MMWR Morb Mortal Wkly Rep. 2007;56(14):332–336. Gonorrhea is often asymptomatic in women. N. gonorrhoeae can also infect the mucous membranes of the mouth, throat, eyes, and rectum. Centers for Disease Control and Prevention. The overall national rate was computed, as were rates per sex, ag… From epidemiological synergy to public health policy and practice: The contribution of other sexually transmitted diseases to sexual transmission of HIV infection. For example, gonorrhea transmission can occur from mother to baby during a vaginal delivery or through contact with the penis, vagina, mouth, or anus. 1999;75(1):3–17. Rates of 10% have been found in some central city adolescent prenatal clinics. Gonorrhea is an infection caused by the bacteria Neisseria gonorrhoeae. Incidence (annual) of Gonorrhea: 800,000 cases (CDC estimate/NIAID) Incidence Rate: approx 1 in 339 or 0.29% or 800,000 people in USA [] Incidence extrapolations for USA for Gonorrhea: 800,000 per year, 66,666 per month, 15,384 per week, 2,191 per day, 91 per hour, 1 per minute, 0 per … Rates of gonorrhea diagnoses rose by 63% between 2012 and 2016, highest in young, urban heterosexuals. Sexually transmitted diseases treatment guidelines, 2010. Between 2015 and 2017, 66.7–75.3% of all tested isolates had an MIC value of 8 µg/mL (Figure 30). Anyone who is sexually active should discuss his or her risk factors with a health care provider and ask whether he or she should be tested for gonorrhea or other STDs. In females, gonorrhea can also infect the cervix. Fairley CK, Hocking JS, Zhang L, Chow EP. Syphilis infection rates also increased, and chlamydia cases remained high. 1 Gonorrhea is a very common infection in the United States and worldwide. Frequent Transmission of Gonorrhea in Men Who Have Sex with Men. Gonorrhea can also be spread perinatally from mother to baby during childbirth. Although medication will stop the infection, it will not repair any permanent damage done by the disease. If a pregnant woman has gonorrhea, she may give the infection to her baby as the baby passes through the birth canal during delivery. N. gonorrhoeae infects the mucous membranes of the reproductive tract, including the cervix, uterus, and fallopian tubes in women, and the urethra in women and men. Antimicrobial resistance remains an important consideration in the treatment of gonorrhea.3, 7-9 In 1986, the Gonococcal Isolate Surveillance Project (GISP), a national sentinel surveillance system, was established to monitor trends in antimicrobial susceptibilities of urethral N. gonorrhoeae strains in the United States.7 Data are collected from selected STD clinic sentinel sites and from regional laboratories (Figure 28). We developed and calibrated a mathematical model of gonorrhea transmission among men who have sex with men (MSM) in the United States. Many men with gonorrhea are asymptomatic 3, 4. National Objectives and Goals, Appendix C. STD Surveillance Case Definitions, Customizable Infographic with Instructions, U.S. Department of Health & Human Services. Collaborating SSuN jurisdictions also conduct sentinel surveillance on all patients seeking care in selected STD clinics. Complications in women include pelvic inflammatory disease and in men include inflammation of the epid… During 2017–2018, the percent of gonorrhea cases reported by STD clinics decreased 7.5% among females and 4.9% among males. Health care providers with STD consultation requests can contact the STD Clinical Consultation Network (STDCCN). The gonorrhea rate among American Indians/Alaska Natives (AI/AN) (329.5 cases per 100,000 population) was 4.6 times that of Whites, the rate among Native Hawaiians/Other Pacific Islanders (NHOPI) (181.4 cases per 100,000 population) was 2.6 times that of Whites, the rate among Hispanics (115.9 cases per 100,000 population) was 1.6 times that of Whites, the rate among Multirace persons (94.4 cases per 100,000 population) was 1.3 times that of Whites, and the rate among Asians (35.1 cases per 100,000 population) was half the rate of Whites (Table 22B). But here are some pertinent data. Pharyngeal infection may cause a sore throat, but usually is asymptomatic 11, 12. Other estimates put the male-to-female transmission rate from one sexual instance at 40 percent and the female-to-male transmission rate at 32 percent. Some people should be tested (screened) for gonorrhea even if they do not have symptoms or know of a sex partner who has gonorrhea 18. The proportion of patients treated with ceftriaxone 250 mg increased from 84.0% in 2011 to 98.1% in 2017 but decreased slightly to 96.5% in 2018. The STD Surveillance Network (SSuN) is an ongoing collaboration of state, county, and city health departments conducting sentinel and enhanced surveillance activities. CDC twenty four seven. In most regions, the rate of gonorrhea increased among both males and females during 2017–2018 and during 2014–2018 (Tables 15 and 16). 