Welcome to 4 th Syphilis Report to the Community. May 18, 2016
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1 Welcome to 4 th Syphilis Report to the Community May 18, 2016
2 Syphilis and STDs in Bexar County Anil T. Mangla, MS, PhD, MPH, FRIPH Assistant Director of Health Syphilis Update to the Community May 18, 2016
3 Acknowledgements Cara J. Hausler, MPH, Senior Epidemiologist Jaseudia S. Killion, MPA, Public Health Associate Sian Hill, Program Manager Crystal Garza, Field Operations Manager DIS Rita Espinoza, MPH, DrPh(c), Chief Epidemiologist
4 Overview Review Data Gonorrhea Chlamydia Syphilis Review law for syphilis testing of pregnant women Activities
5 STDs in Bexar County
6 Chlamydia Cases, Bexar County, * 14,000 Cases 3 Year Moving Average (Cases) 12,000 10,000 Cases 8,000 6,000 4,000 7,400 7,594 8,054 8,849 10,440 11,455 11,828 11,409 11,340 11,127 13,313 2, '06 '07 '08 '09 '10 '11 '12 '13 '14 '15* Year * Preliminary 2015 data (may contain duplicates) Source: local and central STD*MIS data, ranking from CDC
7 Chlamydia Rates, * Cases per 100,000 population Bexar County Texas US '06 '07 '08 '09 '10 '11 '12 '13 '14 '15* Year * Preliminary 2015 data, using 2014 population estimates (may contain duplicates) Source: STD-MIS, Texas and CDC reports, using annual population estimates
8 TOTAL = 11,127 cases in % = 3,207 unable to geo-code
9 Gonorrhea Cases, Bexar County, * 4,000 3,500 3,000 Cases 3 Year Moving Average (Cases) Cases 2,500 2,000 1,500 1,000 2,184 2,562 2,465 2,898 3,401 3,520 3,470 3,365 2,960 3,127 3, '06 '07 '08 '09 '10 '11 '12 '13 '14 '15* Year * Preliminary 2015 data (may contain duplicates) Source: local and central STD*MIS data, ranking from CDC
10 Gonorrhea Rates, * Cases per 100,000 population Bexar County Texas US '06 '07 '08 '09 '10 '11 '12 '13 '14 '15* Year * Preliminary 2015 data, using 2014 population estimates (may contain duplicates) Source: STD-MIS, Texas and CDC reports, using annual population estimates
11 TOTAL = 3,127 cases in % = 912 unable to geo-code
12 Syphilis in Bexar County
13 Primary and Secondary Syphilis Cases, Bexar County, * Cases 3 Year Moving Average (Cases) Cases '06 '07 '08 '09 '10 '11 '12 '13 '14 '15* Year * Preliminary 2015 data Source: local and central STD*MIS data, ranking from CDC
14 Primary and Secondary Syphilis Rates, * Cases per 100,000 Population Bexar County Texas US '06 '07 '08 '09 '10 '11 '12 '13 '14 '15* Year * Preliminary 2015 data, using 2014 population estimates Source: STD*MIS data, Texas and CDC reports, using annual population estimates
15 Congenital Syphilis Rates in Texas Most Highly Populated Counties, County 2012 Rates 2013 Rates 2014 Rates* Bexar Harris Tarrant Dallas These 4 counties account for 67% of the 70 cases of congenital syphilis in Texas in *Per 100,000 live births; 2013 live births used for calculation of 2014 rate. Source: Texas STD/HIV Program; Live births from Texas Health Data
16 Congenital Syphilis Cases, Bexar County, ** Cases Cases 3 Year Moving Average (Cases) '06 '07 '08 '09 '10 '11 '12 '13 '14 '15* Year * Preliminary 2015 data ** Preliminary 2016 data as of Source: local and central STD*MIS data
17 Congenital Syphilis Rates, * Cases per 100,000 Live Births Bexar County Texas US Healthy People 2020 Target '06 '07 '08 '09 '10 '11 '12 '13 '14+ '15*+ Year * Preliminary 2015 data; + Both 2014 and 2015 rates use 2013 live births Source: STD*MIS data, Texas and CDC reports, using annual population estimates
18 TOTAL = 925 cases in % = 156 unable to geo-code
19 HIV, Syphilis and HBV Testing and Pregnancy: State Requirements for Texas Clinicians Texas law (Chapter of the Texas Health and Safety Code) requires physicians or others permitted by law to attend a woman during pregnancy or at delivery to test her for human immunodeficiency virus (HIV), syphilis and hepatitis B virus (HBV). She must be tested for HIV and syphilis at her first prenatal visit and during the third trimester. If no record of third trimester test results are available, expedited tests for HIV and syphilis must be conducted at delivery. Expedited HIV testing of infants at delivery is also required if a mother s results are undetermined. The law also requires pregnant women to be tested for hepatitis B at her first natal visit and at delivery. Source: Texas Department of State Health Services HIV/STD Program
20 HIV, Syphilis and HBV Testing and Pregnancy: State Requirements for Texas Clinicians Source: Texas Department of State Health Services HIV/STD Program
21 Why test pregnant women? Testing and treatment for HIV, HBV and syphilis prevents infected infants. Without knowledge of HIV status, a mother with HIV has an approximately 25% chance of transmitting HIV to her unborn child. If pregnant women with HIV are tested and receive appropriate care and treatment during pregnancy, labor, and delivery, and the newborn is treated as well, the transmission rate can be decreased to 2% or less. Testing and treatment also decreases rates of syphilis and HBV infection. Perinatal syphilis screening allowed Texas clinicians to identify 79 cases of congenital syphilis in 2012, enabling them to provide treatment and follow up. For infants born to women with infectious HBV, 70-95% will not be infected if they receive HBV vaccine and treatment within 12 hours of delivery. Source: Texas Department of State Health Services HIV/STD Program
22 Summary Gonorrhea and Chlamydia are increasing Syphilis and Congenital Syphilis continue to decline Efforts will be maintained and new collaborative efforts will be initiated
23 Prevention Strategies Targeted Prevention Partner Collaboration Mobile Unit
24 Mobile Unit
25 STD Mobile Clinic Schedule of Events Date Time Location Address May am - 8 pm Mission Library South 3134 Roosevelt Ave, May 23 9 am 3 pm Mission Pharmacy Health Fair 3267 Roosevelt, May am 8 pm Carver Library East 3350 E Commerce St, May 26 9 am 8 pm Henry Guerra Library(West) 7978 W Military Dr, June 4 11 am - 7 pm Family Pride 514 W Commerce St, June 9 10 am 6 pm Brook Hollow Library 530 Heimer Rd, June am 8 pm Mission Library South 3134 Roosevelt Ave, TX June 18 9 am 1 pm AARC grand opening 303 N. Frio, June 25 5 pm 8 pm Adult Megaplex San Pedro Ave June am 8 pm Carver Library East 3350 E Commerce St, June am 8 pm Henry Guerra Library 7978 W Military Dr, 78227
26 Anil T. Mangla, MS, PhD, MPH, FRIPH Assistant Director of Health Sian Hill Elmore Health Program Manager Crystal Garza Field Operations Manager
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