There were more than 2.5 million cases of sexually transmitted infections in the United States in 2021, a record high, according to a new federal report.

“The U.S. STI epidemic shows no signs of slowing,” said Leandro Mena, director of the Centers for Disease Control and Prevention’s (CDC) Division of STD Prevention.

The newest CDC data released Tuesday show increased cases of chlamydia, gonorrhea and syphilis. But the agency noted surveillance may still be impacted by COVID-19 disruptions. Increased case counts may reflect an increase in service utilization as health care clinics re-opened and people sought care when available.

But increases in diagnosed and reported cases could also reflect higher disease transmission.

Of all the tracked infections, CDC found chlamydia was the most prevalent, with 1.6 million cases, a nearly 4 percent increase compared to 2000.

Yet unlike gonorrhea and syphilis, CDC said chlamydia rates did not return to pre-pandemic levels, raising concerns that screening continued to be impacted by COVID-19 related disruptions, because the infection is often asymptomatic.

The number of reported STIs fell rapidly during the coronavirus pandemic, particularly in March and April 2020, during shelter-in-place and stay-at-home orders, CDC said. In addition, many of the STI program resources, including case investigations, were redirected to COVID-19 activities.

Cases of gonorrhea rose nearly 5 percent, CDC found. Rates of reported gonorrhea have increased 118 percent since their historic low in 2009. During 2020 to 2021, the overall rate of reported gonorrhea increased 4.6 percent.

Cases of syphilis surged 32 percent in one year, including an “alarming rise” in congenital syphilis — when a newborn contracts the infection from its mother. In 2021, congenital syphilis caused 220 stillbirths and infant deaths.

Congenital syphilis infections have soared from 941 cases in 2017 to 2,855 in 2021, a 203 percent five-year increase. The rate of congenital syphilis has increased each year since 2013.

According to CDC, the 2021 data show STIs continue to disproportionately affect gay and bisexual men and younger people.

Additionally, a disproportionate number of cases were diagnosed among Black and American Indian/Alaska Native people, groups more likely to face social conditions that make it more difficult to stay healthy.

“For the first time in decades, we’re seeing promising new STI interventions on the horizon, but these alone will not solve this epidemic,” Mena said. “It will take many of us working together to effectively use new and existing tools, to increase access to quality sexual healthcare services for more people, and to encourage ongoing innovation and prioritization of STI prevention and treatment in this country.”

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