STD & HIV ANNUAL REPORT. An Annual Review of HIV and STD s reported in Oakland County, Michigan

Transcription

1 STD & HIV ANNUAL REPORT 2016 An Annual Review of HIV and STD s reported in Oakland County, Michigan

2 Similar to numbers reported statewide, Oakland County saw an increase in the number of reported cases of Gonorrhea, Chlamydia and Syphilis. Conversely, there were less Human Immunodeficiency Virus (HIV) cases reported to Oakland County in 2016 than there were in The Oakland County data is available earlier in the year, around March, before national data through CDC, usually available in early October. This report initially had data exclusively pertaining to Oakland County, but was amended to include national CDC data. OCHD STD & HIV Annual Report

3 2016 STD & HIV ANNUAL REPORT An Annual Review of HIV and STD s Reported in Oakland County, Michigan Chlamydia Infections... 3 Gonorrhea Infections... 5 Primary & Secondary Syphilis Infections... 7 Latent & Congenital Syphilis Infections... 9 Human Immunodeficiency Virus (HIV) Citations OCHD STD & HIV Annual Report 2016

4 CHLAMYDIA INFECTIONS Since 2012, the number of chlamydia cases reported to Oakland County Health Division (OCHD) has risen (Table 1). In 2015, the number of reported cases drastically increased. In 2016, the increase was less than half of the increase seen the previous year, but was still significantly higher than the 1.03% and 1.90% increases seen respectively in 2013 and Year Total Number of Chlamydia Cases Reported Percent Change from Previous Year , , % , % , % , % TABLE 1. CHLAMYDIA REPORTED CASES AND PERCENT CHANGE, OAKLAND COUNTY, MI, In 2016, five out of the twelve months of the year were the highest peak seen in that month for the last five years (Figure 1). Five months saw the second highest number of cases reported in the last five years. Chlamydia Cases Reported to Oakland County Health Division, Figure 1 OCHD STD & HIV Annual Report

5 CHLAMYDIA INFECTIONS In 2016, almost 1.6 million cases of chlamydia were reported to CDC. This made chlamydia the most common notifiable condition in the United States during the 2016 reporting year. Nationally, rates of reported chlamydia cases decreased slightly in 2012, but have continued to rise, similar to what occurred in Oakland County. Consistently, the CDC reports a regional increase in the rates of chlamydia. In comparison to other states, Michigan is in the second lowest rate category for reported cases in The overall rate of reported cases of chlamydia in the United States, Guam, Puerto Rico and the Virgin Islands is cases per 100,000 population. Michigan had a rate of 463 cases per 100,000 population, which ranks 30th among other US states and territories. Michigan overall experienced a decrease in cases, down from 469 cases per 100,000 last year in Chlamydia Rates of Reported Cases by State, United States and Outlying Areas, 2016 Figure 2 4 OCHD STD & HIV Annual Report 2016

6 GONORRHEA INFECTIONS Since 2012, the number of gonorrhea cases reported to OCHD has fluctuated, but was trending downward overall until 2016 (Table 2). There was a significant decrease in cases during 2014 and despite a large increase in 2015; the number of cases were trending downward overall. In 2016, the increase nearly doubled from the previous year, resulting in the most cases since 2012, consistent with unofficial numbers reported statewide. Year Total Number of Gonorrhea Cases Reported Percent Change from Previous Year % % % % TABLE 2. GONORRHEA REPORTED CASES AND PERCENT CHANGE, OAKLAND COUNTY, MI, In 2016, the number of gonorrhea cases reported each month was the peak for nine out of the twelve months since 2012 (Figure 2). This is as expected, as 2016 had the highest number of reported cases since Gonorrhea Cases Reported to Oakland County Health Division, Figure 3 OCHD STD & HIV Annual Report

