The rate of sexually transmitted diseases is rising sharply. In fact, the rates of three sexually transmitted infections are at all-time record highs in the United States.

Last year, nearly 2.3 million US cases of these sexually transmitted diseases were diagnosed, according to preliminary data. This data was reported on by Fox 13 out of Salt Lake City, Utah. That’s the highest number ever reported nationwide, breaking the record set in 2016 by more than 200,000 cases, according to the Centers for Disease Control and Prevention.

“It is time that President Trump and [Health and Human Services] Secretary [Alex] Azar declare STDs in America a public health crisis,” David Harvey, executive director of the National Coalition of STD Directors said Tuesday. Harvey’s group co-hosted the National STD Prevention Conference in Washington Tuesday where the CDC made the announcement that the rates of syphilis, gonorrhea, and chlamydia have climbed upward again for the fourth year in a row. “What goes along with that is emergency access to public health funding to make a dent in these STD rates and to bring these rates down and to ensure that all Americans get access to the health care that they need,” he said.

Others say this trend should not come as a surprise. “I think over the last five years, we’ve seen a rapid increase in the prevalence of sexually transmitted infections in the US, and we’re also starting to see a plateau in our fight against the HIV epidemic, as well,” said Rob Stephenson, a professor and director of the Center for Sexuality and Health Disparities at the University of Michigan in Ann Arbor. Stephenson added that “it’s not a surprising trend.”

But the focus of concern is with syphilis, gonorrhea, and chlamydia. “We’re talking about millions of infections with just these three infections,” said Dr. Edward Hook, endowed professor of infectious disease translational research at the University of Alabama at Birmingham’s School of Medicine and scientific committee chair of the National STD Prevention Conference. Hook says this trend is concerning because the increase in these three STDs is significant.

“Gonorrhea diagnoses that were reported to the CDC increased by nearly 67%. Diagnoses of primary and secondary syphilis increased over 75%, and chlamydia rates continued to increase,” he said according to Fox 13. “It’s important to remember that while these are preliminary data, and the data are eight months out of date. There’s absolutely no reason to think that the increases that are being described by the CDC haven’t continued into 2018.”

In 2013, there were 1,752,285 total cases of chlamydia, gonorrhea, and syphilis diagnosed in the United States. That number grew to 1,811,850 in 2014; 1,945,746 in 2015; 2,094,682 in 2016; and 2,294,821 in 2017, according to the preliminary CDC data. The preliminary data suggests that more than 1.7 million cases of chlamydia were diagnosed in 2017, with about 45%  (771,340 cases) emerging among 15- to 24-year-old women and girls.

Syphilis, caused by the bacterium Treponema pallidum, can affect the heart, nervous system, and other organs if left untreated. Syphilis is most often transmitted through sexual contact, although it also can be transmitted in other ways, such as from mother to baby, which is called congenital syphilis.“We know today that some of what is driving congenital syphilis are women who are trading sex for drugs and that that explains some of the infections we are seeing in babies of syphilis,” Harvey said Tuesday.

He also said that the rise in STD infection rates could be centered around the nation’s ongoing opioid epidemic. “There are infectious disease consequences of the opioid epidemic in America, including sexually transmitted infections,” Harvey said.