State health officials are concerned that Alaska gonorrhea rates, which held steady for years, suddenly jumped by 69 percent in 2009 -- the biggest one-year rise since the 1970s, said Susan Jones of the state's Department of Health and Social Services .

There were 997 cases reported last year, for a rate of 144 cases per 100,000 people. In 2008, the rate was 85 per 100,000 people.

Alaska Natives and people living in Southwest Alaska have the highest rates, according to the new numbers. Two-thirds of cases occurred in Alaska Natives.

But the epidemic is almost statewide, with every area except Interior Alaska experiencing a rise, said Jones, who manages the states HIV and sexually transmitted disease program. The state Division of Public Health published a bulletin Tuesday to get the word out.

Gonorrhea is a sexually transmitted disease that can cause pelvic inflammatory disease, infertility and failed pregnancies in women, eye infections in newborns, and infections in men.

State officials don't know for sure why the rate is spiking, but do know it's not from increased testing, said Jones. The number of tests has been consistent, but more of them are coming back positive, she said.

Some providers say the type of gonorrhea circulating recently seems to have milder symptoms than were noted in past gonorrhea outbreaks, Jones said.

"So people aren't rushing in to get treated because they're so uncomfortable. Especially the men," she said. Instead, they're continuing to have sex. "That may be promoting the spread of it."

Women generally have fewer symptoms than men.

John Palmer, with the sexually transmitted disease program at Southcentral Foundation -- which serves Alaska Natives in Anchorage -- said Southcentral is, in fact, seeing patients with a lower level of symptoms.

"Guys are ingrained if you've got gonorrhea, you're going to have burning and heavy discharge," he said. But with the current strain, they may have tingling, or intermittent burning or discharges, he said.

Traditionally, the symptoms drove women to the doctor in one to three months and men within one to three weeks, he said. Now, "instead of coming in within days, they're coming in within maybe three to four months of having the symptoms."

Gonorrhea rates at the Alaska Native Medical Center campus, including Southcentral Foundation, about doubled in 2009 over 2008, Palmer said.

Jones said the rate for Alaska Natives in Anchorage and Mat-Su is high, about the same as the rate for all residents of Southwest Alaska, which includes the Bethel region.

State records show gonorrhea rates rose first in Southwest Alaska. While the state as a whole had stable rates in 2007 and 2008, the gonorrhea incidence more than tripled in the Southwest.

Alaska had the highest gonorrhea rates in the country during the 1970s, when the pipeline-building boom was under way, Jones said. In recent years, Alaska's rate has been about in the middle of the other states, she said.

But that will likely not last.

"I think the rates we calculated for 2009 are going to move us somewhere close to the top 10," Jones said.

Jones and other health officials urge people to get tested. Gonorrhea, which is frequently accompanied by chlamydia, another sexually transmitted disease, can be treated with antibiotics.

And health providers will notify partners of anyone infected, without saying how they were infected.

The city health department has a clinic at 825 L St. where people can get tested and treated.

Palmer said anyone with questions can call him at 729-4296. "I'll talk to anybody."