Rare form of gonorrhea spreads in Michigan: Symptoms, what to know - Detroit Free Press

Rare form of gonorrhea spreads in Michigan: Symptoms, what to know - Detroit Free Press


Rare form of gonorrhea spreads in Michigan: Symptoms, what to know - Detroit Free Press

Posted: 23 Aug 2019 12:00 AM PDT

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A rare and serious infection caused by the same bacteria that causes gonorrhea is spreading in Michigan, and state health officials are urging residents to abstain from sex or use condoms to prevent the spread of disseminated gonococcal infection, or DGI. 

Six cases are under investigation in Kalamazoo, St. Joseph and Calhoun counties, the state Department of Health and Human Services said Friday, in people ranging in age from 20-55. Five of the six cases have been confirmed.

It begins with a sexually transmitted gonorrhea infection, which sometimes can be asymptomatic, and then develops into DGI. The infection often requires hospitalization and can be deadly, said Lynn Sutfin, a spokeswoman for the MDHHS. 

"Often, it is a result of the initial infection that spreads, usually due to two factors — one's immune system's ability to control the infection as well as the virulence of the organism," she said.

Some people may be more at risk for developing DGI, Sutfin said. They include people with lupus, those who have HIV, those who use intravenous drugs or have multiple sex partners, people with complement deficiency (immune system deficiencies), and women.

Symptoms of DGI include:

  • Fever
  • Chills
  • Joint pain
  • Stiffness and swelling

DGI can also cause infections in joints and internal organs. Patients may or may not have the symptoms of a sexually transmitted disease, so anyone experiencing these symptoms is urged to contact their health care provider.

"We are urging Michigan residents to protect themselves from this rare but serious infection and other sexually transmitted diseases through safe sex practices, including using condoms," said Sarah Lyon-Callo, MDHHS state epidemiologist.

People with gonorrhea don't always have symptoms. The Centers for Disease Control and Prevention says that when symptoms appear in men, the most common are:

  • A burning sensation when urinating
  • A white, yellow, or green discharge from the penis
  • And less commonly, painful or swollen testicles

It reports that women often are asymptomatic or are likely to have mild symptoms that can be confused for a bladder or vaginal infection. Among the symptoms of a gonorrhea infection in women are:

  • Painful or burning sensation when urinating
  • Increased vaginal discharge
  • Vaginal bleeding between periods

Rectal infections also may develop with gonorrhea, which also may cause no symptoms or the following in both men and women:

  • Discharge
  • Anal itching
  • Soreness
  • Bleeding
  • Painful bowel movements.

The infections can be treated with antibiotics and anyone with symptoms should seek medical care, Sutfin said. 

All six people in Michigan who have DGI have been hosptialized, Sutfin said. 

In 2018, there were 16,992 cases of gonorrhea in Michigan, the fifth year of steady increases in cases of the disease, according to the MDHHS. In 2013, 10,553 cases were reported.

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Other sexually-transmitted diseases also are on the rise in the state, with increases in chlamydia and syphilis cases as well. 

It's part of a national trend, said Lynn Sutfin, an MDHHS spokeswoman, but one hot spot appears to be Kalamazoo County, which saw a 20% increase from 2017 to 2018 in gonorrhea cases — from 854 cases to 1,027. 

"As far as why STDs are going up in Michigan and across the country, there isn't one particular reason that stands out," Sutfin said. "It seems to be a combination of factors including: inconsistent use of condoms; multiple sexual partners; and the popularity of dating apps that allow for people to 'hook up.' "

Contact Kristen Jordan Shamus: 313-222-5997 or kshamus@freepress.com. Follow her on Twitter @kristenshamus.

Editor's note: This story was updated to include more information about gonorrhea and its symptoms. 

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Honey Bees Can Get STDs, Too Honey Bees Can Get STDs, Too - Mental Floss

Posted: 20 Aug 2019 08:21 PM PDT

Just over one hundred years ago, the world's last passenger pigeon died at Ohio's Cincinnati Zoo. The bird—named Martha, after George Washington's wife—had been born in captivity and was approximately 29 when she died. Her skin was taxidermied and her internal organs became part of the Smithsonian's collections. In Martha's memory, here are a few things you might not have known about the extinct passenger pigeon.