7 GONORRHEA INFECTIONS Nationally, the rates of reported gonorrhea cases have increased steadily since 2012, which is different from the fluctuation documented in Oakland County. The rates of gonorrhea increased markedly across the United States. Each region of the US has displayed a sharp increase, with the Western states seeing the most dramatic increase. In comparison to other states, Michigan is in the middle rate category for reported case rates of gonorrhea in 2016 (Figure 4), but still below the national average. The overall rate of reported cases of gonorrhea in the United States, Guam, Puerto Rico and Virgin Islands is per 100, 000 population. Michigan had a rate of 126 cases per 100,000 population, which ranked Michigan 28th among other US states and territories. Gonorrhea Rates of Reported Cases by State, United States and Outlying Areas, 2016 Figure 4 6 OCHD STD & HIV Annual Report 2016

8 PRIMARY & SECONDARY SYPHILIS INFECTIONS Since 2012, the number of primary and secondary syphilis cases reported to OCHD has fluctuated without a consistent trend (Table 3). There was a large increase in reported cases in 2013, but in 2015 and 2016, there were similar decreases. While there is no consistent trend, it is promising that in the last two years, reported cases have decreased. Year Total Number of Primary & Secondary Syphilis Cases Reported Percent Change from Previous Year % % % % TABLE 3. PRIMARY & SECONDARY SYPHILIS REPORTED CASES AND PERCENT CHANGE, OAKLAND COUNTY, MI, The overall number of cases reported to OCHD was the lowest since had one five year peak month (April) and three minimum months in May, July and November (Figure 3). Although 2015 and 2016 had similar numbers of reported cases, there is no seasonal or other trend observed that may provide insight into disease trends. Primary and Secondary Syphillis Cases Reported to Oakland County Health Division, Figure 5 OCHD STD & HIV Annual Report

9 PRIMARY & SECONDARY SYPHILIS INFECTIONS Nationally, the reported case rates of primary and secondary syphilis have plateaued since about 1998, with a slight upward trend beginning in Conversely, Oakland County experienced a sudden increase in 2013, followed by a decrease in both 2015 and Oakland County rates are still trending higher since the sudden increase in 2013, but are appearing to continue a downward trend. Regionally, the CDC reports that all regions have seen an overall increase in cases, with the sharpest increase again occurred in the West. The Midwestern states still have the lowest case rates since Michigan is in the second lowest rate category for reported case rates of primary and secondary syphilis in 2016 (Figure 6). The overall rate of reported cases in the United States for 2016 was 8.7 cases per 100,000 population. Michigan had a rate of 3.7 cases per 100,000 population, which ranks Michigan 36th among other US states and territories. Primary and Secondary Syphilis Rates of Reported Cases by State, United States and Outlying Areas, 2016 Figure 6 8 OCHD STD & HIV Annual Report 2016

10 LATENT & CONGENITAL SYPHILLIS INFECTIONS Since 2012, the number of latent syphilis cases reported to OCHD has fluctuated year to year, but has trended upward overall (Table 4). There was a large (almost 63%) increase in 2013, but in 2014, there was a 17% decrease in the number of reported cases. In the last two years, the number of reported cases has increased at relatively similar rates. Year Total Number of Latent Syphilis Cases Reported Percent Change from Previous Year % % % % TABLE 4. LATENT SYPHILIS REPORTED CASES AND PERCENT CHANGE, OAKLAND COUNTY, MI, Since 1991 there have been 6 reported cases of congenital syphilis. One case each was reported in 1991, 1992, 2008, had the highest number of reported latent syphilis cases since However, 2016 only had four, five-year peak months in February, March, May, and June (Figure 4) and one five-year minimum in January. No consistent seasonal trending was observed. Latent Syphillis Cases Reported to Oakland County Health Division, Figure 7 OCHD STD & HIV Annual Report

