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Gonorrhea. What is Gonorrhea ?. Gonorrhea is a sexually transmitted disease caused by the bacterium Neisseria gonorrhoeae . The infection can be spread by contact with the mouth, vagina, penis, or anus. Gonorrhea is a very common infectious disease. Source CDC, 2011.
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What is Gonorrhea ? • Gonorrhea is a sexually transmitted disease caused by the bacterium Neisseriagonorrhoeae. • The infection can be spread by contact with the mouth, vagina, penis, or anus. • Gonorrhea is a very common infectious disease. Source CDC, 2011
What is Gonorrhea ? • If not treated, gonorrhea can also spread to the blood or joints. This condition can be life-threatening. • Annually, more than 700,000 people in the United States get new gonorrhea infections and less than half of these infections are reported (CDC) Source CDC, 2011
Neisseriagonorrhoeae. Source CDC, 2011
Symptoms and Pathogenesis Source : CDC
Symptoms of gonorrhea usually appear 2 - 5 days after infection. • In men, symptoms may take up to a month to appear. • Some people do not have symptoms and completely unaware of their infection and therefore do not seek treatment. Source CDC
The signs of rectal or eye infection are similar for both sexes. • Rectal infection is often associated with discharge, anal itching, and painful, bloody bowel movements. • Eye infection may cause burning, itching, or discharge. Source CDC
Absence of treatment increases the risks of complication and transmission. • If not treated, gonorrhea can also spread to the blood or joints. This condition can be life-threatening. • In most cases, men will have symptoms more often than women. • Symptoms in women can be very mild or nonspecific, and may be mistaken for another type of infection. Source CDC
Absence of treatment increases the risks of complication and transmission • Untreated gonorrhea can cause serious and permanent health problems in both women and men. • In men, gonorrhea can cause a painful condition called epididymitis in the tubes attached to the testicles. In rare cases, this may prevent a man from being able to father children. Source CDC
In women, gonorrhea can spread into the uterus (womb) or fallopian tubes (egg canals) and cause pelvic inflammatory disease (PID). • PID can lead to internal abscesses (pus-filled pockets that are hard to cure) and chronic (long-lasting) pelvic pain. Source CDC
PID can damage the fallopian tubes enough that a woman will be unable to have children. • It also can increase her risk of ectopic pregnancy. • Ectopic pregnancy is a life-threatening condition in which a fertilized egg grows outside the uterus, usually in a fallopian tube. It is a life threatening condition. Source CDC
If a pregnant woman has gonorrhea, she may give the infection to her baby as the baby passes through the birth canal during delivery. • This can cause serious health problems for the baby. Treating gonorrhea as soon as it is detected in pregnant women will make these health outcomes less likely. Source CDC
Symptoms in men include: • Burning and pain while urinating • Increased urinary frequency or urgency • Discharge from the penis (white, yellow, or green in color) • Red or swollen opening of penis (urethra) • Tender or swollen testicles • Sore throat (gonococcalpharyngitis) Source CDC
Symptoms in women include: • Vaginal discharge • Burning and pain while urinating • Increased urination • Sore throat • Painful sexual intercourse Source CDC
Symptoms in women include: • Severe pain in lower abdomen (if the infection spreads to the fallopian tubes and stomach area) • Fever (if the infection spreads to the fallopian tubes and stomach area) Source CDC
In 2010, 309,341 cases of gonorrhea were reported to CDC. • For every case of gonorrhea reported there is one undiagnosed. • About half of the women with gonorrhea are also infected with chlamydia, another very common sexually transmitted infection. Source CDC
In 2010, 50% of reported gonorrhea cases occurred in just 63 counties or independent cities. • The highest reported rates of infection are among sexually active teenagers, young adults, and African Americans. Source CDC
In 2010, 1,307,893 Chlamydial infections were reported to CDC. • Under-reporting is substantial because most people with Chlamydia are not aware of their infections and do not seek testing. • Women are frequently re-infected if their sex partners are not treated. Source CDC
