The number of cases of sexually transmitted disease reported in Spokane County has been rising steadily over the past decade and totaled nearly 2,000 last year, the second highest count ever, though it was down slightly from the record in 2008.

That trend, say health officials here, cries out for an increased effort to educate young people about such diseases.

Stacy Wenzl, manager of the Spokane Regional Health District's communicable disease prevention program, puts much of the blame for the increase in STD cases on a rise in risky sexual behavior, mostly in the younger population, but says improvements in STD screening also have played a role in the rising number of cases.

"That program is trying to get more people tested and treated, so we might be diagnosing more infection as a community," Wenzl says. "And there have been improvements in surveillance and working with providers in reporting the diseases, to make sure that all cases are being reported so we can track incidence in the community."

STDs generally include such diseases as chlamydia, gonorrhea, syphilis, and genital herpes.

Many of the most commonly contracted STDs don't initially result in symptoms that are identifiable to those who contract them, which means many people who are infected might not be aware of it, Wenzl says. For that reason, STDs can do a lot of damage to a patient between contraction and initial diagnosis, she says.

"Generally, I think there needs to be more awareness that it's a valid health issue," Wenzl says. "STDs can impact long-term reproductive health, and an untreated infection can lead to bigger consequences down the road."

Those consequences can include infertility in women, cancer, or even death, the Centers for Disease Control says. Data from the CDC reports that STDs cause at least 24,000 women to become infertile in the U.S. each year. STDs also can be spread from a pregnant mother to her fetus, unless treated, it says.

One of the often silent infections is chlamydia, which can have no symptoms in women, the Washington state Department of Health says. Gonorrhea and syphilis are similar in that some people may not show any symptoms at first.

"People need to be proactive about getting routine health checks because the only way to be sure is to get tested," Wenzl says.

Planned Parenthood of Greater Washington and North Idaho offers reduced-cost testing for STDs based on an individual's age and income, says Amy Claussen, its vice president of education and professional training.

"We know that adolescents are hungry for skills and knowledge to manage the barrage of conflicting information about sexuality they receive from varying sources like the media or their peers," she says. "That is why Planned Parenthood provides medically accurate and honest information for adolescents in order to support wise decision making."

The organization, which has three offices in Spokane and one in Cheney, provides a variety of reproductive health-care services, and works with other organizations to provide education.

"Our goal is to ensure that all people have access to an honest education," she says. "We offer age-appropriate educational programs about a wide variety of topics, including prevention of STIs and unintended pregnancy."

The term STIs, or sexually transmitted infections, is synonymous with STDs.

Claussen says that when people realize how common STDs are and how easy it is to protect against them, they are more likely to engage in safe sexual behaviors.

Last year, 1,933 cases of STDs were reported in Spokane County, down about 5 percent from 2008, the health department says. Reported cases jumped by about 21 percent between 2007 and 2008, it says.

"Here in Spokane, we're working really hard to raise awareness of how rates are rising," Wenzl says. "Spokane County has passed the state's rate for cases of chlamydia."

Statewide, 21,178 cases of chlamydia were reported in 2009, including 1,637 in Spokane County, the Washington state Department of Health reports. That number ranks Spokane County fifth among Washington's 38 counties in terms of the rate of incidence, which is the number of cases divided by the county's population.

Gonorrhea is the second most reported STD in Spokane County, with 131 cases last year, ranking the county fourth in the state in rate of incidence.

"With gonorrhea, there are fewer treatments available that are effective, so it's a risk to the public," Wenzl says. "It's been evolving to become resistant to antibiotics, which continues to be problematic because there are fewer treatment options available now."

Wenzl says the population group with the highest reported number of STDs is people age 15 to 25.

"That is the range where most incidents occur, and the reason for that is that the nature of that population is riskier sexual behaviors," she says.

Wenzl adds that teenage girls also are biologically more susceptible to contract STDs, and thus are more likely to be infected than someone older.

Claussen adds that one of the reasons it's more common for young females to be diagnosed with STDs is because they visit the doctor more often than males as part of annual health visits.

In 2007, the Legislature earmarked about $500,000 for the Spokane Regional Health District to improve disease-control prevention programs, including the district's communicable disease prevention program, Wenzl says. The funding also pays for improved surveillance of reported new cases of STDs here and across the state. Due to the recent state budget shortfall, however, that money has since been reduced by about 20 percent, she says.

A portion of the state funding to support the communicable disease prevention program also helps pay for public health education, Wenzl says. That includes a Web site run by the health department called The Daily Risk, designed to provide reproductive health information to adolescents. That funding also is in jeopardy of not being renewed when it expires next year.

"We hope the programs will survive. We've invested a lot into them with staff here so it will be heartbreaking if they have to go away," she says.

She says another big issue in curbing the spread of STDs is the lack of an enforced guideline to regulate how often people should be screened for the infections.

"There aren't any laws, just clinical practice guidelines," she says, adding that not even all physicians follow such rules. "That's part of what we believe is an issue. Part of the problem is that young people don't think they're at risk, or aren't comfortable discussing their sexuality with health-care providers, and some providers aren't comfortable discussing it with their patients, either."

Wenzl says the U.S. Preventive Services Task Force, a national panel of health-care experts that evaluates clinical preventive services, has deemed that screening for STDs such as chlamydia is a cost-effective service because it helps reduce rising health-care costs associated with treating such diseases as they are spread.

"Reproductive health assessments should be a part of the routine yearly visit," she says. "We promote that it should be part of a comprehensive visit and should be incorporated with general well-being and health, not stigmatized."

The health district's communicable disease prevention program also aids community members who have been diagnosed with an STD to ensure they've received adequate care, Wenzl says, as well as getting a diagnosed person's partner any necessary treatments.