Chlamydia among teens is on the rise in Grant County.
The Health Department reports five cases among youth aged 16-24 in 2003 and two already in 2004. In 2002, there were zero.
Adult and Family Nurse Practitioner Karen Triplett is concerned.
"In comparison to counties our size in 2003, we've seen a significant increase over previous years," she said. "These are just the people I know of."
Of the cases tracked by the Oregon Department of Human Services in 2003, three were females aged 15-19, and one aged 20-24. There was only one case reported in 2002, but seven in 2001.
Chlamydia is a common STD caused by a bacterium, which can damage a woman's reproductive organs. The symptoms are usually mild or silent, but serious complications the woman may never notice can cause irreversible damage, including infertility, tubal pregnancy, health problems for newborns and chronic pain, according to the Centers for Disease Control and Prevention.
It is the most frequently reported STD in the 15-19 age group and the most common in Oregon with more than 50 percent of the cases, according to the Oregon Department of Human Services.
"There were 7,498 cases of chlamydia in Oregon in 2003, but there are a lot more infections out there that never get identified or reported," said Doug Harger, head of the Sexually Transmitted Disease section at DHS.
Exacerbating the problem, said Triplett, is how easily it is spread. If you remember the shampoo commercial suggesting hair-washers tell two friends, then they tell two friends, and so on, think about the fact you aren't just having sex with one person, you're having sex with every person they've ever slept with. Then extrapolate that into the future.
When you think about young people, the problem is further complicated by peer pressure, media influence and less experience in making critical decisions.
With too many teens, sex has become a recreational activity.
When teens worry about consequences of having sex, they worry about pregnancy and not so much about STDs, said Debi Hueckman, community development coordinator for the Department of Human Services and a co-leader of PEP, People Encouraging Prevention. (See Related Story)
There is good news though.
The encouraging thing, Triplett said, is that chlamydia is cured with just antibiotics.
"We need to get everyone who is positive treated to get the rates down," she said.
The diagnosis usually surfaces when a person visits their health care provider either concerned they may be infected or when a physical examination or pap smear indicts the presence of the disease. Chlamydia is reportable to the state for the purposes of tracking the disease and clusters, cases where one, possibly unknowing person, is spreading the disease to many.
If a girl comes into the health clinic and is diagnosed with chlamydia, Triplett counsels her on ways to prevent a future reinfection - using birth control and a condoms. Preventative measures, such as birth control and condoms, are free at the clinic.
Then Triplett asks her patient who her partner or partners were and tries to contact them so they can get checked and treated.
"It's hard to get in contact with everyone they had contact with," Triplett admits. "Some have multiple partners. It is truly a big problem. Some guys won't come here for treatment."
In the old days, the test for males involved a small Q-Tip inserted slightly into the penis, Triplett said. These days a urine sample suffices, so more boys or men get tested. Both males and females can go to any doctor to take the test.
"Often the case is that the male partner of a woman with chlamydia does get treated, but he never gets tested. Without a positive test, this is not counted as a case," Harger of DHS said.
Oregon is very committed to testing 16- to 24-year-olds because 40 percent of women end up with fertility problems if chlamydia is left untreated. Women can get PID (pelvic inflammatory disease) as a result, which can damage fallopian tubes, uterus and the surrounding tissue, Triplett said, not to mention cause chronic pain.
"There's many things you can get that I can fix," Triplett said.
She encourages teens, if they are going to have sex, to wear condoms.
"They don't protect 100 percent, but it's better than not," she said. "There's resistance in the community to that message, but we wouldn't have the problem if they'd use birth control and a barrier," she added.
"AT the health center, we are as open as we can be (with hours from 7:30 a.m. to 6 p.m.). It's a safe environment and the visit is confidential.
"Do I think 14-year-olds should be (sexually) active? No," Triplett said. "But it's up to them to decide."
The nurse practitioner does advise teens to talk with their parents about their choices. She noted that there are youth who use abstinence and that she does counsel abstinence.
"But, by the time teens come in here asking for birth control, it's not about abstinence," she warned.
"This is a serious health issue. Kids are at great risk for getting something that could affect the rest of their lives," Triplett said. "I know we can only do what we can do, so don't get chlamydia so we don't have to investigate."
Other STDs in Grant County
HPV or human papillomavirus
Fifty percent of sexually active men and women acquire genital warts (HPV) at some point. By age 50, at least 80 percent of women will have genital HPV infection, according to the CDC. There are 20 million infected in the United States. Triplett doesn't have numbers for Grant County, because this is a non-reportable STD; however she has seen and treated teens for HPV here. The number of people infected is huge, she said.
There are more than 60 types of HPV, including genital warts, but only four or five that put a woman at risk for cervical cancer. When a pap smear comes back ASCUS (atypical squamous cells of undetermined significance), the test is repeated in three to six months because the human body can take care of some of the problems. If the test is still positive, the health care provider will type the HPV and possibly remove the infected cells.
At least 45 million people, ages 12 and older, are infected with genital herpes; one out of every five people. There is no cure, but medications can shorten and prevent outbreaks and daily medications can reduce the possibility of infecting others. As with other STDs, abstinence is the only way to avoid spreading the disease. Condoms reduce the risk. Triplett has occasionally seen herpes at the health department.
Other reportable STDs
There haven't been cases of gonorrhea, syphilis or HIV in the year Triplett's been here; although there have been reports in the past. She warns that especially syphilis seems to be on the rise in other communities, and it just may be a matter of time before it comes here.