ANNAPOLIS – Syphilis and gonorrhea aren’t the only sexually transmitted diseases Marylanders need to worry about.
There’s a more insidious disease on the rise in the state one that infects its victims, but shows no symptoms until it develops into a more serious problem.
Maryland ranks fifth in the nation for the rate of reported chlamydia cases, according to a 1997 report by the Centers For Disease Control and Prevention. In that year, 13,763 chlamydia cases were reported in the state for a rate of 271.4 per 100,000 population.
Chalmydia is called the silent disease because 80 percent of women and 50 percent of men have no symptoms, according to the CDC. When left untreated, it can lead to serious consequences for women, including pelvic inflammatory disease and infertility. The disease also can cause premature births, as well as eye disease and pneumonia in babies.
“Not a lot of attention or media publicity has focused on chlamydia, but because the disease is asymptomatic in women and men, there are a lot of people who have the disease and don’t even know it. That’s a big problem,” said Charlotte Gaydos, assistant professor of public health at the infectious diseases division of the Johns Hopkins School of Medicine in Baltimore.
Last year, the CDC released figures showing that Baltimore leads the nation in the number of reported cases of gonorrhea and syphilis. The city also ranks first in the state in chlamydia rates, 904.6 cases per 100,000 population, according to information by the Department of Health and Mental Hygiene and Maryland Center for Health Statistics.
As incidences of both gonorrhea and syphilis decrease, chlamydia continues to spread, according to information by the CDC. An estimated 3 million Americans contract chlamydia every year, figures showed.
In an effort to bring Maryland’s rate down, delegates Marilyn Goldwater, D-Montgomery, and Joan Pitkin, D-Prince George’s, are co-sponsoring a bill that would require health insurance companies, health service plans and health maintenance organizations to pay for annual chlamydia screenings for their highest risk members.
The bill specifies that insurers pay for screenings for women under age 20, if they are sexually active. It also would cover women at least age 20 and all men who have a prior history of sexually transmitted disease, have a new or multiple sex partners or inconsistently use contraceptives.
“Hopefully, this legislation will raise the consciousness of health officials, insurers and the public,” Pitkin said. A public hearing on the bill is scheduled Thursday in the Economic Matters Committee.
Baltimore City Health Department Commissioner Peter Beilenson said the bill is well intentioned, but doesn’t go far enough.
Beilenson believes limiting the types of people eligible for chlamydia screening coverage could create unintentional problems.
“The bill leaves the decision up to the health care provider, and not every practitioner may recognize a high- risk patient. This type of screening should be a standard benefit to everyone throughout the state,” he said. Health insurers, he said, may raise the bar on the definition of high risk.
Goldwater disagrees.
“If a doctor recommends that a person should have a chlamydia screening test, the insurance company has to cover it,” she said.
Goldwater added that targeting the high-risk population for screening will be more cost effective than treating the long-term effects of chlamydia.
A financial impact study conducted by the Health Care Access and Cost Commission showed there would be a relatively low impact on insurers who covered chlamydia screenings – $1 to $3 extra for women and $1 for men.
Roberta Gidner-Antoniotti, Planned Parenthood of Maryland president and chief executive officer, would like to see the age group for women expanded, but supports the bill as a good first step. She is particularly pleased to see the bill includes testing for men.
“Too often the burden is put on women. We can treat women, but if we don’t treat their partners, then they will infect or re-infect their women,” she said.
Health officials say there is no one reason why chlamydia rates are so high in Maryland. CDC research, however, shows that Maryland has historically had a high rate of sexually transmitted disease.
While he disagreed with the CDC’s findings, Beilenson said drugs, poverty and high-risk behaviors including unprotected sex tend to make rates higher in big cities. He added that chlamydia is a “grossly underreported” disease that only became officially reported in 1994.
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