West Virginia 359 429 515 448 233 40.8 48.8 58.7 51.3 26.7 

Wisconsin 2,095 2,120 2,095 3,144 3,212 83.3 83.7 82.3 122.5 125.1 

Wyoming 143 100 99 130 138 59.2 41.4 41.0 53.8 57.1 

U.S. TOTAL2 69,736 74,409 88,594 104,440 120,094 57.7 59.8 70.5 82.4 94.7 

Guam 68 44 43 59 65 86.0 54.4 51.9 69.7 76.7 

Puerto Rico 400 492 401 358 298 22.4 27.4 21.8 19.3 16.1 

Virgin Islands 8 NR 1 NR 23 15.2 . 1.9 . 43.2 

OUTLYING AREAS 476 536 445 417 386 24.9 28.6 22.6 21.5 19.4 

TOTAL 70,212 74,945 89,039 104,857 120,480 57.2 59.3 69.7 81.5 93.6 

*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 1999 Chlamydia Tables 83 
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, 1999 

Rank City Cases* Rate per 100,000 Population 

1 Richmond, VA 1,972 1,015.6 

2 St Louis, MO 3,090 910.7 

3 Philadelphia, PA 12,660 881.4 

4 Milwaukee, WI 7,641 838.1 

Baltimore, MD 5,286 818.8 

6 New Orleans, LA 3,651 784.3 

7 Atlanta, GA 5,572 753.6 

8 Minneapolis, MN 2,584 708.9 

9 Denver, CO 3,371 675.5 

Newark, NJ 1,881 661.5 

11 Detroit, MI 7,753 615.2 

12 Kansas City, MO 2,738 605.8 

13 Memphis, TN 5,025 578.4 

14 Indianapolis, IN 4,641 570.6 

Washington, DC 2,720 520.0 

16 Chicago, IL 14,863 498.9 

17 St Paul, MN 1,349 498.7 

18 Boston, MA 2,680 481.7 

19 Dallas, TX 9,355 456.1 

Cincinnati, OH 3,801 448.5 

21 Oklahoma City, OK 1,768 433.7 

22 Tulsa, OK 1,636 430.0 

23 Norfolk, VA 920 427.5 

24 San Antonio, TX 5,731 423.6 

Nashville, TN 2,202 412.4 

26 Omaha, NE 1,808 407.4 

27 Portland, OR 2,018 405.3 

28 Austin, TX 2,795 393.3 

29 Columbus, OH 3,997 391.4 

Sacramento, CA 4,469 390.6 

31 Jacksonville, FL 2,713 368.7 

32 Corpus Christi, TX 1,158 366.1 

33 San Francisco, CA 2,718 364.5 

34 New York City, NY 26,766 360.7 

Wichita, KS 1,532 341.9 

36 Birmingham, AL 2,209 334.9 

37 Jersey City, NJ 724 329.0 

38 Houston, TX 10,511 327.8 

39 Oakland, CA 4,111 321.2 

Los Angeles, CA 27,614 320.2 

41 Albuquerque, NM 1,674 318.3 

42 Honolulu, HI 2,631 301.6 

43 Tampa, FL 2,768 299.2 

44 Fort Worth, TX 3,752 276.8 

Phoenix, AZ 7,660 275.1 

46 San Diego, CA 7,591 273.0 

47 El Paso, TX 1,898 269.9 

48 Charlotte, NC 1,669 264.6 

49 Des Moines, IA 922 256.2 

Cleveland, OH 3,446 249.6 

51 Tucson, AZ 1,908 241.3 

52 Seattle, WA 3,949 238.6 

53 Toledo, OH 1,043 232.5 

54 Pittsburgh, PA 2,879 227.0 

Dayton, OH 1,256 224.9 

56 Louisville, KY 1,447 215.3 

57 San Jose, CA 3,428 208.9 

58 St Petersburg, FL 1,768 201.3 

59 Miami, FL 4,012 186.4 

Akron, OH 841 156.4 

61 San Juan, PR 501 47.9 

62 Buffalo, NY NR . 

63 Rochester, NY NR . 

64 Yonkers, NY NR . 

*NR = No report (see Appendix). 

84 Chlamydia Tables STD Surveillance 1999 
Table 9. Chlamydia — Reported cases and rates in selected cities of >200,000 population listed in 

alphabetical order: United States and outlying areas, 1995–1999 

Cases* 

City	 1995 1996 1997 1998 1999 

Akron, OH 1,457 

Albuquerque, NM 1,651 

Atlanta, GA 4,411 

Austin, TX 2,977 

Baltimore, MD 5,638 

Birmingham, AL 992 

Boston, MA 2,179 

Buffalo, NY NR 

Charlotte, NC 1,063 

Chicago, IL 11,687 

Cincinnati, OH 2,846 

Cleveland, OH 5,770 

Columbus, OH 3,500 

Corpus Christi, TX 1,167 

Dallas, TX 5,115 

Dayton, OH 869 

Denver, CO NR 

Des Moines, IA 699 

Detroit, MI 9,026 

El Paso, TX 1,245 

Fort Worth, TX 2,540 

Honolulu, HI 1,738 

Houston, TX 8,075 

Indianapolis, IN 4,662 

Jacksonville, FL 1,611 

Jersey City, NJ 182 

Kansas City, MO 1,997 

Los Angeles, CA 18,659 

Louisville, KY 1,618 

Memphis, TN 3,728 

Miami, FL 2,004 

Milwaukee, WI 4,332 

Minneapolis, MN 1,922 

Nashville, TN 1,926 

New Orleans, LA 3,107 

New York City, NY 26,686 

Newark, NJ 1,077 

Norfolk, VA 832 

Oakland, CA 3,461 

Oklahoma City, OK 1,232 

Omaha, NE 1,335 

Philadelphia, PA 8,079 

Phoenix, AZ 5,896 

Pittsburgh, PA 2,865 

Portland, OR 1,945 

Richmond, VA 2,150 

Rochester, NY NR 

Sacramento, CA 3,760 

San Antonio, TX 4,348 

San Diego, CA 5,250 

San Francisco, CA 2,008 

San Jose, CA 2,838 

Seattle, WA 3,286 

St Louis, MO 2,796 

St Paul, MN 1,027 

St Petersburg, FL 1,579 

Tampa, FL 2,063 

Toledo, OH 968 

Tucson, AZ 1,915 

Tulsa, OK 1,028 

Washington, DC 1,665 

Wichita, KS 1,324 

Yonkers, NY 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 

24,160 

1,253 

4,791 

3,486 

7,758 

2,555 

1,981 

3,331 

26,218 

1,725 

954 

3,651 

2,008 

1,410 

11,763 

7,549 

2,980 

2,128 

1,619 

NR 

4,005 

5,909 

7,044 

2,616 

3,349 

3,486 

2,921 

1,233 

1,692 

2,240 

780 

1,610 

1,782 

3,182 

861 

NR 

841 

1,674 

5,572 

2,795 

5,286 

2,209 

2,680 

NR 

1,669 

14,863 

3,801 

3,446 

3,997 

1,158 

9,355 

1,256 

3,371 

922 

7,753 

1,898 

3,752 

2,631 

10,511 

4,641 

2,713 

724 

2,738 

27,614 

1,447 

5,025 

4,012 

7,641 

2,584 

2,202 

3,651 

26,766 

1,881 

920 

4,111 

1,768 

1,808 

12,660 

7,660 

2,879 

2,018 

1,972 

NR 

4,469 

5,731 

7,591 

2,718 

3,428 

3,949 

3,090 

1,349 

1,768 

2,768 

1,043 

1,908 

1,636 

2,720 

1,532 

NR 

U.S. CITY TOTAL1 211,806 217,005 229,867 252,487 266,575 

San Juan, PR 742 916 739 615 501 

TOTAL 212,548 217,921 230,606 253,102 267,076 

Rates per 100,000 Population 

1995 1996 1997 1998 1999 

274.8 

316.1 

629.5 

447.8 

815.8 

150.8 

392.0 

. 

183.4 

396.4 

329.4 

412.7 

346.2 

373.2 

261.1 

152.3 

. 

200.0 

857.7 

183.5 

198.7 

198.1 

262.4 

570.2 

229.6 

83.7 

455.3 

218.1 

240.4 

431.0 

98.7 

465.2 

501.2 

362.8 

644.7 

365.0 

374.6 

350.2 

286.1 

281.8 

307.5 

539.0 

242.4 

218.7 

401.4 

1,084.3 

. 

340.7 

335.3 

198.6 

274.9 

181.3 

206.0 

779.5 

373.7 

181.3 

233.2 

212.7 

254.5 

271.9 

300.4 

315.7 

. 

134.2 160.3 159.7 156.4 

309.3 310.8 326.1 318.3 

572.5 582.4 713.6 753.6 

395.9 429.2 426.4 393.3 

716.4 922.9 877.2 818.8 

355.4 360.1 375.4 334.9 

355.8	 439.5 465.2 481.7 

. . . . 

134.7 171.0 268.7 264.6 

423.3 321.7 369.6 498.9 

198.5 307.3 571.2 448.5 

248.0 220.4 264.4 249.6 

223.9 308.0 377.4 391.4 

340.0 310.6 385.7 366.1 

266.2 394.9 433.6 456.1 

90.0 144.8 166.4 224.9 

516.3 546.3 567.9 675.5 

205.9 160.1 206.5 256.2 

681.7 608.0 583.3 615.2 

358.7 205.1 241.4 269.9 

143.4 181.0 301.7 276.8 

169.4 171.1 252.7 301.6 

272.5 340.6 360.6 327.8 

590.8 453.9 563.6 570.6 

335.3 327.9 260.0 368.7 

298.2 253.9 308.1 329.0 

710.7 690.2 687.0 605.8 

237.5 272.7 280.2 320.2 

262.6 238.3 186.4 215.3 

517.3 490.1 551.4 578.4 

127.9 175.0 162.0 186.4 

606.4 563.4 850.9 838.1 

501.2 645.1 700.9 708.9 

368.8 341.0 371.0 412.4 

873.1 611.6 715.5 784.3 

360.7 387.7 353.3 360.7 

680.5 586.5 606.6 661.5 

344.3 391.9 443.3 427.5 

272.7 272.8 285.3 321.2 

490.9 229.9 492.6 433.7 

187.0 305.9 317.7 407.4 

551.0 722.1 819.0 881.4 

242.7 244.0 271.1 275.1 

193.0 224.8 234.9 227.0 

395.2 374.2 427.4 405.3 

1,066.2	 1,130.5 833.8 1,015.6 

. . . . 

321.5 310.8 350.0 390.6 

330.1 363.1 436.7 423.6 

210.7 235.0 253.3 273.0 

249.2 306.3 350.8 364.5 

187.1 171.0 204.1 208.9 

200.1 194.4 210.7 238.6 

683.1 776.0 860.8 910.7 

382.8 402.8 455.8 498.7 

175.3 205.2 192.7 201.3 

232.8 311.8 242.1 299.2 

107.1 117.0 173.9 232.5 

286.7 242.0 203.6 241.3 

435.9 205.5 468.4 430.0 

370.5 580.2 608.3 520.0 

250.9	 264.2 192.2 341.9 

. . . . 

313.2 316.7 333.5 361.8 382.0 

85.1 105.0 84.7 58.8 47.9 

310.3 314.0 330.4 357.3 377.1 

*NR = No report (see Appendix).
 

1

Rates exclude population of cities that did not report.
 

STD Surveillance 1999	 Chlamydia Tables 85 
Table 10. Chlamydia — Women – Reported cases and rates in selected cities of >200,000 population listed in 

alphabetical order: United States and outlying areas, 1995–1999 

Cases* 

City	 1995 1996 1997 1998 1999
 

Akron, OH 1,265 

Albuquerque, NM 1,403 

Atlanta, GA 4,084 

Austin, TX 2,600 

Baltimore, MD 5,197 

Birmingham, AL 867 

Boston, MA 1,696 

Buffalo, NY NR 

Charlotte, NC 926 

Chicago, IL 9,720 

Cincinnati, OH 2,176 

Cleveland, OH 5,050 

Columbus, OH 2,862 

Corpus Christi, TX 978 

Dallas, TX 3,950 

Dayton, OH 787 

Denver, CO NG 

Des Moines, IA 571 

Detroit, MI 8,009 

El Paso, TX 1,112 

Fort Worth, TX 2,069 

Honolulu, HI 1,502 

Houston, TX 7,388 

Indianapolis, IN 3,629 

Jacksonville, FL 1,275 

Jersey City, NJ 176 

Kansas City, MO 1,848 

Los Angeles, CA 15,119 

Louisville, KY 1,343 

Memphis, TN 3,090 

Miami, FL 1,519 

Milwaukee, WI 3,275 

Minneapolis, MN 1,442 

Nashville, TN 1,431 

New Orleans, LA 2,438 

New York City, NY 24,600 

Newark, NJ 1,022 

Norfolk, VA 768 

Oakland, CA 2,939 

Oklahoma City, OK 1,069 

Omaha, NE 1,079 

Philadelphia, PA 7,446 

Phoenix, AZ 4,813 

Pittsburgh, PA 2,353 

Portland, OR 1,444 

Richmond, VA 1,955 

Rochester, NY NR 

Sacramento, CA 2,897 

San Antonio, TX 3,785 

San Diego, CA 4,034 

San Francisco, CA 1,535 

San Jose, CA 2,189 

Seattle, WA 2,474 

St Louis, MO 2,609 

St Paul, MN 784 

St Petersburg, FL 1,346 

Tampa, FL 1,646 

Toledo, OH 805 

Tucson, AZ 1,545 

Tulsa, OK 946 

Washington, DC 1,449 

Wichita, KS 1,036 

Yonkers, NY NR 

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 

18,930 

985 

3,786 

2,799 

6,219 

1,762 

1,426 

2,574 

23,449 

1,632 

826 

2,942 

1,585 

1,139 

10,182 

5,653 

2,415 

1,453 

1,452 

NR 

3,069 

4,854 

5,394 

1,541 

2,594 

2,430 

2,630 

897 

1,391 

1,851 

630 

1,299 

1,467 

2,722 

665 

NR 

653 

1,401 

4,287 

2,367 

4,700 

2,086 

2,107 

NR 

1,373 

11,415 

3,211 

2,955 

2,907 

999 

7,143 

834 

2,468 

660 

6,343 

1,599 

2,933 

2,102 

8,740 

3,481 

2,098 

681 

2,413 

21,564 

1,136 

4,020 

3,283 

6,076 

1,756 

1,628 

2,794 

23,896 

1,684 

795 

3,212 

1,449 

1,437 

10,479 

5,787 

2,380 

1,379 

1,713 

NR 

3,452 

4,697 

5,839 

1,541 

2,636 

2,654 

2,736 

972 

1,448 

2,391 

815 

1,531 

1,331 

2,391 

1,218 

NR 

U.S. CITY TOTAL1 179,365 183,348 188,314 206,412 214,076 

San Juan, PR 560 681 580 445 385
 

TOTAL 179,925 184,029 188,894 206,857 214,461 

Rates per 100,000 Population 

1995 1996 1997 1998 1999
 

458.5 

525.3 

1,115.0 

782.5 

1,408.7 

247.5 

588.0 

. 

308.1 

635.2 

478.5 

681.7 

546.8 

611.9 

397.5 

265.0 

. 

313.1 

1,446.8 

317.7 

320.6 

346.3 

478.1 

846.6 

354.4 

156.9 

804.8 

351.5 

378.0 

682.4 

143.2 

669.7 

730.4 

513.6 

943.0 

635.4 

674.5 

681.0 

477.0 

471.6 

480.4 

927.9 

390.5 

338.6 

581.5 

1,807.4 

. 

514.8 

566.3 

309.5 

417.7 

282.9 

306.0 

1,336.4 

547.5 

290.1 

362.8 

338.8 

401.9 

483.7 

490.0 

485.0 

. 

223.7 241.2 249.1 233.3 

496.3 515.1 532.6 519.3 

855.2 954.0 1,090.7 1,108.8 

660.5 710.2 689.4 662.5 

1,237.5 1,595.4 1,470.5 1,364.3 

642.3 647.6 668.6 593.0 

548.6	 638.8 665.9 730.8 

. . . . 

227.5 181.5 426.3 419.6 

756.6 422.1 612.7 737.8 

341.9 524.9 923.7 719.6 

413.8 364.3 433.7 403.9 

349.4 506.7 571.6 549.0 

553.7 495.9 634.1 614.4 

407.3 600.1 642.4 685.0 

160.2 259.1 250.2 286.2 

747.3 809.8 837.9 963.6 

317.3 233.4 309.6 351.7 

1,114.4 1,024.4 978.8 956.5 

635.8 349.9 387.8 436.4 

240.8 292.7 477.7 427.4 

288.5 285.5 423.8 481.6 

499.1 588.1 612.8 540.4 

871.3 629.4 814.3 816.4 

492.0 464.1 359.9 552.0 

562.3 477.8 577.2 598.3 

1,242.3 1,190.7 1,175.9 1,018.8 

371.2 417.6 435.2 495.8 

381.0 353.7 277.8 320.4 

757.7 734.0 830.3 881.6 

199.1 271.8 248.6 291.6 

950.4 850.5 1,298.3 1,268.4 

728.9 868.1 938.6 935.4 

511.6 467.7 507.9 579.9 

1,413.7 901.0 1,029.3 1,117.3 

628.7 662.8 596.4 607.8 

1,256.2 1,079.4 1,090.5 1,125.2 

624.1 719.3 754.7 726.4 

446.0 427.1 452.9 494.5 

830.9 391.1 747.8 683.6 

301.5 486.2 495.6 625.3 

948.3 1,196.5 1,321.5 1,360.0 

373.7 371.8 401.2 410.7 

301.0 355.5 358.2 353.0 

562.5 495.4 571.4 542.3 

1,760.2	 1,837.7 1,360.3 1,604.8 

. . . . 

500.5 477.0 526.0 591.7 

557.7 596.5 692.0 669.7 

312.3 350.8 388.1 420.2 

358.6 384.3 409.3 409.3 

307.2 268.0 318.7 323.9 

288.7 276.6 289.5 316.2 

1,155.5 1,314.7 1,430.9 1,488.6 

546.0 578.3 635.4 688.5 

262.5 320.7 299.0 311.3 

372.5 509.5 389.7 503.4 

178.3 204.1 269.0 348.0 

459.5 380.5 321.3 378.7 

698.1 312.3 744.0 675.1 

615.2 946.7 978.9 859.8 

398.4	 409.6 290.5 532.0 

. . . . 

514.8 520.0 531.2 573.1 594.3 

116.7 142.0 120.9 81.8 70.8 

509.4 515.0 525.7 565.7 586.5 

*NR = No report (see Appendix).
 

1

Rates exclude population of cities that did not report.
 

86 Chlamydia Tables	 STD Surveillance 1999
 
Table 11. Chlamydia — Men – Reported cases and rates in selected cities of >200,000 population listed in 

alphabetical order: United States and outlying areas, 1995–1999 

Cases* 

City	 1995 1996 1997 1998 1999 

Akron, OH 191 

Albuquerque, NM 248 

Atlanta, GA 327 

Austin, TX 377 

Baltimore, MD 441 

Birmingham, AL 116 

Boston, MA 483 

Buffalo, NY NR 

Charlotte, NC 137 

Chicago, IL 1,967 

Cincinnati, OH 656 

Cleveland, OH 697 

Columbus, OH 617 

Corpus Christi, TX 189 

Dallas, TX 1,165 

Dayton, OH 79 

Denver, CO NG 

Des Moines, IA 128 

Detroit, MI 1,017 

El Paso, TX 133 

Fort Worth, TX 471 

Honolulu, HI 236 

Houston, TX 687 

Indianapolis, IN 1,033 

Jacksonville, FL 336 

Jersey City, NJ 6 

Kansas City, MO 149 

Los Angeles, CA 3,540 

Louisville, KY 275 

Memphis, TN 638 

Miami, FL 485 

Milwaukee, WI 1,057 

Minneapolis, MN 480 

Nashville, TN 495 

New Orleans, LA 669 

New York City, NY 2,086 

Newark, NJ 55 

Norfolk, VA 59 

Oakland, CA 522 

Oklahoma City, OK 163 

Omaha, NE 256 

Philadelphia, PA 633 

Phoenix, AZ 1,083 

Pittsburgh, PA 512 

Portland, OR 501 

Richmond, VA 194 

Rochester, NY NR 

Sacramento, CA 824 

San Antonio, TX 563 

San Diego, CA 1,141 

San Francisco, CA 473 

San Jose, CA 629 

Seattle, WA 812 

St Louis, MO 187 

St Paul, MN 243 

St Petersburg, FL 233 

Tampa, FL 417 

Toledo, OH 160 

Tucson, AZ 370 

Tulsa, OK 82 

Washington, DC 216 

Wichita, KS 288 

Yonkers, NY 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 

5,230 

260 

1,005 

685 

1,532 

793 

555 

757 

2,669 

93 

128 

698 

423 

270 

1,581 

1,896 

565 

675 

167 

NR 

907 

1,048 

1,583 

1,075 

717 

1,056 

291 

336 

294 

353 

144 

311 

315 

460 

196 

NR 

183 

272 

1,262 

428 

565 

117 

573 

NR 

296 

3,443 

552 

469 

1,053 

158 

2,156 

415 

898 

262 

1,410 

296 

778 

515 

1,634 

1,157 

615 

43 

325 

6,020 

307 

1,005 

718 

1,556 

828 

574 

857 

2,846 

194 

125 

759 

319 

370 

2,181 

1,873 

499 

639 

259 

NR 

987 

1,032 

1,704 

1,177 

761 

1,295 

354 

377 

317 

377 

222 

377 

305 

316 

314 

NR 

U.S. CITY TOTAL1 32,227 33,384 40,855 45,534 51,719 

San Juan, PR 182 235 159 170 116 

TOTAL 32,409 33,619 41,014 45,704 51,835 

Rates per 100,000 Population 

1995 1996 1997 1998 1999 

75.1 

97.2 

97.8 

113.4 

136.9 

37.7 

180.6 

. 

49.1 

138.7 

160.3 

106.0 

126.5 

123.6 

120.6 

28.9 

. 

76.6 

203.9 

40.5 

74.4 

53.2 

44.9 

265.6 

98.3 

5.7 

71.3 

83.2 

86.6 

154.8 

50.0 

239.0 

258.0 

196.3 

299.5 

60.6 

40.4 

47.3 

88.0 

77.4 

122.2 

90.9 

90.3 

83.3 

212.1 

215.3 

. 

152.4 

89.6 

85.1 

130.3 

79.5 

103.2 

114.4 

184.6 

57.3 

96.8 

73.6 

100.5 

44.9 

83.5 

140.0 

36.1 70.0 62.4 71.0 

113.7 96.9 108.5 106.2 

263.2 172.7 294.3 357.8 

130.0 147.1 159.6 121.1 

118.3 150.1 188.0 187.7 

27.5 32.8 40.0 38.0 

149.0	 226.0 249.2 213.8 

. . . . 

35.1 58.8 98.8 97.5 

65.9 214.2 106.8 240.5 

38.2 61.1 171.5 137.6 

59.6 55.9 71.3 72.2 

87.8 93.5 165.2 214.2 

117.9 118.1 122.3 102.8 

120.8 183.7 213.9 213.9 

13.3 20.0 74.1 155.4 

271.5 265.9 278.3 369.6 

85.0 80.6 94.1 152.2 

202.4 146.9 144.0 236.1 

64.9 51.7 81.1 87.9 

43.3 66.3 114.0 116.3 

52.3 57.7 81.4 118.1 

43.7 91.0 103.7 102.9 

282.4 261.2 287.3 299.0 

168.3 182.9 153.0 172.9 

18.0 15.1 19.8 40.5 

129.3 143.7 148.8 151.1 

103.3 125.8 122.4 140.8 

130.9 109.8 81.9 96.7 

253.7 222.5 243.4 243.4 

51.0 70.7 66.7 69.9 

227.5 247.3 354.1 359.6 

260.3 409.4 448.5 468.3 

211.7 201.6 219.2 226.7 

248.6 277.1 351.3 397.7 

60.2 79.7 76.5 81.6 

41.3 38.5 69.0 144.0 

80.2 71.2 121.0 118.2 

95.2 114.0 110.7 120.4 

126.1 56.9 216.2 163.0 

64.7 111.1 126.2 172.9 

92.8 175.1 237.5 327.6 

108.7 113.6 137.9 136.2 

70.9 77.0 95.1 84.0 

220.1 247.4 277.1 262.3 

231.8	 268.0 191.0 296.2 

. . . . 

131.2 132.0 161.7 176.0 

88.4 115.3 160.8 158.4 

96.5 107.5 113.8 122.5 

137.2 226.2 291.1 318.7 

67.0 74.7 86.7 92.0 

109.8 110.6 129.5 158.8 

120.5 135.1 187.1 227.6 

205.9 212.7 259.8 291.5 

76.1 74.2 71.2 76.7 

86.1 104.7 78.4 83.7 

29.1 20.4 67.2 103.6 

107.5 98.6 80.5 97.5 

156.1 91.6 171.8 166.4 

92.7 165.6 187.7 129.0 

97.9 113.3 89.5 143.3 

. . . . . 

98.3 100.4 122.1 134.8 153.2 

46.4 59.9 40.5 33.8 23.1 

97.7 99.9 121.1 133.4 151.3 

*NR = No report (see Appendix).
 

1

Rates exclude population of cities that did not report.
 

