Wisconsin STD Program

1. Wisconsin STD Program Overview of Gonorrhea Epidemiology and Program Prevention Efforts Meeting February 2, 2010 Wisconsin Department of Health Services: Protecting and Promoting the Health and Safety of the People of Wisconsin.

2. Reported Cases of Gonorrhea by County 2008 1-100 101-1000 >1000 Wisconsin: 72 Counties Douglas 26 Bayfield Ashland Vilas 4 Iron Washburn 2 Saywer 1 Burnett 3 Price Florence Oneida 3 Barron Rusk 1 Marinette 8 Polk 4 Forest 2 Lincoln 3 Langlade 1 Taylor Oconto 6 Chippewa 3 Dunn 5 St. Croix 9 Menominee 3 Marathon 26 Clark Pierce 1 Shawano 6 Eau Claire 10 2 Door Pepin Waupaca 2 Wood 6 Portage 5 Kewaunee 4 Buffalo Outagamie 67 Brown 294 Jackson 3 1 Trempealeau Winnebago 73 Manitowoc 12 Juneau 7 Waushara 4 6,062 = Total Cases Calumet 11 Monroe 16 LaCrosse 35 Adams 2 Marquette 1 Fond du Lac 44 1 GreenLake Sheboygan 20 Vernon Sauk 14 Columbia 14 Dodge 36 Richland 1 Ozaukee 19 21 Washington Crawford 1 Dane 453 Waukesha 81 Jefferson 18 Iowa 2 Grant 7 Milwaukee --- 4,063 Green 3 Racine – 277 Rock 134 Walworth 15 LaFayette 1 Kenosha ---- 160

3. Reported Cases of Gonorrhea in Wisconsin 1999-2008 Cases Year

4. Reported Rates of Gonorrhea per 100,000 Pop Wisconsin: 1999-2008 Rate Year

5. Reported Rates of Gonorrhea per 100,000 PopMilwaukee County: 1999-2008 Rate Year

6. WI Reported Rates of Gonorrhea per 100,000 Popby Gender: 1999-2008 Rate Year

7. Milwaukee County Reported Rates of Gonorrhea per 100,000 Pop by Gender: 1999-2008 Rate Year

8. Reported Age-specific Gonorrhea Rates*:Wisconsin and Milwaukee County 2008 * Cases per 100,000 population.

9. Reported Cases of Gonorrhea by Age & Gender Milwaukee County & WI w/o Milwaukee County2008

10. Reported Cases of Gonorrhea by Race & Gender Wisconsin 2008 Reported Cases Race/Gender Asians and Native Americans were less than 3% of Total

11. Reported Cases of Gonorrhea by Race & Gender Wisconsin w/o Milwaukee County 2008 Reported Cases Race/Gender Asians and Native Americans were less than 7% of Total

12. Reported Gonorrhea Cases by Gender & Race Milwaukee County 2008 Reported Cases Race/Gender Asians and Native Americans were less than 1% of Total

13. % of Total GC Cases Reported in Females by RaceWisconsin w/o Milwaukee County vs. Milwaukee County 2008 Percent of Total Percent of Total Females WI w/o Milw Co Females Milw County Asian females were less than 1% of total Asian females were less than .1%of total

14. % of Total GC Cases Reported in Males by RaceWisconsin w/o Milwaukee County vs. Milwaukee County 2008 Percent of Total Percent of Total Males Milw County Males WI w/o Milw County Asian and Native American Males were less than 3% of Total Asian and Native American Males were less than 1% of Total

15. Reported Gonorrhea Rates* by Race Wisconsin, 2008 52 – fold difference * Cases reported with race specified per 100,000 population.

16. Reported Gonorrhea Rates* by Race Milwaukee County 2008 36 – fold difference * Cases reported with race specified per 100,000 population.

17. Reported Cases of Gonorrhea by WI County 2008 1-100 101-1000 >1000 Wisconsin: 72 Counties Douglas 26 Bayfield Ashland Vilas 4 Iron Washburn 2 Sawyer 1 Burnett 3 Price Florence Oneida 3 Barron Rusk 1 Marinette 8 Polk 4 Forest 2 Lincoln 3 Langlade 1 Taylor Oconto 6 Chippewa 3 Dunn 5 St. Croix 9 Menominee 3 Marathon 26 Clark Pierce 1 Shawano 6 Eau Claire 10 2 Door Pepin Waupaca 2 Wood 6 Portage 5 Kewaunee 4 Buffalo Outagamie 67 Brown 294 Jackson 3 1 Trempealeau Winnebago 73 Manitowoc 12 Juneau 7 Waushara 4 6,062 = Total Cases Calumet 11 Monroe 16 LaCrosse 35 Adams 2 Marquette 1 Fond du Lac 44 1 GreenLake Sheboygan 20 Vernon Sauk 14 Columbia 14 Dodge 36 Richland 1 Ozaukee 19 21 Washington Crawford 1 Dane 453 Waukesha 81 Jefferson 18 Iowa 2 Grant 7 Milwaukee --- 4,063 Green 3 Racine – 277 Rock 134 Walworth 15 LaFayette 1 Kenosha ---- 160

18. Zip Codes with Over 100 Reported Cases of GC in 2008: Zip Code – Number of Cases 53206 – 548 53209 – 402 53210 – 400 53212 – 390 53218 – 376 53216 – 333 53208 – 312 53225 – 175 53205 – 149 53204 – 127 53224 – 116 53233 – 115 These 12 zip codes represent 57% of all the gonorrhea reported in Wisconsin in 2008. Out of 4,032 cases reported from Milwaukee County in 2008 3,443 were reported from the 12 zip codes in the City of Milwaukee noted in the table – this represents 85.4% of the reported cases in Milwaukee County. (12/43 Zip Code areas in Milwaukee City) Milwaukee City Zip Code Areas

19. 53217 53209 Capitol Dr. 53216 53211 27th St 53212 53206 Hwy 43 53210 North Ave. 53208 53205 53202 Milwaukee Zip Code GC Data 2008 • Top Four Zip Code Areas for Reported Cases GC in 2008: Zip Code – Cases • 53206 – 548 • 53209 – 402 • 53210 – 400 • 53212 – 390

20. Disease Intervention Activities in Wisconsin • Public health officers in each health department jurisdiction in WI are statutorily responsible to investigate each case of gonorrhea, including eliciting partners and other at-risk individuals for testing and treatment as necessary. • Two counties use limited criteria to follow-up on cases [Milwaukee and Brown (Green Bay)] • Milwaukee Criteria: • F/u GC+ <= 16 males and females OR any pregnant female to verify Rx and notify partners

21. Milwaukee Field Activity for Gonorrhea Cases 2007 & 2008

22. Timeliness to Treatment Family Planning Treatment Rates Jan-June 2009 Females • Milwaukee County: • GC: 61% • Wisconsin w/o Milwaukee County: • GC: 87%

23. Gonorrhea Positivity by Provider Type Wisconsin RVIPP Data 2008 % Positive

24. University of WI-Madison GC 2009:Enrollment 42,000 24/3326 Tests Positive • Female (4/24) cervical NAAT 0.3% • Male (20/24) urine NAAT 0.6% rectal culture 2.6% pharyngeal culture 3.1% Demographic characteristics of positives • 63% MSM (15/20) • 21% African American (5/24) 46% non-genital specimens (11/20 males)