Chester County Medicine Winter 2019 - 31

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Another infectious disease category causing growing
concern among health care providers is that of Sexually
Transmitted Diseases (STDs), which have shown steep and
sustained increases in recent years. About 2.3 million cases of
Chlamydia, Gonorrhea, and infectious syphilis were reported
in 2017, the fourth consecutive year of sharp increases. Infectious syphilis rose 76% and GC rose 67%, raising another
specter - that of increasingly antibiotic resistant gonorrhea.
Acute Flaccid Myelitis (AFM) is a serious but, so far, rare
but frightening condition which causes weakness in one or
more limbs, mimicking poliomyelitis. The CDC has identified
Coxsackie A16, EV A71, and EV 68 in these patients, but no
sign of polio viruses. Cases have occurred in 46 states, some
90% in children, and most having onset with a respiratory
illness between August and October. In November the CDC
formed an AFM Task Force to help define the cause of, and
improve treatment outcomes for, patients with AFM.
For want of unlimited space, we will close with a few
comments about the Viral hepatitides. Serious Hepatitis A
(HAV) outbreaks occurred (and continue) in several states,
particularly in large urban populations of drug users and
homeless people. Over 7000 cases were reported in 12 states.
Between January, 2017, and April, 2018, the CDC received
over 2500 HAV case reports from multiple states, 2/3 of
which were in patients reporting drug abuse, homelessness, or
both. Over 1500 were in four states (CA, KY, MI, UT), and
71% required hospitalization and 3 % died.
And, finally, the highest incidence of Hepatitis C (HCV)
in the US is now among persons aged 20-29. HCV infections
have more than tripled in recent years, and what the CDC
calls "an HCV epidemic," as a consequence of the opioid epidemic, is emerging among PWIDs (persons who inject drugs),
especially in rural and suburban settings.
Physicians and other healthcare providers are encouraged
to monitor these events and activities closely via the websites
for the CDC, WHO, Pro-MED and other health related
sources.

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Dr. Maher is a retired Public Health physician, former
County Health Director, and a long-time member of
the CCMS Board.

WINTER 2019 | CHESTER COUNT Y Medicine 31

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Chester County Medicine Winter 2019

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