1. At one time, there were billions of passenger pigeons in North America.

According to Smithsonian, Ectopistes migratorius once made up about 40 percent of North America's bird population; there may have been 3 to 5 billion passenger pigeons when Europeans first came to America. In 1813, naturalist John James Audubon encountered a flock as he rode to Louisville:

"I dismounted … and began to mark with my pencil, making a dot for every flock that passed. In a short time, finding the task which I had undertaken impracticable as the birds poured in in countless multitudes, I rose, and counting the dots then put down, found that 163 had been made in twenty-one minutes. I traveled on, and still met more the farther I proceeded. The air was literally filled with Pigeons; the light of noon-day was obscured as by an eclipse …"

When he finally reached Louisville—55 miles from where he first saw the birds—they were still flying, and continued to pass for three days.

2. Passenger pigeons could fly very, very fast.

Though awkward on the ground, these birds—which ranged from Ontario, Quebec, and Nova Scotia down to Texas, Louisiana, Alabama, Georgia, and Florida, nested from the Great Lakes to New York, and wintered from Arkansas to North Carolina and further south—were graceful and highly maneuverable in the air, flying at speeds up to 60 mph.

3. And passenger pigeons were shaped for speed.

According to Smithsonian, "The head and neck were small; the tail long and wedge-shaped, and the wings, long and pointed, were powered by large breast muscles that gave the capability for prolonged flight." On average, males were 16.5 inches, while females were 15.5 inches.

4. male passenger pigeons were gorgeous.

In the 1829 book American Ornithology, Alexander Wilson describes the males in great detail:

"[B]ill black; nostril covered by a high rounding protuberance; eye brilliant fiery orange; orbit, or space surrounding it, purplish flesh-coloured skin; head, upper part of the neck, and chin, a fine slate blue, lightest on the chin; throat, breast and sides, as far as the thighs, a reddish hazel; lower part of the neck and sides of the same resplendent changeable gold, green and purplish crimson, the latter most predominant; the ground colour slate; the plumage of this part is of a peculiar structure, ragged at the ends; belly and vent white; lower part of the breast fading into a pale vinaceous red; thighs the same, legs and feet lake, seamed with white; back, rump and tail-coverts, dark slate, spotted on the shoulders with a few scattered marks of black; the scapulars tinged with brown ; greater coverts light slate; primaries and secondaries dull black, the former tipt and edged with brownish white; tail long, and greatly cunei form, all the feathers tapering towards the point, the two mid dle ones plain deep black, the other five, on each side, hoary white, lightest near the tips, deepening into bluish near the bases, where each is crossed on the inner vane with a broad spot of black, and nearer the root with another of ferruginous; pri maries edged with white; bastard wing black."

The female, he notes, has a "cinereous brown [breast]; upper part of the neck inclining to ash; the spot of changeable gold green and carmine much less, and not so brilliant; tail-coverts brownish slate; naked or bits slate coloured; in all other respects like the male in colour, but less vivid, and more tinged with brown; the eye not so brilliant an orange."

5. When passenger pigeons roosted, they could shear the limbs off trees.

The birds made their homes in forests, flying out during the day to find food (mostly nuts and berries, but also worms and insects) and back at night to roost. According to Wilson, "It was dangerous to walk under these flying and fluttering millions, from the frequent fall of large branches, broken down by the weight of the multitudes above, and which in their descent often destroyed numbers of the birds themselves."

6. The largest recorded passenger pigeon nesting site was in Wisconsin.

In 1871, an estimated 136 million passenger pigeons nested over 850 square miles in central Wisconsin. Pottawatomie Chief Pokagon described the event:

"Every tree, some of them quite low and scrubby, had from one to fifty nests each. Some of the nests overflow from the oaks to the hemlocks and pine woods. When the pigeon hunters attack the breeding places they sometimes cut the timber from thousands of acres... I there counted as high as forty nests in scrub oaks not over twenty-five feet high; in many places I could pick the eggs out of the nests, being not over five or six feet from the ground."

There is a historical marker at Black River Falls to commemorate the event.

7. Passenger pigeons were really noisy.

Aside from the "near-deafening noise" of nesting colonies, little is known about the vocalizations of wild passenger pigeons. What scientific descriptions we do have come from birds in an aviary, described by Wallace Craig in 1911. "If you tell a boy to look for a bird of the same general appearance as the Mourning Dove but larger, he will be sure to mistake some large-appearing Mourning Dove for the Passenger Pigeon," Craig wrote. "But tell him to look for a pigeon that shrieks and chatters and clucks instead of cooing, and the boy will be less likely to make a mistake."

