Wicomico County has the highest rates of chlamydia and gonorrhea of any Maryland county, and health officials say it’s time for residents to own up to the troubling trend as a first step toward healthier sexual behaviors.
“Our goal is to induce leaders in the community and parents and kids to accept that this is our problem, and there are things that can be done about it without creating polarizing views,” said Dr. James Cockey, deputy health officer for the Wicomico County Health Department.
Wicomico’s stubbornly high sexually transmitted disease rates have puzzled health officials for years.
For at least the past decade, the county has ranked among the top Maryland counties, with rates that stand twice as high as the state average.
The only consolation is that Wicomico is no city of Baltimore, whose highly urban geography yields chlamydia rates of more than one infected person for every 80 residents. The rate in Wicomico is one out of every 140 people.
The next-highest rate is the one-in-159 rate in Prince George’s County.
But after years of monitoring and routine public education efforts, Wicomico health officials are ramping up their fight against STDs. Last summer, the health department took an unprecedented step: creating a task force with members from local universities, medical institutions and the school system to address the problem.
The group meets about once every other month to discuss trends and ways to get their message across to those who need to hear it most, Cockey said.
Unsurprisingly, STD rates are highest among the young: high school and college students and those in their early 20s. But STDs don’t exclusively affect that population in Wicomico.
Just ask an emergency room physician — usually the first line of defense against such infections.
“We do have such a broad spectrum of demographic groups,” said registered nurse Sarah Arnett, director of Peninsula Regional Medical Center’s emergency department and a task force member.
Both STDs are ancient scourges. They are curable but represent a growing public health problem.
Symptoms of chlamydia in men include a sharp, burning sensation while urinating and a discharge, according to the Centers for Disease Control and Prevention. In women, the disease can lead to the more-serious pelvic inflammatory disease, which can cause infertility and ectopic pregnancies.
Gonorrhea can also cause a burning sensation while urinating and a discharge. Women, in particular, may experience no symptoms and fail to seek treatment, leaving them vulnerable to infertility and a greater chance of getting or giving the HIV virus.
Chlamydia is still knocked out fairly easily with antibiotics. But gonorrhea is becoming increasingly resistant. The only types of antibiotics that work against it now must be injected, Cockey said. That wasn’t the case as recently as a decade ago.
Identifying the problem
One of the task force’s first missions was to gather explanations for Wicomico’s high rates. That process quickly led to more questions than answers, Cockey said.
Members, for example, pointed to the unusually high concentration of young people tied to the presence of three higher-education facilities: Salisbury University, Wor-Wic Community College and University of Maryland Eastern Shore.
Another theory is that as the crossroads of Delmarva — where routes 13 and 50 intersect — Wicomico is simply more apt to see more traffic and more people than the permanent population would indicate.
And some people speculated it has something to do with the Eastern Correctional Institution. The rate of STDs tend to be higher among inmates, and many of them have partners and families who end up living in Salisbury, the closest city to the prison, Cockey said. For many recent inmates, it’s the first stop upon release.
Despite all the ideas, “we don’t have a solid, proven reason why Wicomico has been so high so many years in a row,” Cockey said.
To understand the problem public health officials face, look at Somerset County. Its STD rates aren’t far behind Wicomico’s, but the makeup of its population offers a clearer explanation for the cause, Cockey said.
Somerset is 42 percent black. Nationally, African-Americans account for a disproportionate amount of STD cases. For example, 69 percent of all reported gonorrhea cases occur in black people, according to the Centers for Disease Control and Prevention.
But Wicomico’s black population represents just 24 percent of the population, which mirrors the state average. So health officials must dig deeper to uncover the reason for its STD prevalence.
Stranger still, Wicomico’s rates of syphilis, HIV/AIDS and teen pregnancy are nowhere near as high as its rates for gonorrhea and chlamydia. Typically, those rates move up and down in lockstep.
“So the reasons it’s so high aren’t clear,” Cockey said.