2018 witnessed a national increase across the board in chlamydia, gonorrhea, and syphilis infection rates, while the states at the top of the ranking in their respective categories all saw individual increases in infection rates. If untreated, gonorrhea infection may lead to serious complications. Infected men may experience pain or burning with urination, discharge from the penis, or testicular pain. Understanding its epidemiology is therefore of major biomedical importance, not only on a population scale but also at the level of direct transmission. For those patients who do experience symptoms, women report burning sensation while urinating (peeing), increased vaginal discharge, or vaginal bleeding between periods. Get the facts from WebMD about gonorrhea, including what causes it and how to prevent it. Changes in the burden of gonorrhea may be masked by changes in screening practices (e.g., screening for chlamydia with tests that also detect N. gonorrhoeae infections or increased screening at extra-genital anatomic sites), the use of diagnostic tests with different test performance (e.g., the broader use of nucleic acid amplification tests [NAATs]), and changes in reporting practices. In men, gonorrhea may be complicated by epididymitis. Also, anyone with an oral, anal, or vaginal sex partner who has been recently diagnosed with an STD should see a health care provider for evaluation. In 2018, the largest proportion of cases among females were reported by private physicians/health maintenance organizations (HMOs) (24.1%), followed by other hospital clinics/facilities (13.6%), laboratories (9.0%), emergency rooms (6.0%), and STD clinics (5.8%) (Figure 23). If left untreated, gonorrhea can also spread to the blood and cause disseminated gonococcal infection (DGI). This may be because ageing comes with natural physiological changes (vaginal drying), psychosocial changes (loss of a partner) and behavioural changes (increases in risky behaviour due to loss of fear of pregnancy), all of which can make older adults more susceptible to contracting STIs Footnote 27 Footnote 28 . You will be subject to the destination website's privacy policy when you follow the link. Although gender and age may play a part in increasing your chances of getting gonorrhea, it’s important to mention that the CDC states that incidences of the infection have recently been on the rise among the male population. 2017;44(7):393–397. Gonorrhea is associated with increased susceptibility to HIV acquisition. Grey JA, Bernstein KT, Sullivan PS, et al. It can also be spread from mother to child during birth. Men who have sex with men (MSM) are at high risk for gonorrhea infection. In women, gonorrhea can spread into the uterus or fallopian tubes and cause pelvic inflammatory disease (PID). Sex Transm Dis. Gonorrhea is sometimes called “the clap” or “the drip.” Gonorrhea is spread through vaginal, anal, and oral sex. Transmission of Gonorrhea What causes gonorrhea? CDC recommends yearly gonorrhea screening for all sexually active women younger than 25 years, as well as older women with risk factors such as new or multiple sex partners, or a sex partner who has a sexually transmitted infection. Determining the key drivers of the reproductive rate for gonorrhea in MSM involves characterizing transmission between anatomic sites, which requires quantifying the site-specific sexual In 2018, the highest rates among females were observed among those aged 20–24 years (702.6 cases per 100,000 females) and 15–19 years (548.1 cases per 100,000 females). For more information on Gonorrhea download the Gonorrhea – CDC Fact Sheet here. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. RR–3):1–137. Declining susceptibility to cefixime (an oral cephalosporin antibiotic) resulted in a change to the CDC treatment guidelines in 2015 to the current CDC-recommended regimen of ceftriaxone (an injectable cephalosporin) and azithromycin.3 The emerging threat of cephalosporin resistance highlights the need for continued surveillance of N. gonorrhoeae antimicrobial susceptibility. As in previous … Although overall gonorrhea positivity rates declined with increasing age for women, MSM, and MSW, a slower decline by age was observed in MSM <40 years of age. 1. The different susceptibility patterns seen in GISP in 2018 are shown in Figure 32. Centers for Disease Control and Prevention. Review. The surest way to avoid transmission of gonorrhea or other STDs is to abstain from vaginal, anal, and oral sex, or to be in a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected. The magnitude of the increase among males suggests either increased transmission or increased case ascertainment (e.g., through increased extra-genital screening) among gay, bisexual, and other men who have sex with men (MSM). 