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. At the gate, he and
other volunteers work to sort
through garbage, recycling
abandoned camping gear
and clothing.
Lesa, another volunteer
working at the gate, said they
plan on removing all trash
from the site but need all the
help they can get.
“A lot of people left with
empty vehicles, which is not
OK,” she said.
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