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Background In 2017, 11,730 gonorrhea (GC) cases were reported to Chicago Department of Public Health (CDPH), a 33% increase from 2015 (8,786 cases). CDPH conducted enhanced GC surveillance to identify factors that may inform interventions. Methods A 33% random sample was selected for further investigation from lab-confirmed GC cases reported August - December 2018 (N=3,337), through Illinois National Electronic Disease Surveillance System. Enhanced surveillance data came from: (1) case telephone interviews, (2) provider case reports, and (3) web-based provider survey. Results From October 2018 - February 2019, enhanced surveillance data was obtained from 459 cases (171 interviews, 399 provider reports; 111 with both), representing 68% of 672 cases with attempted contact, and 14% of all GC cases during the period. Survey respondents were representative of all reported cases: 68% male, median age 27 years, 53% Non-Hispanic Black, 22% Non-Hispanic White, 22% Hispanic. Prior GC infection was documented in 30% of cases, and was more prevalent among males (adjusted prevalence rate ratio [aPRR]= 1.90) and HIV infected persons (aPRR = 1.64). Adolescents and young adults (AYA; aged 13–24 years) comprised 47% of all reported GC cases. Compared to adults, AYA were less likely male (47% vs 80%, p Conclusion Prior GC infection and HIV co-infection were prevalent, without discriminative factors, indicating innovative measures are needed. AYA differ substantially from adults in risk profile, and may have less complete case management. Age-specific and risk-targeted interventions are needed to optimally manage GC and interrupt transmission. Disclosure No significant relationships.

Background Lymphogranuloma venereum (LGV) is caused by Chlamydia trachomatis (CT) serovars L1–L3. The most recent US outbreak of LGV was in 2016 in Michigan in men who have sex with men (MSM) living with HIV. Methods To better understand LGV epidemiology in Chicago and increase provider awareness, in 2016, the Chicago Department of Public Health (CDPH) introduced a case-based reporting system for MSM with suspected LGV proctitis. Providers were asked to complete standard forms for adult MSM demonstrating symptoms of proctitis. Demographic/clinical and behavioral risk factors data were abstracted from 7/21/16 - 4/30/17. Rectal specimens found to be positive for CT on nucleic acid amplification testing were submitted for LGV laboratory confirmation. Results A total of 50 suspect LGV cases were reported to CDPH; 47 specimens were submitted to for further molecular testing: 19 were confirmed to be LGV, 10 were non-LGV/CT positive, 2 had indeterminate results and 16 were CT-negative. All confirmed cases were from rectal swabs: 21% (4/19) were non-Hispanic Black, 42% (8/19) were non-Hispanic white, 32% (6/19) were Hispanic, and 5% (1/19) were non-Hispanic Asian. The median age was 35 years (range = 21–46 years). Of 19 confirmed cases, 84% (N=16) were HIV (+), and in two cases, HIV was diagnosed at the time of LGV infection. The median CD4 count was 613 cells/ml (range = 311–1170 cells/ml, IQR=238); HIV RNA was Conclusion LGV may be suspected in MSM presenting with proctitis symptoms. These data likely underestimate the true local prevalence of LGV in Chicago since reporting was restricted to symptomatic MSM. Improvements in chlamydia case-based surveillance in key populations are critical given the association with LGV and HIV. Disclosure No significant relationships.

Background Trends in congenital syphilis (CS) usually parallel those of primary and secondary (P&S) syphilis in women. Chicago has invested in a multi-pronged approach to address the syphilis epidemic in the city. Between 2010 and 2017, the total number of female P&S syphilis cases in Chicago decreased by 37% (from 87 to 55 cases) in parallel with a decrease in the number of CS cases (from 19 to 11). At the same time, national rates of CS increased 140%, from 9.7 per 100,000 live births in 2010, to a high of 23.3 per 100,000 live births in 2017. Methods A retrospective analysis of surveillance data from 2010 through 2017 was performed on female cases of P&S syphilis (n=483) reported to the Chicago Department of Public Health. Results Of 483 cases reported during this time, 382 (79.1%) were non-Hispanic black, 34 (7.0%) Hispanic, 27 (5.6%) non-Hispanic white, and 40 (8.3%) other or unknown ethnicity. Approximately 7% (32) of females were co-infected with HIV. The median age was 27 and did not change significantly over time, ranging from 24 to 32. Overall, 23% of interviewed females reported having sex while intoxicated with alcohol or drugs, and 15% reported having sex with anonymous partners. Only 6.2% of females diagnosed with P&S syphilis reported exchanging drugs for sex or money and Conclusion Our findings suggest that certain sexual behaviors, in particular anonymous sex and sex while intoxicated, are more frequently reported by women infected with syphilis. To curb the spread of CS further, there is a need to enhance surveillance and collect comprehensive behavioral risk factor data for females. Future interventions should focus on provider and public education, media campaigns targeted towards these sexual behaviors, and expansion of screening programs among females of reproductive age. Disclosure No significant relationships.