Gonorrhea: Rates by Age Among Women Aged 15–44 Years, United States, 2001–2010
Gonorrhea: Rates by Age Among Men Aged 15–44 Years, United States, 2001–2010
Gonorrhea: Rates by Race/Ethnicity, United States, 2001–2010
Gonorrhea: Rates by Race/Ethnicity, United States, 2001–2010
Gonorrhea: Rates per 100,000 population by State, United States and Outlying Areas, 2010
Overview of Gonorrhea in Minnesota Source MDH 2011 HIV/AIDS in M Minnesota : Annual Review
2011 Minnesota Gonorrhea Rates by County Kittson Roseau Lake of the Woods Marshall Koochiching Pennington Beltrami Cook Red Lake Polk Lake Clearwater St. Louis Itasca Norman Mahnomen Hubbard Becker Cass Clay Crow Wing Wadena Aitkin Carlton Rate per 100,000 persons Wilkin Otter Tail 0 - 10 Pine 11 - 29 Todd Morrison Grant Douglas Kanabec 30 - 100 Mille Lacs Traverse Benton > 100 Stevens Pope Stearns Isanti Big Stone Chisago Sherburne City of Minneapolis 211 City of St. Paul 132 Suburban# 30 Greater Minnesota 14 (91 cases missing residence information) Swift Anoka Kandiyohi Wright Meeker Washington Chippewa Ramsey Lac qui Parle Hennepin McLeod Carver Yellow Medicine Renville Dakota Scott Sibley Lincoln Lyon Redwood Goodhue Nicollet Rice Le Sueur Wabasha Brown # 7-county metro area, excluding the cities of Minneapolis and St. Paul Murray Blue Earth Cottonwood Steele Dodge Olmsted Pipestone Winona Watonwan Waseca Rock Nobles Jackson Martin Faribault Fillmore Houston Freeborn Mower
Gonorrhea Rates by Race/Ethnicity Minnesota, 2001-2011 2011 rates compared with Whites: Black = 26x higher American Indian = 6x higher Asian/PI = 0x higher Hispanic = 2x higher * Persons of Hispanic ethnicity can be of any race.
Gonorrhea Rates by Race/Ethnicity Minnesota, 2001-2011 * Persons of Hispanic ethnicity can be of any race.
Diagnosis of Gonorrhea Infection • Gram stain: done by staining a sample of tissue or discharge and then looking at it under a microscope. • Cultures: (cells that grow in a lab dish) provide absolute proof of infection. Results provided within 24 to 72 hours. • Samples for a culture are taken from the cervix, vagina, urethra, anus, or throat.
Transmission • Any sexually active person can be infected with gonorrhea. • Thus, transmission may occur from persons who are unaware of their infection.
Transmission • Transmission of the organism occurs during vaginal, anal, or oral sex. • Pregnant women with the disease can pass it to the babies they are carrying.
Transmission • You are more likely to develop this infection if you: • Have multiple sexual partners • Have a partner with a past history of any sexually transmitted infection • Do not use a condom during sex • Abuse alcohol or illegal substance
Transmission • In Summary: there are 3 modes of transmission • Sexual transmission : most frequent • Vertical transmission mother‐to‐infant or transmission during parturition: only major exception to sexual • Transmission via inanimate objects : extremely uncommon.
Gonorrhea and HIV • Untreated gonorrhea can increase a person’s risk of acquiring or transmitting HIV.
Abstain from sexual activity or be faithful (be in a long-term mutually monogamous relationship with an uninfected partner). • Limit your number of sex partners : the fewer partners you have, the less likely you are to get infected. • Notify sex partners immediately if infected. • Make sure partners are tested and treated.
Correct and consistent condom use. Latex condoms are highly effective at preventing transmission of HIV and some other sexually transmitted diseases. • Get tested and treated and insist that your partners do too. • Get a test from a medical provider if infection is suspected and obtain medical treatment immediately if you think you were exposed.
Do not inject drugs. If you inject drugs, you should get counseling and treatment to stop or reduce your drug use. • If you cannot stop injecting drugs, use clean needles and works when injecting. • Pregnant women should consult a health care provider for appropriate examination, testing, and treatment, as necessary.
Health care providers in every state in the U.S. are required by law to tell their State Board of Health about anyone diagnosed with gonorrhea. • The goal of this law is make sure the patient gets proper follow-up care and that their sexual partners are found and tested.