11 LATENT & CONGENITAL SYPHILLIS INFECTIONS CDC reports only early latent syphilis infections in the year end report, while Oakland County reports all latent cases. Despite fluctuation in case counts, in earlier years, the last two years have illustrated an overall upward trend. According to CDC, early latent infection case rates plateaued in 1998, but started to increase slightly in The last national decrease in early latent syphilis cases was in While there have only been 6 cases of congenital syphilis reported in Oakland County since 1991, the CDC reports that national case rates have continued to increase since 2013 (Figure 8). Congenital Syphilis Reported Cases by Year of Birth and Rates of Primary and Secondary Syphilis Among Women, United States, Figure 8 10 OCHD STD & HIV Annual Report 2016

12 HUMAN IMMUNODEFICIENCY VIRUS (HIV) INFECTIONS Since 2012, the number of new HIV diagnoses reported to OCHD has fluctuated year to year, but has remained stable over time. The numbers reported below in Table 5 reflect both new diagnoses and cases new to Oakland County. Year HIV Diagnoses (Non-stage 3) Percent Change from Previous Year % % % TABLE 5. NEW, NON-STAGE 3 HIV DIAGNOSES AND PERCENT CHANGE, OAKLAND COUNTY, MI, Since 2012, the number of stage 3 HIV diagnoses reported to OCHD has fluctuated, but trended downward overall despite an increase in reported cases in The numbers reported below, in Table 5, reflect both new diagnoses of stage 3 disease and cases new to Oakland County. Year Stage 3 HIV Diagnoses Percent Change from Previous Year % % % TABLE 6. STAGE 3 HIV DIAGNOSES AND PERCENT CHANGE, OAKLAND COUNTY, MI, Statewide, there was an increase in the number of cases reported from % of the new diagnoses statewide were in the MSM (men who have sex with men) population3. The age group with the highest percentage of new diagnoses was years at 22%, followed closely by years at 20%. Statewide data shows that males were disproportionately affected, with 82% of new diagnoses occurring in males. Overall, 58% of new diagnoses were in persons who identify as black, while 31% identified as white, 6% as Hispanic. OCHD STD & HIV Annual Report

13 HUMAN IMMUNODEFICIENCY VIRUS (HIV) INFECTIONS Figure 9 The prevalence of HIV has increased again this year. Prevalence has increased not because of significantly more infections, but because those living with HIV are living longer. Advancements in antiretroviral therapy (ART) have made living with HIV much more possible and manageable. Oakland County data depicts the same prevalence trend seen within the state of Michigan as a whole, but the number of cases in Oakland County decreased slightly, while state numbers increased. In 2016, most counties in Michigan have a new diagnosis rate of 1-4 cases per 100,0003. Seven (7) counties reported no new diagnoses. Oakland County, along with 8 other counties had new case rates of 5-9 per 100,000. Ingham and Saginaw counties had new diagnosis rates of 10 per 100,000 while Detroit reported 38 new cases per 100,000 population (Figure 9). 12 OCHD STD & HIV Annual Report 2016

14 CITATIONS 1. Sexually Transmitted Disease Surveillance Surveillance and Data Management Branch; National Center of HIV/AIDS, Viral Hepatitis, STD, and TB Prevention; Centers for Disease Control and Prevention. Published September, Sexually Transmitted Disease Surveillance: Tables for Chlamydia, Gonorrhea, and Syphilis. Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention; Centers for Disease Control and Prevention. Last Updated September 26, Michigan Statewide HIV Surveillance Report: New Diagnoses and Prevalence Tables. HIV & STD Surveillance & Epidemiology Section, Division of Communicable Disease, Bureau of Disease Control, Prevention and Epidemiology; Michigan Department of Health and Human Services. Data as of July 1, HIV in Michigan: An overview of the epidemic during HIV & STD Surveillance & Epidemiology Section, Division of Communicable Disease, Bureau of Disease Control, Prevention and Epidemiology; Michigan Department of Health and Human Services. Data as of July 1, OCHD STD & HIV Annual Report

15 B OCHD STD & HIV Annual Report 2016