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Counties with the perfect STI charges in Kansas

Counties with the perfect STI charges in Kansas
March 20, 2024


Counties with the perfect STI charges in KansasSTACKER – Sexually transmitted infections are on the upward thrust, placing extra other people in peril as they unfold. Chlamydia charges have just about doubled since 2000, whilst the velocity of gonorrhea went up via 50% over the similar duration. The Facilities for Illness Regulate and Prevention reviews that syphilis charges are achieving ranges final observed within the Nineteen Fifties.

However some areas of the U.S. are seeing upper charges than others.

Stacker used CDC knowledge to have a look at which counties reported the perfect charge of sexually transmitted infections in Kansas. Counties are ranked via the velocity of chlamydia infections, essentially the most distinguished STI on the nationwide point, with gonorrhea after which syphilis charges serving as tiebreakers. This tale specializes in bacterial infections, which may also be cured, relatively than viral infections akin to HIV and herpes. On the county point, 2021 instances are the latest to be had from the CDC, however state and national-level knowledge for 2022 also are integrated. This tale specializes in sexual transmissions and does no longer come with congenital syphilis instances that had been inherited from the mummy.

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Condoms are probably the greatest option to save you the unfold of STIs for other people with more than one sexual companions, however analysis has discovered a reducing charge of condom use amongst instantly, bisexual, and homosexual male populations.

All the way through the HIV/AIDS epidemic during the Nineteen Eighties and Nineteen Nineties, public well being efforts advocating for condom use helped curb the unfold of the virus. As of late, alternatively, condoms are now not the one device. Drugs akin to PrEP decrease the chance of contracting HIV from intercourse via up to 99%.

Whilst more moderen knowledge isn’t to be had, the most recent CDC survey from 2011-2015 confirmed lower than part of single males used condoms all through the final time they’d intercourse.

Amongst highschool scholars having intercourse, the proportion the usage of condoms has fallen from 60% in 2011 to 52% in 2021. Whilst one-third of sexually energetic scholars used hormonal start keep an eye on, handiest 10% used each condoms and start keep an eye on. Strategies just like the tablet and IUDs are efficient at combating being pregnant however don’t forestall the unfold of STIs.

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Chlamydia, gonorrhea, and syphilis are technically bacterial infections—which means they may be able to be cured with antibiotics—however they may be able to nonetheless have lasting well being affects, together with pelvic inflammatory illness and infertility. Those dangers are heightened when left untreated, which many STIs are as they don’t clearly provide themselves.

The CDC recommends annual trying out for cisgender girls, transgender males, and gender-nonconforming other people with cervixes. It additionally recommends annual trying out for men with male sexual companions. Folks in those teams who steadily have intercourse with nameless companions must be examined each and every 3 to 6 months. Somebody with signs must at all times get examined in step with the ideas.

The CDC says there may be little proof that screening amongst instantly males lowers the unfold, and the company’s restricted finances is put against systems reaping benefits essentially the most at-risk teams. Then again, some public well being teams suggest for trying out amongst all other people without reference to intercourse and sexual orientation.

Knowledge from the Nationwide Survey of Circle of relatives Expansion presentations males on reasonable have extra opposite-sex sexual companions than girls, and a few argue that catching STIs during a sexual community relatively than simply for essentially the most at-risk teams may curb their unfold.

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Quickly, a tablet might also lend a hand counter the unfold of STIs. DoxyPEP may also be taken 24 to 72 hours after unprotected intercourse and forestalls an STI prior to it turns into spreadable and symptomatic. The CDC has shared proposed pointers recommending it for males who’ve intercourse with males and transgender girls. The drug used to be firstly licensed for treating inhalation of anthrax, and docs can prescribe it for off-label use.

Learn on to look how STI an infection charges in Kansas examine nationally, and the highest counties.