STD Surveillance 1999	 Chlamydia Tables 87 
Table 12A. Gonorrhea — Reported cases by age, gender, and race/ethnicity: United States, 1995–1999 

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 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 

199725-29 

30-34 

35-39 

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 6,019 803 5,216 838 57 781 4,765 684 4,081 342 55 287 24 3 21 50 4 46 

15-19 103,442 33,741 69,701 15,777 2,659 13,118 80,643 28,799 51,844 5,819 2,057 3,762 466 82 384 737 144 593 

20-24 103,566 50,207 53,359 14,271 4,394 9,877 81,613 42,139 39,474 6,452 3,261 3,191 589 206 383 641 207 434 

25-29 

30-34 

35-39

1998

54,544 31,369 23,175 

31,574 19,800 11,774 

22,413 15,252 7,161 

7,953 3,523 4,430 

5,563 3,093 2,470 

4,115 2,566 1,549 

42,184 25,406 16,778 

23,487 15,133 8,354 

16,685 11,661 5,024 

3,657 

2,111 

1,297 

2,144 

1,377 

863 

1,513 

734 

434 

372 173 199 

210 106 104 

154 92 62 

378 123 255 

203 91 112 

162 70 92 

40-44 12,807 9,652 3,155 2,217 1,478 739 9,768 7,619 2,149 652 449 203 87 57 30 83 49 34 

45-54 9,087 7,596 1,491 1,635 1,256 379 6,884 5,945 939 461 329 132 48 25 23 59 41 18 

55-64 2,128 1,894 234 412 358 54 1,581 1,435 146 112 87 25 10 6 4 13 8 5 

65+ 1,193 857 336 241 168 73 843 622 221 83 63 20 9 3 6 17 1 16 

TOTAL 347,882 171,553 176,329 53,195 19,602 33,593 269,287 139,738 129,549 21,068 10,709 10,359 1,978 757 1,221 2,354 747 1,607 

10-14 5,952 824 5,128 850 56 794 4,649 701 3,948 379 62 317 35 2 33 39 3 36 

15-19 104,336 34,266 70,070 15,132 2,593 12,539 81,376 29,147 52,229 6,565 2,264 4,301 566 139 427 697 123 574 

20-24 108,639 52,677 55,962 14,800 4,587 10,213 85,570 44,163 41,407 6,924 3,426 3,498 685 302 383 660 199 461 

199925-29 

30-34 

35-39 

56,082 32,574 23,508 

32,340 20,685 11,655 

23,432 16,210 7,222 

8,202 3,673 4,529 

5,673 3,124 2,549 

4,558 2,779 1,779 

43,337 26,376 16,961 

23,940 15,903 8,037 

17,238 12,398 4,840 

3,921 

2,261 

1,341 

2,238 

1,415 

877 

1,683 

846 

464 

323 181 142 

255 146 109 

158 98 60 

299 106 193 

211 97 114 

137 58 79 

40-44 14,004 10,648 3,356 2,527 1,786 741 10,648 8,336 2,312 682 443 239 73 38 35 74 45 29 

45-54 10,341 8,657 1,684 1,946 1,502 444 7,803 6,740 1,063 454 330 124 65 44 21 73 41 32 

55-64 2,355 2,122 233 536 464 72 1,676 1,548 128 116 90 26 16 12 4 11 8 3 

65+ 907 725 182 197 158 39 621 505 116 72 57 15 7 2 5 10 3 7 

TOTAL 359,463 179,780 179,683 54,574 20,773 33,801 277,695 146,123 131,572 22,790 11,230 11,560 2,189 969 1,220 2,215 685 1,530 

NOTE: These tables should be used only for race/ethnicity and age comparisons, not for overall totals or gender totals. This is because, 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: 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. The 0 to 9 year age group 

is not shown because some of these may not be due to sexual transmission; however, they are included in the totals. 

88 Gonorrhea Tables STD Surveillance 1999 
Table 12B. Gonorrhea — Reported rates per 100,000 population by age, gender, and race/ethnicity: United States, 

1995–1999 

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 41.3 12.4 71.7 8.9 1.2 17.1 237.0 79.7 398.9 19.3 5.7 33.6 5.6 0.6 10.7 19.0 9.2 29.1 

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 81.0 35.0 128.0 296.2 141.1 454.4 

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 70.2 59.9 80.5 309.5 220.3 402.4 

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 

44.4 52.6 36.7 

23.0 28.6 17.7 

10.5 14.2 7.1 

186.7 159.4 214.8 

1995

138.9 117.4 159.8 

97.8 104.6 91.4 

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 7.7 10.1 5.5 46.6 59.9 34.3 

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 4.3 6.0 2.9 20.0 26.9 13.5 

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 1.8 4.0 0.0 3.6 7.6 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 2.1 3.2 1.3 4.9 7.8 2.8 

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 20.3 18.1 22.3 92.9 70.7 114.3 

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 3.3 1.3 5.3 21.7 5.1 38.6 

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 64.1 21.5 107.8 329.0 147.7 513.3 

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 64.8 53.5 76.2 364.9 238.1 494.4 

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 

36.6 39.1 34.3 

22.6 27.5 18.1 

13.8 16.9 10.9 

215.6 174.0 258.9 

1996

143.9 126.0 161.6 

101.3 111.8 91.2 

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 8.2 10.5 6.2 57.5 74.6 41.7 

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 4.0 5.4 2.8 20.5 22.4 18.8 

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 2.1 2.1 2.1 3.4 3.7 3.3 

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 1.0 1.6 0.6 1.6 0.0 2.7 

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 18.0 15.3 20.5 104.8 75.1 133.7 

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 3.5 0.9 6.2 23.7 4.1 43.8 

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 68.6 31.5 106.5 342.9 150.3 537.2 

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 74.5 69.7 79.4 342.6 225.5 461.4 

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 

38.1 37.4 38.8 

27.9 37.6 19.0 

12.6 15.3 10.2 

189.8 150.0 231.5 

1997

141.7 129.1 154.2 

72.3 63.4 81.0 

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 9.5 12.6 6.8 48.6 47.3 49.7 

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 5.2 8.0 2.9 18.5 18.6 18.3 

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 1.6 2.7 0.7 7.6 12.6 3.2 

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 0.5 0.4 0.6 1.5 3.6 0.0 

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 19.5 18.1 20.8 99.4 66.4 131.3 

10-14 32.4 8.4 57.5 6.8 0.9 13.0 173.2 49.0 301.1 13.4 4.2 23.1 3.4 0.8 6.1 24.9 3.9 46.5 

15-19 547.0 347.0 758.7 125.1 40.9 214.4 2,892.2 2,034.2 3,777.2 222.6 151.1 300.3 66.0 22.9 110.0 390.7 152.3 630.5 

20-24 605.2 576.4 635.1 125.8 75.7 178.1 3,371.6 3,529.5 3,218.0 257.3 250.9 264.2 86.6 61.2 111.4 414.5 266.5 563.8 

25-29 

30-34 

35-39 

302.9 

162.1 

102.8 

350.2 

205.1 

140.6 

256.1 

119.9 

65.4 

65.3 57.9 72.7 

41.3 46.0 36.6 

26.1 32.4 19.7 

1,754.4 2,217.8 1,332.7 

946.0 1,306.1 630.9 

632.2 945.8 357.3 

149.3 

83.2 

54.4 

168.7 

104.6 

70.3 

128.3 

60.2 

37.5 

45.6 45.8 45.4 

25.3 27.4 23.4 

18.5 23.1 14.2 

241.0 153.3 332.8 

138.0 123.7 152.2 

105.6 92.4 118.6 

1998 

40-44 60.7 92.3 29.6 14.1 18.8 9.4 396.0 663.0 163.1 32.9 44.9 20.7 11.1 15.4 7.2 58.0 70.8 46.0 

45-54 27.2 46.6 8.7 6.3 9.8 2.9 199.2 380.3 49.6 17.5 25.6 9.8 4.1 4.6 3.7 27.7 40.0 16.2 

55-64 9.7 18.2 2.0 2.4 4.2 0.6 75.2 157.8 12.2 7.3 12.3 3.1 1.5 1.9 1.1 10.3 13.5 7.4 

65+ 3.6 6.3 1.7 0.9 1.5 0.4 31.5 59.5 13.6 4.9 8.8 2.0 1.3 1.0 1.5 12.1 1.7 19.6 

TOTAL 133.3 134.5 132.1 28.2 21.2 34.8 851.2 933.2 777.5 72.3 72.9 71.6 20.9 16.7 24.8 119.4 77.0 160.3 

10-14 30.9 8.4 54.6 6.6 0.9 12.7 163.7 48.6 282.4 14.4 4.6 24.6 4.7 0.5 9.1 19.2 2.9 36.0 

15-19 534.0 341.1 738.1 116.1 38.6 198.3 2,830.6 1,996.5 3,691.0 242.8 160.9 331.8 76.6 37.2 117.0 365.0 128.5 602.6 

20-24 614.7 585.6 644.9 126.3 76.6 178.4 3,425.8 3,582.4 3,273.1 266.9 255.0 279.6 96.6 86.1 106.8 420.8 252.7 590.3 

25-29 

30-34 

35-39 

301.7 

160.2 

103.6 

352.3 

206.7 

144.0 

251.7 

114.5 

63.5 

65.3 58.6 72.1 

40.7 44.9 36.4 

27.8 33.9 21.8 

1,743.8 2,225.7 1,304.6 

930.1 1,323.8 585.5 

630.2 970.0 332.2 

154.5 

85.7 

53.9 

170.3 

103.5 

68.6 

137.6 

66.6 

38.4 

38.0 46.1 31.1 

29.1 35.9 23.3 

18.0 23.4 13.1 

187.8 130.2 248.1 

1999

141.2 129.7 152.6 

88.0 75.4 100.3 

40-44 64.0 98.2 30.4 15.5 21.9 9.1 417.5 701.8 169.6 33.1 42.6 23.4 8.8 9.7 8.0 50.9 64.1 38.7 

45-54 29.9 51.2 9.5 7.3 11.3 3.3 217.9 416.6 54.1 16.5 24.6 8.8 5.3 7.7 3.2 33.7 39.4 28.4 

55-64 10.4 19.6 2.0 3.0 5.3 0.8 76.7 163.8 10.3 7.3 12.1 3.0 2.3 3.7 1.1 8.6 13.3 4.4 

65+ 2.6 5.1 0.9 0.7 1.3 0.2 22.5 46.7 6.9 4.1 7.7 1.5 0.9 0.6 1.2 7.0 5.0 8.4 

TOTAL 133.0 136.1 130.0 27.9 21.7 33.9 848.8 943.7 763.5 75.3 73.7 77.0 22.1 20.4 23.7 110.7 69.7 150.4 

NOTE: These tables should be used only for race/ethnicity and age comparisons, not for overall totals or gender totals. This is because, 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: 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. The 0 to 9 year age group 

is not shown because some of these may not be due to sexual transmission; however, they are included in the totals. 

STD Surveillance 1999 Gonorrhea Tables 89 
Table 13. Gonorrhea — Reported cases and rates by state/area, ranked according to rates: United States and 

outlying areas, 1999 

Rank State/Area Cases Rate per 100,000 Population 

1 South Carolina 15,037 392.0 

2 Mississippi 10,411 378.3 

3 Louisiana 13,189 301.9 

4 Georgia 21,244 278.0 

5 North Carolina 19,428 257.4 

6 Alabama 10,888 250.2 

7 Delaware 1,662 223.5 

8 Tennessee 11,366 209.3 

9 Maryland 10,430 203.1 

10 Illinois 23,254 193.1 

11 Texas 32,910 166.6 

12 Michigan 15,907 162.0 

13 Ohio 18,141 161.8 

14 Florida 22,939 153.8 

15 Missouri 8,187 150.5 

16 Virginia 9,402 138.4 

U.S. TOTAL1 360,076 133.2 

17 Wisconsin 6,662 127.5 

18 Arkansas 3,226 127.1 

19 Oklahoma 4,021 120.1 

20 Pennsylvania 13,295 110.8 

21 New York 19,826 109.1 

22 Indiana 6,092 103.3 

23 Connecticut 3,321 101.4 

24 Kansas 2,665 101.4 

YEAR 2000 OBJECTIVE 100.0 

25 New Jersey 7,852 96.8 

26 Arizona 4,293 92.0 

27 Nebraska 1,471 88.5 

28 Kentucky 3,349 85.1 

29 Nevada 1,303 74.6 

30 Colorado 2,526 63.6 

31 Rhode Island 601 60.8 

32 Minnesota 2,830 59.9 

33 California 18,672 57.2 

34 New Mexico 974 56.1 

35 Alaska 302 49.2 

36 Iowa 1,365 47.7 

37 Virgin Islands 51 46.5 

38 Massachusetts 2,453 39.9 

39 Hawaii 463 38.8 

40 Washington 2,132 37.5 

41 Guam 59 36.9 

42 West Virginia 584 32.2 

43 Oregon 903 27.5 

44 South Dakota 192 26.0 

45 North Dakota 83 13.0 

46 Utah 254 12.1 

47 New Hampshire 115 9.7 

48 Wyoming 43 8.9 

49 Vermont 52 8.8 

50 Puerto Rico 321 8.3 

51 Idaho 89 7.2 

52 Maine 83 6.7 

53 Montana 53 6.0 

1

Includes cases reported by Washington, D.C., but excludes outlying areas (Guam, Puerto Rico and Virgin Islands). 

90 Gonorrhea Tables STD Surveillance 1999 
Table 14. Gonorrhea — Reported cases and rates by state/area and region listed in alphabetical order: United 

States and outlying areas, 1995–1999 

Cases Rates per 100,000 Population 

State/Area 1995 1996 1997 1998 1999 1995 1996 1997 1998 1999 

Alabama 14,683 13,169 12,031 12,737 10,888 345.2 307.2 278.5 292.7 250.2 

Alaska 660 466 391 331 302 109.3 77.0 64.2 53.9 49.2 

Arizona 3,844 3,709 3,802 4,213 4,293 91.1 83.6 83.5 90.2 92.0 

Arkansas 5,630 5,056 4,382 3,953 3,226 226.7 201.7 173.7 155.7 127.1 

California 24,606 18,674 17,979 19,590 18,672 77.9 58.6 55.7 60.0 57.2 

Colorado 2,803 2,021 2,315 2,033 2,526 74.8 53.0 59.5 51.2 63.6 

Connecticut 4,055 3,388 3,154 3,177 3,321 123.8 103.7 96.5 97.0 101.4 

Delaware 2,201 1,456 1,273 1,556 1,662 306.9 201.3 174.0 209.3 223.5 

Florida 20,874 19,181 19,079 19,080 22,939 147.4 133.0 130.2 127.9 153.8 

Georgia 21,025 19,806 18,471 20,666 21,244 292.0 270.0 246.7 270.4 278.0 

Hawaii 563 497 510 506 463 47.4 42.0 43.0 42.4 38.8 

Idaho 149 98 158 182 89 12.8 8.3 13.1 14.8 7.2 

Illinois 21,747 17,964 18,423 21,735 23,254 183.8 151.7 154.9 180.4 193.1 

Indiana 8,880 6,638 6,155 6,307 6,092 153.0 113.9 105.0 106.9 103.3 

Iowa 1,723 1,145 1,311 1,616 1,365 60.6 40.2 46.0 56.5 47.7 

Kansas 2,797 2,044 2,075 2,622 2,665 109.0 79.3 80.0 99.7 101.4 

Kentucky 4,751 4,229 4,027 3,813 3,349 123.1 108.9 103.0 96.9 85.1 

Louisiana 9,292 9,315 10,782 12,499 13,189 214.0 214.6 247.8 286.1 301.9 

Maine 94 55 66 67 83 7.6 4.4 5.3 5.4 6.7 

Maryland 12,984 11,592 11,568 11,254 10,430 257.5 229.1 227.1 219.2 203.1 

Massachusetts 2,658 2,189 2,225 2,258 2,453 43.8 36.0 36.4 36.7 39.9 

Michigan 18,220 15,130 15,736 16,359 15,907 190.8 155.5 161.0 166.6 162.0 

Minnesota 2,852 2,697 2,417 2,708 2,830 61.9 58.0 51.6 57.3 59.9 

Mississippi 9,511 6,988 9,367 10,689 10,411 352.6 257.8 343.1 388.4 378.3 

Missouri 11,326 8,421 7,658 9,463 8,187 212.8 157.0 141.8 174.0 150.5 

Montana 65 38 66 55 53 7.5 4.3 7.5 6.2 6.0 

Nebraska 1,133 1,164 1,210 1,204 1,471 69.2 70.6 73.0 72.4 88.5 

Nevada 1,237 1,025 829 1,445 1,303 80.8 64.0 49.4 82.7 74.6 

New Hampshire 118 153 96 91 115 10.3 13.2 8.2 7.7 9.7 

New Jersey 5,783 8,721 7,566 7,858 7,852 72.8 109.0 94.0 96.8 96.8 

New Mexico 1,054 890 857 957 974 62.5 52.0 49.5 55.1 56.1 

New York 25,992 20,604 22,393 19,062 19,826 143.3 113.6 123.5 104.9 109.1 

North Carolina 23,961 18,229 16,888 19,230 19,428 333.0 249.4 227.4 254.8 257.4 

North Dakota 38 37 68 80 83 5.9 5.8 10.6 12.5 13.0 

Ohio 23,176 14,946 14,961 18,275 18,141 207.8 133.9 133.7 163.0 161.8 

Oklahoma 5,077 4,897 4,760 5,243 4,021 154.9 148.6 143.5 156.7 120.1 

Oregon 854 887 773 880 903 27.2 27.8 23.8 26.8 27.5 

Pennsylvania 13,038 10,803 9,967 11,719 13,295 108.0 89.7 82.9 97.6 110.8 

Rhode Island 545 486 422 430 601 55.1 49.2 42.7 43.5 60.8 

South Carolina 12,120 11,661 11,487 11,575 15,037 330.0 313.8 305.5 301.7 392.0 

South Dakota 237 176 172 221 192 32.5 23.9 23.3 29.9 26.0 

Tennessee 13,892 11,709 11,023 11,840 11,366 264.3 220.6 205.3 218.0 209.3 

Texas 30,801 23,124 26,612 32,833 32,910 164.5 121.1 136.9 166.2 166.6 

Utah 306 277 278 236 254 15.7 13.7 13.5 11.2 12.1 

Vermont 69 47 53 38 52 11.8 8.0 9.0 6.4 8.8 

Virginia 10,340 9,293 8,888 9,265 9,402 156.2 139.4 132.0 136.4 138.4 

Washington 2,765 2,020 1,956 1,948 2,132 50.9 36.6 34.9 34.2 37.5 

West Virginia 860 736 957 920 584 47.0 40.4 52.7 50.8 32.2 

Wisconsin 5,524 4,481 4,316 6,365 6,662 107.8 87.1 83.5 121.9 127.5 

Wyoming 51 41 54 36 43 10.6 8.5 11.3 7.5 8.9 

U.S. TOTAL1 392,651 326,805 326,564 355,728 360,076 149.4 123.2 122.0 131.6 133.2 

Northeast 52,352 46,446 45,942 44,700 47,598 101.7 90.2 89.1 86.4 92.0 

Midwest 97,653 74,843 74,502 86,955 86,849 158.0 120.4 119.3 138.3 138.1 

South 203,689 174,873 176,152 191,661 193,622 221.7 188.0 187.0 200.8 202.9 

West 38,957 30,643 29,968 32,412 32,007 67.6 52.4 50.5 53.8 53.1 

Guam 90 56 47 72 59 60.3 36.7 30.1 45.0 36.9 

Puerto Rico 618 648 526 400 321 16.7 17.4 13.7 10.4 8.3 

Virgin Islands 31 12 40 39 51 28.3 10.9 36.5 35.6 46.5 

OUTLYING AREAS 739 716 613 511 431 18.7 18.0 15.0 12.4 10.4 

TOTAL 393,390 327,521 327,177 356,239 360,507 147.5 121.7 120.4 129.8 131.4 

1

Includes cases reported by Washington, D.C. 

STD Surveillance 1999 Gonorrhea Tables 91 
Table 15. Gonorrhea — Women – Reported cases and rates by state/area listed in alphabetical order: United 

States and outlying areas, 1995–1999 

Cases Rates per 100,000 Population 

State/Area 1995 1996 1997 1998 1999 1995 1996 1997 1998 1999 

Alabama 6,938 6,730 5,984 6,313 5,460 313.6 302.3 266.9 278.8 241.2 

Alaska 318 242 230 181 153 111.4 84.4 79.6 62.0 52.4 

Arizona 1,700 1,690 1,625 1,730 1,760 79.7 75.5 70.8 73.3 74.6 

Arkansas 2,592 2,506 2,071 1,919 1,576 201.7 193.7 159.2 146.2 120.1 

California 11,349 8,847 8,462 9,345 8,903 71.9 55.6 52.5 57.2 54.5 

Colorado 1,401 1,028 1,224 1,055 1,271 74.1 53.4 62.4 52.7 63.5 

Connecticut 2,075 1,815 1,642 1,714 1,796 122.9 108.1 97.7 101.7 106.6 

Delaware 1,171 799 705 855 912 318.1 215.4 188.0 223.8 238.8 

Florida 9,439 9,409 9,513 8,923 11,040 129.2 126.9 126.3 116.2 143.8 

Georgia 9,995 9,806 9,532 10,056 10,092 270.2 260.7 248.5 256.3 257.2 

Hawaii 290 244 264 278 251 49.4 41.6 44.8 46.7 42.2 

Idaho 68 53 83 74 42 11.7 8.9 13.7 12.0 6.8 

Illinois 11,027 9,112 6,765 11,250 11,698 181.6 150.3 111.2 182.3 189.5 

Indiana 4,143 3,305 3,141 3,308 3,254 138.9 110.6 104.5 109.2 107.4 

Iowa 950 666 762 895 759 65.1 45.6 52.2 60.9 51.7 

Kansas 1,528 1,084 1,133 1,454 1,573 117.2 82.8 86.0 108.8 117.7 

Kentucky 2,259 2,013 1,882 1,866 1,626 113.6 100.9 93.7 92.1 80.2 

Louisiana 4,003 3,923 5,202 6,143 6,697 177.6 174.4 230.7 270.8 295.3 

Maine 56 27 31 31 40 8.8 4.3 4.9 4.9 6.3 

Maryland 6,323 5,692 5,767 5,391 4,749 243.9 219.2 220.6 204.2 179.9 

Massachusetts 1,231 1,146 1,151 1,155 1,207 39.1 36.4 36.4 36.3 37.9 

Michigan 8,117 7,780 7,969 8,265 7,771 165.5 155.9 159.1 164.0 154.2 

Minnesota 1,488 1,383 1,307 1,443 1,495 63.6 58.7 55.1 60.2 62.4 

Mississippi 5,218 3,681 5,188 5,973 6,137 371.5 261.3 365.7 416.8 428.2 

Missouri 5,315 4,193 4,113 4,924 4,459 193.2 151.7 147.9 175.5 159.0 

Montana 27 19 31 33 35 6.2 4.3 7.0 7.5 7.9 

Nebraska 600 604 670 683 814 71.7 71.8 79.3 80.4 95.8 

Nevada 448 362 317 591 480 59.6 46.1 38.6 68.9 56.0 

New Hampshire 70 95 57 47 61 12.0 16.1 9.6 7.8 10.1 

New Jersey 2,706 3,743 3,564 3,763 3,824 66.0 90.8 86.0 89.9 91.4 

New Mexico 583 459 509 530 528 68.2 52.9 58.0 60.1 59.8 

New York 13,999 10,952 12,833 10,586 10,639 148.7 116.5 136.6 112.2 112.8 

North Carolina 11,101 8,482 7,844 9,129 9,089 299.7 225.8 205.6 234.9 233.9 

North Dakota 15 18 42 56 46 4.7 5.6 13.1 17.5 14.3 

Ohio 11,978 8,161 8,349 10,117 9,707 207.8 141.7 144.8 174.7 167.6 

Oklahoma 2,764 2,610 2,418 2,932 2,240 164.7 155.1 142.8 171.2 130.8 

Oregon 387 418 348 430 433 24.3 25.9 21.2 25.9 26.1 

Pennsylvania 6,805 5,730 5,396 6,472 7,356 108.5 91.8 86.6 103.9 118.0 

Rhode Island 274 245 263 258 371 53.3 47.8 51.4 50.3 72.3 

South Carolina 4,597 4,807 5,128 5,730 5,874 241.9 250.2 263.9 288.3 295.6 

South Dakota 117 94 87 124 117 31.6 25.1 23.3 33.1 31.2 

Tennessee 6,197 5,106 4,940 5,263 4,965 227.7 186.3 178.2 187.3 176.7 

Texas 15,008 11,933 13,797 16,704 16,819 158.2 123.6 140.4 166.8 168.0 

Utah 121 95 84 70 100 12.3 9.4 8.1 6.6 9.5 

Vermont 43 23 32 22 22 14.5 7.7 10.7 7.3 7.3 

Virginia 4,886 4,495 4,290 4,543 4,566 144.6 132.2 124.9 130.7 131.4 

Washington 1,301 929 965 863 1,009 47.6 33.5 34.3 30.2 35.3 

West Virginia 459 363 512 549 357 48.4 38.5 54.5 58.5 38.0 

Wisconsin 2,713 2,343 2,344 3,754 3,826 104.0 89.6 89.3 141.3 144.0 

Wyoming 30 25 30 23 26 12.6 10.5 12.6 9.6 10.9 

U.S. TOTAL1 188,460 161,126 162,515 179,717 179,534 140.2 119.0 119.0 130.0 129.9 

Guam 49 30 12 25 28 69.9 41.8 16.3 33.3 37.3 

Puerto Rico 205 219 212 163 132 10.7 11.4 10.7 8.1 6.6 

Virgin Islands 14 4 19 16 38 24.5 7.0 33.3 27.8 66.0 

OUTLYING AREAS 268 253 243 204 198 13.2 12.3 11.5 9.5 9.3 

TOTAL 188,728 161,379 162,758 179,921 179,732 138.3 117.4 117.3 128.2 128.0 

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.
 