He described five vocalizations, including a "unmusical" keck that was "loud, sometimes very loud, harsh, and rather high-pitched ... so far as it can be said to have any pitch at all. It is generally given singly, but sometimes two or more in succession with but, short pause between. … [It] resembles the kah-of-excitement also in that it is often followed immediately by other notes, such as the coo," and "Scolding, Chattering, Clucking [which] represent the wide variations of this most characteristic and frequent utterance of the Passenger Pigeon. … Wm. Brewster (quoted in Bendire, p. 134) says: 'They make a sound resembling the croaking of wood-frogs.'"

8. Passenger pigeon courtship rituals different from those of other pigeons.

Most pigeons perform courtship rituals—which include bowing and strutting—on the ground, but the passenger pigeon was awkward there, so courtship took place on branches or other perches, according to Craig, with the male vocalizing, slightly flapping his wings, and holding his head over the female's neck. Before mating, the birds would stand side by side, preen each other, and then clasp bills (which is decidedly not how John James Audubon illustrated it above; Craig wrote that "however great the value of this plate in other respects, its value as a record of the attitudes and habits of the species, is very little").

9. In 1900, a reward was offered to whomever could find passenger pigeons in the wild.

A slow decline in the mid-1800s was followed by a catastrophic decline [PDF], and by the late 1800s, it was unusual to see a passenger pigeon in the wild. In an article published on January 16, 1910, The New York Times [PDF] announced that a "THREE HUNDRED DOLLAR REWARD Will Be Paid for a Nesting Pair of Wild Pigeons":

"Unless the State and Federal Governments come to the rescue of American game, plumed and song birds, the not distant future will witness the practical extinction of some of the most beautiful and valuable species. … The wild pigeon fifty years was so common in the United States that during migratory periods the flocks that crossed the country sometimes dulled the sun from the view of the man below. To-day a standing reward of $300 is offered to any person who can show a nesting pair of these birds."

Sadly, it was too little, too late; the last passenger pigeon seen in the wild was shot that year. Deforestation and the boom-and-bust availability of its food were factors in the bird's extinction. Hunting, also, may have done the species in; they went from huge numbers to extinct in just 40 years.

10. Scientists are trying to bring the passenger pigeon back.

The Great Passenger Pigeon Comeback, launched in 2012, aims to bring back the passenger pigeon using the DNA of its closest relative, the band-tailed pigeon. According to National Geographic, the scientists working on the project "can't extract an intact passenger pigeon genome from museum specimens. So they're hoping they can do the next best thing: retool the genome of a living bird species so that it gives rise to a passenger pigeon." The plan is to study DNA from museum specimens to see what sequences might be responsible for passenger pigeon traits; then, once they've created a genome similar to the passenger pigeons, they'll "insert this altered DNA into reproductive cells in band-tailed pigeon embryos. The birds will mature, mate, and lay eggs. And out of those eggs will emerge passenger pigeons—or at least birds that are a lot like the way passenger pigeons used to be."

I’m Terrified to Have Sex Because Everyone Lies About STDs - Slate

Posted: 13 Aug 2019 12:00 AM PDT

Senior woman surrounded by neon plus signs.

Photo illustration by Slate. Photo by Getty Images Plus.

How to Do It is Slate's sex advice column. Send your questions for Stoya and Rich to howtodoit@slate.comNothing's too small (or big).

Dear How to Do It,

I'm a 60-year-old woman who still attracts attention from others, which I desire. But I always say no, because of STDs. I do not trust men to answer me honestly about their status, and I know some men may not even know if they have an STD. My motto is better safe than sorry, so I stay at home, alone. I get by with sex toys, but I so wish for physical contact. So sad when the skin craves love. Is there any way out of this box?

—Not Out There

Dear Not Out There,

I'm seeing two possible options for you. One is to focus on intimacy and closeness, and seek out cuddling partners. Your current boundaries might not be exciting or appealing to everyone, but even one snuggling buddy would be more physical contact than you're getting now. You can't be the only person who craves intimate touch but is wary of or uninterested in sexual activity.

In that scenario, you'd stay within your boundaries, whatever they may be. If you're feeling up to it, you might explore kissing. Depending on how that goes, you could even try masturbating together. Which brings me to the other possibility—allow yourself to accept some managed risk.

You can ask new partners to get a new round of STI testing. Talk with your doctor or gynecologist about what level of testing is appropriate for you, and decide what you feel comfortable asking of your potential partners. Show them your test. Ask to see theirs.