Emma Rubin // Stacker

State-level statistics

– Chlamydia instances: 474.4 in keeping with 100K (#27 nationally, 13,935 instances)
– Gonorrhea instances: 170.1 in keeping with 100K (#25 nationally, 4,997 instances)
– Number one and secondary syphilis instances: 11.8 in keeping with 100K (#32 nationally, 347 instances)

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#50. Coffey County

– Chlamydia instances: 263.9 in keeping with 100K other people (22 instances)
– Gonorrhea instances: 60.0 in keeping with 100K other people (5 instances)
– Syphilis instances (non-congenital): 0 instances
— Number one and secondary syphilis: 0 instances
— Nonprimary and nonsecondary early syphilis: 0 instances

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#49. Stevens County

– Chlamydia instances: 264.5 in keeping with 100K other people (14 instances)
– Gonorrhea instances: 0 instances
– Syphilis instances (non-congenital): 0 instances
— Number one and secondary syphilis: 0 instances
— Nonprimary and nonsecondary early syphilis: 0 instances

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#48. Grey County

– Chlamydia instances: 265.8 in keeping with 100K other people (15 instances)
– Gonorrhea instances: 35.4 in keeping with 100K other people (2 instances)
– Syphilis instances (non-congenital): 0 instances
— Number one and secondary syphilis: 0 instances
— Nonprimary and nonsecondary early syphilis: 0 instances

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#47. Ellsworth County

– Chlamydia instances: 268.3 in keeping with 100K other people (17 instances)
– Gonorrhea instances: 94.7 in keeping with 100K other people (6 instances)
– Syphilis instances (non-congenital): 0 instances
— Number one and secondary syphilis: 0 instances
— Nonprimary and nonsecondary early syphilis: 0 instances

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#46. Scott County

– Chlamydia instances: 272.9 in keeping with 100K other people (14 instances)
– Gonorrhea instances: 19.5 in keeping with 100K other people (1 case)
– Syphilis instances (non-congenital): 0 instances
— Number one and secondary syphilis: 0 instances
— Nonprimary and nonsecondary early syphilis: 0 instances

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#45. Linn County

– Chlamydia instances: 277.0 in keeping with 100K other people (27 instances)
– Gonorrhea instances: 41.0 in keeping with 100K other people (4 instances)
– Syphilis instances (non-congenital): 0 instances
— Number one and secondary syphilis: 0 instances
— Nonprimary and nonsecondary early syphilis: 0 instances

Brandy S Imlay // Shutterstock

#44. Doniphan County

– Chlamydia instances: 281.1 in keeping with 100K other people (21 case)
– Gonorrhea instances: 120.5 in keeping with 100K other people (9 instances)
– Syphilis instances (non-congenital): 26.8 in keeping with 100K other people (2 instances)
— Number one and secondary syphilis: 13.4 in keeping with 100K other people (1 case)
— Nonprimary and nonsecondary early syphilis: 13.4 in keeping with 100K other people (1 case)

Roberto Galan // Shutterstock

#43. Chautauqua County

– Chlamydia instances: 294.6 in keeping with 100K other people (10 instances)
– Gonorrhea instances: 58.9 in keeping with 100K other people (2 instances)
– Syphilis instances (non-congenital): 0 instances
— Number one and secondary syphilis: 0 instances
— Nonprimary and nonsecondary early syphilis: 0 instances

Patrick Jennings // Shutterstock

#42. Grant County

– Chlamydia instances: 300.4 in keeping with 100K other people (22 instances)
– Gonorrhea instances: 81.9 in keeping with 100K other people (6 instances)
– Syphilis instances (non-congenital): 13.7 in keeping with 100K other people (1 case)
— Number one and secondary syphilis: 0 instances
— Nonprimary and nonsecondary early syphilis: 13.7 in keeping with 100K other people (1 case)

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#41. Wilson County

– Chlamydia instances: 304.9 in keeping with 100K other people (26 instances)
– Gonorrhea instances: 164.2 in keeping with 100K other people (14 instances)
– Syphilis instances (non-congenital): 0 instances
— Number one and secondary syphilis: 0 instances
— Nonprimary and nonsecondary early syphilis: 0 instances

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#40. Pratt County

– Chlamydia instances: 305.0 in keeping with 100K other people (28 instances)
– Gonorrhea instances: 87.1 in keeping with 100K other people (8 instances)
– Syphilis instances (non-congenital): 0 instances
— Number one and secondary syphilis: 0 instances
— Nonprimary and nonsecondary early syphilis: 0 instances

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#39. Sherman County

– Chlamydia instances: 305.3 in keeping with 100K other people (18 instances)
– Gonorrhea instances: 50.9 in keeping with 100K other people (3 instances)
– Syphilis instances (non-congenital): 0 instances
— Number one and secondary syphilis: 0 instances
— Nonprimary and nonsecondary early syphilis: 0 instances