92 Gonorrhea Tables STD Surveillance 1999 
Table 16. Gonorrhea — Men – Reported cases and rates by state/area listed in alphabetical order: United 

States and outlying areas, 1995–1999 

Cases Rates per 100,000 Population 

State/Area 1995 1996 1997 1998 1999 1995 1996 1997 1998 1999 

Alabama 7,698 6,409 6,022 6,411 5,399 377.2 311.0 290.0 307.1 258.6 

Alaska 342 224 161 150 149 107.5 70.4 50.3 46.6 46.2 

Arizona 2,144 2,019 2,177 2,483 2,533 102.8 91.9 96.4 107.5 109.7 

Arkansas 3,031 2,536 2,295 2,029 1,650 252.9 209.1 187.9 165.5 134.6 

California 13,121 9,729 9,452 10,192 9,618 83.1 61.0 58.5 62.4 58.9 

Colorado 1,402 992 1,091 978 1,255 75.5 52.4 56.5 49.7 63.8 

Connecticut 1,980 1,573 1,512 1,463 1,525 124.8 99.1 95.1 92.1 96.0 

Delaware 1,030 657 568 701 750 295.1 186.4 159.3 193.9 207.4 

Florida 11,435 9,772 9,566 10,054 11,851 166.6 139.5 134.3 138.9 163.7 

Georgia 11,030 10,000 8,916 10,525 11,039 315.0 279.8 244.2 283.1 296.9 

Hawaii 273 253 246 228 211 45.5 42.4 41.2 38.1 35.3 

Idaho 81 45 75 108 46 14.0 7.6 12.4 17.6 7.5 

Illinois 10,720 8,852 11,658 10,485 11,545 186.2 153.1 200.6 178.5 196.6 

Indiana 4,737 3,331 3,006 2,991 2,836 168.0 117.3 105.1 104.2 98.8 

Iowa 773 479 549 721 606 55.9 34.5 39.4 51.7 43.5 

Kansas 1,269 960 942 1,168 1,092 100.6 75.6 73.7 90.4 84.5 

Kentucky 2,492 2,216 2,137 1,887 1,669 133.2 117.5 112.5 98.8 87.4 

Louisiana 5,289 5,392 5,580 6,356 6,492 253.3 257.8 266.1 302.6 309.0 

Maine 38 28 35 36 43 6.3 4.6 5.8 5.9 7.1 

Maryland 6,661 5,897 5,801 5,846 5,669 271.9 239.4 233.9 234.3 227.2 

Massachusetts 1,427 1,043 1,074 1,103 1,246 48.8 35.5 36.4 37.2 42.0 

Michigan 10,103 7,350 7,767 8,094 8,136 217.5 155.0 163.0 169.5 170.3 

Minnesota 1,364 1,314 1,110 1,265 1,335 60.1 57.3 48.0 54.3 57.3 

Mississippi 4,284 3,266 4,049 4,653 4,184 331.4 250.9 308.6 352.8 317.2 

Missouri 6,011 4,228 3,545 4,539 3,728 233.6 162.6 135.2 172.4 141.6 

Montana 38 19 35 22 18 8.8 4.3 8.0 5.0 4.1 

Nebraska 532 551 537 520 657 66.5 68.2 66.1 63.9 80.8 

Nevada 789 663 512 854 822 101.3 81.2 59.9 96.1 92.5 

New Hampshire 48 58 39 44 54 8.5 10.2 6.7 7.5 9.3 

New Jersey 3,077 4,972 3,999 4,094 4,019 80.0 128.1 102.3 104.2 102.2 

New Mexico 471 431 348 427 445 56.7 51.1 40.8 50.0 52.1 

New York 11,993 9,652 9,560 8,476 9,176 137.5 110.5 109.3 96.9 105.0 

North Carolina 12,860 9,747 9,044 10,101 10,339 368.5 274.4 250.5 276.0 282.5 

North Dakota 23 19 26 24 37 7.2 5.9 8.1 7.6 11.6 

Ohio 10,940 6,672 6,506 8,023 8,245 203.1 123.5 120.1 148.1 152.2 

Oklahoma 2,313 2,287 2,342 2,311 1,781 144.6 141.9 144.3 141.4 109.0 

Oregon 467 469 425 450 470 30.2 29.7 26.5 27.8 29.0 

Pennsylvania 6,233 5,073 4,571 5,247 5,939 107.5 87.5 79.0 90.9 102.9 

Rhode Island 271 241 159 172 230 57.0 50.7 33.4 36.2 48.4 

South Carolina 7,388 6,828 6,340 5,769 9,052 416.7 380.2 349.0 312.1 489.7 

South Dakota 120 82 85 97 75 33.4 22.6 23.4 26.7 20.7 

Tennessee 7,695 6,603 6,083 6,577 6,401 303.6 257.3 234.4 251.0 244.3 

Texas 15,793 11,191 12,815 15,995 15,973 171.0 118.6 133.3 164.1 163.9 

Utah 185 182 194 166 154 19.1 18.1 18.9 15.9 14.8 

Vermont 26 24 21 16 30 9.0 8.3 7.2 5.5 10.3 

Virginia 5,414 4,783 4,590 4,720 4,832 167.1 146.4 139.2 142.3 145.7 

Washington 1,464 1,091 991 1,085 1,123 54.3 39.7 35.4 38.4 39.7 

West Virginia 401 373 445 369 227 45.5 42.5 50.8 42.3 26.0 

Wisconsin 2,811 2,138 1,972 2,611 2,827 111.8 84.5 77.5 101.7 110.1 

Wyoming 21 16 24 13 17 8.7 6.6 9.9 5.4 7.0 

U.S. TOTAL1 203,557 165,321 163,634 175,253 179,564 158.7 127.4 124.9 132.7 136.0 

Guam 41 26 35 47 31 51.8 32.1 42.3 55.5 36.6 

Puerto Rico 413 429 314 237 189 23.2 23.9 17.1 12.8 10.2 

Virgin Islands 17 8 21 23 13 32.3 15.2 39.9 43.2 24.4 

OUTLYING AREAS 471 463 370 307 233 24.6 24.0 18.8 15.4 11.7 

TOTAL 204,028 165,784 164,004 175,560 179,797 156.7 125.9 123.3 131.0 134.1 

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 1999 Gonorrhea Tables 93 
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, 1999 

Rank City Cases Rate per 100,000 Population 

1 Baltimore, MD 6,124 948.6 

2 Richmond, VA 1,827 940.9 

3 St Louis, MO 2,876 847.6 

4 Rochester, NY 2,037 846.6 

5 Atlanta, GA 5,631 761.6 

6 Washington, DC 3,536 675.9 

7 Detroit, MI 7,900 626.8 

8 Newark, NJ 1,741 612.3 

9 Norfolk, VA 1,291 599.9 

Memphis, TN 5,038 579.9 

11 New Orleans, LA 2,687 577.2 

12 Philadelphia, PA 7,775 541.3 

13 Milwaukee, WI 4,884 535.7 

14 Chicago, IL 14,488 486.4 

15 Kansas City, MO 1,956 432.8 

16 Minneapolis, MN 1,558 427.4 

17 Jacksonville, FL 2,981 405.2 

18 Buffalo, NY 1,233 389.2 

19 Birmingham, AL 2,492 377.8 

Indianapolis, IN 3,045 374.4 

21 Dallas, TX 7,476 364.5 

22 Nashville, TN 1,785 334.3 

23 Cincinnati, OH 2,814 332.1 

24 Oklahoma City, OK 1,351 331.4 

25 Columbus, OH 3,120 305.5 

26 Charlotte, NC 1,908 302.5 

27 Tulsa, OK 964 253.4 

28 Cleveland, OH 3,391 245.6 

29 Denver, CO 1,157 231.8 

Omaha, NE 1,000 225.3 

31 Jersey City, NJ 490 222.6 

32 Austin, TX 1,562 219.8 

33 San Francisco, CA 1,606 215.3 

34 Fort Worth, TX 2,847 210.1 

35 St Petersburg, FL 1,835 208.9 

36 St Paul, MN 545 201.5 

37 Tampa, FL 1,787 193.1 

38 Houston, TX 5,939 185.2 

39 Louisville, KY 1,195 177.8 

Wichita, KS 771 172.1 

41 Dayton, OH 932 166.9 

42 Corpus Christi, TX 524 165.6 

43 New York City, NY 12,210 164.6 

44 Boston, MA 900 161.8 

45 Akron, OH 848 157.7 

46 San Antonio, TX 2,087 154.2 

47 Toledo, OH 624 139.1 

48 Oakland, CA 1,700 132.8 

49 Miami, FL 2,775 128.9 

Phoenix, AZ 3,586 128.8 

51 Pittsburgh, PA 1,573 124.0 

52 Portland, OR 540 108.5 

53 Sacramento, CA 1,236 108.0 

YEAR 2000 OBJECTIVE 100.0 

54 Des Moines, IA 333 92.5 

55 Albuquerque, NM 472 89.7 

56 Los Angeles, CA 6,054 70.2 

57 San Diego, CA 1,561 56.1 

58 Seattle, WA 922 55.7 

59 Yonkers, NY 102 52.8 

Tucson, AZ 415 52.5 

61 Honolulu, HI 430 49.3 

62 San Jose, CA 418 25.5 

63 El Paso, TX 156 22.2 

64 San Juan, PR 179 17.1 

94 Gonorrhea Tables STD Surveillance 1999 
Table 18. Gonorrhea — Reported cases and rates in selected cities of >200,000 population listed in 

alphabetical order: United States and outlying areas, 1995–1999 

Cases 

City 1995 1996 1997 1998 1999
 

Akron, OH 1,043
 

Albuquerque, NM 625
 

Atlanta, GA 7,330
 

Austin, TX 1,600
 

Baltimore, MD 6,928
 

Birmingham, AL 4,321
 

Boston, MA 917
 

Buffalo, NY 1,691
 

Charlotte, NC 2,146
 

Chicago, IL 12,586
 

Cincinnati, OH 2,590
 

Cleveland, OH 5,746
 

Columbus, OH 2,887
 

Corpus Christi, TX 373
 

Dallas, TX 8,027
 

Dayton, OH 1,603
 

Denver, CO 1,375
 

Des Moines, IA 362
 

Detroit, MI 8,553
 

El Paso, TX 159
 

Fort Worth, TX 2,442
 

Honolulu, HI 543
 

Houston, TX 6,984
 

Indianapolis, IN 4,709
 

Jacksonville, FL 2,476
 

Jersey City, NJ 223
 

Kansas City, MO 3,186
 

Los Angeles, CA 7,935
 

Louisville, KY 2,441
 

Memphis, TN 6,108
 

Miami, FL 2,338
 

Milwaukee, WI 4,160
 

Minneapolis, MN 1,689
 

Nashville, TN 2,622
 

New Orleans, LA 3,353
 

New York City, NY 16,499
 

Newark, NJ 2,222
 

Norfolk, VA 1,679
 

Oakland, CA 2,195
 

Oklahoma City, OK 2,028
 

Omaha, NE 880
 

Philadelphia, PA 6,565
 

Phoenix, AZ 3,149
 

Pittsburgh, PA 1,598
 

Portland, OR 543
 

Richmond, VA 2,371
 

Rochester, NY 2,210
 

Sacramento, CA 1,828
 

San Antonio, TX 1,914
 

San Diego, CA 2,176
 

San Francisco, CA 1,853
 

San Jose, CA 492
 

Seattle, WA 1,295
 

St Louis, MO 4,425
 

St Paul, MN 560
 

St Petersburg, FL 1,545
 

Tampa, FL 1,833
 

Toledo, OH 944
 

Tucson, AZ 359
 

Tulsa, OK 1,452
 

Washington, DC 5,687
 

Wichita, KS 713
 

Yonkers, NY 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
 

5,986
 

1,462
 

5,235
 

2,573
 

4,856
 

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
 

848
 

472
 

5,631
 

1,562
 

6,124
 

2,492
 

900
 

1,233
 

1,908
 

14,488
 

2,814
 

3,391
 

3,120
 

524
 

7,476
 

932
 

1,157
 

333
 

7,900
 

156
 

2,847
 

430
 

5,939
 

3,045
 

2,981
 

490
 

1,956
 

6,054
 

1,195
 

5,038
 

2,775
 

4,884
 

1,558
 

1,785
 

2,687
 

12,210
 

1,741
 

1,291
 

1,700
 

1,351
 

1,000
 

7,775
 

3,586
 

1,573
 

540
 

1,827
 

2,037
 

1,236
 

2,087
 

1,561
 

1,606
 

418
 

922
 

2,876
 

545
 

1,835
 

1,787
 

624
 

415
 

964
 

3,536
 

771
 

102
 

U.S. CITY TOTAL 191,207 153,705 156,025 170,107 165,041 

San Juan, PR 349 343 233 227 179
 

TOTAL 191,556 154,048 156,258 170,334 165,220 

Rates per 100,000 Population 

1995 1996 1997 1998 1999
 

196.7 

119.7 

1,046.1 

240.7 

1,002.4 

656.9 

165.0 

518.5 

370.3 

426.9 

299.8 

411.0 

285.6 

119.3 

409.7 

281.0 

278.1 

103.6 

812.7 

23.4 

191.0 

61.9 

227.0 

575.9 

352.9 

102.6 

726.4 

92.8 

362.7 

706.1 

115.1 

446.7 

440.5 

494.0 

695.8 

225.6 

772.8 

706.7 

181.5 

464.0 

202.7 

438.0 

129.5 

122.0 

112.1 

1,195.8 

909.5 

165.7 

147.6 

82.3 

253.6 

31.4 

81.2 

1,233.6 

203.8 

177.4 

207.2 

207.5 

47.7 

384.0 

1,026.1 

170.0 

63.2 

121.9 125.8 153.1 157.7 

106.6 103.4 108.4 89.7 

729.2 756.8 757.3 761.6 

199.9 220.7 253.7 219.8 

966.9 1,018.3 1,082.6 948.6 

490.0 471.3 481.0 377.8 

147.2 168.5 176.5 161.8 

397.7 366.0 349.8 389.2 

305.8 277.7 302.9 302.5 

389.9 394.6 468.6 486.4 

168.5 299.7 422.8 332.1 

240.6 197.8 219.5 245.6 

146.2 218.0 301.8 305.5 

116.6 110.6 141.9 165.6 

290.6 328.4 361.8 364.5 

168.7 190.6 195.5 166.9 

199.8 228.5 195.0 231.8 

87.8 93.2 103.1 92.5 

644.1 690.3 671.2 626.8 

22.9 22.1 35.8 22.2 

102.4 132.5 244.2 210.1 

52.6 55.6 55.1 49.3 

192.6 209.2 225.4 185.2 

390.0 357.9 377.5 374.4 

324.4 285.1 334.8 405.2 

171.0 171.2 223.1 222.6 

539.2 418.7 561.6 432.8 

67.2 67.9 69.4 70.2 

307.0 270.9 217.5 177.8 

606.0 563.1 602.5 579.9 

113.7 106.0 119.5 128.9 

384.2 363.4 532.6 535.7 

403.7 373.0 428.5 427.4 

381.6 384.1 332.8 334.3 

635.4 584.8 578.0 577.2 

177.2 212.3 163.0 164.6 

948.7 691.2 626.3 612.3 

623.7 639.1 657.5 599.9 

138.5 124.4 136.1 132.8 

452.6 222.9 385.4 331.4 

139.7 184.4 196.3 225.3 

435.4 448.1 506.2 541.3 

111.2 111.5 127.3 128.8 

81.9 80.1 106.5 124.0 

115.1 97.0 105.8 108.5 

909.6 761.5 786.4 940.9 

879.2 774.1 827.9 846.6 

125.0 122.6 135.1 108.0 

102.7 131.4 137.6 154.2 

67.8 55.4 57.4 56.1 

222.8 206.2 249.1 215.3 

30.3 29.3 27.6 25.5 

57.3 56.2 58.9 55.7 

827.4 820.8 1,076.3 847.6 

216.8 138.7 191.9 201.5 

134.2 137.8 167.2 208.9 

175.9 247.0 183.3 193.1 

92.7 76.7 146.0 139.1 

67.5 73.7 51.0 52.5 

336.6 160.2 343.8 253.4 

821.8 861.5 861.7 675.9 

135.2 140.0 104.0 172.1 

51.1 41.0 54.4 52.8 

277.6 221.9 223.9 241.2 234.0 

40.0 39.3 26.7 21.7 17.1 

274.6 219.6 221.5 238.0 230.8 

STD Surveillance 1999 Gonorrhea Tables 95
 
Table 19. Gonorrhea — Women – Reported cases and rates in selected cities of >200,000 population listed in 

alphabetical order: United States and outlying areas, 1995–1999 

Cases 

City 1995 1996 1997 1998 1999
 

Akron, OH 600
 

Albuquerque, NM 324
 

Atlanta, GA 3,426
 

Austin, TX 815
 

Baltimore, MD 3,065
 

Birmingham, AL 2,145
 

Boston, MA 432
 

Buffalo, NY 984
 

Charlotte, NC 823
 

Chicago, IL 6,507
 

Cincinnati, OH 1,268
 

Cleveland, OH 2,856
 

Columbus, OH 1,498
 

Corpus Christi, TX 192
 

Dallas, TX 3,758
 

Dayton, OH 876
 

Denver, CO 646
 

Des Moines, IA 181
 

Detroit, MI 3,080
 

El Paso, TX 72
 

Fort Worth, TX 1,239
 

Honolulu, HI 284
 

Houston, TX 2,976
 

Indianapolis, IN 2,186
 

Jacksonville, FL 1,025
 

Jersey City, NJ 100
 

Kansas City, MO 1,556
 

Los Angeles, CA 3,361
 

Louisville, KY 1,039
 

Memphis, TN 2,711
 

Miami, FL 767
 

Milwaukee, WI 1,954
 

Minneapolis, MN 808
 

Nashville, TN 1,035
 

New Orleans, LA 1,088
 

New York City, NY 8,792
 

Newark, NJ 994
 

Norfolk, VA 722
 

Oakland, CA 1,316
 

Oklahoma City, OK 1,115
 

Omaha, NE 462
 

Philadelphia, PA 3,330
 

Phoenix, AZ 1,325
 

Pittsburgh, PA 875
 

Portland, OR 243
 

Richmond, VA 1,067
 

Rochester, NY 1,219
 

Sacramento, CA 1,013
 

San Antonio, TX 998
 

San Diego, CA 834
 

San Francisco, CA 598
 

San Jose, CA 285
 

Seattle, WA 533
 

St Louis, MO 1,897
 

St Paul, MN 298
 

St Petersburg, FL 706
 

Tampa, FL 830
 

Toledo, OH 466
 

Tucson, AZ 194
 

Tulsa, OK 715
 

Washington, DC 2,237
 

Wichita, KS 394
 

Yonkers, NY 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
 

2,792
 

624
 

2,259
 

1,053
 

2,862
 

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
 

413
 

234
 

2,443
 

768
 

2,702
 

1,229
 

410
 

725
 

754
 

7,041
 

1,600
 

1,779
 

1,575
 

224
 

3,616
 

393
 

515
 

161
 

3,706
 

78
 

1,405
 

231
 

2,699
 

1,601
 

1,242
 

228
 

1,045
 

2,835
 

494
 

2,163
 

1,152
 

2,783
 

781
 

736
 

1,198
 

6,402
 

806
 

542
 

950
 

721
 

546
 

4,179
 

1,434
 

920
 

250
 

956
 

1,047
 

692
 

1,113
 

653
 

381
 

190
 

331
 

1,510
 

276
 

939
 

945
 

388
 

179
 

527
 

1,509
 

452
 

73
 

U.S. CITY TOTAL 89,197 74,507 74,888 83,241 79,870 

San Juan, PR 102 102 83 85 73
 

TOTAL 89,299 74,609 74,971 83,326 79,943 

Rates per 100,000 Population 

1995 1996 1997 1998 1999
 

217.5 

121.3 

935.4 

245.3 

830.8 

612.3 

149.8 

577.7 

273.9 

425.2 

278.8 

385.5 

286.2 

120.1 

378.2 

295.0 

254.3 

99.2 

556.4 

20.6 

192.0 

65.5 

192.6 

509.9 

284.9 

89.2 

677.6 

78.1 

292.4 

598.7 

72.3 

399.6 

409.2 

371.5 

420.8 

227.1 

656.0 

640.2 

213.6 

491.9 

205.7 

415.0 

107.5 

125.9 

97.9 

986.4 

967.4 

180.0 

149.3 

64.0 

162.7 

36.8 

65.9 

971.7 

208.1 

152.2 

182.9 

196.1 

50.5 

365.6 

756.4 

184.4 

61.8 

132.9 128.9 155.4 147.6 

97.2 113.7 114.2 86.7 

653.3 674.9 636.8 631.8 

209.0 247.5 250.2 214.9 

850.8 933.0 945.7 784.3 

474.4 447.3 442.0 349.4 

140.3 154.3 165.4 142.2 

458.5 431.4 412.8 438.8 

238.8 203.0 253.7 230.4 

378.1 204.8 453.8 455.1 

223.9 338.6 458.0 358.6 

254.4 214.4 228.6 243.2 

152.2 230.7 299.1 297.4 

119.7 100.8 111.3 137.8 

308.3 323.4 344.4 346.8 

155.8 172.0 168.2 134.9 

185.8 225.1 180.8 201.1 

92.0 86.9 100.7 85.8 

575.9 626.0 625.4 558.9 

21.3 21.1 33.6 21.3 

113.6 150.8 254.0 204.7 

51.7 58.2 60.0 52.9 

168.4 194.3 203.1 166.9 

363.3 329.0 359.3 375.5 

301.9 267.1 236.3 326.8 

156.7 181.8 202.9 200.3 

521.0 459.3 583.5 441.2 

61.3 61.7 64.2 65.2 

251.8 211.1 176.0 139.3 

509.2 480.2 495.4 474.4 

99.1 93.0 93.5 102.3 

380.7 358.4 597.5 581.0 

375.4 374.1 429.4 416.0 

279.1 302.1 255.8 262.2 

478.4 487.5 463.1 479.1 

175.1 234.6 172.7 162.8 

664.4 566.7 530.5 538.5 

543.6 571.1 541.8 495.2 

160.3 141.7 151.9 146.2 

444.7 220.6 395.8 340.2 

138.8 200.3 215.0 237.6 

429.2 451.2 511.1 542.4 

94.1 88.8 100.4 101.8 

83.7 79.9 116.9 136.5 

108.5 80.6 96.7 98.3 

783.7 618.6 704.5 895.6 

884.1 768.4 827.4 840.2 

129.0 132.7 148.9 118.6 

104.6 139.2 144.3 158.7 

66.6 48.9 49.5 47.0 

105.6 80.3 106.8 101.2 

32.3 25.7 27.5 23.3 

42.8 48.9 38.6 39.4 

685.7 758.6 916.7 821.5 

219.2 141.4 196.9 195.5 

133.9 139.8 158.7 201.9 

164.1 260.9 186.5 199.0 

93.8 68.9 149.5 165.7 

72.4 71.8 43.3 44.3 

340.2 150.1 369.2 267.3 

642.0 683.5 684.7 542.7 

136.6 143.7 106.1 197.4 

53.8 34.8 54.3 72.1 

251.3 209.0 208.9 228.6 219.4 

21.3 21.3 17.3 15.6 13.4 

248.3 206.5 206.4 225.5 216.3 

96 Gonorrhea Tables STD Surveillance 1999
 
Table 20. Gonorrhea — Men – Reported cases and rates in selected cities of >200,000 population listed in 

alphabetical order: United States and outlying areas, 1995–1999 

Cases 

City 1995 1996 1997 1998 1999
 

Akron, OH 440
 

Albuquerque, NM 301
 

Atlanta, GA 3,904
 

Austin, TX 785
 

Baltimore, MD 3,863
 

Birmingham, AL 2,146
 

Boston, MA 485
 

Buffalo, NY 707
 

Charlotte, NC 1,323
 

Chicago, IL 6,079
 

Cincinnati, OH 1,308
 

Cleveland, OH 2,855
 

Columbus, OH 1,371
 

Corpus Christi, TX 181
 

Dallas, TX 4,269
 

Dayton, OH 726
 

Denver, CO 729
 

Des Moines, IA 181
 

Detroit, MI 5,473
 

El Paso, TX 87
 

Fort Worth, TX 1,203
 

Honolulu, HI 259
 

Houston, TX 4,008
 

Indianapolis, IN 2,523
 

Jacksonville, FL 1,451
 

Jersey City, NJ 123
 

Kansas City, MO 1,630
 

Los Angeles, CA 4,574
 

Louisville, KY 1,402
 

Memphis, TN 3,397
 

Miami, FL 1,571
 

Milwaukee, WI 2,206
 

Minneapolis, MN 871
 

Nashville, TN 1,587
 

New Orleans, LA 2,265
 

New York City, NY 7,707
 

Newark, NJ 1,228
 

Norfolk, VA 945
 

Oakland, CA 879
 

Oklahoma City, OK 913
 

Omaha, NE 417
 

Philadelphia, PA 3,235
 

Phoenix, AZ 1,824
 

Pittsburgh, PA 723
 

Portland, OR 300
 

Richmond, VA 1,301
 

Rochester, NY 991
 

Sacramento, CA 805
 

San Antonio, TX 916
 

San Diego, CA 1,237
 

San Francisco, CA 1,255
 

San Jose, CA 204
 

Seattle, WA 762
 

St Louis, MO 2,528
 

St Paul, MN 262
 

St Petersburg, FL 839
 

Tampa, FL 1,003
 

Toledo, OH 478
 

Tucson, AZ 165
 

Tulsa, OK 737
 

Washington, DC 3,449
 

Wichita, KS 319
 

Yonkers, NY 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
 

3,194
 

831
 

2,976
 

1,518
 

1,994
 

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
 

429
 

237
 

3,172
 

792
 

3,410
 

1,258
 

490
 

508
 

1,154
 

7,444
 

1,193
 

1,589
 

1,523
 

300
 

3,834
 

539
 

642
 

172
 

4,194
 

78
 

1,425
 

199
 

3,193
 

1,443
 

1,739
 

262
 

911
 

3,218
 

699
 

2,875
 

1,618
 

2,098
 

777
 

1,049
 

1,489
 

5,797
 

935
 

749
 

667
 

630
 

454
 

3,596
 

2,152
 

653
 

290
 

870
 

990
 

534
 

974
 

896
 

1,225
 

224
 

591
 

1,366
 

269
 

893
 

842
 

235
 

236
 

437
 

2,014
 

319
 

29
 

U.S. CITY TOTAL 101,764 79,067 81,021 86,659 84,820 

San Juan, PR 247 241 150 142 106
 

TOTAL 102,011 79,308 81,171 86,801 84,926 

Rates per 100,000 Population 

1995 1996 1997 1998 1999
 

173.1 

117.9 

1,167.4 

236.1 

1,198.9 

697.9 

181.3 

453.7 

474.3 

428.6 

319.7 

434.3 

281.2 

118.4 

442.1 

265.4 

303.3 

108.3 

1,097.2 

26.5 

190.0 

58.4 

261.7 

648.7 

424.4 

116.9 

780.1 

107.6 

441.4 

824.0 

161.8 

498.8 

468.2 

629.3 

1,014.0 

224.0 

903.0 

757.2 

148.1 

433.8 

199.0 

464.5 

152.0 

117.6 

127.0 

1,443.7 

847.1 

148.9 

145.8 

92.3 

345.7 

25.8 

96.9 

1,546.3 

199.0 

206.2 

232.8 

219.9 

44.8 

403.8 

1,334.1 

155.1 

64.7 

108.8 121.3 147.4 166.4 

116.5 92.6 102.3 92.5 

812.1 844.0 884.0 899.3 

190.8 193.9 256.1 224.2 

1,100.2 1,116.4 1,233.5 1,132.6 

507.1 496.6 524.5 408.8 

154.6 183.6 188.4 182.8 

331.5 294.9 281.1 335.2 

377.8 357.8 356.0 380.1 

402.7 597.8 484.6 520.0 

106.4 253.1 378.4 297.4 

222.2 176.5 207.5 244.8 

138.1 203.0 302.6 309.8 

113.4 120.7 174.3 195.1 

272.3 333.7 378.3 380.3 

181.6 210.0 225.1 201.8 

214.3 232.1 209.9 264.3 

83.3 100.0 105.7 99.9 

719.6 761.5 722.1 702.3 

24.7 23.2 38.3 23.2 

90.9 113.7 229.7 213.0 

53.4 53.1 50.2 45.6 

217.0 224.1 247.8 201.0 

419.2 389.6 397.7 372.9 

348.3 304.6 439.7 488.9 

185.2 160.0 244.7 246.6 

559.1 374.3 537.4 423.5 

73.2 74.1 74.7 75.3 

368.2 337.0 261.7 220.1 

712.2 654.0 720.8 696.4 

129.6 120.1 147.9 157.6 

388.1 368.9 460.8 484.9 

433.7 371.9 427.6 439.5 

494.4 474.4 418.2 414.3 

816.8 697.2 711.5 691.0 

179.6 187.4 152.1 166.2 

1,264.0 829.2 732.8 694.2 

696.9 701.5 777.2 708.1 

116.1 106.6 118.8 105.8 

461.1 225.3 374.1 321.9 

139.8 166.4 175.7 212.2 

442.6 444.6 500.6 540.1 

128.7 134.8 154.8 156.5 

79.8 80.4 94.7 109.9 

121.9 114.2 115.3 119.0 

1,059.8 933.3 886.4 995.1 

874.0 780.3 828.5 853.5 

120.3 110.3 120.0 95.2 

100.6 123.1 129.8 149.5 

63.6 58.6 63.5 64.4 

342.7 335.5 394.3 331.7 

27.4 32.5 27.4 27.1 

72.1 63.7 79.8 72.5 

996.2 894.8 1,264.8 878.4 

214.2 135.8 186.4 208.0 

134.4 135.4 176.2 216.2 

188.2 232.4 177.7 187.0 

90.6 85.1 142.3 109.6 

62.4 75.7 59.0 61.1 

332.8 170.9 316.4 238.4 

1,026.0 1,062.5 1,062.7 821.9 

133.7 136.1 101.8 145.6 

48.1 47.8 54.4 31.6 

304.7 235.1 239.5 253.9 248.5 

62.9 61.4 38.2 28.3 21.1 

301.9 233.1 237.2 250.7 245.3 

STD Surveillance 1999 Gonorrhea Tables 97
 
Table 21. All stages of syphilis — Reported cases and rates by state/area listed in alphabetical order: United 

