Throughout campus, students are carrying hand sanitizer and steering clear of people coughing and sneezing. But they may already carry an infection–and have no idea.

The Washington State Department of Health (DOH) declared a gonorrhea outbreak in the state last month, with a 34 percent increase in reported cases over last year at this time. While Whitman County is not one of the areas seeing outbreak levels, local experts said students should be concerned.

“Unfortunately, people believe that only sexually promiscuous or ‘dirty’ people get (sexually transmitted infections),” said Christine Johnson, vice president of community outreach for Planned Parenthood in the region in an email to the Daily Evergreen. “It’s untrue that young people in college have not had enough exposure and therefore are unlikely to contract STIs, having unprotected sex even once is risky.”

Washington State DOH infectious disease field coordinator Jon Stockton said young people are particularly at risk. Women are especially vulnerable to bacterial infections such as gonorrhea or chlamydia, which is the most commonly diagnosed STI.

Most people infected with gonorrhea or chlamydia show no symptoms, which helps the diseases spread, Johnson said.

People are often surprised when diagnosed with an STD because they didn’t experience commonly known symptoms such as pain with urination or discharge, Stockton said.

“Even though you feel good, it doesn’t necessarily mean you don’t have anything,” he said. “That’s why screening is so important.”

The infection can do “continual harm,” he said, whether someone is aware there’s a problem or not. 

“Infertility because of contracting chlamydia is the biggest threat to infected individuals because the infection scars the reproductive organs,” Johnson said.

If untreated, gonorrhea can spread to the joints and blood. Complications from either infection can lead to the inability to have children. While sexually transmitted infections can have dire consequences, they can be easy to identify and treat.

Johnson said students often fear treatment and its costs.

“Frequently, students who are still financially dependent upon their parents are reluctant to seek testing because they are concerned their parents will be angry because they are having sex,” she said.

WSU Health and Wellness Services (HWS) works with students who are on their parents’ insurance to keep their tests confidential, said billing manager Merry Lawrence. HWS also has financial assistance available so students never pay more than they can afford.

Testing for chlamydia and gonorrhea is cheap and usually doesn’t involve swabbing or an exam, Johnson said. Treatment consists of taking an antibiotic.

Some recent strains of gonorrhea show resistance to antibiotics, which Stockton said is concerning.

 “When it comes down to how you protect yourself, it’s always going to be communication, and it’s always going to be condoms are by far the best ways to protect yourself,” Stockton said.

Brenda Saltzer, CEO of WISH Medical, a faith-based non-profit organization in Moscow which offers STI screening, said she worries that students overestimate condoms’ effectiveness.

“A condom can only protect what it covers,” she said.

Debbie Medel, a nurse practitioner at WISH Medical, said abstinence and mutually monogamous relationships are the only guaranteed way to prevent infection. Even oral sex can work as transmission.

“Oral sex is still sex,” she said.

Stockton explained that gonorrhea and other STIs can infect the throat, eyes and rectum.

While Washington, particularly in eastern counties such as Spokane, is experiencing an outbreak–defined as a 50 percent increase or more over previous years–Whitman County has only had nine reported cases this year. Last year at this time, there were six.

There have been a total of 3,137 reported cases of gonorrhea in the state between January and September of this year. There were 2,350 during the same period last year, according to the DOH.

Washington’s infection rate is still below the national average, which Stockton attributes partly to a practice called expedited partner therapy. Someone diagnosed with an STI is not only given medication for themselves, but also for current and past partners.

The Centers for Disease Control and Prevention recommends women under the age 25 and men under the age 30 get tested yearly for the most common infections.

“If students have been sexually active and never tested, they should be fully tested now,” Johnson said. “It’s important to have a courageous conversation with each sexual partner to determine the risk of sexual activity with that person.”