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#38. Miami County

– Chlamydia instances: 309.3 in keeping with 100K other people (107 instances)
– Gonorrhea instances: 60.7 in keeping with 100K other people (21 case)
– Syphilis instances (non-congenital): 2.9 in keeping with 100K other people (1 case)
— Number one and secondary syphilis: 0 instances
— Nonprimary and nonsecondary early syphilis: 2.9 in keeping with 100K other people (1 case)

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#37. Edwards County

– Chlamydia instances: 317.8 in keeping with 100K other people (9 instances)
– Gonorrhea instances: 0 instances
– Syphilis instances (non-congenital): 35.3 in keeping with 100K other people (1 case)
— Number one and secondary syphilis: 0 instances
— Nonprimary and nonsecondary early syphilis: 35.3 in keeping with 100K other people (1 case)

Roberto Galan // Shutterstock

#36. Harper County

– Chlamydia instances: 318.9 in keeping with 100K other people (17 instances)
– Gonorrhea instances: 75.0 in keeping with 100K other people (4 instances)
– Syphilis instances (non-congenital): 18.8 in keeping with 100K other people (1 case)
— Number one and secondary syphilis: 18.8 in keeping with 100K other people (1 case)
— Nonprimary and nonsecondary early syphilis: 0 instances

Actual Window Ingenious // Shutterstock

#35. Atchison County

– Chlamydia instances: 326.4 in keeping with 100K other people (53 instances)
– Gonorrhea instances: 86.2 in keeping with 100K other people (14 instances)
– Syphilis instances (non-congenital): 0 instances
— Number one and secondary syphilis: 0 instances
— Nonprimary and nonsecondary early syphilis: 0 instances

jstillma // Shutterstock

#34. Brown County

– Chlamydia instances: 338.4 in keeping with 100K other people (32 instances)
– Gonorrhea instances: 116.3 in keeping with 100K other people (11 case)
– Syphilis instances (non-congenital): 21.2 in keeping with 100K other people (2 instances)
— Number one and secondary syphilis: 21.2 in keeping with 100K other people (2 instances)
— Nonprimary and nonsecondary early syphilis: 0 instances

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#33. Franklin County

– Chlamydia instances: 354.0 in keeping with 100K other people (92 instances)
– Gonorrhea instances: 69.3 in keeping with 100K other people (18 instances)
– Syphilis instances (non-congenital): 7.7 in keeping with 100K other people (2 instances)
— Number one and secondary syphilis: 7.7 in keeping with 100K other people (2 instances)
— Nonprimary and nonsecondary early syphilis: 0 instances

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#32. Neosho County

– Chlamydia instances: 354.8 in keeping with 100K other people (56 instances)
– Gonorrhea instances: 44.3 in keeping with 100K other people (7 instances)
– Syphilis instances (non-congenital): 12.7 in keeping with 100K other people (2 instances)
— Number one and secondary syphilis: 6.3 in keeping with 100K other people (1 case)
— Nonprimary and nonsecondary early syphilis: 6.3 in keeping with 100K other people (1 case)

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#31. Jackson County

– Chlamydia instances: 362.0 in keeping with 100K other people (48 instances)
– Gonorrhea instances: 196.1 in keeping with 100K other people (26 instances)
– Syphilis instances (non-congenital): 7.5 in keeping with 100K other people (1 case)
— Number one and secondary syphilis: 0 instances
— Nonprimary and nonsecondary early syphilis: 7.5 in keeping with 100K other people (1 case)

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#30. Harvey County

– Chlamydia instances: 366.7 in keeping with 100K other people (124 instances)
– Gonorrhea instances: 150.8 in keeping with 100K other people (51 case)
– Syphilis instances (non-congenital): 14.8 in keeping with 100K other people (5 instances)
— Number one and secondary syphilis: 11.8 in keeping with 100K other people (4 instances)
— Nonprimary and nonsecondary early syphilis: 3.0 in keeping with 100K other people (1 case)

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#29. Johnson County

– Chlamydia instances: 369.4 in keeping with 100K other people (2,265 instances)
– Gonorrhea instances: 96.7 in keeping with 100K other people (593 instances)
– Syphilis instances (non-congenital): 17.4 in keeping with 100K other people (107 instances)
— Number one and secondary syphilis: 12.2 in keeping with 100K other people (75 instances)
— Nonprimary and nonsecondary early syphilis: 5.2 in keeping with 100K other people (32 instances)