States and outlying areas, 1995–1999 

Cases Rates per 100,000 Population 

State/Area 1995 1996 1997 1998 1999 1995 1996 1997 1998 1999 

Alabama 1,640 1,889 1,486 1,139 1,018 38.6 44.1 34.4 26.2 23.4 

Alaska 20 15 12 13 13 3.3 2.5 2.0 2.1 2.1 

Arizona 417 468 600 697 833 9.9 10.6 13.2 14.9 17.8 

Arkansas 1,270 843 572 506 364 51.1 33.6 22.7 19.9 14.3 

California 5,771 4,420 3,827 2,869 2,859 18.3 13.9 11.9 8.8 8.8 

Colorado 304 165 153 122 91 8.1 4.3 3.9 3.1 2.3 

Connecticut 270 334 325 177 126 8.2 10.2 9.9 5.4 3.8 

Delaware 129 124 113 114 72 18.0 17.1 15.4 15.3 9.7 

Florida 3,468 2,912 2,746 2,539 2,957 24.5 20.2 18.7 17.0 19.8 

Georgia 3,666 2,953 2,835 1,836 1,973 50.9 40.3 37.9 24.0 25.8 

Hawaii 25 30 47 18 11 2.1 2.5 4.0 1.5 0.9 

Idaho 12 24 24 15 13 1.0 2.0 2.0 1.2 1.1 

Illinois 3,712 2,071 1,954 2,028 1,967 31.4 17.5 16.4 16.8 16.3 

Indiana 870 675 522 509 802 15.0 11.6 8.9 8.6 13.6 

Iowa 170 86 72 48 37 6.0 3.0 2.5 1.7 1.3 

Kansas 150 136 169 116 95 5.8 5.3 6.5 4.4 3.6 

Kentucky 501 398 403 339 302 13.0 10.3 10.3 8.6 7.7 

Louisiana 3,692 2,409 1,808 1,651 1,423 85.0 55.5 41.5 37.8 32.6 

Maine 4 4 13 4 1 0.3 0.3 1.0 0.3 0.1 

Maryland 1,679 2,234 2,455 2,156 1,385 33.3 44.1 48.2 42.0 27.0 

Massachusetts 506 633 730 568 385 8.3 10.4 11.9 9.2 6.3 

Michigan 1,203 851 794 692 778 12.6 8.7 8.1 7.0 7.9 

Minnesota 187 116 124 75 71 4.1 2.5 2.6 1.6 1.5 

Mississippi 4,532 2,365 1,441 1,161 906 168.0 87.2 52.8 42.2 32.9 

Missouri 1,265 618 503 379 395 23.8 11.5 9.3 7.0 7.3 

Montana 13 4 5 0 3 1.5 0.5 0.6 0.0 0.3 

Nebraska 35 27 34 35 24 2.1 1.6 2.1 2.1 1.4 

Nevada 193 142 120 139 92 12.6 8.9 7.2 8.0 5.3 

New Hampshire 32 29 26 14 17 2.8 2.5 2.2 1.2 1.4 

New Jersey 1,470 1,448 1,166 836 800 18.5 18.1 14.5 10.3 9.9 

New Mexico 138 78 103 76 80 8.2 4.6 6.0 4.4 4.6 

New York 8,880 6,529 5,645 5,147 4,094 49.0 36.0 31.1 28.3 22.5 

North Carolina 3,066 2,670 2,202 2,133 1,713 42.6 36.5 29.7 28.3 22.7 

North Dakota 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Ohio 1,938 1,324 761 474 364 17.4 11.9 6.8 4.2 3.2 

Oklahoma 589 467 410 369 538 18.0 14.2 12.4 11.0 16.1 

Oregon 67 70 48 32 37 2.1 2.2 1.5 1.0 1.1 

Pennsylvania 1,948 1,440 1,182 910 932 16.1 12.0 9.8 7.6 7.8 

Rhode Island 90 72 84 55 55 9.1 7.3 8.5 5.6 5.6 

South Carolina 1,669 1,286 1,139 876 925 45.4 34.6 30.3 22.8 24.1 

South Dakota 7 2 8 3 3 1.0 0.3 1.1 0.4 0.4 

Tennessee 2,604 2,322 2,368 1,754 1,734 49.5 43.8 44.1 32.3 31.9 

Texas 7,926 5,897 5,382 3,967 3,699 42.3 30.9 27.7 20.1 18.7 

Utah 50 49 56 58 49 2.6 2.4 2.7 2.8 2.3 

Vermont 0 1 1 6 3 0.0 0.2 0.2 1.0 0.5 

Virginia 1,590 1,265 1,118 719 722 24.0 19.0 16.6 10.6 10.6 

Washington 211 134 137 143 204 3.9 2.4 2.4 2.5 3.6 

West Virginia 65 59 20 11 15 3.6 3.2 1.1 0.6 0.8 

Wisconsin 585 496 317 257 190 11.4 9.6 6.1 4.9 3.6 

Wyoming 2 8 4 2 0 0.4 1.7 0.8 0.4 0.0 

U.S. TOTAL1 69,353 53,218 46,708 38,366 35,628 26.4 20.1 17.5 14.2 13.2 

Guam 6 3 1 3 12 4.0 2.0 0.6 1.9 7.5 

Puerto Rico 1,619 1,469 1,577 1,461 1,457 43.9 39.5 41.2 37.8 37.7 

Virgin Islands 19 17 10 35 13 17.3 15.5 9.1 31.9 11.9 

OUTLYING AREAS 1,644 1,489 1,588 1,499 1,482 41.6 37.4 38.8 36.3 35.9 

TOTAL 70,997 54,707 48,296 39,865 37,110 26.6 20.3 17.8 14.5 13.5 

1

Includes cases reported by Washington, D.C. 

98 Syphilis Tables STD Surveillance 1999 
Table 22. All stages of syphilis — Reported cases and rates in selected cities of >200,000 population listed in 

alphabetical order: United States and outlying areas, 1995–1999 

Cases 

City 1995 1996 1997 1998 1999 

Akron, OH 8 

Albuquerque, NM 41 

Atlanta, GA 1,074 

Austin, TX 183 

Baltimore, MD 1,089 

Birmingham, AL 640 

Boston, MA 193 

Buffalo, NY 32 

Charlotte, NC 347 

Chicago, IL 2,244 

Cincinnati, OH 399 

Cleveland, OH 750 

Columbus, OH 31 

Corpus Christi, TX 62 

Dallas, TX 1,022 

Dayton, OH 399 

Denver, CO 179 

Des Moines, IA 92 

Detroit, MI 707 

El Paso, TX 142 

Fort Worth, TX 489 

Honolulu, HI 22 

Houston, TX 2,691 

Indianapolis, IN 168 

Jacksonville, FL 192 

Jersey City, NJ 136 

Kansas City, MO 68 

Los Angeles, CA 3,009 

Louisville, KY 272 

Memphis, TN 1,596 

Miami, FL 1,008 

Milwaukee, WI 464 

Minneapolis, MN 86 

Nashville, TN 202 

New Orleans, LA 649 

New York City, NY 7,881 

Newark, NJ 392 

Norfolk, VA 278 

Oakland, CA 185 

Oklahoma City, OK 291 

Omaha, NE 21 

Philadelphia, PA 1,696 

Phoenix, AZ 270 

Pittsburgh, PA 27 

Portland, OR 42 

Richmond, VA 122 

Rochester, NY 104 

Sacramento, CA 86 

San Antonio, TX 394 

San Diego, CA 371 

San Francisco, CA 84 

San Jose, CA 78 

Seattle, WA 93 

St Louis, MO 734 

St Paul, MN 28 

St Petersburg, FL 168 

Tampa, FL 277 

Toledo, OH 52 

Tucson, AZ 78 

Tulsa, OK 105 

Washington, DC 722 

Wichita, KS 42 

Yonkers, NY 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 

96 

38 

2,193 

227 

1,371 

876 

397 

52 

293 

520 

5,801 

363 

222 

139 

227 

1 

1,293 

342 

16 

45 

171 

68 

58 

378 

227 

151 

70 

61 

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 

72 

26 

548 

112 

299 

42 

1,937 

125 

206 

85 

13 

1,630 

232 

1,435 

874 

275 

53 

412 

463 

4,961 

241 

158 

128 

110 

17 

1,093 

473 

21 

23 

137 

32 

55 

309 

259 

171 

93 

62 

261 

8 

79 

207 

25 

52 

36 

644 

85 

34 

7 

45 

591 

56 

1,472 

246 

240 

12 

211 

1,457 

32 

151 

115 

27 

736 

39 

35 

20 

477 

81 

175 

18 

1,401 

239 

154 

34 

14 

1,264 

213 

1,036 

773 

233 

34 

416 

348 

4,652 

191 

108 

129 

181 

26 

804 

572 

12 

17 

81 

39 

31 

237 

187 

129 

62 

69 

170 

10 

56 

177 

23 

36 

75 

579 

21 

22 

6 

50 

580 

62 

941 

278 

164 

6 

194 

1,324 

12 

88 

109 

20 

695 

16 

46 

7 

567 

79 

177 

8 

1,111 

553 

79 

42 

66 

1,189 

174 

924 

888 

166 

28 

505 

228 

3,737 

171 

84 

127 

300 

10 

825 

722 

7 

19 

64 

16 

20 

228 

251 

128 

56 

122 

165 

6 

39 

117 

21 

42 

109 

458 

34 

12 

U.S. CITY TOTAL 35,371 27,881 25,018 21,098 19,272 

San Juan, PR 692 722 719 673 681 

TOTAL 36,063 28,603 25,737 21,771 19,953 

Rates per 100,000 Population 

1995 1996 1997 1998 1999 

1.5 

7.8 

153.3 

27.5 

157.6 

97.3 

34.7 

9.8 

59.9 

76.1 

46.2 

53.6 

3.1 

19.8 

52.2 

69.9 

36.2 

26.3 

67.2 

20.9 

38.2 

2.5 

87.5 

20.5 

27.4 

62.6 

15.5 

35.2 

40.4 

184.5 

49.6 

49.8 

22.4 

38.1 

134.7 

107.8 

136.3 

117.0 

15.3 

66.6 

4.8 

113.1 

11.1 

2.1 

8.7 

61.5 

42.8 

7.8 

30.4 

14.0 

11.5 

5.0 

5.8 

204.6 

10.2 

19.3 

31.3 

11.4 

10.4 

27.8 

130.3 

10.0 

33.4 

1.5 0.8 1.3 1.1 

6.3 10.6 8.6 9.5 

116.9 120.7 79.9 78.4 

12.9 14.1 7.9 8.7 

231.0 271.0 228.0 145.8 

106.4 72.0 37.3 42.2 

46.1 54.7 43.1 29.5 

6.8 7.2 3.8 1.9 

52.3 24.9 33.4 30.8 

43.0 45.1 48.9 44.4 

19.4 10.9 3.8 1.4 

27.0 18.0 10.9 6.4 

8.8 11.5 11.3 10.7 

9.2 6.9 8.5 6.3 

39.6 35.4 35.9 33.9 

64.9 22.4 7.0 2.9 

13.5 14.4 7.0 9.2 

9.6 7.3 5.6 1.9 

47.7 50.3 37.8 45.0 

17.2 16.0 11.5 11.2 

29.2 22.5 12.9 13.1 

3.0 4.8 2.1 0.9 

65.7 61.3 43.7 34.7 

22.8 15.4 29.4 68.0 

31.4 28.1 20.9 10.7 

44.2 39.0 15.4 19.1 

8.5 2.9 3.1 14.6 

25.8 19.0 14.7 13.8 

33.8 34.6 31.7 25.9 

158.5 165.7 119.2 106.4 

43.0 42.7 35.9 41.3 

43.2 30.3 25.6 18.2 

13.6 13.8 9.3 7.7 

55.0 77.2 77.9 94.6 

109.7 98.7 74.8 49.0 

79.1 67.6 62.7 50.4 

127.1 84.7 67.2 60.1 

95.4 68.9 50.2 39.0 

11.2 10.2 10.1 9.9 

51.7 25.0 44.4 73.6 

0.2 3.9 5.9 2.3 

87.8 75.3 56.0 57.4 

13.1 17.5 20.5 25.9 

1.2 1.6 0.9 0.6 

9.2 4.7 3.4 3.8 

89.5 71.2 41.7 33.0 

28.1 13.3 16.2 6.7 

5.2 4.9 2.7 1.7 

28.8 23.2 17.5 16.9 

8.5 9.5 6.7 9.0 

20.7 23.4 17.3 17.2 

4.4 5.8 3.8 3.4 

3.8 3.8 4.2 7.4 

94.2 76.3 50.1 48.6 

6.2 2.9 3.7 2.2 

9.9 9.1 6.4 4.4 

35.1 22.8 19.1 12.6 

13.9 5.5 5.1 4.7 

7.9 6.7 4.6 5.3 

28.6 9.3 19.7 28.6 

116.1 121.7 110.7 87.6 

13.4 19.4 4.7 7.6 

17.2 17.6 11.4 6.2 

51.3 40.2 35.9 29.9 27.3 

79.3 82.8 82.4 64.3 65.1 

51.7 40.8 36.5 30.4 27.9 

STD Surveillance 1999 Syphilis Tables 99 
Table 23A. Primary and secondary syphilis — Reported cases by age, gender, and race/ethnicity: United States, 

1995–1999 

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 

10-14 106 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 

15-19 610 193 417 53 11 42 505 163 342 42 16 26 3 0 3 7 3 4 

20-24 1,027 508 519 104 30 74 835 418 417 72 51 21 5 3 2 11 6 5 

199825-29 

30-34 

35-39 

1,026 

1,177 

1,177 

507 

625 

683 

519 

552 

494 

129 50 79 

146 77 69 

173 105 68 

781 383 398 

949 484 465 

926 522 404 

99 

64 

64 

65 

53 

46 

34 

11 

18 

5 4 1 

9 7 2 

7 6 1 

12 5 7 

9 4 5 

7 4 3 

40-44 830 533 297 129 95 34 653 403 250 40 30 10 3 2 1 5 3 2 

45-54 777 576 201 122 102 20 609 439 170 44 34 10 1 1 0 1 0 1 

55-64 231 194 37 50 47 3 161 129 32 16 14 2 2 2 0 2 2 0 

65+ 102 86 16 21 18 3 71 60 11 9 7 2 0 0 0 1 1 0 

TOTAL 7,004 3,912 3,092 932 535 397 5,531 3,008 2,523 451 316 135 35 25 10 55 28 27 

10-14 25 2 23 3 1 2 21 1 20 1 0 1 0 0 0 0 0 0 

15-19 524 182 342 48 16 32 424 139 285 43 24 19 1 1 0 8 2 6 

20-24 963 512 451 120 46 74 719 383 336 109 75 34 5 3 2 10 5 5 

199925-29 

30-34 

35-39 

994 

1,091 

1,158 

509 

593 

679 

485 

498 

479 

139 69 70 

169 99 70 

192 115 77 

744 364 380 

808 415 393 

885 501 384 

93 

96 

70 

67 

72 

57 

26 

24 

13 

7 7 0 

12 6 6 

3 3 0 

11 2 9 

6 1 5 

8 3 5 

40-44 809 539 270 142 99 43 603 391 212 55 46 9 7 3 4 2 0 2 

45-54 756 573 183 140 97 43 562 431 131 42 36 6 5 5 0 7 4 3 

55-64 228 187 41 54 41 13 151 129 22 21 16 5 1 0 1 1 1 0 

65+ 74 65 9 24 22 2 46 39 7 4 4 0 0 0 0 0 0 0 

TOTAL 6,634 3,844 2,790 1,033 605 428 4,972 2,795 2,177 535 398 137 41 28 13 53 18 35 

NOTE: These tables should be used only for race/ethnicity and age comparisons, not for overall totals or gender totals. This is because, 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 (Rhode Island); 1999 (New Hampshire). Differences between total cases 

from this table and others in the report are due to different reporting forms and above exclusions. The 0 to 9 year age group is not shown because some 

of these may not be due to sexual transmission; however, they are included in the totals. 

100 Syphilis Tables STD Surveillance 1999 
Table 23B. Primary and secondary syphilis — Reported rates per 100,000 population by age, gender, and 

race/ethnicity: United States, 1995–1999 

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 1.0 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 

5.6 6.3 5.0 

2.0 2.7 1.3 

1995 

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 

5.8 5.2 6.4 

2.6 2.7 2.5 

1996 

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 

4.0 2.6 5.3 

3.2 2.6 3.8 

1997 

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 0.3 2.1 0.0 0.0 0.1 0.0 0.0 0.0 0.0 0.0 0.0 

15-19 3.1 1.9 4.4 0.4 0.2 0.7 17.6 11.2 24.2 1.6 1.1 2.0 0.4 0.0 0.8 3.7 3.1 4.2 

20-24 5.8 5.6 6.0 0.9 0.5 1.3 33.4 33.9 33.0 2.8 3.8 1.7 0.7 0.9 0.6 7.0 7.6 6.4 

25-29 

30-34 

35-39 

5.5 

5.8 

5.2 

5.5 

6.2 

6.1 

5.6 

5.4 

4.3 

1.0 0.8 1.3 

1.0 1.1 1.0 

1.1 1.3 0.8 

31.4 32.3 30.6 

36.9 40.3 33.9 

33.9 40.8 27.7 

3.9 

2.4 

2.6 

4.9 

3.9 

3.6 

2.8 

0.9 

1.5 

0.6 1.0 0.2 

1.0 1.7 0.4 

0.8 1.4 0.2 

7.5 6.1 9.0 

6.0 5.4 6.7 

4.5 5.2 3.8 

1998 

40-44 3.8 4.9 2.7 0.8 1.2 0.4 25.6 33.9 18.3 1.9 2.9 1.0 0.4 0.5 0.2 3.4 4.3 2.7 

45-54 2.2 3.4 1.1 0.5 0.8 0.1 17.0 27.1 8.7 1.6 2.5 0.7 0.1 0.2 0.0 0.5 0.0 0.9 

55-64 1.0 1.8 0.3 0.3 0.5 0.0 7.4 13.6 2.6 1.0 1.9 0.2 0.3 0.6 0.0 1.6 3.3 0.0 

65+ 0.3 0.6 0.1 0.1 0.1 0.0 2.6 5.5 0.7 0.5 0.9 0.2 0.0 0.0 0.0 0.7 1.7 0.0 

TOTAL 2.6 3.0 2.2 0.5 0.6 0.4 16.9 19.4 14.6 1.5 2.1 0.9 0.4 0.5 0.2 2.7 2.8 2.7 

10-14 0.1 0.0 0.2 0.0 0.0 0.0 0.7 0.1 1.4 0.0 0.0 0.1 0.0 0.0 0.0 0.0 0.0 0.0 

15-19 2.7 1.8 3.6 0.4 0.2 0.5 14.8 9.5 20.1 1.6 1.7 1.5 0.1 0.3 0.0 4.2 2.1 6.3 

20-24 5.5 5.7 5.2 1.0 0.8 1.3 28.8 31.1 26.6 4.2 5.6 2.7 0.7 0.9 0.6 6.4 6.4 6.4 

25-29 

30-34 

35-39 

5.4 

5.4 

5.1 

5.5 

6.0 

6.1 

5.2 

4.9 

4.2 

1.1 1.1 1.1 

1.2 1.4 1.0 

1.2 1.4 0.9 

29.9 30.7 29.2 

31.4 34.6 28.6 

32.4 39.2 26.4 

3.7 

3.6 

2.8 

5.1 

5.3 

4.5 

2.1 

1.9 

1.1 

0.8 1.8 0.0 

1.4 1.5 1.3 

0.3 0.7 0.0 

6.9 2.5 11.6 

4.0 1.3 6.7 

5.1 3.9 6.4 

1999 

40-44 3.7 5.0 2.5 0.9 1.2 0.5 23.6 32.9 15.6 2.7 4.4 0.9 0.8 0.8 0.9 1.4 0.0 2.7 

45-54 2.2 3.4 1.0 0.5 0.7 0.3 15.7 26.6 6.7 1.5 2.7 0.4 0.4 0.9 0.0 3.2 3.9 2.7 

55-64 1.0 1.7 0.3 0.3 0.5 0.1 6.9 13.6 1.8 1.3 2.2 0.6 0.1 0.0 0.3 0.8 1.7 0.0 

65+ 0.2 0.5 0.0 0.1 0.2 0.0 1.7 3.6 0.4 0.2 0.5 0.0 0.0 0.0 0.0 0.0 0.0 0.0 

TOTAL 2.5 2.9 2.0 0.5 0.6 0.4 15.2 18.1 12.6 1.8 2.6 0.9 0.4 0.6 0.3 2.7 1.8 3.4 

NOTE: These tables should be used only for race/ethnicity and age comparisons, not for overall totals or gender totals. This is because, 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 (Rhode Island); 1999 (New Hampshire). Differences between total cases 

from this table and others in the report are due to different reporting forms and above exclusions. The 0 to 9 year age group is not shown because some 

of these may not be due to sexual transmission; however, they are included in the totals. 

STD Surveillance 1999 Syphilis Tables 101 
Table 24. Primary and secondary syphilis — Reported cases and rates by state/area, ranked according to 

rates: United States and outlying areas, 1999 

Rank State/Area Cases Rate per 100,000 Population 

1 Tennessee 641 11.8 

2 Indiana 450 7.6 

3 Louisiana 306 7.0 

4 Mississippi 194 7.0 

5 South Carolina 269 7.0 

6 Maryland 343 6.7 

7 North Carolina 464 6.1 

8 Georgia 430 5.6 

9 Oklahoma 187 5.6 

10 Alabama 202 4.6 

11 Arizona 212 4.5 

YEAR 2000 OBJECTIVE 4.0 

12 Puerto Rico 146 3.8 

13 Illinois 422 3.5 

14 Arkansas 87 3.4 

15 Florida 383 2.6 

16 Kentucky 101 2.6 

17 Michigan 249 2.5 

U.S. TOTAL1 6,657 2.5 

18 Texas 473 2.4 

19 Virginia 153 2.3 

20 Missouri 96 1.8 

21 Washington 77 1.4 

22 Delaware 10 1.3 

23 Guam 2 1.3 

24 California 283 0.9 

25 Virgin Islands 1 0.9 

26 New Jersey 68 0.8 

27 New York 150 0.8 

28 Ohio 92 0.8 

29 Wisconsin 41 0.8 

30 New Mexico 12 0.7 

31 Pennsylvania 84 0.7 

32 Massachusetts 37 0.6 

33 Connecticut 16 0.5 

34 Kansas 14 0.5 

35 Vermont 3 0.5 

36 Nebraska 6 0.4 

37 Hawaii 3 0.3 

38 Iowa 9 0.3 

39 Nevada 5 0.3 

40 Rhode Island 3 0.3 

41 West Virginia 5 0.3 

42 Alaska 1 0.2 

43 Colorado 8 0.2 

44 Minnesota 10 0.2 

45 Oregon 8 0.2 

46 Idaho 1 0.1 

47 Montana 1 0.1 

48 New Hampshire 1 0.1 

49 Utah 2 0.1 

50 Maine 0 0.0 

51 North Dakota 0 0.0 

52 South Dakota 0 0.0 

53 Wyoming 0 0.0 

1

Includes cases reported by Washington, D.C., but excludes outlying areas (Guam, Puerto Rico and Virgin Islands). 

