Sexually transmitted disease diagnoses in 2018 broke a record for the fifth consecutive year, according to new data from the U.S. Centers for Disease Control and Prevention (CDC).

Chlamydia was the most common STD in 2018, with more than 1.7 million cases reported, followed by more than 580,000 cases of gonorrhea—3% and 5% increases over 2017, respectively. Though less common, syphilis diagnoses also rose, topping 115,000 cases in total, according to the CDC.

“These are just infections that were diagnosed and reported,” says Elizabeth Torrone, an epidemiologist at the CDC. Since lots of STDs are asymptomatic, “many people have infections that never get diagnosed and reported. This really just gives us the minimum burden of the STD epidemic.”

The report says chlamydia and gonorrhea also topped the CDC’s most recent list of “nationally notifiable” illnesses, a collection of about 120 infectious diseases and other conditions that local health departments report to the CDC. (Full 2018 data is not yet available; 2017 is the latest year on record.) Other common STDs, like HPV, are not considered nationally notifiable.

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