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Since 1987, reported cases of chancroid declined steadily until 2001 when 38 cases were reported (Figure 39, Table 1). In 2005, 17 cases of chancroid were reported in the United States, the lowest number of cases ever reported. Only 10 states and one outlying area reported one or more cases of chancroid in 2005 (Table 41). Although the overall decline in reported chancroid cases most likely reflects a decline in the incidence of this disease, these data should be interpreted with caution since Haemophilus ducreyi, the causative organism of chancroid, is difficult to culture and, as a result, this condition may be substantially under diagnosed.1,2

Human Papillomavirus

Persistent infection with high risk human papillomavirus (HR-HPV) can lead to development of anogenital cancers (i.e. cervical cancer). Sentinel surveillance for cervical infection with high-risk human papillomavirus types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68 was conducted in 29 STD, family planning and primary care clinics in six locations (Boston, Baltimore, New Orleans, Denver, Seattle and Los Angeles) as part of an effort to estimate national burden of disease and inform prevention programs such as vaccine programs in the U.S. Testing was performed using a commercially available test for HR-HPV testing (Digene Hybrid Capture 2, Gaithersburg). Interim results from 2003–2004 document an overall HR-HPV prevalence of 22.5%. Prevalence in STD clinics was 28%, 24% in family planning clinics, and 16% in primary care clinics. Prevalence by age group was: 14-19 years 35%; 20-29 years 29%; 30-39 years 14%; 40-49 years 12%; and 50-65 years 6%.

In June 2006, a quadrivalent HPV vaccine was licensed for use in the United States. The vaccine provides protection against types 6, 11, 16, and 18. PCR based HR-HPV testing and typing using the Roche line blot assay provided type-specific estimates of prevalence for types 16 and 18, two types contained in the HPV vaccine. Overall prevalence of HPV 16/18 was 8%. Prevalence of HPV 16/18 by age group was: 14-19 years 16%; 20-29 years 10%; 30-39 years 3%; 40-49 years 2%; 50-65 years 1%.3,4

Pelvic Inflammatory Disease

For data on Pelvic Inflammatory Disease (PID), see the Special Focus Profile on Women and Infants.

Other Sexually Transmitted Diseases

Case reporting data for genital herpes simplex virus (HSV), genital warts or other human papillomavirus infections, and trichomoniasis are not available. Trend data are limited to estimates of the initial office visits in physicians' office practices for these conditions from the National Disease and Therapeutic Index (NDTI) (Figures 40, 41, 42 and Table 42).

1 Schulte JM, Martich FA, Schmid GP. Chancroid in the United States, 1981–1990: Evidence for underreporting of cases. MMWR 1992;41(no. SS-3):57-61.

2 Mertz KJ, Trees D, Levine WC, et al. Etiology of genital ulcers and prevalence of human immunodeficiency virus coinfection in 10 US cities. J Infect Dis 1998;178:1795-8.

3 Datta SD, Koutsky L, Douglas J, et al. Sentinel surveillance for human papillomavirus among women in the United States, 2003–2004 [Abstract no. MO-306]. In: Program and abstracts of the 16th Biennial Meeting of the International Society for Sexually Transmitted Diseases Research, Amsterdam, The Netherlands, July 10-13, 2005

4 Datta SD, Koutsky L, Ratelle S, et al. Type-Specific High-Risk HPV Prevalence from the HPV Sentinel Surveillance Project, US, 2003–2005 [Abstract no. P-099]. In Program and abstracts of the International Human Papillomavirus Meeting, Prague, Czech Republic, September 2006.

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