102 Syphilis Tables STD Surveillance 1999 
Table 25. Primary and secondary syphilis — Reported cases and rates by state/area and region listed in 

alphabetical order: United States and outlying areas, 1995–1999 

Cases Rates per 100,000 Population 

State/Area 1995 1996 1997 1998 1999 1995 1996 1997 1998 1999 

Alabama 612 528 410 274 202 14.4 12.3 9.5 6.3 4.6 

Alaska 2 0 1 1 1 0.3 0.0 0.2 0.2 0.2 

Arizona 46 102 132 185 212 1.1 2.3 2.9 4.0 4.5 

Arkansas 495 262 173 108 87 19.9 10.5 6.9 4.3 3.4 

California 584 509 386 327 283 1.8 1.6 1.2 1.0 0.9 

Colorado 100 26 15 10 8 2.7 0.7 0.4 0.3 0.2 

Connecticut 86 103 62 26 16 2.6 3.2 1.9 0.8 0.5 

Delaware 19 35 22 21 10 2.6 4.8 3.0 2.8 1.3 

Florida 383 368 296 294 383 2.7 2.6 2.0 2.0 2.6 

Georgia 901 689 515 333 430 12.5 9.4 6.9 4.4 5.6 

Hawaii 0 3 1 4 3 0.0 0.3 0.1 0.3 0.3 

Idaho 0 4 1 2 1 0.0 0.3 0.1 0.2 0.1 

Illinois 1,026 501 435 424 422 8.7 4.2 3.7 3.5 3.5 

Indiana 321 207 151 215 450 5.5 3.6 2.6 3.6 7.6 

Iowa 48 23 7 5 9 1.7 0.8 0.2 0.2 0.3 

Kansas 47 28 32 14 14 1.8 1.1 1.2 0.5 0.5 

Kentucky 185 154 135 106 101 4.8 4.0 3.5 2.7 2.6 

Louisiana 1,024 533 364 430 306 23.6 12.3 8.4 9.8 7.0 

Maine 2 1 2 1 0 0.2 0.1 0.2 0.1 0.0 

Maryland 554 729 891 648 343 11.0 14.4 17.5 12.6 6.7 

Massachusetts 69 85 78 46 37 1.1 1.4 1.3 0.7 0.6 

Michigan 304 183 153 211 249 3.2 1.9 1.6 2.1 2.5 

Minnesota 45 16 16 9 10 1.0 0.3 0.3 0.2 0.2 

Mississippi 1,952 817 390 261 194 72.4 30.1 14.3 9.5 7.0 

Missouri 584 221 118 109 96 11.0 4.1 2.2 2.0 1.8 

Montana 4 0 0 0 1 0.5 0.0 0.0 0.0 0.1 

Nebraska 14 6 3 8 6 0.9 0.4 0.2 0.5 0.4 

Nevada 36 20 11 15 5 2.4 1.2 0.7 0.9 0.3 

New Hampshire 0 1 0 2 1 0.0 0.1 0.0 0.2 0.1 

New Jersey 188 177 150 107 68 2.4 2.2 1.9 1.3 0.8 

New Mexico 13 3 9 14 12 0.8 0.2 0.5 0.8 0.7 

New York 449 214 138 119 150 2.5 1.2 0.8 0.7 0.8 

North Carolina 1,132 1,052 721 723 464 15.7 14.4 9.7 9.6 6.1 

North Dakota 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Ohio 896 584 218 134 92 8.0 5.2 1.9 1.2 0.8 

Oklahoma 197 179 117 98 187 6.0 5.4 3.5 2.9 5.6 

Oregon 5 9 10 6 8 0.2 0.3 0.3 0.2 0.2 

Pennsylvania 248 164 123 98 84 2.1 1.4 1.0 0.8 0.7 

Rhode Island 4 4 2 1 3 0.4 0.4 0.2 0.1 0.3 

South Carolina 570 402 378 271 269 15.5 10.8 10.1 7.1 7.0 

South Dakota 0 0 1 1 0 0.0 0.0 0.1 0.1 0.0 

Tennessee 906 850 747 567 641 17.2 16.0 13.9 10.4 11.8 

Texas 1,557 890 676 443 473 8.3 4.7 3.5 2.2 2.4 

Utah 4 3 5 4 2 0.2 0.1 0.2 0.2 0.1 

Vermont 0 0 0 4 3 0.0 0.0 0.0 0.7 0.5 

Virginia 600 393 237 149 153 9.1 5.9 3.5 2.2 2.3 

Washington 17 9 17 44 77 0.3 0.2 0.3 0.8 1.4 

West Virginia 16 7 1 3 5 0.9 0.4 0.1 0.2 0.3 

Wisconsin 185 176 89 78 41 3.6 3.4 1.7 1.5 0.8 

Wyoming 1 2 0 1 0 0.2 0.4 0.0 0.2 0.0 

U.S. TOTAL1 16,543 11,388 8,556 7,035 6,657 6.3 4.3 3.2 2.6 2.5 

Northeast 1,046 749 555 404 362 2.0 1.5 1.1 0.8 0.7 

Midwest 3,470 1,945 1,223 1,208 1,389 5.6 3.1 2.0 1.9 2.2 

South 11,215 8,004 6,190 4,810 4,293 12.2 8.6 6.6 5.0 4.5 

West 812 690 588 613 613 1.4 1.2 1.0 1.0 1.0 

Guam 0 0 0 0 2 0.0 0.0 0.0 0.0 1.3 

Puerto Rico 285 208 249 177 146 7.7 5.6 6.5 4.6 3.8 

Virgin Islands 2 11 2 7 1 1.8 10.0 1.8 6.4 0.9 

OUTLYING AREAS 287 219 251 184 149 7.3 5.5 6.1 4.5 3.6 

TOTAL 16,830 11,607 8,807 7,219 6,806 6.3 4.3 3.2 2.6 2.5 

1

Includes cases reported by Washington, D.C. 

STD Surveillance 1999 Syphilis Tables 103 
Table 26. Primary and secondary syphilis — Women – Reported cases and rates by state/area listed in 

alphabetical order: United States and outlying areas, 1995–1999 

Cases Rates per 100,000 Population 

State/Area 1995 1996 1997 1998 1999 1995 1996 1997 1998 1999 

Alabama 257 244 183 133 102 11.6 11.0 8.2 5.9 4.5 

Alaska 1 0 0 0 0 0.4 0.0 0.0 0.0 0.0 

Arizona 14 43 37 67 65 0.7 1.9 1.6 2.8 2.8 

Arkansas 267 144 103 59 44 20.8 11.1 7.9 4.5 3.4 

California 219 187 116 132 76 1.4 1.2 0.7 0.8 0.5 

Colorado 42 10 5 3 6 2.2 0.5 0.3 0.1 0.3 

Connecticut 34 58 25 16 6 2.0 3.5 1.5 0.9 0.4 

Delaware 7 14 10 11 1 1.9 3.8 2.7 2.9 0.3 

Florida 189 172 131 116 162 2.6 2.3 1.7 1.5 2.1 

Georgia 360 284 194 130 160 9.7 7.6 5.1 3.3 4.1 

Hawaii 0 1 0 0 2 0.0 0.2 0.0 0.0 0.3 

Idaho 0 3 0 0 0 0.0 0.5 0.0 0.0 0.0 

Illinois 500 246 194 171 180 8.2 4.1 3.2 2.8 2.9 

Indiana 151 115 82 113 225 5.1 3.8 2.7 3.7 7.4 

Iowa 31 16 4 0 6 2.1 1.1 0.3 0.0 0.4 

Kansas 22 10 12 6 8 1.7 0.8 0.9 0.4 0.6 

Kentucky 83 81 66 49 45 4.2 4.1 3.3 2.4 2.2 

Louisiana 505 271 187 196 153 22.4 12.0 8.3 8.6 6.7 

Maine 0 0 1 0 0 0.0 0.0 0.2 0.0 0.0 

Maryland 233 329 400 302 164 9.0 12.7 15.3 11.4 6.2 

Massachusetts 27 30 33 15 15 0.9 1.0 1.0 0.5 0.5 

Michigan 132 82 68 86 95 2.7 1.6 1.4 1.7 1.9 

Minnesota 25 8 4 4 5 1.1 0.3 0.2 0.2 0.2 

Mississippi 1,000 427 201 128 93 71.2 30.3 14.2 8.9 6.5 

Missouri 283 103 63 50 49 10.3 3.7 2.3 1.8 1.7 

Montana 2 0 0 0 0 0.5 0.0 0.0 0.0 0.0 

Nebraska 4 4 0 3 3 0.5 0.5 0.0 0.4 0.4 

Nevada 12 10 6 3 3 1.6 1.3 0.7 0.3 0.3 

New Hampshire 0 0 0 1 1 0.0 0.0 0.0 0.2 0.2 

New Jersey 72 81 59 37 32 1.8 2.0 1.4 0.9 0.8 

New Mexico 3 1 5 8 3 0.4 0.1 0.6 0.9 0.3 

New York 218 92 56 28 34 2.3 1.0 0.6 0.3 0.4 

North Carolina 536 484 353 347 202 14.5 12.9 9.3 8.9 5.2 

North Dakota 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Ohio 417 287 101 72 43 7.2 5.0 1.8 1.2 0.7 

Oklahoma 90 80 53 45 77 5.4 4.8 3.1 2.6 4.5 

Oregon 2 3 2 2 5 0.1 0.2 0.1 0.1 0.3 

Pennsylvania 92 62 52 31 27 1.5 1.0 0.8 0.5 0.4 

Rhode Island 2 1 1 1 1 0.4 0.2 0.2 0.2 0.2 

South Carolina 285 182 173 131 117 15.0 9.5 8.9 6.6 5.9 

South Dakota 0 0 0 1 0 0.0 0.0 0.0 0.3 0.0 

Tennessee 432 422 370 284 283 15.9 15.4 13.3 10.1 10.1 

Texas 770 437 315 183 182 8.1 4.5 3.2 1.8 1.8 

Utah 0 0 2 0 0 0.0 0.0 0.2 0.0 0.0 

Vermont 0 0 0 1 2 0.0 0.0 0.0 0.3 0.7 

Virginia 299 204 112 61 71 8.8 6.0 3.3 1.8 2.0 

Washington 6 2 8 7 3 0.2 0.1 0.3 0.2 0.1 

West Virginia 11 6 1 2 3 1.2 0.6 0.1 0.2 0.3 

Wisconsin 93 85 49 40 18 3.6 3.3 1.9 1.5 0.7 

Wyoming 0 1 0 0 0 0.0 0.4 0.0 0.0 0.0 

U.S. TOTAL1 7,776 5,379 3,895 3,109 2,796 5.8 4.0 2.9 2.2 2.0 

Guam 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Puerto Rico 141 100 116 81 73 7.4 5.2 5.8 4.0 3.6 

Virgin Islands 0 5 0 1 1 0.0 8.8 0.0 1.7 1.7 

OUTLYING AREAS 141 105 116 82 74 6.9 5.1 5.5 3.8 3.5 

TOTAL 7,917 5,484 4,011 3,191 2,870 5.8 4.0 2.9 2.3 2.0 

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.
 

104 Syphilis Tables STD Surveillance 1999 
Table 27. Primary and secondary syphilis — Men – Reported cases and rates by state/area listed in 

alphabetical order: United States and outlying areas, 1995–1999 

Cases Rates per 100,000 Population 

State/Area 1995 1996 1997 1998 1999 1995 1996 1997 1998 1999 

Alabama 355 284 227 141 100 17.4 13.8 10.9 6.8 4.8 

Alaska 1 0 1 1 1 0.3 0.0 0.3 0.3 0.3 

Arizona 32 59 95 118 147 1.5 2.7 4.2 5.1 6.4 

Arkansas 228 118 70 49 43 19.0 9.7 5.7 4.0 3.5 

California 363 322 270 195 206 2.3 2.0 1.7 1.2 1.3 

Colorado 58 16 10 7 2 3.1 0.8 0.5 0.4 0.1 

Connecticut 52 45 37 10 10 3.3 2.8 2.3 0.6 0.6 

Delaware 12 21 12 10 9 3.4 6.0 3.4 2.8 2.5 

Florida 194 196 165 178 220 2.8 2.8 2.3 2.5 3.0 

Georgia 541 405 321 203 269 15.5 11.3 8.8 5.5 7.2 

Hawaii 0 2 1 4 1 0.0 0.3 0.2 0.7 0.2 

Idaho 0 1 1 2 1 0.0 0.2 0.2 0.3 0.2 

Illinois 526 255 241 253 242 9.1 4.4 4.1 4.3 4.1 

Indiana 169 92 69 102 225 6.0 3.2 2.4 3.6 7.8 

Iowa 17 7 3 5 3 1.2 0.5 0.2 0.4 0.2 

Kansas 25 18 20 8 6 2.0 1.4 1.6 0.6 0.5 

Kentucky 102 73 69 57 56 5.5 3.9 3.6 3.0 2.9 

Louisiana 519 262 177 234 153 24.9 12.5 8.4 11.1 7.3 

Maine 2 1 1 1 0 0.3 0.2 0.2 0.2 0.0 

Maryland 321 400 490 346 179 13.1 16.2 19.8 13.9 7.2 

Massachusetts 42 55 45 31 22 1.4 1.9 1.5 1.0 0.7 

Michigan 172 101 85 125 154 3.7 2.1 1.8 2.6 3.2 

Minnesota 20 8 12 5 5 0.9 0.3 0.5 0.2 0.2 

Mississippi 952 390 189 131 101 73.6 30.0 14.4 9.9 7.7 

Missouri 301 118 55 59 47 11.7 4.5 2.1 2.2 1.8 

Montana 2 0 0 0 1 0.5 0.0 0.0 0.0 0.2 

Nebraska 10 2 3 5 3 1.3 0.2 0.4 0.6 0.4 

Nevada 24 10 5 12 2 3.1 1.2 0.6 1.3 0.2 

New Hampshire 0 1 0 1 0 0.0 0.2 0.0 0.2 0.0 

New Jersey 116 96 91 70 36 3.0 2.5 2.3 1.8 0.9 

New Mexico 10 2 4 6 9 1.2 0.2 0.5 0.7 1.1 

New York 231 122 82 91 116 2.6 1.4 0.9 1.0 1.3 

North Carolina 596 568 368 376 262 17.1 16.0 10.2 10.3 7.2 

North Dakota 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Ohio 479 297 117 62 49 8.9 5.5 2.2 1.1 0.9 

Oklahoma 107 99 64 53 110 6.7 6.1 3.9 3.2 6.7 

Oregon 3 6 8 4 3 0.2 0.4 0.5 0.2 0.2 

Pennsylvania 156 102 71 67 57 2.7 1.8 1.2 1.2 1.0 

Rhode Island 2 3 1 0 2 0.4 0.6 0.2 0.0 0.4 

South Carolina 285 220 205 140 152 16.1 12.3 11.3 7.6 8.2 

South Dakota 0 0 1 0 0 0.0 0.0 0.3 0.0 0.0 

Tennessee 474 428 377 283 358 18.7 16.7 14.5 10.8 13.7 

Texas 787 453 361 260 289 8.5 4.8 3.8 2.7 3.0 

Utah 4 3 3 4 2 0.4 0.3 0.3 0.4 0.2 

Vermont 0 0 0 3 1 0.0 0.0 0.0 1.0 0.3 

Virginia 301 189 125 88 82 9.3 5.8 3.8 2.7 2.5 

Washington 11 7 9 37 74 0.4 0.3 0.3 1.3 2.6 

West Virginia 5 1 0 1 2 0.6 0.1 0.0 0.1 0.2 

Wisconsin 92 91 40 38 23 3.7 3.6 1.6 1.5 0.9 

Wyoming 1 1 0 1 0 0.4 0.4 0.0 0.4 0.0 

U.S. TOTAL1 8,764 6,009 4,660 3,924 3,856 6.8 4.6 3.6 3.0 2.9 

Guam 0 0 0 0 2 0.0 0.0 0.0 0.0 2.4 

Puerto Rico 144 108 133 96 73 8.1 6.0 7.2 5.2 3.9 

Virgin Islands 2 6 2 6 0 3.8 11.4 3.8 11.3 0.0 

OUTLYING AREAS 146 114 135 102 75 7.6 5.9 6.8 5.1 3.8 

TOTAL 8,910 6,123 4,795 4,026 3,931 6.8 4.7 3.6 3.0 2.9 

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 1999 Syphilis Tables 105 
10

20

30

40

50

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, 1999 

Rank City Cases Rate per 100,000 Population 

1 Indianapolis, IN 407 50.0 

2 Nashville, TN 250 46.8 

3 Baltimore, MD 246 38.1 

4 Memphis, TN 258 29.7 

5 Atlanta, GA 213 28.8 

6 Oklahoma City, OK 114 28.0 

7 Detroit, MI 189 15.0 

8 St Louis, MO 51 15.0 

9 Tulsa, OK 45 11.8 

New Orleans, LA 51 11.0 

11 Louisville, KY 67 10.0 

12 Chicago, IL 282 9.5 

13 Norfolk, VA 20 9.3 

14 Washington, DC 45 8.6 

15 Charlotte, NC 53 8.4 

16 Newark, NJ 22 7.7 

17 Dallas, TX 151 7.4 

18 Phoenix, AZ 195 7.0 

19 Richmond, VA 13 6.7 

San Juan, PR 61 5.8 

21 Philadelphia, PA 69 4.8 

22 Milwaukee, WI 39 4.3 

23 Miami, FL 91 4.2 

24 Columbus, OH 43 4.2 

YEAR 2000 OBJECTIVE 4.0 

25 San Francisco, CA 29 3.9 

26 Seattle, WA 65 3.9 

27 Birmingham, AL 24 3.6 

28 Boston, MA 16 2.9 

29 Austin, TX 19 2.7 

Houston, TX 77 2.4 

31 San Antonio, TX 31 2.3 

32 Albuquerque, NM 11 2.1 

33 Kansas City, MO 8 1.8 

34 New York City, NY 130 1.8 

35 Tampa, FL 15 1.6 

36 Wichita, KS 7 1.6 

37 Minneapolis, MN 6 1.6 

38 Fort Worth, TX 22 1.6 

39 Jersey City, NJ 3 1.4 

Toledo, OH 6 1.3 

41 El Paso, TX 9 1.3 

42 Omaha, NE 5 1.1 

43 Tucson, AZ 8 1.0 

44 Los Angeles, CA 83 1.0 

45 Jacksonville, FL 7 1.0 

46 Portland, OR 5 1.0 

47 San Diego, CA 25 0.9 

48 Cleveland, OH 12 0.9 

49 Oakland, CA 10 0.8 

Denver, CO 4 0.8 

51 St Paul, MN 2 0.7 

52 St Petersburg, FL 4 0.5 

53 Yonkers, NY 1 0.5 

54 Dayton, OH 2 0.4 

55 Honolulu, HI 3 0.3 

56 Buffalo, NY 1 0.3 

57 Corpus Christi, TX 1 0.3 

58 Sacramento, CA 2 0.2 

59 San Jose, CA 3 0.2 

Pittsburgh, PA 2 0.2 

61 Cincinnati, OH 1 0.1 

62 Des Moines, IA 0 0.0 

63 Rochester, NY 0 0.0 

64 Akron, OH 0 0.0 

106 Syphilis Tables STD Surveillance 1999 
Table 29. Primary and secondary syphilis — Reported cases and rates in selected cities of >200,000 

population listed in alphabetical order: United States and outlying areas, 1995–1999 

Cases 

City 1995 1996 1997 1998 1999 

Akron, OH 1 

Albuquerque, NM 6 

Atlanta, GA 320 

Austin, TX 17 

Baltimore, MD 417 

Birmingham, AL 264 

Boston, MA 40 

Buffalo, NY 2 

Charlotte, NC 125 

Chicago, IL 582 

Cincinnati, OH 252 

Cleveland, OH 263 

Columbus, OH 7 

Corpus Christi, TX 8 

Dallas, TX 268 

Dayton, OH 244 

Denver, CO 68 

Des Moines, IA 27 

Detroit, MI 130 

El Paso, TX 2 

Fort Worth, TX 140 

Honolulu, HI 0 

Houston, TX 417 

Indianapolis, IN 74 

Jacksonville, FL 50 

Jersey City, NJ 27 

Kansas City, MO 24 

Los Angeles, CA 273 

Louisville, KY 128 

Memphis, TN 477 

Miami, FL 51 

Milwaukee, WI 150 

Minneapolis, MN 24 

Nashville, TN 97 

New Orleans, LA 221 

New York City, NY 364 

Newark, NJ 43 

Norfolk, VA 130 

Oakland, CA 16 

Oklahoma City, OK 106 

Omaha, NE 7 

Philadelphia, PA 199 

Phoenix, AZ 43 

Pittsburgh, PA 4 

Portland, OR 4 

Richmond, VA 37 

Rochester, NY 18 

Sacramento, CA 5 

San Antonio, TX 50 

San Diego, CA 53 

San Francisco, CA 32 

San Jose, CA 2 

Seattle, WA 5 

St Louis, MO 361 

St Paul, MN 7 

St Petersburg, FL 20 

Tampa, FL 33 

Toledo, OH 22 

Tucson, AZ 1 

Tulsa, OK 48 

Washington, DC 112 

Wichita, KS 16 

Yonkers, NY 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 

120 

91 

260 

31 

71 

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 

0 

11 

213 

19 

246 

24 

16 

1 

53 

282 

1 

12 

43 

1 

151 

2 

4 

0 

189 

9 

22 

3 

77 

407 

7 

3 

8 

83 

67 

258 

91 

39 

6 

250 

51 

130 

22 

20 

10 

114 

5 

69 

195 

2 

5 

13 

0 

2 

31 

25 

29 

3 

65 

51 

2 

4 

15 

6 

8 

45 

45 

7 

1 

U.S. CITY TOTAL 6,936 5,266 4,148 3,565 3,573 

San Juan, PR 70 74 99 79 61 

TOTAL 7,006 5,340 4,247 3,644 3,634 

Rates per 100,000 Population 

1995 1996 1997 1998 1999 

0.2 

1.1 

45.7 

2.6 

60.3 

40.1 

7.2 

0.6 

21.6 

19.7 

29.2 

18.8 

0.7 

2.6 

13.7 

42.8 

13.8 

7.7 

12.4 

0.3 

10.9 

0.0 

13.6 

9.1 

7.1 

12.4 

5.5 

3.2 

19.0 

55.1 

2.5 

16.1 

6.3 

18.3 

45.9 

5.0 

15.0 

54.7 

1.3 

24.3 

1.6 

13.3 

1.8 

0.3 

0.8 

18.7 

7.4 

0.5 

3.9 

2.0 

4.4 

0.1 

0.3 

100.6 

2.5 

2.3 

3.7 

4.8 

0.1 

12.7 

20.2 

3.8 

1.0 

0.0 0.8 0.6 0.0 

0.4 1.7 2.1 2.1 

34.6 28.2 22.0 28.8 

1.3 1.2 2.1 2.7 

82.3 101.8 72.2 38.1 

30.6 16.2 5.5 3.6 

7.5 9.3 4.1 2.9 

1.9 0.6 1.3 0.3 

22.6 7.8 10.9 8.4 

11.7 11.9 11.3 9.5 

8.9 4.0 1.4 0.1 

9.3 4.4 2.2 0.9 

5.3 5.3 5.4 4.2 

0.0 0.6 0.0 0.3 

11.8 7.3 6.1 7.4 

35.5 5.0 1.1 0.4 

2.2 1.6 0.6 0.8 

1.7 0.0 0.8 0.0 

8.4 8.6 12.1 15.0 

1.5 0.4 0.3 1.3 

7.3 2.9 1.9 1.6 

0.3 0.1 0.5 0.3 

4.8 5.7 3.1 2.4 

10.4 8.7 20.3 50.0 

10.3 4.9 2.2 1.0 

4.6 4.1 0.5 1.4 

1.6 0.4 1.3 1.8 

2.5 1.3 1.4 1.0 

15.5 16.0 13.5 10.0 

45.9 39.6 29.9 29.7 

1.9 2.4 1.4 4.2 

17.2 9.2 7.8 4.3 

1.0 3.1 1.1 1.6 

36.2 38.0 39.3 46.8 

35.6 28.1 22.6 11.0 

1.9 1.3 1.1 1.8 

8.8 9.1 9.5 7.7 

39.5 19.2 15.3 9.3 

0.8 0.6 0.9 0.8 

26.0 8.9 15.0 28.0 

0.0 0.2 0.9 1.1 

9.6 7.4 6.2 4.8 

3.4 4.4 6.2 7.0 

0.2 0.4 0.0 0.2 

1.4 0.6 0.8 1.0 

34.6 25.5 11.3 6.7 

5.4 0.8 2.9 0.0 

0.5 0.4 0.1 0.2 

1.9 2.0 1.9 2.3 

1.3 0.8 0.9 0.9 

4.5 7.1 3.4 3.9 

0.2 0.3 0.2 0.2 

0.1 0.7 2.0 3.9 

40.7 18.7 17.1 15.0 

1.1 0.0 1.1 0.7 

0.9 1.3 0.9 0.5 

4.9 3.7 3.5 1.6 

6.6 1.3 1.8 1.3 

1.3 1.5 0.9 1.0 

10.5 2.1 3.7 11.8 

21.5 22.1 15.5 8.6 

3.5 3.6 0.7 1.6 

0.0 1.0 0.5 0.5 

10.1 7.6 6.0 5.1 5.1 

8.0 8.5 11.4 7.5 5.8 

10.0 7.6 6.0 5.1 5.1 

STD Surveillance 1999 Syphilis Tables 107 
Table 30. Primary and secondary syphilis — Women – Reported cases and rates in selected cities of >200,000 

population listed in alphabetical order: United States and outlying areas, 1995–1999 

