Chlamydia infections are circulating unchecked in Hawaii County, state Department of Health data shows.
The bacterial sexually transmitted infections were the most common of the county’s reportable ailments in 2016. Reportable or “notifiable” illnesses are reported by physicians to the state.
The county reported 682 chlamydia cases in 2016 — more prevalent in the county than any other reportable illness, including influenza, strep throat or norovirus, a common foodborne illness that gained notoriety after outbreaks on cruise ships.
“It is recommended by the (Centers for Disease Control and Prevention) that all sexually active adolescents and adults have a chlamydia and gonorrhea screening at least yearly until the age of 25, and that all sexually active adolescents and adults aged 13 to 65 be tested at least once in a lifetime for HIV/hepatitis C,” said University of Hawaii at Hilo spokesman Jerry Chang.
Individuals at greater risk, such as those with multiple sex partners, should be tested more often, he said.
About 30 percent of people with chlamydia also have bacterial gonorrhea, said Gerald Hasty, Department of Health program coordinator for STD clinics and field services.
But chlamydia was reported to the state of Hawaii more than eight times as often as the flu last year.
Hawaii County had 198,449 residents in 2016, the Department of Health estimated. To put chlamydia in context, per 100,000 people living on the Big Island last year, new diagnoses averaged:
• Chlamydia, 343.67
• Strep throat, 91.21
• Influenza, 40.82
• Norovirus, 12.09
• AIDS, 1.01
The Big Island is not alone.
One in every 25 women ages 14-24 nationwide contracts chlamydia at any given time.
That rate, from 2007-12, CDC data shows, highlights a condition rarely discussed but perhaps more common — with more-serious consequences — than most people realize.
Chlamydia is the most common sexually transmitted infection in the county, state and nation, Hasty said.
Testing, diagnosis and treatment is widely available, including at testing clinics, urgent care, women’s health services and at family-practice offices.
“The University of Hawaii at Hilo Student Medical Services offers free and confidential testing for chlamydia and gonorrhea through a simple, noninvasive urine screen,” Chang said.
Most insurance policies cover routine chlamydia testing, Hasty said.
Chlamydia often has few or no symptoms, the CDC says. Noticeable symptoms can include vaginal discharge in women, penile discharge and pain and swelling in one or both testicles in men, and a burning sensation during urination for males and females.
Rectal bleeding or discharge and rectal pain are symptoms of rectal chlamydia, which also can afflict men and women, the CDC emphasizes.
Chlamydia symptoms are less prevalent in men than women.
Chlamydia can cause female infertility or a “potentially fatal” ectopic pregnancy, with the fertilized egg implanting outside the uterus, pain and birth defects, especially problems with the baby’s eyes, the CDC says.
The CDC says the only way to avoid chlamydia is to not have vaginal, anal or oral sex. To decrease risk, CDC recommends staying in a long-term, monogamous relationship with someone known to be negative for STDs. Another way to decrease risk is to properly use a condom during every sexual encounter.
Most people with chlamydia don’t know they have it, Hasty said. That’s one reason it’s so common.
“That high case rate is also very strongly biased by gender,” Hasty said.
From a young age, he said, women can get routine health checkups for mammograms, cervical screenings, pap smears, pregnancy, menstrual changes and pelvic exams.
Most women get routine STD screening, but men don’t, Hasty said, which is why men are less likely to get diagnosed with chlamydia.
Most of Hawaii County’s diagnosed cases are in females.
“Men also have these infections,” Hasty said. “It’s jut not documented.”
Hasty advises sexually active people to ask their doctors to test for chlamydia because, despite the already high number of cases, data can be deceiving.
“There are many more of these than those numbers would indicate,” he said.
Email Jeff Hansel at jhansel@hawaiitribune-herald.com.