Public health group convenes to combat rising syphilis, gonorrhea rates in Iowa

A clinician tests a sample Sept. 13, 2019, in the lab at the Planned Parenthood clinic in Iowa City. (The Gazette)

CEDAR RAPIDS — A public health group is reconvening to combat an alarming increase in sexually transmitted infections in Linn and Johnson counties and in Iowa.

With a rise in chlamydia, gonorrhea and syphilis infections, the Sexual Health Alliance of Linn & Johnson Counties met this week with public health officials and advocates to brainstorm ways to blunt the increase.

The alliance suspended meetings during the COVID-19 pandemic to focus on restructuring and reorganization, while public health agencies and health care professionals focused on combating the virus.

The group, founded in 2010, has worked on a variety of sexual health initiatives, including research on public school sexual health education, screenings, condom distribution and panel discussions.

Now, the public health departments in Linn and Johnson counties will develop coalitions within their counties and meet together every six months to collaborate on goals.

At the top of their priority list is the resurgence of gonorrhea and syphilis, which is increasing nationally and in Iowa.

Spike in syphilis, congenital syphilis

Most concerning are cases of syphilis and of congenital syphilis that is passed on to newborns — an infection that was nearly eradicated over 20 years ago.

Statewide, syphilis cases have increased more than 10-fold in the last decade, from 70 cases to 751. In Linn County alone, the cases have more than tripled.

From 2019 to 2021, Iowa went from one congenital syphilis case per year to 11.

"Congenital syphilis is a huge concern. We don't want any babies born with it," said Heather Meador, clinic branch supervisor for Linn County Public Health.

Without treatment, the infection can spread to the brain and nervous system and can cause blindness, hearing loss and serious birth defects in newborns.

Though many states require syphilis testing of pregnant women in the course of prenatal care, Iowa does not.

"This is very alarming, considering this is the most cases we've seen in the past 20 years combined," said Alicia Steines, public health nurse for Linn County Public Health. "Iowa has seen fatalities among infants, and attention really needs to be brought to this so pregnant women can receive timely prenatal care and testing to have healthy baby outcomes."

Gonorrhea cases more than triple

Statewide, gonorrhea cases more than tripled from about 2,000 in 2011 to about 7,000 in 2020, before dipping slightly in 2021.

The surge comes despite a decrease in testing since the pandemic, which could indicate potential undiagnosed cases.

From 2014 to 2020, Linn County's gonorrhea cases increased more than five times — from just over 100 cases to slightly under 600.

Public health officials are wary of the new treatment-resistant strains of gonorrhea being seen around the country.

"We haven't seen a lot of those (cases) here in Iowa, but we have to be aware of the possibility of those occurring In Iowa," Steines said. "Those infections that occur on the coasts tend to trend inward."

Sexual health education concerns

The Sexual Health Alliance also raised concerns about two legislative proposals that could impact sex education among teenagers — one of the groups most impacted by the rise of sexually transmitted infections.

Republican lawmakers on Thursday advanced Senate Study Bill 1145 proposed by Gov. Kim Reynolds for consideration by the full Senate Education Committee.

Under the bill, Iowa schools no longer would be required to teach students about AIDS, the immune system disease caused by the human immunodeficiency virus (HIV), or about the availability of the HPV vaccine.

HPV, or human papillomavirus, is a sexually transmitted infection that affects many sexually active men and women. Most cases go away with no health problems, but some cause cancer, including cervical cancer, according to the U.S. Centers for Disease Control and Prevention. The vaccine for the virus is recommended for children ages 11 to 12.

A separate bill recommended for passage by House Republicans, House File 187, would remove the provision in Iowa law requiring schools to teach about "the availability of a vaccine to prevent HPV" in grades seven and eight, making the instruction optional.

General instruction about sexually transmitted infections, such as HPV and AIDS, still would be required under both bills.

"The governor's proposed language supports the continuation of these practices, without naming in code each disease that may be included in such teaching," Molly Severn, Reynolds' legislative liaison and lobbyist, testified Thursday during a Senate subcommittee hearing on the bill.

Public health experts argue that removing the provision would endanger the health of students. They said the vaccine is one of the most effective ways to prevent cancer.

"Well-designed and implemented sex education reduces risky behaviors," Steines said. "This legislation being proposed really weakens sexual health education within our schools."

Studies also show that the education does not cause or correlate with an increase in sexual activity, Meador said.

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