9. Anyone with genital symptoms such as discharge, burning during urination, unusual sores, or rash should stop having sex and see a health care provider immediately. This service is provided by the National Network of STD Clinical Prevention Training Centers and operates five days a week. The reproductive ratio of sexually transmitted diseases (STDs) in communities is a function of three components: the efficiency of transmission of disease between individuals, the rate of sexual partner exchange in a population, and duration of infectivity (1, 2). Among 15–19 year olds, rates decreased 1.3% during 2017–2018. Major textbooks and published studies indicate the penis is key to gonorrhea transmission between men (Figure, panel A) (4). The following tables, slide presentations, and annual reports provide the most recent available data and statistics for reportable sexually transmitted diseases (STDs) among Ohioans. Detailed fact sheets are intended for individuals with specific questions about sexually transmitted diseases. The South had the highest rate of reported gonorrhea cases (194.4 cases per 100,000 population) among the four regions of the United States in 2018, followed by the Midwest (184.5 cases per 100,000 population), the West (179.7 cases per 100,000 population), and the Northeast (138.4 cases per 100,000 population) (Figure 15, Table 14). In 2018, 0.2% of isolates had elevated ceftriaxone MICs. Correct and consistent use of condoms significantly decreases the risk of sexual transmission. The surest way to avoid transmission of gonorrhea or other STDs is to abstain from vaginal, anal, and oral sex, or to be in a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected. CDC now recommends dual therapy (i.e. If a person has had oral and/or anal sex, pharyngeal and/or rectal swab specimens should be collected either for culture or for NAAT (if the local laboratory has validated the use of NAAT for extra-genital specimens) 20. In 2018, the rate of reported gonorrhea cases remained highest among Blacks (548.9 cases per 100,000 population) (Table 22B). Gonorrhoea is caused by the bacterium Neisseria gonorrhoeae. San Francisco had the highest proportion of cases estimated to be MSM (86.4%), while Baltimore had the lowest proportion of MSM cases (20.1%). People who have had gonorrhea and received treatment may be reinfected if they have sexual contact with a person infected with gonorrhea. Recent statistics indicate that the highest rates of transmission occur among sexually active teenagers, young adults, and African Americans. Gonorrhea by County. In 2018, 0.02% of all tested isolates had an MIC above 16 µg/mL. Gonorrhea is the second most commonly reported notifiable disease in the United States. Gonorrhea, colloquially known as the clap, is a sexually transmitted infection (STI) caused by the bacterium Neisseria gonorrhoeae. DOI: 10.1097/OLQ.0b013e318286bb53. Methods: Laboratory-confirmedcases of gonorrhea are reported to the Public Health Agency of Canada (PHAC) by all of the Canadian provinces and territories. Susceptibility testing for azithromycin began in 1992. But looking at oropharyngeal gonorrhea specifically, the cure rate is approximately 80% for men and 83% for women (Lewis, 2015). Ejaculation does not have to occur for gonorrhea to be transmitted or acquired. Obviously, the more someone has sex with an infected person, the higher the chances of transmission become. Sexually transmitted infections among US women and men: Prevalence and incidence estimates, 2008. Gonorrhea can also be transmitted from a pregnant woman to her baby during a vaginal delivery. Although latex condoms have been recommended for prevention of sexually transmitted infections (STIs), including human immunodeficiency virus (HIV), for many years (1, 2), this recommendation has recently been questioned because of concerns about condom effectiveness against STIs other than HIV (3, 4). Overall, gonorrhea has a cure rate of around 96% (Lewis, 2015). Although latex condoms have been recommended for prevention of sexually transmitted infections (STIs), including human immunodeficiency virus (HIV), for many years (1, 2), this recommendation has recently been questioned because of concerns about condom effectiveness against STIs other than HIV (3, 4). As you correctly state, most throat gonorrhea is asymptomatic. Antimicrobial susceptibility is measured by the minimum inhibitory concentration (MIC), the lowest antimicrobial concentration that inhibits bacterial growth in the laboratory. Saving Lives, Protecting People, http://www.gytnow.org/talking-to-your-partner, Sexually Transmitted Disease Surveillance, 2018, Centers for Disease Control and Prevention. The percentage of isolates with elevated cefixime MICs (≥0.25 µg/mL) declined from 1.4% in 2011 to 0.3% in 2018 (Figure 29). 