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#28. Mcpherson County

– Chlamydia instances: 378.2 in keeping with 100K other people (114 instances)
– Gonorrhea instances: 136.0 in keeping with 100K other people (41 case)
– Syphilis instances (non-congenital): 3.3 in keeping with 100K other people (1 case)
— Number one and secondary syphilis: 3.3 in keeping with 100K other people (1 case)
— Nonprimary and nonsecondary early syphilis: 0 instances

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#27. Thomas County

– Chlamydia instances: 380.9 in keeping with 100K other people (30 instances)
– Gonorrhea instances: 88.9 in keeping with 100K other people (7 instances)
– Syphilis instances (non-congenital): 0 instances
— Number one and secondary syphilis: 0 instances
— Nonprimary and nonsecondary early syphilis: 0 instances

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#26. Greeley County

– Chlamydia instances: 383.4 in keeping with 100K other people (5 instances)
– Gonorrhea instances: 0 instances
– Syphilis instances (non-congenital): 0 instances
— Number one and secondary syphilis: 0 instances
— Nonprimary and nonsecondary early syphilis: 0 instances

Stephanie L Bishop // Shutterstock

#25. Barton County

– Chlamydia instances: 392.6 in keeping with 100K other people (99 instances)
– Gonorrhea instances: 55.5 in keeping with 100K other people (14 instances)
– Syphilis instances (non-congenital): 11.9 in keeping with 100K other people (3 instances)
— Number one and secondary syphilis: 4.0 in keeping with 100K other people (1 case)
— Nonprimary and nonsecondary early syphilis: 7.9 in keeping with 100K other people (2 instances)

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#24. Rice County

– Chlamydia instances: 394.0 in keeping with 100K other people (37 instances)
– Gonorrhea instances: 74.5 in keeping with 100K other people (7 instances)
– Syphilis instances (non-congenital): 0 instances
— Number one and secondary syphilis: 0 instances
— Nonprimary and nonsecondary early syphilis: 0 instances

Sabrina Janelle Gordon // Shutterstock

#23. Cowley County

– Chlamydia instances: 414.5 in keeping with 100K other people (143 instances)
– Gonorrhea instances: 202.9 in keeping with 100K other people (70 instances)
– Syphilis instances (non-congenital): 17.4 in keeping with 100K other people (6 instances)
— Number one and secondary syphilis: 5.8 in keeping with 100K other people (2 instances)
— Nonprimary and nonsecondary early syphilis: 11.6 in keeping with 100K other people (4 instances)

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#22. Leavenworth County

– Chlamydia instances: 416.1 in keeping with 100K other people (342 instances)
– Gonorrhea instances: 119.2 in keeping with 100K other people (98 instances)
– Syphilis instances (non-congenital): 15.8 in keeping with 100K other people (13 instances)
— Number one and secondary syphilis: 7.3 in keeping with 100K other people (6 instances)
— Nonprimary and nonsecondary early syphilis: 8.5 in keeping with 100K other people (7 instances)

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#21. Saline County

– Chlamydia instances: 421.2 in keeping with 100K other people (227 instances)
– Gonorrhea instances: 278.4 in keeping with 100K other people (150 instances)
– Syphilis instances (non-congenital): 24.1 in keeping with 100K other people (13 instances)
— Number one and secondary syphilis: 9.3 in keeping with 100K other people (5 instances)
— Nonprimary and nonsecondary early syphilis: 14.8 in keeping with 100K other people (8 instances)

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#20. Labette County

– Chlamydia instances: 441.9 in keeping with 100K other people (88 instances)
– Gonorrhea instances: 276.2 in keeping with 100K other people (55 instances)
– Syphilis instances (non-congenital): 5.0 in keeping with 100K other people (1 case)
— Number one and secondary syphilis: 5.0 in keeping with 100K other people (1 case)
— Nonprimary and nonsecondary early syphilis: 0 instances

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#19. Sumner County

– Chlamydia instances: 451.2 in keeping with 100K other people (101 case)
– Gonorrhea instances: 151.9 in keeping with 100K other people (34 instances)
– Syphilis instances (non-congenital): 4.5 in keeping with 100K other people (1 case)
— Number one and secondary syphilis: 4.5 in keeping with 100K other people (1 case)
— Nonprimary and nonsecondary early syphilis: 0 instances

