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STD Update 2012: Epidemiology and Clinical Care
Slide Presentation
Decembe 19, 2012
Susan Philip, MD, MPH

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Slide 1.
STD Update 2012: Epidemiology and Clinical Care
Slide 1.
Disclosures
Slide 2.
Overview
Slide 3.
Stay Up-To-Date on STDs in San Francisco
Slide 4.
Reportable STD Rates, San Francisco 2007-2011
Slide 5.
STDs among MSM in San Francisco, 2011
Slide 6.
Early Syphilis Rates (per 100,000 population), San Francisco 2007-2011
Slide 7.
Demographics of Early Syphilis STD Update 2012
Slide 8.
Age of Early Syphilis STD Update 2012
Slide 9.
Reporting Provider of Early Syphilis STD Update 2012
Slide 10.
Behavioral Risks of Interviewed Early Syphilis STD Update 2012
Slide 11.
STDs among Adolescents in San Francisco, 2011 (1)
Slide 12.
Chlamydia Rates (per 100,000 population), San Francisco 2007-2011
Slide 13.
Case 1
Slide 14.
Case 1 (continued)
Slide 15.
Syphilis Staging Flowchart
Slide 16.
Slide 17
Slide 17.
Slide 18
Slide 18.
Slide 19
Slide 19.
Case 1 (continued)
Slide 20.
Case 1(continued)
Slide 21.
HIV and Neurosyphilis
Slide 22.
To LP or Not to LP, That is the Question
Slide 23.
What Is the Clinical Significance of Persistent Stable Titers (Serofast)?
Slide 24.
Case 2
Slide 25.
Case 2(continued)
Slide 26.
Tests of Choice for Gonorrhea and Chlamydia
Slide 27.
What If Non-genital STDs Were Ignored?
Slide 28.
Proportion of asymptomatic rectal and urethral chlamydial and gonococcal infection among MSM - San Francisco, 2003
Slide 29.
Case 2(continued)
Slide 30.
History of Antibiotics for NG
Slide 31.
Penicillinase-Producing N. Gonorrhoeae (1970s - 1980s) and the Spread of Ciprofloxacin Resistance (1990s - 2000s)
Slide 32.
The Gonococcal Isolate Surveillance Project (GISP)
Slide 33.
GISP Sites and Regional Laboratories - United States, 2000-2010
Slide 34.
The Emerging Threat of Untreatable Gonococcal Infection
Slide 36.
Update to CDC's Sexually Transmitted Diseases Treatment Guidelines, 2010
Slide 36.
Current Recommended Gonorrhea Treatment
Slide 37.
Alternative Gonorrhea Treatment for Uncomplicated Urogenital GC
Slide 38.
What if I Suspect Gonorrhea Treatment failure?
Slide 39.
Case 3
Slide 40.
What about Patients with Penicillin or Cephalosporin Allergies?
Slide 41.
SFDPH Response to Gonorrhea in San Francisco
Slide 42.
Reported Gonorrhea by Diagnosing Provider, 2011
Slide 43.
Reported Gonorrhea Treatment SF July 1 2011-June 30 2012 (n= 3071)
Slide 44.
Follow-Up for STD Clinic Patients at Risk for Treatment Failure
Slide 45.
California GISP
Slide 46.
CA GISP SF Results Jan 2012-Sept 2012
Slide 47.
CA GISP SF Results 2012
Slide 48.
Remaining Questions
Slide 49.
Rapid, Molecular Methods to Assess Susceptibility?
Slide 50.
Since We Still Need Culture, How to Get it to the Lab?
Slide 51.
When to Retest for TOC with NAAT?
Slide 51.
When to Retest for TOC with NAAT?
Slide 51.
Other Alternative Treatment?
Slide 54.
Thank You!
Slide 55.

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