SIOUX CITY | Preliminary reports project that 2017 was a rampant year for gonorrhea in Woodbury County, which follows state and national trends.
More than 468,500 cases of gonorrhea were recorded in the United States in 2016. The bacterial infection if left untreated in women can lead to serious reproductive complications, including tubal infertility, ectopic pregnancy and chronic pelvic pain.
Reported cases of gonorrhea in Iowa have more than doubled over four years, according to the Iowa Department of Public Health (IDPH).
There were 3,600 cases of the sexually transmitted disease in Iowa in 2017, according to the state's preliminary data. That would be a 145 percent increase since 2013, and a one-year increase of more than 38 percent.
While Siouxland District Health Department deputy director Tyler Brock said he is still gathering data from Woodbury County testing sites, he said the numbers he has seen so far indicate a rise in cases.
Gonorrhea has steadily increased in Woodbury County since about 2012, when 58 cases were tallied. In 2016, 131 cases of the bacterial infection were recorded. Gonorrhea can cause itching and burning in the genital area, abdominal pain and fever, but most people who are infected show no symptoms.
"We've had high numbers of gonorrhea for a number of years," said Brock, who couldn't offer a particular reason for the increase. "It's been going up pretty steadily in the state as well."
George Walton, the state public health department's STD program manager, said he thinks part of the overall increase is because gonorrhea is showing up in more segments of Iowa's population. He said robust testing could also be boosting diagnoses.
"We're starting to find more infections that in the past would have been missed," he said. "That's a part of it, certainly not all of it."
Gonorrhea diagnoses are increasing among both men and women, but faster among men, which likely indicates an increase among men who have sex with men, according to the department.
According to the IDPH, gonorrhea primarily impacts young Iowans: ages 15 to 34 account for 80 percent of diagnoses. The disease disproportionately impacts Iowa's black population, which accounts for nearly 30 percent of diagnoses, but only 3.5 percent of the state's population.
Brock said the rise of gonorrhea, which is becoming increasingly difficult to treat, is concerning.
A report from the Centers for Disease Control and Prevention revealed the number of cases of gonorrhea with strains that showed "decreased susceptibility" to the common antibiotic azithromycin dramatically jumped from 0.6 percent to 2.5 percent in just a year's time between 2013 and 2014.
"There's a lot of resistance to antibiotics with gonorrhea, not so much in the Midwest where we're at, but certainly internationally and on the coasts there is a lot of resistance," Brock said. "Even though we haven't seen the resistance here, we are absolutely concerned about increasing gonorrhea rates."
Walton said the IDPH is encouraging medical facilities to be more thorough in testing for gonorrhea.
Siouxland District Health Department is expanding its free STD testing services and training additional staff members to perform female exams.
"We feel that's just going to reduce barriers to people coming in and getting tested and treated," Brock said. "We feel that we're going to have increased capacity to get people in because of multiple changes that we're making."
Erin Murphy of the Journal Des Moines Bureau contributed to this story.