Sometimes tests can miss new infections. You can ask your partners to wait the window period—the time in which an infection can be in the body without it showing up on a test—after his last sexual interaction before testing (this is more of an option in monogamous relationships). If you decide to have penetrative sex, use condoms even though everyone has been tested. If you engage in oral sex without barriers, get your throat swabbed every once in a while. You can exercise layers of precaution for even safer sex. Testing reduces the likelihood of having sex with someone with an STD, condoms reduce transmission possibility in the event of exposure, and regular testing afterward increases the chances of management or total cure.

It's completely up to you, and you should move slowly and be gentle with yourself. Let your emotions happen, and pay attention for signs you might be feeling overwhelmed. There's no rush, and there doesn't have to be an end goal other than human connection.

Dear How to Do It,

I am in my 20s and have been in a relationship with my boyfriend for a year last month. When I first met "Jim," I felt as if I had found the person I had always dreamt of: He is very attractive, hardworking, family oriented, kind, etc. The only issue I have with our relationship is with the amount of intimacy we share, and I'm not just referring to sexually. We have sex roughly every three to four weeks, but he doesn't really give verbal affirmation (besides "I love you" or "Miss you"), and cuddling isn't really a thing we do. He will do things like put his hand on my leg in the car, put his arm around me when we are out, and regularly giving me "peck" kisses, but that's about as far as our intimacy gets most of the time. I thought as we got more comfortable with each other, this would improve, but after a year, he seems very content with this. (He shows love by spending quality time with me, whereas I do verbally and physically).

When I've talked to my friends about this, they believe I should try to initiate more or put myself out there—I rarely ever do—but frankly the lack of intimacy has left me feeling extremely insecure about myself and left me constantly questioning everything about our relationship. It has also caused me to secretly be angry at him, and I feel myself distancing myself from him, and he has no idea. I'm too young to be in a relationship that barely has sex and lacks intimacy. I feel as if the only option I have is to bring this up to him, but I'm not even sure how. I don't want to tell someone they need to touch me more or be more verbal with what they feel about me if they don't want to. That just feels unnatural. But I love him very much and want to continue building a future together. What should I do? Do you think this is something that doesn't usually get better and I'm better off leaving now, or can intimacy improve just from communicating what my needs are?

—Out of Touch

Dear Out of Touch,

I get a version of your question often, so I reached out to Logan Levkoff, a doctor, sex educator, and author of multiple books on sex and dating. She says what you might not want to hear: "I understand that people want to avoid uncomfortable conversations, but that's just unrealistic if you want a relationship to go the distance (however you define 'distance')." Consider this: If you really do love and want relationship longevity with this person, is it worth holding back, crossing your fingers, and hoping that something changes? It's not "unnatural" to tell your partner about your needs, and for him to try to meet them. He might even crave more intimacy himself.

If you're nervous about broaching this conversation, you can set yourself up for success. Pick a good time when neither of you are rushed or stressed, and things are quiet. Foster intimacy by maintaining eye contact and arranging your body to be open—legs uncrossed or crossed toward the person you're speaking with, arms by your sides or on your lap. Focus on your goal going into the conversation—to communicate about what you need to feel comfortable and cared for, and hear the same from your partner. Levkoff added, "If you don't want to come out directly and say, 'I would really love for you to do _______,' think about asking him, 'What do I do that makes you feel loved and appreciated? What would you like me to do more of?' Ideally, this will initiate a conversation about your needs, too. If it doesn't (and the question is not reciprocated), then it seems like there is a deeper underlying issue at play."

It might not feel fun or easy, but this is part of the work of having a healthy long-term relationship. Our partners aren't mind readers. To get our needs met, we usually need to ask for what we want. It's absolutely normal and fine for this to feel difficult or scary at first (though it's great and also normal if it doesn't). I absolutely believe that intimacy can improve, and the first step is communication.

Dear How to Do It,

I am a 41-year-old woman who's never really dated. I've had a few longer-term relationships (the longest lasting eight years) with men who started out as friends and then developed into something more, but I've never actually "dated," as in "go out to dinner with someone you don't know that well to see if you like each other." As a late bloomer and an introvert, I missed the standard awkward high school and college dating scene, and now I feel like the odd ball who doesn't know how to get started. Since the end of my last relationship, I've been single for the better part of a decade. In the meantime, I've had a couple of major blows to my self-image as a sexual person (hysterectomy and menopause, major weight gain and loss, and arthritis that makes me feel 90 years old on some days), and now live a life where I don't meet a lot of men through work or social contacts. Add in the fact that I'm still an introvert with a touch of social anxiety, and dating starts to seem like an even bigger challenge to tackle.

