FARGO — State health officials in North Dakota and Minnesota have released new figures showing reported incidents of many sexually transmitted diseases dropped during 2020, while others increased.

The latter included gonorrhea, with North Dakota showing a 10% increase in 2020, while Minnesota case numbers rose by 27% last year, according to figures provided by state health departments.

And although syphilis cases fell about 18.5% in North Dakota last year and Minnesota saw 3% fewer cases, the disease nonetheless remains a serious threat in those states and across the country, according to Shari Renton, surveillance coordinator for sexually transmitted diseases for the North Dakota Department of Health.

Renton said that about a decade ago syphilis rarely, if ever, occurred in North Dakota.

"But now, it's definitely skyrocketing at really alarming levels. A big part of that is it's not on everyone's minds," Renton said.

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"They call it the great imitator, because the symptoms can mimic many other conditions. So, if people aren't thinking syphilis, it can often get missed," added Renton, who said North Dakota reported three cases of congenital syphilis in 2020, the first time such cases had been seen in the state in a decade.

She said the disease can be prevented in babies if the disease is detected early enough in pregnant mothers for treatment to begin and she said it is also beneficial to screen mothers at the time of birth so it is known whether a baby has been exposed to the disease.

"We are seeing syphilis more in women than ever before," Renton said, adding: "Before, we'd often see it with men who have sex with men and now it's really spilled into the female population as well."

While the overall case numbers of syphilis declined in Minnesota last year, the early, more symptomatic stages increased 8% from 2019 to 2020.

Statewide in Minnesota, seven cases of congenital syphilis were reported in 2020, a 66% drop from 2019.

Minnesota health officials also said syphilis outbreaks in Cass and Beltrami counties remain a critical concern.

Renton said it is difficult to say what accounts for the rise in gonorrhea cases in 2020 and the ongoing challenges represented by syphilis, but she said lack of condom use is an issue.

In the case of gonorrhea, Renton said increased drug resistance could account for some of the increase in infections detected in 2020, adding that the fact treatment must be done in a provider's office may also account for why rates of infection increased last year.

For other STDs, the numbers for 2020 showed an 11% decrease in chlamydia cases in both North Dakota and Minnesota, while new HIV cases dropped by nearly 17% in North Dakota and by 18% in Minnesota.

Health officials said the numbers for 2020 reflect some uncertainty, as the pandemic may have affected how many people were tested compared to past years.

"During the time of the pandemic it's hard to know if overall testing was down. We know that testing was down with our public health lab," Renton said, noting that because many people infected by an STD don't show symptoms, regular screening is wise.

"Everyone really should speak with their health care provider to see what risk they might be at and what things they can do and then definitely get screened," Renton said.