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About East Oregonian : E.O. (Pendleton, OR) 1888-current | View Entire Issue (July 21, 2017)
Page 10A OFF PAGE ONE East Oregonian Friday, July 21, 2017 GONORRHEA: Many experience no symptoms Gonorrhea cases: Oregon vs. U.S. the tide is actually turning Continued from 1A in Umatilla County. Riann Roggiero, communicable disease nurse for Umatilla County public health, said the 2016 year-end ranking could have been worse. “In 2016, I was notifi ed by the state that Umatilla County was rated number one in Oregon,” Roggiero said. “This time last year, we were projected to hit 120 cases.” The county decided to push back. Roggiero teamed with state disease inter- vention specialist Patrick Dinwiddie to make fi eld visits to partners of patients diagnosed with gonorrhea. These were folks who hadn’t responded to Roggiero’s phone calls. The pair visited about 35 people in three days spread out over a few months. As one might imagine, the topic of gonorrhea wasn’t a great icebreaker. The health workers eased into the subject and worked to make each person understand that he or she was at risk. “They realized we weren’t there to hunt them down and make them feel ashamed,” Roggiero said. Many times, Roggiero, who is a registered nurse, tested for gonorrhea and gave the necessary combination of antibiotics on the spot, some- times to two people at the same residence. She admin- istered an intramuscular injection of ceftriaxone and another drug, azithromycin, by mouth inside the privacy of the home, except for once. On that occasion, the patient insisted the health workers stay outside and ushered Roggiero to the side of the house. The nurse instructed the woman to lower the waistband of her pants in order to bare the injection site. As Roggiero gave the shot, a neighbor called out in concern. Roggiero, bound by federal Health Insurance Portability and Account- ability (HIPAA) privacy rules, couldn’t explain. It was an awkward moment. Umatilla County Public Health Administrator Jim Setzer said the aggressive response actually increased 150 (Infection rate per 100,000 people) Up 23.7% from 2010 120 U.S. 90 The Eagle/Rylan Boggs Three Rainbow attendees man a hydration station after the Rainbow Gathering. With temperatures reaching close to 100 degrees, dehydration is a ma- jor concern for volunteers cleaning up the site. Up 278.3% from 2010 60 Oregon 30 Source: Oregon Public Health Division Alan Kenaga/EO Media Group 0 2010 ’11 the county’s gonorrhea numbers for a time, because cases that might have gone unreported were detected and treated. Setzer wasn’t bothered by the uptick. “I’d rather know that we’re aggressively pursuing gonorrhea, that we’re iden- tifying and treating cases,” Setzer said. In the long run, the disease started to wane. Instead of the projected 120 cases, the county had 88. So far in 2017, there are 33 cases. Gonorrhea spreads through sexual activity and is most prevalent in men and women in their twenties and thirties. Many experience no symptoms at all. Undetected and untreated gonorrhea can lead to infertility, ectopic pregnancies and chronic pelvic pain in women and sterility in men. Dr. Sean Schafer, a physician with the HIV/STD and tuberculosis section of the Oregon Public Health Division, lauded Umatilla County’s proactive response. “They’ve done a good job with the resources they have,” Schafer said. Schafer said gonorrhea numbers are on the rise both nationally and interna- tionally. Oregon, once only about a third per capita of the rest of the country’s rate, has ’12 ’13 ’14 caught up in recent years. “Since 2010 or so, we’ve increased substantially — about fourfold,” he said. “We’ve essentially gone from about 30 cases per 100,000 to over 100 cases per 100,000.” He said the rest of the country increased more slowly and the two eventu- ally converged. Also worrisome is the bacteria’s ability to evolve and adapt to the point where treatment is ineffective. So far, only a small number of cases of treatment failures are documented, he said, none in the United States, but the possibility lurks. Oregon, as other states, regularly sends samples for testing by ARSI (Antibiotic Resistance Solutions Initia- tive) funded by Congress in 2016 to improve detection and containment of resistant infections. ARSI could be weakened if Trump’s 2018 budget request to cut ARSI by roughly $23 million goes through. Schafer said one odd reason for the increase in gonorrhea cases is that people with HIV don’t worry as much about unsafe sex anymore. “Ironically, drugs used to treat HIV are very effective and if taken regularly elim- inate the chance of infecting STARTS THURSDAY, JULY 20! ’15 2016 someone else,” he said. “National statistics have documented the decline in condom use. People are less concerned about catching a lethal disease” and perceive gonorrhea and syphilis to be much less dangerous. Another reason for the upswing in gonorrhea could be an increase in metham- phetamine use. “Meth is an upper,” he said. “It reduces judgment and leads to riskier sex.” Schafer encouraged physicians to screen patients for gonorrhea. “This is an epidemic,” he said. “Doctors should be asking questions. They can help control the spread.” Roggiero and Setzer urged people who test positive for gonorrhea to be honest with their partners. If not, an STD can become an endless loop of being treated and getting reinfected. Once a partner knows the truth, he or she needs to act. “Telling a partner is a scary, hard step, but it doesn’t solve the problem,” Setzer said. “The partner needs to get tested.” ——— Contact Kathy Aney at kaney@eastoregonian.com or call 541-966-0810. RAINBOW: Area anticipated to be recovered within a year Continued from 1A said attendees who stayed after the gathering have been naturalizing the area by removing trails, fi re pits and latrines, ensuring all holes are fi lled in and spreading duff over disturbed areas. “The idea is to make it look like we were never here, but we’ll never achieve that,” Scott said. He explained the vege- tation will need time to bounce back, and they can’t simply wave a magic wand and remove all traces of the people who attended the gathering this year. Scott typically works clean-up at gatherings, and said this one is better than some. “I’ve seen smaller gath- erings produce more trash,” he said. He attributes this to a downhill walk to the parking lot, allowing people to more easily remove what they brought in, and a dry climate, which didn’t ruin gear with heavy rains. While the few are left to clean up after the many, Scott doesn’t feel animosity toward those who left behind uncleaned campsites. Instead, he directs it at the hangers-on who refuse to leave the gathering but aren’t assisting with the cleanup. “You can’t clean the house while all the children are inside,” Scott said. The majority of the area is anticipated to be recovered within a year, while some smaller areas will take signifi cantly longer to recover, according to a Forest Service press release. “Only time will tell, but we will do our very best to continue to document damages and impacts to the land, water, and wildlife as well as establish long term monitoring to assess impacts,” Blue Mountain District Ranger Dave Hale- meier said. One of the biggest priorities for those cleaning up is the removal of trash. Everything from cigarette butts to tents were left at the gathering, and volunteers are slowly moving it to the front gate, where it is then trucked to the transfer station outside John Day. David, a volunteer working near the gate, said roughly 90 percent of the trash has been removed from the forest. 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