The state of Washington has been identified by the Centers for Disease Control and Prevention (CDC) as part of a rapidly growing outbreak of gonorrhea.

A CDC report released earlier this month showed that, while the majority of the country boasted a continued decline in the rates of reported cases, the rates of infection in eight states —all of them west of the Rocky Mountains — increased sharply from 2000 to 2005.

"At this point in time, I don't have any information to make me optimistic," said Mark Stenger, the sexually transmitted disease (STD) epidemiologist for the state of Washington and a co-author of the CDC report. "It appears that our case rates are even accelerating with respect to gonorrhea, and in fact, it's been very steep over the last two years."

Washington state showed a 30 percent increase in reported cases from 2004 to 2005 alone, according to the report.

Gonorrhea is a sexually transmitted infection, and the second most commonly reported disease in the United States, according to the CDC. It can be transmitted during childbirth, but the vast majority of infections are a result of sexual contact. While symptoms may never appear and treatment is as simple as a course of antibiotics, gonorrhea can cause serious side effects and even infertility if left untreated.

Researchers remain unsure of the outbreak's origin.

"We were fairly tentative in our conclusions on purpose because we really need more study to really understand what's going on," Stenger said.

One theory is that the statistics reflect a greater amount of tests being performed. The idea is simple: if more people are tested, more infections are diagnosed.

"Data do suggest increases in gonorrhea rates are likely due in part to increased testing and the use of more sensitive tests," said CDC spokeswoman Jennifer Ruth.

She also pointed out that from 2000 to 2004, gonorrhea testing increased 87 percent in the eight states in the CDC report.

However, increased testing isn't the only factor.

If the difference was based entirely on increased screening, doctors would expect to diagnose more people who don't show symptoms, Stenger said. The study, though, showed an increase in symptomatic cases, suggesting a real increase in the prevalence of the disease.

Another theory is that an increase in risky sexual behavior associated with methamphetamine abuse has triggered the rise in gonorrhea cases. Through interviews with patients who have gonorrhea, the Washington state Department of Health has discovered that the increase in gonorrhea cases may be more coincidence than anything.

"We find they're high-risk in all areas of their lives, in terms of drug and alcohol abuse," Stenger said, adding that methamphetamine often creates tight social networks.

Closer social contact facilitates transmission of infections — just think of how the flu spreads through offices and schools when winter forces everyone inside. If a disease like gonorrhea is introduced into these networks, it can spread far more quickly than it would otherwise. This could explain any correlation between increased methamphetamine use and gonorrhea rates.

The outbreak isn't looking to dissipate anytime soon, evidenced by its eastward motion.

"We actually saw the increases in gonorrhea rates beginning in Hawaii in 2003, moving onshore to California in 2004, spreading up through Oregon and Washington in 2005, and now it's beginning to spread eastward from here," Stenger said.

The timing of this recent outbreak poses another problem for some patients, notably those who visit Planned Parenthood. Last November, Medicaid dropped STD screenings from the health care provider's coverage.

"We used to see a fair amount of men who would come in for the testing and treatment, and now that they can't get that service paid for, they're just not coming in anymore," said Kristen Glundberg-Prosser, public affairs director for Planned Parenthood of Western Washington.

While Planned Parenthood is asking the state legislature for additional funding to restore treatment options, Glundberg-Prosser added that "there's no real dedicated funding source for STD testing and treatment, and it's a huge public health concern."

Reach reporter Trevor Klein at news@thedaily.washington.edu.