Cases 

City 1995 1996 

Akron, OH 0 

Albuquerque, NM 2 

Atlanta, GA 110 

Austin, TX 7 

Baltimore, MD 166 

Birmingham, AL 109 

Boston, MA 15 

Buffalo, NY 1 

Charlotte, NC 61 

Chicago, IL 254 

Cincinnati, OH 121 

Cleveland, OH 128 

Columbus, OH 5 

Corpus Christi, TX 6 

Dallas, TX 135 

Dayton, OH 100 

Denver, CO 25 

Des Moines, IA 19 

Detroit, MI 54 

El Paso, TX 0 

Fort Worth, TX 73 

Honolulu, HI 0 

Houston, TX 215 

Indianapolis, IN 34 

Jacksonville, FL 22 

Jersey City, NJ 8 

Kansas City, MO 15 

Los Angeles, CA 95 

Louisville, KY 60 

Memphis, TN 238 

Miami, FL 19 

Milwaukee, WI 75 

Minneapolis, MN 14 

Nashville, TN 43 

New Orleans, LA 88 

New York City, NY 180 

Newark, NJ 14 

Norfolk, VA 62 

Oakland, CA 8 

Oklahoma City, OK 49 

Omaha, NE 2 

Philadelphia, PA 72 

Phoenix, AZ 13 

Pittsburgh, PA 2 

Portland, OR 1 

Richmond, VA 19 

Rochester, NY 10 

Sacramento, CA 2 

San Antonio, TX 27 

San Diego, CA 20 

San Francisco, CA 5 

San Jose, CA 1 

Seattle, WA 1 

St Louis, MO 165 

St Paul, MN 4 

St Petersburg, FL 9 

Tampa, FL 19 

Toledo, OH 9 

Tucson, AZ 0 

Tulsa, OK 23 

Washington, DC 48 

Wichita, KS 8 

Yonkers, NY 1 

0 

1 

86 

6 

240 

81 

14 

1 

64 

169 

39 

61 

27 

0 

113 

96 

6 

5 

40 

3 

41 

1 

84 

48 

38 

3 

2 

86 

57 

199 

14 

76 

2 

97 

70 

61 

14 

51 

3 

51 

0 

51 

35 

0 

3 

31 

6 

2 

16 

11 

3 

0 

0 

66 

0 

2 

22 

17 

5 

14 

57 

6 

0 

1997 

2 

5 

67 

3 

309 

43 

19 

1 

18 

145 

13 

27 

30 

0 

66 

15 

3 

0 

45 

0 

12 

0 

84 

36 

12 

5 

1 

32 

51 

165 

16 

46 

3 

97 

57 

37 

12 

25 

0 

15 

0 

43 

31 

4 

1 

21 

1 

2 

12 

5 

8 

0 

6 

36 

0 

7 

21 

3 

5 

4 

58 

4 

0 

1998 1999 

1 

6 

62 

6 

222 

15 

5 

1 

36 

132 

8 

15 

32 

0 

46 

3 

2 

0 

67 

0 

9 

0 

44 

87 

8 

0 

2 

50 

45 

134 

11 

35 

2 

93 

41 

18 

14 

13 

5 

26 

1 

30 

64 

0 

1 

8 

4 

0 

8 

7 

4 

1 

1 

25 

2 

4 

20 

4 

1 

6 

34 

1 

1 

0 

3 

85 

2 

112 

10 

5 

0 

18 

116 

0 

3 

21 

1 

57 

0 

3 

0 

74 

2 

4 

2 

30 

204 

3 

0 

5 

25 

30 

126 

27 

17 

3 

102 

24 

28 

10 

7 

2 

42 

2 

21 

62 

0 

3 

7 

0 

1 

10 

6 

1 

0 

2 

28 

1 

2 

7 

5 

1 

22 

24 

4 

0 

U.S. CITY TOTAL 3,091 2,397 1,789 1,523 1,412 

San Juan, PR 40 38 41 38 34 

TOTAL 3,131 2,435 1,830 1,561 1,446 

Rates per 100,000 Population 

1995 1996 1997 1998 1999 

0.0 

0.7 

30.0 

2.1 

45.0 

31.1 

5.2 

0.6 

20.3 

16.6 

26.6 

17.3 

1.0 

3.8 

13.6 

33.7 

9.8 

10.4 

9.8 

0.0 

11.3 

0.0 

13.9 

7.9 

6.1 

7.1 

6.5 

2.2 

16.9 

52.6 

1.8 

15.3 

7.1 

15.4 

34.0 

4.6 

9.2 

55.0 

1.3 

21.6 

0.9 

9.0 

1.1 

0.3 

0.4 

17.6 

7.9 

0.4 

4.0 

1.5 

1.4 

0.1 

0.1 

84.5 

2.8 

1.9 

4.2 

3.8 

0.0 

11.8 

16.2 

3.7 

1.0 

0.0 0.7 0.4 0.0 

0.4 1.9 2.2 1.1 

23.1 17.8 16.0 22.0 

1.8 0.9 1.7 0.6 

66.9 87.9 64.4 32.5 

23.0 12.3 4.3 2.8 

4.8 6.6 1.7 1.7 

0.6 0.6 0.6 0.0 

20.7 5.7 11.0 5.5 

11.2 9.6 8.5 7.5 

8.7 2.9 1.8 0.0 

8.3 3.7 2.1 0.4 

5.2 5.7 6.0 4.0 

0.0 0.0 0.0 0.6 

11.2 6.4 4.4 5.5 

32.6 5.1 1.0 0.0 

2.4 1.2 0.8 1.2 

2.7 0.0 0.0 0.0 

7.0 7.9 10.1 11.2 

0.9 0.0 0.0 0.5 

6.2 1.8 1.3 0.6 

0.2 0.0 0.0 0.5 

5.4 5.3 2.7 1.9 

11.2 8.5 20.4 47.8 

10.2 3.2 2.1 0.8 

2.7 4.5 0.0 0.0 

0.9 0.4 0.8 2.1 

2.0 0.7 1.1 0.6 

16.1 14.5 12.7 8.5 

44.0 36.4 29.4 27.6 

1.3 1.5 1.0 2.4 

15.8 9.7 7.3 3.5 

1.0 1.5 1.1 1.6 

34.8 34.7 33.1 36.3 

27.5 22.7 16.4 9.6 

1.6 1.0 0.5 0.7 

9.3 8.0 9.4 6.7 

45.1 22.5 11.9 6.4 

0.5 0.0 0.8 0.3 

22.5 6.6 12.3 19.8 

0.0 0.0 0.4 0.9 

6.5 5.5 3.9 2.7 

2.6 2.3 4.5 4.4 

0.0 0.6 0.0 0.0 

1.2 0.4 0.4 1.2 

29.7 20.0 7.5 6.6 

4.8 0.8 3.2 0.0 

0.4 0.3 0.0 0.2 

2.4 1.7 1.1 1.4 

0.8 0.4 0.5 0.4 

0.8 2.2 1.1 0.3 

0.0 0.0 0.1 0.0 

0.0 0.7 0.1 0.2 

34.8 19.4 13.6 15.2 

0.0 0.0 1.4 0.7 

0.4 1.5 0.9 0.4 

4.8 4.5 4.2 1.5 

7.2 1.3 1.7 2.1 

1.3 1.3 0.2 0.2 

7.1 2.0 3.0 11.2 

19.9 20.7 12.2 8.6 

2.7 1.8 0.4 1.7 

0.0 0.0 1.0 0.0 

8.7 6.7 5.0 4.2 3.9 

8.3 7.9 8.5 7.0 6.2 

8.7 6.7 5.0 4.2 3.9 

108 Syphilis Tables STD Surveillance 1999 
Table 31. Primary and secondary syphilis — Men – Reported cases and rates in selected cities of >200,000 

population listed in alphabetical order: United States and outlying areas, 1995–1999 

Cases 

City 1995 1996 1997 1998 1999 

Akron, OH 1 

Albuquerque, NM 4 

Atlanta, GA 210 

Austin, TX 10 

Baltimore, MD 251 

Birmingham, AL 155 

Boston, MA 25 

Buffalo, NY 1 

Charlotte, NC 64 

Chicago, IL 328 

Cincinnati, OH 131 

Cleveland, OH 135 

Columbus, OH 2 

Corpus Christi, TX 2 

Dallas, TX 133 

Dayton, OH 144 

Denver, CO 43 

Des Moines, IA 8 

Detroit, MI 76 

El Paso, TX 2 

Fort Worth, TX 67 

Honolulu, HI 0 

Houston, TX 202 

Indianapolis, IN 40 

Jacksonville, FL 28 

Jersey City, NJ 19 

Kansas City, MO 9 

Los Angeles, CA 176 

Louisville, KY 68 

Memphis, TN 239 

Miami, FL 32 

Milwaukee, WI 75 

Minneapolis, MN 10 

Nashville, TN 54 

New Orleans, LA 133 

New York City, NY 184 

Newark, NJ 29 

Norfolk, VA 68 

Oakland, CA 8 

Oklahoma City, OK 57 

Omaha, NE 5 

Philadelphia, PA 127 

Phoenix, AZ 30 

Pittsburgh, PA 2 

Portland, OR 3 

Richmond, VA 18 

Rochester, NY 8 

Sacramento, CA 3 

San Antonio, TX 23 

San Diego, CA 33 

San Francisco, CA 27 

San Jose, CA 1 

Seattle, WA 4 

St Louis, MO 196 

St Paul, MN 3 

St Petersburg, FL 11 

Tampa, FL 14 

Toledo, OH 13 

Tucson, AZ 1 

Tulsa, OK 25 

Washington, DC 64 

Wichita, KS 8 

Yonkers, NY 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 

70 

46 

126 

20 

36 

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 

0 

8 

128 

16 

134 

14 

11 

1 

35 

166 

1 

9 

22 

0 

94 

2 

1 

0 

115 

7 

18 

1 

47 

203 

4 

3 

3 

57 

37 

132 

64 

22 

3 

148 

27 

102 

12 

13 

8 

72 

3 

48 

133 

2 

2 

6 

0 

1 

20 

19 

28 

3 

63 

23 

1 

2 

8 

1 

7 

23 

21 

3 

1 

U.S. CITY TOTAL 3,843 2,869 2,358 2,042 2,158 

San Juan, PR 30 36 58 41 27 

TOTAL 3,873 2,905 2,416 2,083 2,185 

Rates per 100,000 Population 

1995 1996 1997 1998 1999 

0.4 

1.6 

62.8 

3.0 

77.9 

50.4 

9.3 

0.6 

22.9 

23.1 

32.0 

20.5 

0.4 

1.3 

13.8 

52.6 

17.9 

4.8 

15.2 

0.6 

10.6 

0.0 

13.2 

10.3 

8.2 

18.1 

4.3 

4.1 

21.4 

58.0 

3.3 

17.0 

5.4 

21.4 

59.5 

5.3 

21.3 

54.5 

1.3 

27.1 

2.4 

18.2 

2.5 

0.3 

1.3 

20.0 

6.8 

0.6 

3.7 

2.5 

7.4 

0.1 

0.5 

119.9 

2.3 

2.7 

3.2 

6.0 

0.3 

13.7 

24.8 

3.9 

1.1 

0.0 0.8 0.8 0.0 

0.4 1.6 2.0 3.1 

47.1 39.6 28.6 36.3 

0.9 1.4 2.5 4.5 

100.1 117.4 81.0 44.5 

39.1 20.8 6.8 4.5 

10.4 12.3 6.7 4.1 

3.2 0.7 2.0 0.7 

24.7 10.1 10.9 11.5 

12.4 14.3 14.4 11.6 

9.1 5.2 1.0 0.2 

10.5 5.2 2.3 1.4 

5.5 4.9 4.7 4.5 

0.0 1.3 0.0 0.0 

12.5 8.2 7.9 9.3 

38.7 4.8 1.1 0.7 

2.1 2.1 0.4 0.4 

0.6 0.0 1.7 0.0 

10.0 9.5 14.2 19.3 

2.1 0.9 0.6 2.1 

8.4 4.1 2.5 2.7 

0.5 0.2 0.9 0.2 

4.3 6.1 3.5 3.0 

9.5 9.0 20.2 52.5 

10.5 6.8 2.2 1.1 

6.6 3.8 0.9 2.8 

2.4 0.5 1.9 1.4 

3.0 1.8 1.6 1.3 

14.8 17.6 14.5 11.7 

48.0 43.1 30.5 32.0 

2.5 3.4 1.9 6.2 

18.8 8.8 8.3 5.1 

1.1 4.8 1.1 1.7 

37.8 41.7 46.2 58.4 

45.0 34.5 29.7 12.5 

2.2 1.7 1.8 2.9 

8.1 10.4 9.7 8.9 

34.3 16.1 18.9 12.3 

1.1 1.1 1.0 1.3 

29.8 11.3 17.9 36.8 

0.0 0.5 1.4 1.4 

13.2 9.6 8.9 7.2 

4.2 6.5 7.9 9.7 

0.3 0.2 0.0 0.3 

1.7 0.8 1.2 0.8 

40.4 32.1 16.0 6.9 

6.0 0.9 2.6 0.0 

0.7 0.4 0.2 0.2 

1.4 2.3 2.8 3.1 

1.9 1.3 1.2 1.4 

8.3 12.2 5.7 7.6 

0.4 0.6 0.2 0.4 

0.1 0.6 3.9 7.7 

47.7 17.9 21.2 14.8 

2.3 0.0 0.8 0.8 

1.5 1.0 1.0 0.5 

5.0 2.9 2.7 1.8 

6.0 1.4 1.9 0.5 

1.3 1.8 1.6 1.8 

14.1 2.1 4.4 12.5 

23.4 23.8 19.2 8.6 

4.2 5.6 0.9 1.4 

0.0 2.2 0.0 1.1 

11.5 8.5 7.0 6.0 6.3 

7.6 9.2 14.8 8.2 5.4 

11.5 8.5 7.1 6.0 6.3 

STD Surveillance 1999 Syphilis Tables 109 
Table 32. Primary and secondary syphilis — Counties and independent cities* ranked by number of reported 

cases: United States, 1999** 

Rank County/Independent City Cases Rate per 100,000 Population Cumulative Percent 

1 Marion County, IN 407 50.0 6 

2 Cook County, IL (includes Chicago) 324 6.2 11 

3 Shelby County, TN 258 29.7 15 

4 Davidson County, TN 250 46.8 19 

5 Baltimore (City), MD 246 38.1 22 

6 Fulton County, GA 221 29.9 26 

7 Wayne County, MI 202 9.5 29 

8 Maricopa County, AZ 195 7.0 32 

9 Dallas County, TX 151 7.4 34 

10 Oklahoma County, OK 122 19.3 36 

11 Los Angeles County, CA 96 1.0 37 

12 Dade County, FL 91 4.2 39 

13 Harris County, TX 77 2.4 40 

14 Philadelphia County, PA 69 4.8 41 

15 Jefferson County, KY 67 10.0 42 

16 King County, WA 65 3.9 43 

17 Mecklenburg County, NC 55 8.7 44 

18 Hinds County, MS 54 21.8 44 

19 Danville (City), VA 53 104.2 45 

20 Guilford County, NC 53 13.7 46 

21 Orleans County, LA 52 11.2 47 

22 Orange County, FL 52 6.5 48 

23 St Louis (City), MO 51 15.0 48 

24 Richmond County, GA 50 26.1 49 

25 Madison County, TN 46 53.5 50 

*Accounting for 50% of reported primary and secondary syphilis cases.
 

**Corrections to the reported number of cases in the future could alter the ranking and/or inclusion of the counties and independent cities in this table.
 

110 Syphilis Tables STD Surveillance 1999 
Table 33. Early latent syphilis — Reported cases and rates by state/area listed in alphabetical order: United 

States and outlying areas, 1995–1999 

Cases Rates per 100,000 Population 

State/Area 1995 1996 1997 1998 1999 1995 1996 1997 1998 1999 

Alabama 676 801 623 440 367 15.9 18.7 14.4 10.1 8.4 

Alaska 3 0 0 0 1 0.5 0.0 0.0 0.0 0.2 

Arizona 113 129 201 206 290 2.7 2.9 4.4 4.4 6.2 

Arkansas 529 446 237 185 123 21.3 17.8 9.4 7.3 4.8 

California 1,426 1,148 961 783 591 4.5 3.6 3.0 2.4 1.8 

Colorado 68 21 13 10 6 1.8 0.6 0.3 0.3 0.2 

Connecticut 92 104 86 37 12 2.8 3.2 2.6 1.1 0.4 

Delaware 57 40 37 44 16 7.9 5.5 5.1 5.9 2.2 

Florida 1,484 1,323 1,179 1,092 1,227 10.5 9.2 8.0 7.3 8.2 

Georgia 1,616 1,304 1,085 740 729 22.4 17.8 14.5 9.7 9.5 

Hawaii 0 2 0 0 1 0.0 0.2 0.0 0.0 0.1 

Idaho 1 5 5 0 1 0.1 0.4 0.4 0.0 0.1 

Illinois 1,774 917 1,032 641 640 15.0 7.7 8.7 5.3 5.3 

Indiana 377 265 169 121 172 6.5 4.5 2.9 2.1 2.9 

Iowa 77 38 27 20 4 2.7 1.3 0.9 0.7 0.1 

Kansas 40 46 58 39 19 1.6 1.8 2.2 1.5 0.7 

Kentucky 166 126 122 101 81 4.3 3.2 3.1 2.6 2.1 

Louisiana 1,598 959 550 446 404 36.8 22.1 12.6 10.2 9.2 

Maine 0 2 2 0 0 0.0 0.2 0.2 0.0 0.0 

Maryland 703 1,152 1,218 848 610 13.9 22.8 23.9 16.5 11.9 

Massachusetts 154 178 127 104 65 2.5 2.9 2.1 1.7 1.1 

Michigan 567 413 354 261 302 5.9 4.2 3.6 2.7 3.1 

Minnesota 55 29 21 8 9 1.2 0.6 0.4 0.2 0.2 

Mississippi 2,389 1,484 962 650 553 88.6 54.7 35.2 23.6 20.1 

Missouri 506 259 202 165 99 9.5 4.8 3.7 3.0 1.8 

Montana 9 4 4 0 2 1.0 0.5 0.5 0.0 0.2 

Nebraska 3 5 5 3 6 0.2 0.3 0.3 0.2 0.4 

Nevada 68 32 24 38 28 4.4 2.0 1.4 2.2 1.6 

New Hampshire 3 3 0 1 1 0.3 0.3 0.0 0.1 0.1 

New Jersey 294 303 236 231 99 3.7 3.8 2.9 2.8 1.2 

New Mexico 25 5 8 8 2 1.5 0.3 0.5 0.5 0.1 

New York 2,100 1,203 763 679 700 11.6 6.6 4.2 3.7 3.9 

North Carolina 1,231 1,071 879 846 740 17.1 14.7 11.8 11.2 9.8 

North Dakota 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Ohio 723 508 331 227 168 6.5 4.6 3.0 2.0 1.5 

Oklahoma 280 216 179 158 249 8.5 6.6 5.4 4.7 7.4 

Oregon 17 9 14 7 6 0.5 0.3 0.4 0.2 0.2 

Pennsylvania 1,212 883 668 424 414 10.0 7.3 5.6 3.5 3.4 

Rhode Island 14 8 7 0 1 1.4 0.8 0.7 0.0 0.1 

South Carolina 791 581 481 383 407 21.5 15.6 12.8 10.0 10.6 

South Dakota 1 0 2 0 1 0.1 0.0 0.3 0.0 0.1 

Tennessee 1,129 957 984 659 647 21.5 18.0 18.3 12.1 11.9 

Texas 3,015 2,167 1,863 1,480 1,273 16.1 11.4 9.6 7.5 6.4 

Utah 7 8 2 3 5 0.4 0.4 0.1 0.1 0.2 

Vermont 0 0 0 2 0 0.0 0.0 0.0 0.3 0.0 

Virginia 546 406 379 230 212 8.2 6.1 5.6 3.4 3.1 

Washington 12 5 13 16 17 0.2 0.1 0.2 0.3 0.3 

West Virginia 11 8 1 2 3 0.6 0.4 0.1 0.1 0.2 

Wisconsin 299 243 169 115 90 5.8 4.7 3.3 2.2 1.7 

Wyoming 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

U.S. TOTAL1 26,657 20,187 16,631 12,741 11,677 10.1 7.6 6.2 4.7 4.3 

Guam 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Puerto Rico 738 631 679 659 680 20.0 17.0 17.7 17.1 17.6 

Virgin Islands 17 6 8 28 12 15.5 5.5 7.3 25.5 10.9 

OUTLYING AREAS 755 637 687 687 692 19.1 16.0 16.8 16.6 16.8 

TOTAL 27,412 20,824 17,318 13,428 12,369 10.3 7.7 6.4 4.9 4.5 

1

Includes cases reported by Washington, D.C. 

STD Surveillance 1999 Syphilis Tables 111 
Table 34. Early latent syphilis — Reported cases and rates in selected cities of >200,000 population listed in 

alphabetical order: United States and outlying areas, 1995–1999 

Cases 

City 1995 1996 1997 1998 1999 

Akron, OH 6 

Albuquerque, NM 9 

Atlanta, GA 531 

Austin, TX 79 

Baltimore, MD 466 

Birmingham, AL 289 

Boston, MA 65 

Buffalo, NY 6 

Charlotte, NC 180 

Chicago, IL 1,400 

Cincinnati, OH 115 

Cleveland, OH 361 

Columbus, OH 11 

Corpus Christi, TX 29 

Dallas, TX 410 

Dayton, OH 98 

Denver, CO 46 

Des Moines, IA 54 

Detroit, MI 364 

El Paso, TX 21 

Fort Worth, TX 280 

Honolulu, HI 0 

Houston, TX 892 

Indianapolis, IN 55 

Jacksonville, FL 111 

Jersey City, NJ 30 

Kansas City, MO 29 

Los Angeles, CA 952 

Louisville, KY 81 

Memphis, TN 652 

Miami, FL 499 

Milwaukee, WI 229 

Minneapolis, MN 24 

Nashville, TN 97 

New Orleans, LA 215 

New York City, NY 1,945 

Newark, NJ 77 

Norfolk, VA 110 

Oakland, CA 55 

Oklahoma City, OK 140 

Omaha, NE 3 

Philadelphia, PA 1,100 

Phoenix, AZ 79 

Pittsburgh, PA 13 

Portland, OR 11 

Richmond, VA 70 

Rochester, NY 23 

Sacramento, CA 21 

San Antonio, TX 161 

San Diego, CA 60 

San Francisco, CA 14 

San Jose, CA 4 

Seattle, WA 1 

St Louis, MO 289 

St Paul, MN 9 

St Petersburg, FL 83 

Tampa, FL 79 

Toledo, OH 27 

Tucson, AZ 29 

Tulsa, OK 44 

Washington, DC 396 

Wichita, KS 12 

Yonkers, NY 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 

525 

64 

382 

242 

94 

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 

6 

2 

241 

23 

472 

103 

41 

1 

99 

522 

5 

63 

34 

9 

384 

5 

4 

2 

223 

9 

66 

1 

248 

102 

42 

1 

16 

330 

38 

338 

331 

84 

7 

201 

65 

659 

23 

34 

22 

147 

2 

394 

266 

1 

5 

34 

2 

3 

72 

23 

14 

11 

6 

40 

1 

16 

57 

5 

14 

40 

284 

11 

2 

U.S. CITY TOTAL 13,557 10,449 9,139 6,874 6,306 

San Juan, PR 313 308 305 300 296 

TOTAL 13,870 10,757 9,444 7,174 6,602 

Rates per 100,000 Population 

1995 1996 1997 1998 1999 

1.1 

1.7 

75.8 

11.9 

67.4 

43.9 

11.7 

1.8 

31.1 

47.5 

13.3 

25.8 

1.1 

9.3 

20.9 

17.2 

9.3 

15.4 

34.6 

3.1 

21.9 

0.0 

29.0 

6.7 

15.8 

13.8 

6.6 

11.1 

12.0 

75.4 

24.6 

24.6 

6.3 

18.3 

44.6 

26.6 

26.8 

46.3 

4.5 

32.0 

0.7 

73.4 

3.2 

1.0 

2.3 

35.3 

9.5 

1.9 

12.4 

2.3 

1.9 

0.3 

0.1 

80.6 

3.3 

9.5 

8.9 

5.9 

3.9 

11.6 

71.4 

2.9 

8.4 

0.8 0.0 0.7 1.1 

0.0 1.1 1.0 0.4 

53.6 50.8 41.0 32.6 

7.2 4.8 2.7 3.2 

133.4 148.3 100.1 73.1 

51.6 34.2 14.4 15.6 

14.9 11.1 10.8 7.4 

1.9 1.6 0.6 0.3 

24.2 14.0 15.4 15.7 

25.5 31.5 18.9 17.5 

5.0 3.1 1.3 0.6 

14.5 11.8 7.1 4.6 

3.2 3.3 4.1 3.3 

3.2 1.9 4.1 2.8 

16.8 15.1 19.7 18.7 

16.4 5.0 0.9 0.9 

1.4 1.4 1.4 0.8 

6.5 5.4 3.1 0.6 

24.8 23.3 14.3 17.7 

6.4 4.8 2.0 1.3 

16.6 14.5 8.9 4.9 

0.0 0.0 0.0 0.1 

22.6 16.7 11.4 7.7 

6.9 4.1 5.4 12.5 

14.3 11.1 9.4 5.7 

7.8 4.6 0.9 0.5 

2.9 1.3 1.3 3.5 

8.4 7.6 6.1 3.8 

10.6 9.8 9.5 5.7 

63.4 68.2 44.0 38.9 

21.4 20.9 11.2 15.4 

19.9 15.4 10.3 9.2 

4.2 3.7 1.4 1.9 

18.6 32.4 27.7 37.6 

32.3 25.4 18.0 14.0 

14.7 9.1 8.7 8.9 

19.3 10.5 19.7 8.1 

43.4 37.9 23.2 15.8 

2.0 2.6 2.0 1.7 

20.3 11.3 17.2 36.1 

0.0 0.5 0.7 0.5 

56.9 44.6 28.3 27.4 

4.1 7.0 6.9 9.6 

0.2 0.2 0.1 0.1 

1.2 1.6 1.0 1.0 

40.8 30.1 18.5 17.5 

9.5 3.7 3.7 0.8 

1.3 0.9 1.0 0.3 

8.8 7.2 4.7 5.3 

1.6 0.6 0.8 0.8 

1.5 2.2 2.0 1.9 

0.4 0.2 0.3 0.7 

0.0 0.3 0.5 0.4 

38.9 24.3 18.6 11.8 

0.7 0.4 0.4 0.4 

4.0 3.2 2.2 1.8 

15.5 9.1 8.2 6.2 

5.1 1.3 1.1 1.1 

1.8 0.8 0.8 1.8 

12.6 4.1 11.6 10.5 

68.8 65.8 55.1 54.3 

6.9 10.3 2.9 2.5 

6.3 2.6 1.0 1.0 

19.7 15.1 13.1 9.7 8.9 

35.9 35.3 35.0 28.7 28.3 

19.9 15.3 13.4 10.0 9.2 

112 Syphilis Tables STD Surveillance 1999 
Table 35. Late and late latent syphilis — Reported cases and rates by state/area listed in alphabetical order: 