2008;35(12 Suppl):S13–18. It is spread during vaginal, anal, or oral sex. As was observed during 2014–2017, the rate of reported gonorrhea cases among males was higher than the rate among females in 2018 (Figure 18, Tables 15 and 16). Objective: To summarize trends observed in gonorrhea rates for 2010-2015in Canada. Gonorrhea is an infection caused by a sexually transmitted bacterium that can infect both males and females. More information on gonorrhea rates among race/Hispanic ethnicity groups can be found in the Special Focus Profiles, STDs in Racial and Ethnic Minorities. Received for publication August 20, 2003; accepted for publication February 2, 2004. DOI: 10.3201/eid2301.161205. Monitoring of MIC trends is useful because increasing MICs can oftentimes be an early indicator of the emergence of antimicrobial resistance. On the basis of this observation, we call for interventions. Gonorrhea most often affects the urethra, rectum or throat. Sex Transm Infect. Additional information about the SSuN methodology can be found in Section A2.2 of the Appendix. Infection may involve the genitals, mouth, and/or rectum. In addition, epidemiologic and biologic studies provide evidence that gonococcal infections facilitate the transmission of HIV infection.1 Together, sexual behavior and community prevalence can increase the risk of acquiring gonorrhea. Gonorrhea is the second most commonly reportable STI in the USA. Centers for Disease Control and Prevention Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. During 2014–2018, the rate among males increased 78.7% (119.1 to 212.8 cases per 100,000 males) and the rate among females increased 45.2% (100.4 to 145.8 cases per 100,000 females). Urogenital gonorrhea can be diagnosed by testing urine, urethral (for men), or endocervical or vaginal (for women) specimens using nucleic acid amplification testing (NAAT) 19. Gonorrhea is spread by having unprotected vaginal, anal, or oral sex with someone who has gonorrhea, or from mother-to-child during childbirth. Gonorrhea can also be spread to a baby during birth if the mother has it. In a study to determine the effectiveness of antiherpetic therapy (valacylovir) to prevent transmission of HSV-2, monogamous couples who were HSV-2 discordant -- i.e. Incidence (annual) of Gonorrhea: 800,000 cases (CDC estimate/NIAID) Incidence Rate: approx 1 in 339 or 0.29% or 800,000 people in USA [] Incidence extrapolations for USA for Gonorrhea: 800,000 per year, 66,666 per month, 15,384 per week, 2,191 per day, 91 per hour, 1 per minute, 0 per … Estimating the population sizes of men who have sex with men in US states and counties using data from the American Community Survey. Gonorrhea is a sexually transmitted disease. Gonorrhea, colloquially known as the clap, is a sexually transmitted infection (STI) caused by the bacterium Neisseria gonorrhoeae. Of more concern, in recent years there have been two cases of drug-resistant g… Many STDs — including chlamydia, gonorrhea, syphilis, herpes, HIV, HPV, and trichomoniasis — can be spread by way of oral sex. During 2009–2018, the percentage of GISP isolates that exhibited elevated ceftriaxone MICs, defined as ≥0.125 µg/mL, fluctuated between 0.1% and 0.4% (Figure 29). The transmission of gonorrhea can occur in several ways: Male-to-female transmission of gonorrhea via semen occurs at a rate of approximately 50% to 70% per episode of vaginal intercourse with ejaculation; male-to-female transmission of gonorrhea can occur without ejaculation 6) . During 2014–2018, the rate of gonorrhea in the West increased by 79.9% (99.9 to 179.7 cases per 100,000 population) and the rate in the Midwest increased by 73.7% (106.2 to 184.5 cases per 100,000 population), while the Northeast and South had lower overall increases during this time period (64.0% and 49.7%, respectively). The overall rate of reported gonorrhea cases in the 50 most populous metropolitan statistical areas (MSAs) was 194.9 cases per 100,000 population in 2018, representing a 2.9% increase compared with the rate in 2017 (189.4 cases per 100,000 population) (Table 17). Welcome to the STD forum. A slight decline occurred in 2013, but the rates then increased again during 2014-2018 (Figure 2). You can also get gonorrhea by touching your eye if you have infected fluids on your hand. Gonorrhea is a sexually transmitted disease causing growing concern, with a substantial increase in reported incidence over the past few years in the United Kingdom and rising levels of resistance to a wide range of antibiotics. But babies of infected mothers can be infected during childbirth. Additionally, the definitions of core groups based on the count and percentage of repeaters per census tract agreed well with each other (figures 2 and 3 ). Rectal intercourse transmission rates have