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#18. Bernard Law Montgomery County

– Chlamydia instances: 462.2 in keeping with 100K other people (144 instances)
– Gonorrhea instances: 266.4 in keeping with 100K other people (83 instances)
– Syphilis instances (non-congenital): 22.5 in keeping with 100K other people (7 instances)
— Number one and secondary syphilis: 19.3 in keeping with 100K other people (6 instances)
— Nonprimary and nonsecondary early syphilis: 3.2 in keeping with 100K other people (1 case)

Jacob Boomsma // Shutterstock

#17. Reno County

– Chlamydia instances: 468.9 in keeping with 100K other people (288 instances)
– Gonorrhea instances: 136.8 in keeping with 100K other people (84 instances)
– Syphilis instances (non-congenital): 6.5 in keeping with 100K other people (4 instances)
— Number one and secondary syphilis: 3.3 in keeping with 100K other people (2 instances)
— Nonprimary and nonsecondary early syphilis: 3.3 in keeping with 100K other people (2 instances)

Michael Rosebrock // Shutterstock

#16. Kearny County

– Chlamydia instances: 488.3 in keeping with 100K other people (19 instances)
– Gonorrhea instances: 77.1 in keeping with 100K other people (3 instances)
– Syphilis instances (non-congenital): 0 instances
— Number one and secondary syphilis: 0 instances
— Nonprimary and nonsecondary early syphilis: 0 instances

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#15. Ellis County

– Chlamydia instances: 493.2 in keeping with 100K other people (142 instances)
– Gonorrhea instances: 128.5 in keeping with 100K other people (37 instances)
– Syphilis instances (non-congenital): 10.4 in keeping with 100K other people (3 instances)
— Number one and secondary syphilis: 3.5 in keeping with 100K other people (1 case)
— Nonprimary and nonsecondary early syphilis: 6.9 in keeping with 100K other people (2 instances)

Sabrina Janelle Gordon // Shutterstock

#14. Butler County

– Chlamydia instances: 493.5 in keeping with 100K other people (335 instances)
– Gonorrhea instances: 167.9 in keeping with 100K other people (114 instances)
– Syphilis instances (non-congenital): 10.3 in keeping with 100K other people (7 instances)
— Number one and secondary syphilis: 2.9 in keeping with 100K other people (2 instances)
— Nonprimary and nonsecondary early syphilis: 7.4 in keeping with 100K other people (5 instances)

Michael Rosebrock // Shutterstock

#13. Ford County

– Chlamydia instances: 500.6 in keeping with 100K other people (171 case)
– Gonorrhea instances: 79.0 in keeping with 100K other people (27 instances)
– Syphilis instances (non-congenital): 20.5 in keeping with 100K other people (7 instances)
— Number one and secondary syphilis: 11.7 in keeping with 100K other people (4 instances)
— Nonprimary and nonsecondary early syphilis: 8.8 in keeping with 100K other people (3 instances)

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#12. Kiowa County

– Chlamydia instances: 501.7 in keeping with 100K other people (12 instances)
– Gonorrhea instances: 0 instances
– Syphilis instances (non-congenital): 0 instances
— Number one and secondary syphilis: 0 instances
— Nonprimary and nonsecondary early syphilis: 0 instances

Joseph Sohm // Shutterstock

#11. Seward County

– Chlamydia instances: 505.8 in keeping with 100K other people (110 instances)
– Gonorrhea instances: 115.0 in keeping with 100K other people (25 instances)
– Syphilis instances (non-congenital): 13.8 in keeping with 100K other people (3 instances)
— Number one and secondary syphilis: 0 instances
— Nonprimary and nonsecondary early syphilis: 13.8 in keeping with 100K other people (3 instances)

mark reinstein // Shutterstock

#10. Lyon County

– Chlamydia instances: 537.5 in keeping with 100K other people (172 instances)
– Gonorrhea instances: 112.5 in keeping with 100K other people (36 instances)
– Syphilis instances (non-congenital): 0 instances
— Number one and secondary syphilis: 0 instances
— Nonprimary and nonsecondary early syphilis: 0 instances