United States and outlying areas, 1995–1999 

Cases Rates per 100,000 Population 

State/Area 1995 1996 1997 1998 1999 1995 1996 1997 1998 1999 

Alabama 334 538 422 413 443 7.9 12.5 9.8 9.5 10.2 

Alaska 15 15 11 12 11 2.5 2.5 1.8 2.0 1.8 

Arizona 248 231 255 281 307 5.9 5.2 5.6 6.0 6.6 

Arkansas 217 103 121 183 140 8.7 4.1 4.8 7.2 5.5 

California 3,417 2,567 2,319 1,637 1,897 10.8 8.1 7.2 5.0 5.8 

Colorado 135 115 125 100 76 3.6 3.0 3.2 2.5 1.9 

Connecticut 86 125 175 114 97 2.6 3.8 5.4 3.5 3.0 

Delaware 52 49 52 49 46 7.3 6.8 7.1 6.6 6.2 

Florida 1,489 1,128 1,198 1,082 1,315 10.5 7.8 8.2 7.3 8.8 

Georgia 1,104 931 1,218 749 799 15.3 12.7 16.3 9.8 10.5 

Hawaii 25 25 46 14 7 2.1 2.1 3.9 1.2 0.6 

Idaho 11 14 18 13 11 0.9 1.2 1.5 1.1 0.9 

Illinois 728 549 414 892 852 6.2 4.6 3.5 7.4 7.1 

Indiana 172 197 199 173 173 3.0 3.4 3.4 2.9 2.9 

Iowa 45 25 38 23 24 1.6 0.9 1.3 0.8 0.8 

Kansas 62 62 77 63 62 2.4 2.4 3.0 2.4 2.4 

Kentucky 143 113 141 127 120 3.7 2.9 3.6 3.2 3.0 

Louisiana 1,034 902 872 767 701 23.8 20.8 20.0 17.6 16.0 

Maine 2 1 9 3 1 0.2 0.1 0.7 0.2 0.1 

Maryland 394 317 288 616 405 7.8 6.3 5.7 12.0 7.9 

Massachusetts 283 364 524 416 283 4.7 6.0 8.6 6.8 4.6 

Michigan 304 233 258 202 207 3.2 2.4 2.6 2.1 2.1 

Minnesota 85 69 87 58 52 1.8 1.5 1.9 1.2 1.1 

Mississippi 126 10 48 235 147 4.7 0.4 1.8 8.5 5.3 

Missouri 135 123 173 90 191 2.5 2.3 3.2 1.7 3.5 

Montana 0 0 1 0 0 0.0 0.0 0.1 0.0 0.0 

Nebraska 18 16 26 24 12 1.1 1.0 1.6 1.4 0.7 

Nevada 89 89 85 86 59 5.8 5.6 5.1 4.9 3.4 

New Hampshire 29 25 26 11 14 2.5 2.2 2.2 0.9 1.2 

New Jersey 893 888 696 411 587 11.2 11.1 8.6 5.1 7.2 

New Mexico 100 70 86 54 66 5.9 4.1 5.0 3.1 3.8 

New York 6,005 4,957 4,639 4,291 3,201 33.1 27.3 25.6 23.6 17.6 

North Carolina 670 516 584 540 490 9.3 7.1 7.9 7.2 6.5 

North Dakota 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Ohio 281 217 202 109 98 2.5 1.9 1.8 1.0 0.9 

Oklahoma 95 62 105 97 94 2.9 1.9 3.2 2.9 2.8 

Oregon 45 52 23 19 23 1.4 1.6 0.7 0.6 0.7 

Pennsylvania 420 335 354 367 427 3.5 2.8 2.9 3.1 3.6 

Rhode Island 72 60 75 54 51 7.3 6.1 7.6 5.5 5.2 

South Carolina 266 259 261 198 230 7.2 7.0 6.9 5.2 6.0 

South Dakota 6 2 5 1 1 0.8 0.3 0.7 0.1 0.1 

Tennessee 540 480 605 515 439 10.3 9.0 11.3 9.5 8.1 

Texas 3,152 2,674 2,694 1,930 1,885 16.8 14.0 13.9 9.8 9.5 

Utah 39 38 49 50 42 2.0 1.9 2.4 2.4 2.0 

Vermont 0 0 1 0 0 0.0 0.0 0.2 0.0 0.0 

Virginia 419 450 495 334 354 6.3 6.8 7.4 4.9 5.2 

Washington 181 119 107 82 110 3.3 2.2 1.9 1.4 1.9 

West Virginia 38 44 17 6 7 2.1 2.4 0.9 0.3 0.4 

Wisconsin 90 74 50 58 52 1.8 1.4 1.0 1.1 1.0 

Wyoming 1 6 4 1 0 0.2 1.2 0.8 0.2 0.0 

U.S. TOTAL1 24,296 20,364 20,446 17,752 16,738 9.2 7.7 7.6 6.6 6.2 

Guam 6 3 1 3 10 4.0 2.0 0.6 1.9 6.3 

Puerto Rico 582 620 640 597 614 15.8 16.7 16.7 15.5 15.9 

Virgin Islands 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

OUTLYING AREAS 588 623 641 600 624 14.9 15.6 15.7 14.5 15.1 

TOTAL 24,884 20,987 21,087 18,352 17,362 9.3 7.8 7.8 6.7 6.3 

1

Includes cases reported by Washington, D.C. 

STD Surveillance 1999 Syphilis Tables 113 
Table 36. Late and late latent syphilis — Reported cases and rates in selected cities of >200,000 population 

listed in alphabetical order: United States and outlying areas, 1995–1999 

Cases 

City 1995 1996 1997 1998 1999 

Akron, OH 1 

Albuquerque, NM 26 

Atlanta, GA 207 

Austin, TX 87 

Baltimore, MD 191 

Birmingham, AL 78 

Boston, MA 88 

Buffalo, NY 23 

Charlotte, NC 41 

Chicago, IL 141 

Cincinnati, OH 26 

Cleveland, OH 108 

Columbus, OH 13 

Corpus Christi, TX 24 

Dallas, TX 334 

Dayton, OH 50 

Denver, CO 65 

Des Moines, IA 11 

Detroit, MI 192 

El Paso, TX 115 

Fort Worth, TX 60 

Honolulu, HI 22 

Houston, TX 1,283 

Indianapolis, IN 39 

Jacksonville, FL 30 

Jersey City, NJ 70 

Kansas City, MO 13 

Los Angeles, CA 1,605 

Louisville, KY 59 

Memphis, TN 442 

Miami, FL 409 

Milwaukee, WI 74 

Minneapolis, MN 36 

Nashville, TN 7 

New Orleans, LA 213 

New York City, NY 5,291 

Newark, NJ 232 

Norfolk, VA 31 

Oakland, CA 91 

Oklahoma City, OK 32 

Omaha, NE 11 

Philadelphia, PA 329 

Phoenix, AZ 142 

Pittsburgh, PA 10 

Portland, OR 27 

Richmond, VA 14 

Rochester, NY 59 

Sacramento, CA 54 

San Antonio, TX 174 

San Diego, CA 252 

San Francisco, CA 37 

San Jose, CA 68 

Seattle, WA 87 

St Louis, MO 60 

St Paul, MN 12 

St Petersburg, FL 63 

Tampa, FL 156 

Toledo, OH 3 

Tucson, AZ 47 

Tulsa, OK 13 

Washington, DC 201 

Wichita, KS 14 

Yonkers, NY 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 

60 

43 

12 

42 

115 

10 

35 

18 

125 

13 

21 

0 

41 

289 

57 

81 

136 

191 

13 

19 

0 

33 

19 

28 

14 

260 

70 

57 

7 

175 

73 

62 

41 

1,128 

21 

89 

62 

4 

806 

56 

473 

367 

42 

27 

36 

208 

4,110 

159 

26 

86 

16 

14 

300 

156 

14 

11 

29 

21 

36 

182 

206 

101 

83 

46 

109 

7 

40 

83 

13 

34 

11 

168 

22 

27 

0 

29 

120 

22 

331 

110 

155 

6 

44 

507 

9 

20 

17 

13 

187 

28 

24 

6 

131 

65 

27 

14 

879 

30 

69 

28 

2 

557 

54 

383 

463 

62 

25 

58 

157 

3,881 

82 

25 

91 

39 

19 

287 

187 

11 

8 

20 

21 

16 

143 

135 

88 

54 

28 

46 

6 

29 

65 

10 

23 

14 

202 

5 

17 

0 

37 

119 

20 

202 

149 

107 

4 

39 

476 

6 

11 

30 

10 

156 

9 

37 

5 

136 

60 

87 

4 

755 

38 

30 

38 

41 

740 

69 

321 

456 

36 

15 

54 

108 

2,907 

115 

30 

92 

34 

3 

355 

245 

4 

9 

17 

13 

13 

121 

196 

84 

40 

51 

69 

3 

18 

41 

10 

20 

23 

129 

16 

9 

U.S. CITY TOTAL 13,736 11,430 11,095 10,184 9,072 

San Juan, PR 309 339 312 293 322 

TOTAL 14,045 11,769 11,407 10,477 9,394 

Rates per 100,000 Population 

1995 1996 1997 1998 1999 

0.2 

5.0 

29.5 

13.1 

27.6 

11.9 

15.8 

7.1 

7.1 

4.8 

3.0 

7.7 

1.3 

7.7 

17.0 

8.8 

13.1 

3.1 

18.2 

17.0 

4.7 

2.5 

41.7 

4.8 

4.3 

32.2 

3.0 

18.8 

8.8 

51.1 

20.1 

7.9 

9.4 

1.3 

44.2 

72.4 

80.7 

13.0 

7.5 

7.3 

2.5 

21.9 

5.8 

0.8 

5.6 

7.1 

24.3 

4.9 

13.4 

9.5 

5.1 

4.3 

5.5 

16.7 

4.4 

7.2 

17.6 

0.7 

6.2 

3.4 

36.3 

3.3 

22.4 

0.8 0.0 0.0 0.0 

5.9 7.8 5.5 7.0 

26.6 40.0 16.2 16.1 

4.4 8.2 3.1 2.8 

10.9 12.3 51.3 31.3 

22.5 20.6 16.7 22.6 

23.3 34.3 27.9 19.2 

2.5 4.1 1.9 1.3 

5.2 3.1 7.0 6.2 

3.4 0.0 17.0 16.0 

5.4 3.9 1.1 0.7 

2.9 1.4 1.4 0.8 

0.3 2.8 1.7 2.9 

6.0 4.4 4.1 3.2 

10.9 12.9 9.1 7.6 

11.7 12.5 5.0 1.6 

9.7 11.4 4.8 7.4 

1.4 2.0 1.7 1.4 

13.2 16.1 10.4 10.8 

8.8 10.4 9.2 8.5 

4.8 4.7 2.0 6.4 

2.6 4.7 1.6 0.5 

35.2 35.7 27.4 23.5 

5.5 2.6 3.7 4.7 

6.6 12.1 9.4 4.1 

31.3 28.5 12.7 17.3 

4.0 0.9 0.4 9.1 

13.7 9.4 6.5 8.6 

7.3 8.4 8.0 10.3 

46.1 54.6 44.1 36.9 

17.9 17.9 21.5 21.2 

5.8 4.6 6.8 3.9 

8.1 7.0 6.9 4.1 

0.0 6.7 10.9 10.1 

41.8 44.3 33.7 23.2 

60.7 56.0 52.3 39.2 

89.6 55.9 28.8 40.4 

10.3 11.3 11.6 13.9 

7.8 6.9 7.1 7.2 

4.6 3.6 9.6 8.3 

0.2 3.2 4.3 0.7 

17.3 20.7 20.0 24.7 

5.5 5.8 6.7 8.8 

0.9 1.1 0.9 0.3 

6.5 2.2 1.6 1.8 

14.1 15.1 10.3 8.8 

12.8 8.7 8.7 5.4 

3.0 3.2 1.4 1.1 

17.6 13.7 10.6 8.9 

5.3 7.6 4.9 7.0 

14.4 13.8 11.8 11.3 

3.7 5.2 3.3 2.4 

3.7 2.8 1.7 3.1 

12.3 31.9 13.6 20.3 

4.4 2.5 2.2 1.1 

4.8 4.6 3.3 2.0 

12.9 9.1 7.0 4.4 

2.2 2.9 2.2 2.2 

4.6 4.4 2.9 2.5 

4.7 2.9 3.7 6.0 

23.2 31.8 38.6 24.7 

3.0 5.0 1.1 3.6 

10.9 14.0 8.8 4.7 

19.9 16.5 15.9 14.4 12.9 

35.4 38.9 35.8 28.0 30.8 

20.1 16.8 16.2 14.6 13.1 

114 Syphilis Tables STD Surveillance 1999 
Table 37. Congenital syphilis — Reported cases and rates in infants <1 year of age: United States (excluding 

outlying areas), 1963–1999 

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 1,857 47.6 

1996 1,279 32.9 

1997 1,075 27.7 

1998 838 21.6 

1999 556 14.3 

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. Yearly case counts in this table correspond to confirmed diagnoses of congenital syphilis 

among those known to be less than one year of age. As a result, the case counts in this table are a subset of those listed in Table 1 for the years prior 

to 1995. 

STD Surveillance 1999 Syphilis Tables 115 
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, 1999 

Rank State/Area* Cases Rate per 100,000 Live Births 

1 New Jersey 46 40.6 

YEAR 2000 OBJECTIVE 40.0 

2 Maryland 27 38.5 

3 Arkansas 14 38.4 

4 South Carolina 19 36.4 

5 Arizona 24 31.7 

6 Illinois 53 29.3 

7 Mississippi 12 28.9 

8 Puerto Rico 17 26.5 

9 Texas 68 20.4 

10 Louisiana 12 18.2 

11 North Carolina 19 17.8 

12 California 88 16.8 

13 New York 43 16.7 

14 Florida 32 16.6 

15 Oklahoma 8 16.6 

16 Michigan 20 15.0 

U.S. TOTAL1 556 14.3 

17 Georgia 15 12.7 

18 Missouri 9 12.2 

19 Wisconsin 7 10.5 

20 Alabama 6 9.8 

21 South Dakota 1 9.8 

22 Tennessee 7 9.4 

23 Indiana 7 8.4 

24 New Hampshire 1 7.0 

25 Pennsylvania 7 4.9 

26 Ohio 6 3.9 

27 Virginia 3 3.3 

28 Connecticut 1 2.3 

29 Colorado 1 1.8 

30 Alaska 0 0.0 

31 Delaware 0 0.0 

32 Hawaii 0 0.0 

33 Idaho 0 0.0 

34 Iowa 0 0.0 

35 Kansas 0 0.0 

36 Kentucky 0 0.0 

37 Maine 0 0.0 

38 Massachusetts 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 Mexico 0 0.0 

44 North Dakota 0 0.0 

45 Oregon 0 0.0 

46 Rhode Island 0 0.0 

47 Utah 0 0.0 

48 Vermont 0 0.0 

49 Washington 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).
 

116 Syphilis Tables STD Surveillance 1999 
Table 39. Congenital syphilis — Reported cases and rates in infants <1 year of age by state/area listed in 

alphabetical order: United States and outlying areas, 1995–1999 

Cases Rates per 100,000 Live Births 

State/Area* 1995 1996 1997 1998 1999 1995 1996 1997 1998 1999 

Alabama 18 22 31 12 6 29.8 36.4 50.9 19.7 9.8 

Alaska 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Arizona 10 6 12 25 24 13.8 8.0 15.9 33.0 31.7 

Arkansas 29 32 41 30 14 82.4 88.0 112.4 82.2 38.4 

California 344 196 161 122 88 62.3 36.3 30.7 23.2 16.8 

Colorado 1 3 0 2 1 1.8 5.4 0.0 3.5 1.8 

Connecticut 6 2 2 0 1 13.5 4.5 4.6 0.0 2.3 

Delaware 1 0 2 0 0 9.7 0.0 19.5 0.0 0.0 

Florida 112 93 73 71 32 59.3 49.1 37.9 36.9 16.6 

Georgia 45 29 17 14 15 40.1 25.4 14.4 11.8 12.7 

Hawaii 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Idaho 0 1 0 0 0 0.0 5.4 0.0 0.0 0.0 

Illinois 184 104 73 71 53 99.0 56.8 40.4 39.3 29.3 

Indiana 0 6 3 0 7 0.0 7.2 3.6 0.0 8.4 

Iowa 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Kansas 1 0 2 0 0 2.7 0.0 5.4 0.0 0.0 

Kentucky 7 5 5 5 0 13.4 9.5 9.4 9.4 0.0 

Louisiana 36 15 22 8 12 54.8 23.0 33.3 12.1 18.2 

Maine 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Maryland 28 36 58 44 27 38.7 50.3 82.6 62.7 38.5 

Massachusetts 0 6 1 2 0 0.0 7.5 1.2 2.5 0.0 

Michigan 28 22 29 18 20 20.8 16.5 21.7 13.5 15.0 

Minnesota 2 2 0 0 0 3.2 3.1 0.0 0.0 0.0 

Mississippi 65 54 41 15 12 157.2 131.7 98.7 36.1 28.9 

Missouri 40 15 10 15 9 54.8 20.3 13.5 20.3 12.2 

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 1 0 0 0 0.0 3.8 0.0 0.0 0.0 

New Hampshire 0 0 0 0 1 0.0 0.0 0.0 0.0 7.0 

New Jersey 95 80 84 87 46 82.7 70.0 74.2 76.8 40.6 

New Mexico 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

New York 326 155 105 58 43 120.1 58.7 40.8 22.5 16.7 

North Carolina 33 31 18 24 19 32.5 29.7 16.8 22.4 17.8 

North Dakota 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Ohio 38 15 10 4 6 24.7 9.9 6.6 2.6 3.9 

Oklahoma 17 10 9 16 8 37.2 21.6 18.6 33.1 16.6 

Oregon 0 0 1 0 0 0.0 0.0 2.3 0.0 0.0 

Pennsylvania 68 58 37 21 7 44.8 39.1 25.7 14.6 4.9 

Rhode Island 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

South Carolina 42 44 19 24 19 82.5 86.1 36.4 46.0 36.4 

South Dakota 0 0 0 1 1 0.0 0.0 0.0 9.8 9.8 

Tennessee 29 35 32 13 7 39.6 47.5 43.0 17.5 9.4 

Texas 202 166 149 114 68 62.6 50.2 44.6 34.1 20.4 

Utah 0 0 0 1 0 0.0 0.0 0.0 2.3 0.0 

Vermont 0 1 0 0 0 0.0 14.8 0.0 0.0 0.0 

Virginia 25 16 7 6 3 27.0 17.3 7.6 6.5 3.3 

Washington 1 1 0 1 0 1.3 1.3 0.0 1.3 0.0 

West Virginia 0 0 1 0 0 0.0 0.0 4.8 0.0 0.0 

Wisconsin 11 3 9 6 7 16.3 4.5 13.5 9.0 10.5 

Wyoming 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

U.S. TOTAL1 1,857 1,279 1,075 838 556 47.6 32.9 27.7 21.6 14.3 

Guam 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Puerto Rico 14 10 9 28 17 22.1 15.8 14.0 43.7 26.5 

Virgin Islands 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

OUTLYING AREAS 14 10 9 28 17 20.1 14.4 12.8 39.8 24.1 

TOTAL 1,871 1,289 1,084 866 573 47.1 32.5 27.4 21.9 14.5 

*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 1999 Syphilis Tables 117 
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, 1999 

Rank City* Cases Rate per 100,000 Live Births 

1 Newark, NJ 11 215.5 

2 Baltimore, MD 21 215.0 

3 Detroit, MI 19 113.6 

4 St Louis, MO 5 86.7 

Chicago, IL 44 86.0 

6 Atlanta, GA 7 83.3 

7 Houston, TX 31 74.5 

8 Phoenix, AZ 16 70.7 

9 Miami, FL 10 70.4 

Oklahoma City, OK 5 65.6 

11 Milwaukee, WI 7 65.2 

12 Memphis, TN 7 62.1 

13 Tampa, FL 4 57.5 

14 Los Angeles, CA 36 53.0 

New Orleans, LA 4 51.7 

16 Oakland, CA 3 46.8 

17 Birmingham, AL 2 46.4 

18 Indianapolis, IN 6 44.6 

YEAR 2000 OBJECTIVE 40.0 

19 San Diego, CA 7 37.5 

New York City, NY 41 34.5 

21 Charlotte, NC 3 34.4 

22 Philadelphia, PA 7 31.7 

23 St Petersburg, FL 1 29.8 

24 San Juan, PR 2 28.8 

Rochester, NY 1 23.9 

26 Cleveland, OH 2 21.1 

27 Fort Worth, TX 2 21.1 

28 Sacramento, CA 2 19.1 

29 San Antonio, TX 4 18.6 

Columbus, OH 2 18.2 

31 Dallas, TX 4 17.7 

32 Tulsa, OK 1 15.7 

33 Kansas City, MO 1 13.1 

34 San Jose, CA 2 12.4 

San Francisco, CA 1 12.2 

36 Denver, CO 1 10.7 

37 El Paso, TX 1 7.6 

38 Tucson, AZ 0 0.0 

39 Washington, DC 0 0.0 

Jacksonville, FL 0 0.0 

41 Honolulu, HI 0 0.0 

42 Des Moines, IA 0 0.0 

43 Wichita, KS 0 0.0 

44 Louisville, KY 0 0.0 

Boston, MA 0 0.0 

46 Minneapolis, MN 0 0.0 

47 St Paul, MN 0 0.0 

48 Omaha, NE 0 0.0 

49 Jersey City, NJ 0 0.0 

Albuquerque, NM 0 0.0 

51 Buffalo, NY 0 0.0 

52 Yonkers, NY 0 0.0 

53 Akron, OH 0 0.0 

54 Cincinnati, OH 0 0.0 

Dayton, OH 0 0.0 

56 Toledo, OH 0 0.0 

57 Portland, OR 0 0.0 

58 Pittsburgh, PA 0 0.0 

59 Nashville, TN 0 0.0 

Austin, TX 0 0.0 

61 Corpus Christi, TX 0 0.0 

62 Norfolk, VA 0 0.0 

63 Richmond, VA 0 0.0 

64 Seattle, WA 0 0.0 

*Mother’s residence used to assign case. 

