January 30

Elephant, wedding cake, gonorrhea: Maine CDC official talks public health dangers with Colby students

The state’s public health campaign following a 2012 gonorrhea outbreak is just one example of the challenges faced by epidemiologists, Dr. Stephen Sears says.

By Matt Hongoltz-Hetling mhhetling@centralmaine.com
Staff Writer

What do an elephant, a wedding cake, and people with gonorrhea have in common?

click image to enlarge

SPREADING THE WORD: State epidemiologist Stephen Sears speaks to a Colby College class about topics ranging from Lyme disease, gonorrhea, elephant tuberculosis and other infectious diseases hursday.

Staff photo by David Leaming

Gonorrhea reports

Gonorrhea reports

State public health officials used a marketing campaign in salons and bars, directed at women, to raise public awareness about prevention and testing after an Androscoggin County gonorrhea outbreak in 2012, and the effort resulted in a steep decline of the sexually transmitted disease.

The 2013 numbers, which are not yet official, were compiled by Sarah Bly, a coordinator within the Maine Center for Disease Control. All figures have been rounded to the nearest whole number. The total number of cases in the state declined from 456 to 246.

County-by-county change in gonorrhea prevalence between 2012 and 2013

Androscoggin decreased from 179 to 85

Aroostook decreased from 10 to 6

Cumberland decreased from 41 to 23

Franklin stayed the same, at 3

Hancock decreased from 17 to 7

Kennebec decreased from 25 to 8

Knox increased from 15 to 18

Lincoln increased from 9 to 12

Oxford increased from 2 to 9

Penobscot decreased from 14 to 11

Piscataquis stayed the same, at 0

Sagahadoc decreased from 28 to 6

Somerset decreased from 23 to 10

Waldo increased from 8 to 10

Washington decreased from 19 to 12

York decreased from 18 to 12

Maine: The state as a whole decreased from 34 to 18.5.

They’re all public health risks Maine has faced in the last two years, state epidemiologist Stephen Sears told a class of Colby College students Thursday morning, part of a message about the emerging challenges faced by public health workers in Maine.

After the lecture to Colby Professor Thom Klepach’s Human Anatomy and Physiology students, Sears said he wanted to raise awareness about epidemiology, which is full of challenges for a new generation of public health workers. As hospitals shift toward disease prevention and population health, he said, epidemiology is gaining in importance in the health field.

“I just wanted to let them know it’s a big world,” he said. “Not everyone who wants to help has to become a medical doctor.”

One significant challenge state health officials faced came in 2012, when there was a spike in the number of gonorrhea cases reported in Maine.

In 2008, there were fewer than 100 cases of gonorrhea reported in the state, Sears said, but in 2012, that number had skyrocketed to 458, enough to make it a major concern for Sears and his colleagues in the infectious disease division at the Maine Center for Disease Control and Prevention.

The numbers showed that the sexually transmitted disease threatened to get out of control.

Sears, who said after the lecture he hoped to make students more aware of public health as a career option, offered a behind-the-scenes look at how the state viewed and responded to the breakout.

First, public health workers collected and analyzed the data, which showed who was getting the disease, and where.

Some areas of Maine, the CDC team found, were worse than others. Statewide, the rate of gonorrhea cases in 2012 was still lower than the nation as a whole. An average of 34 cases per 100,000 people was reported in Maine, far lower than the national average of 104 cases per 100,000 people.

But Androscoggin County was off the chart, with a rate of 179 cases per 100,000 people.

The team also found that the increase was most apparent among young women. In 2007, women accounted for 38 percent of reported cases, but that percentage grew to a majority, 53 percent of cases, by 2012. And most of the women were aged 18 to 28.

“Now we have an idea of what’s going on,” Sears said. “So now what? What do we do with this information?”

The goal was to stop people, especially young women, from having unprotected sex and from unknowingly spreading the disease to others. But getting the message into the right hands was a challenge.

Sears said the team worked with public health students at Bates College in Lewiston — it’s in Androscoggin County, the epicenter of the outbreak — to create a marketing campaign with some pizazz to it.

Posters included a “hunk series,” which featured shirtless, well-muscled men shooting dreamy looks into the camera.

“Hey girl,” one reads. “Did you know gonorrhea is curable, if treated early? Get tested, beautiful.”

Other posters included depictions of young women in cool, retro styles, also advising STD tests.

The campaign was printed on palm cards, posters and coasters, which were posted in bars, hair salons, nail salons and tanning salons.

“They’re not the typical public health partners,” Sears said, “but we wanted to get to all the places that younger women might be hanging out.”

State officials also contacted health practitioners to let them know that the disease was on the rise, and distributed condoms to encourage safe sex.

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