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#9. Crawford County

– Chlamydia instances: 588.1 in keeping with 100K other people (230 instances)
– Gonorrhea instances: 232.7 in keeping with 100K other people (91 case)
– Syphilis instances (non-congenital): 5.1 in keeping with 100K other people (2 instances)
— Number one and secondary syphilis: 5.1 in keeping with 100K other people (2 instances)
— Nonprimary and nonsecondary early syphilis: 0 instances

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#8. Douglas County

– Chlamydia instances: 598.2 in keeping with 100K other people (714 instances)
– Gonorrhea instances: 161.7 in keeping with 100K other people (193 instances)
– Syphilis instances (non-congenital): 13.4 in keeping with 100K other people (16 instances)
— Number one and secondary syphilis: 5.9 in keeping with 100K other people (7 instances)
— Nonprimary and nonsecondary early syphilis: 7.5 in keeping with 100K other people (9 instances)

William Silver // Shutterstock

#7. Bourbon County

– Chlamydia instances: 607.4 in keeping with 100K other people (87 instances)
– Gonorrhea instances: 139.6 in keeping with 100K other people (20 instances)
– Syphilis instances (non-congenital): 0 instances
— Number one and secondary syphilis: 0 instances
— Nonprimary and nonsecondary early syphilis: 0 instances

Sean Pavone // Shutterstock

#6. Sedgwick County

– Chlamydia instances: 639.7 in keeping with 100K other people (3,351 case)
– Gonorrhea instances: 362.7 in keeping with 100K other people (1,900 instances)
– Syphilis instances (non-congenital): 34.9 in keeping with 100K other people (183 instances)
— Number one and secondary syphilis: 17.6 in keeping with 100K other people (92 instances)
— Nonprimary and nonsecondary early syphilis: 17.4 in keeping with 100K other people (91 case)

Nicholas Warren // Shutterstock

#5. Riley County

– Chlamydia instances: 673.1 in keeping with 100K other people (486 instances)
– Gonorrhea instances: 130.2 in keeping with 100K other people (94 instances)
– Syphilis instances (non-congenital): 5.5 in keeping with 100K other people (4 instances)
— Number one and secondary syphilis: 1.4 in keeping with 100K other people (1 case)
— Nonprimary and nonsecondary early syphilis: 4.2 in keeping with 100K other people (3 instances)

Kristi Blokhin // Shutterstock

#4. Finney County

– Chlamydia instances: 695.4 in keeping with 100K other people (265 instances)
– Gonorrhea instances: 162.7 in keeping with 100K other people (62 instances)
– Syphilis instances (non-congenital): 18.4 in keeping with 100K other people (7 instances)
— Number one and secondary syphilis: 5.2 in keeping with 100K other people (2 instances)
— Nonprimary and nonsecondary early syphilis: 13.1 in keeping with 100K other people (5 instances)

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#3. Shawnee County

– Chlamydia instances: 816.2 in keeping with 100K other people (1,455 instances)
– Gonorrhea instances: 389.3 in keeping with 100K other people (694 instances)
– Syphilis instances (non-congenital): 13.5 in keeping with 100K other people (24 instances)
— Number one and secondary syphilis: 4.5 in keeping with 100K other people (8 instances)
— Nonprimary and nonsecondary early syphilis: 9.0 in keeping with 100K other people (16 instances)

Wirestock Creators // Shutterstock

#2. Wyandotte County

– Chlamydia instances: 921.9 in keeping with 100K other people (1,540 instances)
– Gonorrhea instances: 326.3 in keeping with 100K other people (545 instances)
– Syphilis instances (non-congenital): 42.5 in keeping with 100K other people (71 case)
— Number one and secondary syphilis: 27.5 in keeping with 100K other people (46 instances)
— Nonprimary and nonsecondary early syphilis: 15.0 in keeping with 100K other people (25 instances)

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#1. Geary County

– Chlamydia instances: 1,380.3 in keeping with 100K other people (496 instances)
– Gonorrhea instances: 384.0 in keeping with 100K other people (138 instances)
– Syphilis instances (non-congenital): 41.7 in keeping with 100K other people (15 instances)
— Number one and secondary syphilis: 25.0 in keeping with 100K other people (9 instances)
— Nonprimary and nonsecondary early syphilis: 16.7 in keeping with 100K other people (6 instances)

This tale options knowledge reporting and writing via Emma Rubin and is a part of a chain using knowledge automation throughout 49 states.

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