118 Syphilis Tables STD Surveillance 1999 
NY

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

>200,000 population listed in alphabetical order: United States and outlying areas, 1995–1999 

Cases 

City* 1995 1996 1997 1998 1999 

Akron, OH 0 0 0 0 0 

Albuquerque, NM 0 0 0 0 0 

Atlanta, GA 16 15 12 5 7 

Austin, TX 0 0 0 0 0 

Baltimore, MD 15 30 56 29 21 

Birmingham, AL 9 11 6 5 2 

Boston, MA 0 2 0 2 0 

Buffalo, NY 1 2 3 0 0 

Charlotte, NC 1 2 0 1 3 

Chicago, IL 121 66 50 49 44 

Cincinnati, OH 6 1 0 0 0 

Cleveland, OH 18 5 6 3 2 

Columbus, OH 0 0 1 1 2 

Corpus Christi, TX 1 0 0 1 0 

Dallas, TX 10 2 3 18 4 

Dayton, OH 7 7 0 0 0 

Denver, CO 0 1 0 1 1 

Des Moines, IA 0 0 0 0 0 

Detroit, MI 21 15 25 14 19 

El Paso, TX 4 4 2 0 1 

Fort Worth, TX 9 5 6 1 2 

Honolulu, HI 0 0 0 0 0 

Houston, TX 99 98 101 56 31 

Indianapolis, IN 0 0 0 0 6 

Jacksonville, FL 1 1 0 0 0 

Jersey City, NJ 9 1 4 3 0 

Kansas City, MO 2 0 1 0 1 

Los Angeles, CA 179 97 67 62 36 

Louisville, KY 4 3 3 4 0 

Memphis, TN 25 27 28 11 7 

Miami, FL 49 37 31 37 10 

Milwaukee, WI 11 3 9 6 7 

Minneapolis, MN 2 1 0 0 0 

Nashville, TN 1 1 0 0 0 

New Orleans, LA 0 0 4 2 4 

New York City, NY 281 131 84 45 41 

Newark, NJ 40 27 26 26 11 

Norfolk, VA 7 5 1 0 0 

Oakland, CA 23 8 2 2 3 

Oklahoma City, OK 13 4 5 11 5 

Omaha, NE 0 0 0 0 0 

Philadelphia, PA 68 58 37 21 7 

Phoenix, AZ 6 2 10 19 16 

Pittsburgh, PA 0 0 0 0 0 

Portland, OR 0 0 1 0 0 

Richmond, VA 1 0 1 3 0 

Rochester, NY 4 1 0 2 1 

Sacramento, CA 6 3 5 2 2 

San Antonio, TX 9 7 4 5 4 

San Diego, CA 6 5 13 7 7 

San Francisco, CA 1 2 2 1 1 

San Jose, CA 4 2 1 0 2 

Seattle, WA 0 0 0 0 0 

St Louis, MO 24 8 5 3 5 

St Paul, MN 0 0 0 0 0 

St Petersburg, FL 2 1 0 0 1 

Tampa, FL 9 16 7 4 4 

Toledo, OH 0 0 0 0 0 

Tucson, AZ 1 2 0 0 0 

Tulsa, OK 0 3 1 3 1 

Washington, DC 13 14 11 8 0 

Wichita, KS 0 0 2 0 0 

Yonkers, 3 0 0 2 0 

U.S. CITY TOTAL 1,142 736 636 475 321 

San Juan, PR 0 1 3 1 2 

TOTAL 1,142 737 639 476 323 

Rates per 100,000 Live Births 

1995 1996 1997 1998 1999 

0.0 

0.0 

196.4 

0.0 

140.9 

219.0 

0.0 

19.4 

12.5 

221.9 

105.4 

189.6 

0.0 

21.2 

46.2 

239.0 

0.0 

0.0 

119.4 

28.8 

98.8 

0.0 

244.5 

0.0 

9.2 

225.2 

29.3 

251.3 

62.2 

225.8 

315.6 

98.4 

34.9 

12.4 

0.0 

222.9 

740.3 

160.1 

357.2 

183.2 

0.0 

281.0 

27.0 

0.0 

0.0 

34.7 

89.9 

52.8 

42.9 

30.0 

11.6 

25.3 

0.0 

398.1 

0.0 

59.6 

123.5 

0.0 

11.8 

0.0 

144.2 

0.0 

110.8 

0.0 0.0 0.0 0.0 

0.0 0.0 0.0 0.0 

184.7 142.7 59.5 83.3 

0.0 0.0 0.0 0.0 

289.3 573.4 296.9 215.0 

265.3 139.2 116.0 46.4 

25.8 0.0 25.5 0.0 

41.6 62.7 0.0 0.0 

23.7 0.0 11.5 34.4 

124.9 97.7 95.8 86.0 

17.3 0.0 0.0 0.0 

53.8 63.2 31.6 21.1 

0.0 9.1 9.1 18.2 

0.0 0.0 20.9 0.0 

9.0 13.3 79.6 17.7 

246.1 0.0 0.0 0.0 

10.9 0.0 10.7 10.7 

0.0 0.0 0.0 0.0 

90.4 149.4 83.7 113.6 

29.7 15.2 0.0 7.6 

53.3 63.2 10.5 21.1 

0.0 0.0 0.0 0.0 

235.2 242.8 134.6 74.5 

0.0 0.0 0.0 44.6 

9.0 0.0 0.0 0.0 

24.8 101.9 76.5 0.0 

0.0 13.1 0.0 13.1 

137.2 98.6 91.3 53.0 

44.2 46.0 61.3 0.0 

243.1 248.5 97.6 62.1 

246.5 218.4 260.6 70.4 

26.7 83.8 55.9 65.2 

17.2 0.0 0.0 0.0 

12.4 0.0 0.0 0.0 

0.0 51.7 25.8 51.7 

106.5 70.6 37.8 34.5 

530.1 509.4 509.4 215.5 

122.2 25.5 0.0 0.0 

124.7 31.2 31.2 46.8 

54.6 65.6 144.4 65.6 

0.0 0.0 0.0 0.0 

254.4 167.6 95.1 31.7 

8.5 44.2 83.9 70.7 

0.0 0.0 0.0 0.0 

0.0 14.0 0.0 0.0 

0.0 30.5 91.5 0.0 

24.5 0.0 47.8 23.9 

27.7 47.6 19.1 19.1 

32.6 18.6 23.3 18.6 

25.5 69.6 37.5 37.5 

23.9 24.4 12.2 12.2 

12.3 6.2 0.0 12.4 

0.0 0.0 0.0 0.0 

136.7 86.7 52.0 86.7 

0.0 0.0 0.0 0.0 

29.2 0.0 0.0 29.8 

232.2 100.6 57.5 57.5 

0.0 0.0 0.0 0.0 

22.9 0.0 0.0 0.0 

50.5 15.7 47.1 15.7 

166.9 138.8 100.9 0.0 

0.0 32.2 0.0 0.0 

0.0 0.0 75.2 0.0 

141.3 91.7 80.3 60.0 40.5 

0.0 14.3 43.2 14.4 28.8 

139.8 91.1 80.0 59.6 40.4 

*Mother’s 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 1999 Syphilis Tables 119 
Table 42. Chancroid — Reported cases and rates by state/area listed in alphabetical order: United States and 

outlying areas, 1995–1999 

Cases Rates per 100,000 Population 

State/Area 1995 1996 1997 1998 1999 1995 1996 1997 1998 1999 

Alabama 7 0 1 1 1 0.2 0.0 0.0 0.0 0.0 

Alaska 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Arizona 2 2 0 2 0 0.0 0.0 0.0 0.0 0.0 

Arkansas 1 1 1 7 0 0.0 0.0 0.0 0.3 0.0 

California 8 8 19 7 7 0.0 0.0 0.1 0.0 0.0 

Colorado 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Connecticut 0 0 0 2 0 0.0 0.0 0.0 0.1 0.0 

Delaware 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Florida 24 3 3 3 3 0.2 0.0 0.0 0.0 0.0 

Georgia 2 0 1 2 1 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 21 20 5 0 0 0.2 0.2 0.0 0.0 0.0 

Indiana 0 1 0 1 0 0.0 0.0 0.0 0.0 0.0 

Iowa 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Kansas 2 2 0 1 0 0.1 0.1 0.0 0.0 0.0 

Kentucky 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Louisiana 129 58 3 1 9 3.0 1.3 0.1 0.0 0.2 

Maine 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Maryland 0 2 1 0 0 0.0 0.0 0.0 0.0 0.0 

Massachusetts 7 2 4 0 1 0.1 0.0 0.1 0.0 0.0 

Michigan 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Minnesota 0 0 0 0 1 0.0 0.0 0.0 0.0 0.0 

Mississippi 0 1 1 3 0 0.0 0.0 0.0 0.1 0.0 

Missouri 0 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 2 0 2 0 0 0.1 0.0 0.1 0.0 0.0 

New Hampshire 0 1 0 0 0 0.0 0.1 0.0 0.0 0.0 

New Jersey 4 4 0 0 0 0.1 0.0 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 336 182 119 82 39 1.9 1.0 0.7 0.5 0.2 

North Carolina 18 14 9 9 7 0.3 0.2 0.1 0.1 0.1 

North Dakota 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Ohio 5 6 3 3 0 0.0 0.1 0.0 0.0 0.0 

Oklahoma 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Oregon 0 0 1 0 1 0.0 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 1 0.0 0.0 0.0 0.0 0.1 

South Carolina 0 8 15 19 48 0.0 0.2 0.4 0.5 1.3 

South Dakota 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Tennessee 2 2 1 0 0 0.0 0.0 0.0 0.0 0.0 

Texas 26 65 53 34 16 0.1 0.3 0.3 0.2 0.1 

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 2 1 1 7 3 0.0 0.0 0.0 0.1 0.0 

Washington 5 1 2 1 0 0.1 0.0 0.0 0.0 0.0 

West Virginia 1 0 0 0 0 0.1 0.0 0.0 0.0 0.0 

Wisconsin 3 2 0 3 4 0.1 0.0 0.0 0.1 0.1 

Wyoming 0 0 1 1 1 0.0 0.0 0.2 0.2 0.2 

U.S. TOTAL1 607 386 246 189 143 0.2 0.1 0.1 0.1 0.1 

Guam 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 

Puerto Rico 1 2 1 2 1 0.0 0.1 0.0 0.1 0.0 

Virgin Islands 2 0 0 0 0 1.8 0.0 0.0 0.0 0.0 

OUTLYING AREAS 3 2 1 2 1 0.1 0.1 0.0 0.0 0.0 

TOTAL 610 388 247 191 144 0.2 0.1 0.1 0.1 0.1 

1

Includes cases reported by Washington, D.C. 

120 Chancroid Tables STD Surveillance 1999 
Table 43. Chancroid — Reported cases and rates in selected cities of >200,000 population listed in 

alphabetical order: United States and outlying areas, 1995–1999 

Cases 

City 1995 1996 1997 1998 1999 

Akron, OH 0 0 0 0 0 

Albuquerque, NM 0 0 0 0 0 

Atlanta, GA 0 0 1 1 0 

Austin, TX 0 0 0 0 0 

Baltimore, MD 0 1 0 0 0 

Birmingham, AL 0 0 0 0 0 

Boston, MA 2 0 3 0 0 

Buffalo, NY 0 0 0 0 0 

Charlotte, NC 3 4 1 0 1 

Chicago, IL 21 20 5 0 0 

Cincinnati, OH 1 0 0 0 0 

Cleveland, OH 0 0 0 2 0 

Columbus, OH 0 0 3 1 0 

Corpus Christi, TX 1 0 0 0 1 

Dallas, TX 12 13 13 6 4 

Dayton, OH 1 1 0 0 0 

Denver, CO 0 0 0 0 0 

Des Moines, IA 0 0 0 0 0 

Detroit, MI 0 0 0 0 0 

El Paso, TX 0 1 2 4 0 

Fort Worth, TX 0 0 1 0 2 

Honolulu, HI 0 0 0 0 0 

Houston, TX 0 25 23 20 7 

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 4 2 12 0 1 

Louisville, KY 0 0 0 0 0 

Memphis, TN 2 2 0 0 0 

Miami, FL 0 0 0 0 0 

Milwaukee, WI 0 1 0 2 2 

Minneapolis, MN 0 0 0 0 1 

Nashville, TN 0 0 0 0 0 

New Orleans, LA 125 52 3 0 4 

New York City, NY 334 181 119 82 39 

Newark, NJ 1 0 0 0 0 

Norfolk, VA 1 0 0 0 1 

Oakland, CA 2 0 1 0 1 

Oklahoma City, OK 0 0 0 0 0 

Omaha, NE 0 0 0 0 0 

Philadelphia, PA 0 0 0 0 0 

Phoenix, AZ 0 1 0 2 0 

Pittsburgh, PA 0 0 0 0 0 

Portland, OR 0 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 0 0 0 

San Francisco, CA 0 1 3 4 0 

San Jose, CA 0 0 0 0 0 

Seattle, WA 4 0 1 0 0 

St Louis, MO 0 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 1 0 0 0 

Tulsa, OK 0 0 0 0 0 

Washington, DC 0 0 0 0 0 

Wichita, KS 0 1 0 0 0 

Yonkers, NY 0 0 0 0 0 

U.S. CITY TOTAL 516 309 191 124 64 

San Juan, PR 0 1 0 1 1 

TOTAL 516 310 191 125 65 

Rates per 100,000 Population 

1995 1996 1997 1998 1999 

0.0 

0.0 

0.0 

0.0 

0.0 

0.0 

0.4 

0.0 

0.5 

0.7 

0.1 

0.0 

0.0 

0.3 

0.6 

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 

0.2 

0.0 

0.0 

0.0 

0.0 

25.9 

4.6 

0.3 

0.4 

0.2 

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 

0.3 

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 0.0 

0.0 0.5 0.0 0.0 

0.0 0.0 0.0 0.0 

0.7 0.2 0.0 0.2 

0.7 0.2 0.0 0.0 

0.0 0.0 0.0 0.0 

0.0 0.0 0.1 0.0 

0.0 0.3 0.1 0.0 

0.0 0.0 0.0 0.3 

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 0.1 

0.0 0.0 0.0 0.0 

0.8 0.7 0.6 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 0.0 

0.0 0.1 0.0 0.0 

0.0 0.0 0.0 0.0 

0.2 0.0 0.0 0.0 

0.0 0.0 0.0 0.0 

0.1 0.0 0.2 0.2 

0.0 0.0 0.0 0.3 

0.0 0.0 0.0 0.0 

11.0 0.6 0.0 0.9 

2.5 1.6 1.1 0.5 

0.0 0.0 0.0 0.0 

0.0 0.0 0.0 0.5 

0.0 0.1 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 0.1 0.0 

0.0 0.0 0.0 0.0 

0.0 0.0 0.0 0.0 

0.0 0.0 0.0 0.0 

0.0 0.0 0.0 0.0 

0.0 0.0 0.0 0.0 

0.0 0.0 0.0 0.0 

0.1 0.0 0.0 0.0 

0.1 0.4 0.5 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 

0.1 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 0.0 

0.7 0.4 0.3 0.2 0.1 

0.0 0.1 0.0 0.1 0.1 

0.7 0.4 0.3 0.2 0.1 

STD Surveillance 1999 Chancroid Tables 121 

Sources and Limitations of Data
 

CDC Surveillance Data 

Much of the information in this document is based on cases of sexually transmitted diseases 

(STDs) reported to the Division of STD Prevention (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 United States 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 December 31, 1999, 30 states have been notified to discontinue hardcopy reporting and are 

sending primary and secondary (P&S) 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 consistently submitted 

high quality case-extended data and were, therefore, notified by CDC 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 of 200,000 or more persons 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 26 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 the total number of cases among the tables and 

figures. In most instances, these discrepancies are less than 5% of total reported cases and have 

STD Surveillance 1999 Appendix Sources and Limitations of Data 123 
minimal impact on national case totals and rates. However, for a specific area, the discrepancies 

may be larger. 

Reports and corrections sent to CDC on hardcopy forms and for NETSS electronic data through 

August 4, 2000 have been included in this report. 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 

persons. In this report, the 1999 rates for all states, cities and outlying areas were calculated by dividing the number of cases reported from each area in 1999 by the estimated area-specific 1998 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 1991-1999 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; 1991-1998 Estimates of the Population of Counties by Age, 

Sex and Race/Hispanic Origin: 1990 to 1998; machine-readable data files). Rates for 1999 use population estimates for 1998. 

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 from the health departments located in these areas. Population estimates for the Virgin Islands were updated through 1995 and were used to calculate the rates for 1995 through 1999. 

Population estimates for Guam were projected for each year through 1998 based on the 1990 census. Puerto Rico’s population estimates from 1997 to 1998 were obtained from the Bureau of the 

Census. Rates for 1999 were based on the 1998 population estimates. 

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 

124 Sources and Limitations of Data Appendix STD Surveillance 1999 
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 1999 age- and race-specific rates for chlamydia (1996-99 only), gonorrhea, and syphilis in the National Profile, Special Focus Profiles and Detailed Tables sections were calculated from estimates based on this redistribution. 

Rates of congenital syphilis for 1989-1999 were calculated using live births from the National 

Center for Health Statistics (NCHS) (Vital Statistics: Natality Tapes 1989-1997 or Vital Statistics Reports, United States 1999, Vol. 48 No.10-Natality). Race-specific rates for 1996-1999 were calculated using live births for 1997. 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, the 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 Chlamydia Cases 

In 1999, 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. 

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. 

For more details on GISP gonorrhea cases, refer to the following annual publication: Division of 

STD Prevention. Sexually Transmitted Disease Surveillance 1999 Supplement: Gonococcal Isolate 

Surveillance Project (GISP) Annual Report 1999, U.S. Department of Health and Human Services, 

Public Health Service. Atlanta: Centers for Disease Control and Prevention (in press). 

STD Surveillance 1999 Appendix Sources and Limitations of Data 125 
Reporting of Syphilis Cases 

Cases of unknown duration, neurosyphilis, and late syphilis with clinical manifestations have 

been counted with late and late latent syphilis. 

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.1 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 is used to collect 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 

through 1999. 

Chlamydia, gonorrhea, and syphilis prevalence monitoring 

Chlamydia and gonorrhea test positivity for women attending family planning clinics, prenatal 

clinics, Indian Health Service clinics, the U.S. Job Corps, the U.S. Army, and men and women entering jail and juvenile detention facilities was calculated by dividing the number of persons testing 

positive for chlamydia or gonorrhea (numerator) by the total number of persons screened for each 

disease (denominator) and was expressed as a percentage. Except for the Job Corps and Army 

screening data, the denominator for these data sources may contain more than one test from the 

same individual if that person was tested more than once during a year. Various test methods were 

used for all of these data sources except the Job Corps and U.S. Army, and for most of the figures 

shown no adjustments of test positivity were made based on laboratory test type and sensitivity. 

However, for Figure 9, the chlamydia test results for each test type were weighted to reflect the sensitivity of the test used.2 The weights used in this adjustment are the reciprocals of the sensitivities of 

the laboratory test methods used. These test-specific sensitivities were defined as the midpoints of 

the range of published values for the sensitivities for each technology type (e.g., non-amplified, nucleic acid amplification, and culture) based on expert consultation regarding test evaluation studies.3,4 Limitations of this adjustment include: unknown dates that laboratories changed tests, missing information on the test method, variation of test sensitivity within a technology type, and no adjustment for confirmation testing such as negative grey zone testing. 

For more details on chlamydia prevalence, refer to the following annual publication: Division of 

STD Prevention. Sexually Transmitted Disease Surveillance 1999 Supplement: Chlamydia Prevalence Monitoring Project Annual Report 1999, U.S. Department of Health and Human Services, 

Public Health Service. Atlanta: Centers for Disease Control and Prevention (in press). 

126 Sources and Limitations of Data Appendix STD Surveillance 1999 
Syphilis seroreactivity data on men and women entering jails and juvenile detention facilities 

were calculated by dividing the number of persons with a reactive syphilis serologic test (numerator) 

by the total number of persons screened for syphilis (denominator) and expressed as a percentage. 

These seroreactivity data in most instances do not reflect confirmatory testing and thus biologic false 

positive test results were not systematically excluded. The extent to which these data reflect prevalence of active syphilis infection varies by site. Further details from each site, including prevalence of 

high titer infections (> 1:8) which may be more indicative of active infection, are provided in Sexually Transmitted Disease Surveillance 1999 Supplement: Syphilis Surveillance Annual Report ­

1999, U.S. Department of Health and Human Services, Public Health Service. Atlanta: Centers for 

Disease Control and Prevention (in press). 

Prevalence data for region- and state-specific figures were published with permission from the 

HHS Regional Infertility Prevention Programs, selected state STD prevention programs, the Job 

Corps, U.S. Department of Labor, U.S. Army, and the Indian Health Service. 

Definition of HHS Regions 

Health and Human Services (HHS) regions referred to in the text 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. 

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 1966-1999). For more information on this 

database, contact IMS America, Ltd., 660 West Germantown Pike, Plymouth Meeting, PA 19462; 

Telephone: (610) 834-5000. 

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 1980-1998), 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 1995-1998) 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. 

STD Surveillance 1999 Appendix Sources and Limitations of Data 127 
Healthy People Year 2000 Revisions 

In 1995, the Healthy People 2000 objectives were revised.5 The year 2000 objectives for the diseases in this report were revised as follows: primary and secondary syphilis — 10 cases per 100,000 

persons to 4 cases per 100,000 persons; congenital syphilis — 50 cases per 100,000 live births to 40 

cases per 100,000 live births; and gonorrhea — 225 cases per 100,000 persons to 100 cases per 

100,000 persons. 

Healthy People Year 2010 Objectives 

In January 2000, CDC released provisional objectives for Healthy People 2010 (HP2010).6 The 

provisional year 2010 rate objectives for the diseases addressed in this report are: primary and secondary syphilis — 0.2 cases per 100,000 persons; congenital syphilis — 1 case per 100,000 live 

births; and gonorrhea — 19 cases per 100,000 persons. An additional provisional target established in the HP2010 objectives is to reduce the Chlamydia trachomatis test positivity to 3% among 

females aged 15 to 24 years who attend family planning and STD clinics and among males aged 15 

to 24 who attend STD clinics. 

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)7 

and incorporated the Office of Management and Budget’s (OMB) official metro status based on the 

results of the 1990 Population Census.8 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 

categories.7 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 

128 Sources and Limitations of Data Appendix STD Surveillance 1999 
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. 

1Kaufman RE, Jones, OG, Blount, JH, Wiesner PJ. Questionnaire survey of reported early congenital syphilis: problems in diagnosis, prevention, and treatment. Sex Transm Dis 1977;4:135-9. 

2Webster Dicker L, Mosure DJ, Levine WC, Black CM, Berman SM. The impact of switching laboratory tests 

on reported trends in Chlamydia trachomatis infections. Am J Epidemiol 2000;151:430-435. 

3Newhall WJ, DeLisle, S, Fine D, et al. Head-to-head evaluation of five different non-culture chlamydia tests 

relative to a quality-assured culture standard. Sex Trans Dis 1994;21:S165-6. 

4Centers for Disease Control and Prevention. 2001 Guidelines for the Laboratory Detection of Chlamydia 

trachomatis (CT) and Neisseria gonorrhea (GC) Infections. (In preparation). 

5U.S. Department of Health and Human Services. Healthy People 2000: Midcourse Review and 1995 Revisions. U.S. Government Printing Office, Washington, DC, 1995. 

6U.S. Department of Health and Human Services. Healthy People 2010 (Conference Edition, in Two 

Volumes). U.S. Government Printing Office, Washington, DC, 2000. 

7Rural-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. 

8Federal 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. 

STD Surveillance 1999 Appendix Sources and Limitations of Data 129 
Figure A1. Chlamydia — National electronic telecommunications system for surveillance 

(NETSS) transmission status by state, 1999 

* 

Guam NETSS Data: 

Summary 

Case 

Case Extended 

Discontinued 

Hardcopy 

Puerto Rico Virgin Is.* 

*Upstate New York (New York City reports case extended chlamydia records to NETSS) 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 system for surveillance 

(NETSS) transmission status by state, 1999 

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, 

Los Angeles, New York City and Washington, DC projects report case extended gonorrhea 

records to NETSS. 

130 NETSS Appendix STD Surveillance 1999 
Figure A3. Primary and secondary syphilis — National electronic telecommunications 

system for surveillance (NETSS) transmission status by state, 1999 

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. New York City 

reports case extended syphilis records to NETSS. 

STD Surveillance 1999 Appendix NETSS 131 
Table A1. Healthy People 2000 Sexually Transmitted Diseases Objective 19.1–19.8 Status 

Baseline 

Objective Year Baseline 1995 1996 1997 1998 1999 2000 

19.1 Gonorrhea (per 100,000 persons) 1989 300 149 124 123 133 133 100 

a. Black (non-Hispanic) 1989 1,990 1,046 817 802 851 849 650 

b. Adolescents 15-19 years 1989 1,123 671 544 522 547 534 375 

c. Female 15-44 years 1989 501 299 259 252 282 283 175 

19.2 Chlamydia prevalence among females 15-24 

years 

Female 15-19 years 1988 12.2% 6.7% 5.4% —­ 6.9%* 6.6%* 5% 

Female 20-24 years 1988 8.5% 4.2% 3.4% —­ 4.4%* 4.5%* 5% 

19.3 Primary and secondary syphilis (per 100,000 1989 18.1 6.3 4.3 3.2 2.6 2.5 4 

persons) 

a. Black 1989 118 45 30 22 17 15 30 

19.4 Congenital syphilis (per 100,000 live births) 1990 91.0 47.4 33.3 27.7 21.6 14.3 40 

a. Black 1992 a

417.8 213.2 150.5 122.4 90.3 57.9 175 

b. Hispanic 1992 a

134.6 61.2 38.9 33.4 28.7 20.4 50 

19.5 Annual number of first time consultations1 

Genital herpes 1988 163,000 160,000 208,000 176,000 188,000 224,000 138,500 

Genital warts 1988 290,000 253,000 191,000 145,000 211,000 240,000 246,500 

19.6 Pelvic inflammatory disease 

Hospitalizations per 100,000 females 15-44 years 1988 311 162 164 157 155 —­ 100 

Initial visits to physicians (number of visits)1 1988 430,800 262,000 286,000 261,000 234,000 251,000 290,000 

Hospitalizations per 100,000 females 

a. Black 15-44 years 1988 655 296 320 281 291 —­ 150 

b. Adolescents 15-19 years 1988 342 141 168 186 162 —­ 110 

19.7** Sexually transmitted Hepatitis B (number of cases) 1987 47,593 2

29,446 —­ —­ —­ —­ 30,500 

19.8 Repeat gonorrhea infection in last 12 months 1987 20% 18.4% 18.5% 17.0% 17.5% 17.2% 15% 

a. Black 1992 21.3% 20.1% 19.8% 18.3% 18.6% 19.2% 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 1998-1999 and associated increases in test sensitivity. 

**Duplicate Objective. 

132 Healthy People 2000 Appendix STD Surveillance 1999 
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 31, 2000. 

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 Andrew Schamess, M.D.
 

Florida Landis Crockett, M.D., M.P.H.
 

Georgia Alpha Bryant, M.D.
 

Hawaii Peter Whiticar
 

Idaho Roger Perotto
 

Illinois Charlie Rabins, M.P.H.
 

Chicago Frank Oldham, Jr.
 

Indiana Lori Phillips (acting)
 

Iowa Mary Weaver, R.N., M.S.N.
 

Kansas Gianfranco Pezzino, M.D., M.P.H.
 

Kentucky Barry Wainscott, M.D.
 

Louisiana Vacant
 

Maine Sally Lou Patterson
 

Maryland Rafiq Miazad, M.D., M.P.H.
 

Baltimore Emanuel Nwokolo, Ph.D., M.P.H.
 

Massachusetts Paul Etkind, M.P.H.
 

Michigan Loretta Davis-Satterla
 

Minnesota Jill M. DeBoer, M.P.H.
 

Mississippi Mary Jane Coleman, R.N., B.S.N.
 

Missouri Mahree Skala, M.A.
 

Montana Kathleen Martin
 

Nebraska Christine M. Newlon
 

Nevada Richard Whitley, M.S.
 

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 Larry Shireley, M.S., M.P.H.
 

Ohio J. Nick Baird, M.D.
 

Oklahoma William R. Pierson, M.B.A.
 

Oregon Melvin Kohn, M.D.
 

Pennsylvania Michelle Patrick, M.P.A.
 

Philadelphia Robert Levenson
 

Rhode Island Thomas E. Bertrand, M.P.H.
 

South Carolina Lynda Kettinger, M.P.H.
 

South Dakota Laurie Gill
 

Tennessee Drema Mace
 

Texas Rose Brownridge, 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 Karl Musgrave, D.V.M., M.P.H.
 

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 Luci’en Moolenarr, D.D.S, M.P.H. 

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 

Kathleen O’Connor 

John Heath 

Jack E. Wroten 

Alpha Bryant, M.D. 

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 

Ruth Vogel, M.P.H., L.P.N. 

Paul Etkind, M.P.H. 

Mark A. Miller 

Jill M. DeBoer, M.P.H. 

Mike Cassell 

Mary Menges 

Bruce Deitle 

Dan Harrah 

Robert Nellis 

David R. Ayotte, M.S.P.H. 

Jerry Carolina 

Al Chowning 

F. Bruce Coles, D.O. 

Steve Rubin 

Peter Moore 

Kirby Kruger 

J. Nick Baird, M.D. 

Mark Turner, M.P.H. 

Jan Karius 

Susan Arrowsmith 

Martin Goldberg 

Thomas E. Bertrand, M.P.H. 

Tim Lindman 

David Morgan 

Chris Freeman 

Casey S. Blass 

John Contreras 

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.
 

Norman Peterson, M.D., 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.
 

Paul Blake, M.D., M.P.H.
 

Paul Effler, M.D., M.P.H.
 

Christine G. Hahn, M.D., M.P.H.
 

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.
 

Jeffrey Roche, M.D., M.P.H.
 

Jeffrey Roche, M.D., M.P.H.
 

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.
 

Melvin Kohn, 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 1999 Contributors 133