Public health officials in the Northwest say they're seeing gonorrhea infections at levels they haven't seen in years. Three counties in Washington state are now in the midst of an outbreak. Parts of Oregon and Idaho are set to top even last year's high numbers.
And health departments are seeing some unusual trends in the data.
Washington public health officials say King County often drives statewide trends, just through the sheer heft of Seattle's urban population. But the 31 percent increase in gonorrhea cases over last year has largely been from spikes in Snohomish, Spokane and Yakima counties.
Oregon is seeing increases in unexpected places too.
“We've seen during the last year and a half increases in counties that are more rural than our metropolitan area of Portland,” the Oregon Health Authority's Dr. Sean Schafer said.
That includes places like Jackson, Douglas and Lane counties. Schafer said he hasn't seen such a high overall gonorrhea in Oregon since the early '90s.
Idaho's usually low gonorrhea numbers have risen dramatically as well. The infection rate around the Boise area has more than doubled since just two years ago.
North Idaho, far southwest Idaho and the Magic Valley have also sharp increases. The cause remains a mystery. One theory is the cyclical nature of the disease, another points to the higher rate of meth use in some rural areas.
Health departments are working with doctors to increase screening for the disease and are encouraging people to practice safe sex.
The Northwest's rates – at around 20-50 cases per 100,000 people – are still better than the rest of the country, which hovers around 100 per 100,000 people. But health officials say the increase comes at a time when there are signs gonorrhea bacteria could become resistant to the last remaining oral antibiotic treatment.
People who get gonorrhea -- and women in particular -- may have few symptoms. If left unchecked, it can cause pelvic inflammatory disease in women and increase the risk of tubal pregnancy. In both men and women, it has lead to infertility in rare cases.