There's something inherently awkward about sitting down with a stranger to evaluate whether you'd like to kiss each other.

I'm happy with my day-to-day life, but I miss having someone to share it with. I'm just not sure how to get started. I've asked my friends if they know anyone to introduce me to, but they don't seem to know anyone who meets my criteria (I wouldn't have thought the list is too picky: actually single, AKA not "we're getting a divorce but haven't done it yet"; nonsmoker; gainfully employed; responsible for own transportation; doesn't live in mom's basement; no active criminal or mental health issues; and so forth.) I thought about online dating, but I've heard so many horror stories it makes me even more nervous. My community doesn't have any "singles" events/groups to meet people through, and I'm not really keen on trying to meet guys in bars. Do you have any advice on how/where to meet people in a low-pressure environment—I think it's telling that all of my former relationships started out by hanging out in a group of friends—or how to start selectively dating at an age where it feels like everyone else has figured it out but me?

—40-Year-Old Date Virgin

Dear 40YODV,

A lot of people in their 30s and 40s are getting divorced after a long period of not dating. Others are just now getting their lives on track. Almost everyone is a little awkward on the dating scene. There's something inherently awkward about sitting down with a stranger to evaluate whether you'd like to kiss each other. Consuming food in a semi-ritualized manner as an introduction. Tentatively feeling out whether to hold hands in a theater while watching the summer's big movie. The online aspect makes the whole thing even stranger—deciding romantic and sexual interest based on a handful of photos. And yet, most of us do it at some point.

Find reasons to be where other people are. Take a class in something. Go to the park and read. Splurge for the shared coffee shop experience on the weekend. Present yourself as available—leave the headphones at home and make eye contact liberally. Make new friends as you're able. Maybe some of them are dateable by your criteria—which I agree are not particularly narrow—or have friends who are. In other words, widen your friend circle if your friends are low on suggestions; there's nothing wrong with what's worked for you in the past. Remember some people are monogamous, and others are polyamorous or otherwise open. Some are classic romantic dating types, and others are buddies-with-sex types. Consider what you might be open to. It might be worth a few fairly random dates via dating app (yes, people of all ages use them) or other means to see how you feel once you're actually on one, but if they aren't for you, there's no need to continue with something that doesn't work for you.

Dear How to Do It,

I'm in a loving relationship of four years with my fiancé (both nonbinary). We don't have sex often because of depression cutting into our sex drives, but when we do, I often find myself essentially dissociating for the experience, especially when I'm on the receiving end. I suspect this has to do with traumatic past experiences and ADHD, but I like sex with my fiancé and want to be in the moment, to enjoy the intimacy and pleasure. It often takes me a long time to come, and my orgasms are quite mild/anticlimactic, which I don't mind, but it contributes to the ease at which I can start checking out, thinking about other things, like chores that need to be done or even just getting songs stuck in my head. How can I be more mindful during sex and focus on the moment?

—Present

Dear Present,

The short answer is to practice mindfulness regularly—no matter what area of your life you're training yourself on those skills, the effect will likely generalize. Practice breathing when you aren't having sex. Practice focusing on your breath while you're breathing. Gently return your attention every time you notice that it has wandered. Do the same thing during sex. Don't get frustrated or angry with yourself, just calmly notice that your brain has started folding laundry and return your attention to your fiancé or your body. Think of every time your mind wanders as an opportunity to practice returning your attention to what you want it focused on.

You might consider being a more active participant—depending on how your partner feels, simultaneously mutual oral or digital sex might provide enough complexity to keep you focused. It could be worth talking to an ADHD specialist about ways to manage and work with your brain, which, again, are likely to help in the bedroom if they help anywhere else.

—Stoya

More How to Do It

In high school, my younger sister "Eva" got very intensely into a conservative church, purity pledges and all. My brother "Josh" and I never did, and both turned out to be pretty nonreligious with unremarkable dating lives. Eva remained very involved in her church, and three months ago, at 22, she married her similarly devout husband. This past weekend, Josh informed me that our brother-in-law confessed to him (over too much to drink) that he and Eva hadn't consummated the marriage despite multiple attempts together. He didn't mention what kind of difficulties they were having, only that it was also his first time and he felt pretty lost. Josh was focused on getting him sober and getting him home, so the conversation didn't continue. I feel terrible for them! I'm trying to figure out if I can say something to Eva: Do I give her an adult version of The Talk? Slide a pamphlet in her purse and run away? Josh said he would be open to talking to our brother-in-law too, if he could figure out what to say.

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