not been quantified, but rectal intercourse appears to be an efficient mode of transmission. www.cdc.gov/std, Centers for Disease Control and Prevention. Second, the rates of gonorrhea are highest among adolescents and young adults. Based on new data from the CDC, rates of three sexually transmitted diseases (STDs)--gonorrhea, chlamydia, and syphilis broke a new record in 2017, attaining their highest rates ever. Even when a woman has symptoms, they are often so mild and nonspecific that they are mistaken for a bladder or vaginal infection 8, 9. Gonorrhea is a very common sexually transmitted disease, especially among 15- to 24-year-olds.. Gonorrhea is a sexually transmitted disease with … Received for publication February 21, 2003; accepted for publication August 5, 2003. From 2006 to 2009, gonorrhea rates were lower among men than women. The rate of reported gonorrhea cases among males increased the most in the Midwest (10.1% during 2017–2018 and 90.8% during 2014–2018) and Northeast (9.3% during 2017–2018 and 86.2% during 2014–2018); however, increases were all also reported in the West (6.6% during 2017–2018 and 85.0% during 2014–2018) and South (2.4% during 2017–2018 and 66.3% during 2014–2018) (Table 16). Patients treated with gentamicin 240 mg increased from 0.2% in 2015 to 1.4% in 2018 and patients treated with cefixime 400mg decreased from 0.3% in 2015 to 0.1% in 2018. Enhanced gonorrhea case report data for 2018 were obtained from Cycle 3 of SSuN, which includes 10 jurisdictions randomly sampling all cases reported in their jurisdictions. Most women with gonorrhea are asymptomatic 6, 7. Symptoms of rectal infection in both men and women may include discharge, anal itching, soreness, bleeding, or painful bowel movements 10. The infection is carried in semen (cum), pre-cum, and vaginal fluids. Among males, the rate was highest among those aged 20–24 years (720.9 cases per 100,000 males) and 25–29 years (674.0 cases per 100,000 males). Frequent transmission of gonorrhea in men who have sex with men. It causes the sexually transmitted genitourinary infection gonorrhea as well as other forms of gonococcal disease including disseminated gonococcemia, septic arthritis, and gonococcal ophthalmia neonatorum. In 2018, rates of reported gonorrhea cases continued to be highest among adolescents and young adults (Figure 19, Table 21). The proportion of reported patients that received the recommended dual treatment ranged from 83.8% (95% CI: 81.9–85.6) in Florida to 95.5% (95% CI: 92.9–98.1) in San Francisco, California. It is also associated with an increase in HIV transmission, because gonococcal urethritis increases HIV shedding in men. According to a study presented at the 2002 National STD Prevention Conference, there is a 50% risk reduction by using condoms. It is important to take all of the medication prescribed to cure gonorrhea.   If you’re sexually active you may be at risk of contracting it—the bacteria can cause infections in the genitals, rectum, or throat. Centers for Disease Control and Prevention. 555,608 cases of gonorrhea were reported to the CDC in 2017; the gonorrhea rate is up 18.6 percent from 2016. The rate among Blacks was 7.7 times the rate among Whites (71.1 cases per 100,000 population). Received for publication February 21, 2003; accepted for publication August 5, 2003. More information about gonorrhea in race/Hispanic ethnicity groups, females of reproductive age, adolescents, young adults, and MSM can be found in the Special Focus Profiles. A pregnant woman may also pass the infection to her baby during delivery. Gonorrhea can be passed even if the penis doesn’t go all the way in the vagina or anus. In cases where urethral infection is complicated by epididymitis, men with gonorrhea may also complain of testicular or scrotal pain. Increases in the rate of Neisseria gonorrhoeae among gay, bisexual and other men who have sex with men (MSM) — findings from the STD Surveillance Network 2010–2015. Among six jurisdictions participating in SSuN continuously from 2010 to 2018, estimated rates of gonorrhea among MSM, MSW, and women were calculated by extending published estimates of the MSM population and are presented in Figure 26.5,6 The estimated gonorrhea case rate among MSM increased 375.5% during 2010–2018 from 1,368.6 cases per 100,000 MSM in 2010 to 6,508.0 cases per 100,000 MSM in 2018. transmission routes for gonorrhea by anatomic site in MSM (Figure, panel A), although one should acknowledge that no studies have reported site-specific gonorrhea transmission between MSM partners. The overall prevalence, represented by the average of the mean value by nine of the 10 SSuN jurisdictions, where data was available, was 20.5% for MSM, 9.1% for MSW, and 5.4% for women. 2013;40(3):187–193. Antimicrobial resistance in gonorrhea is of increasing concern, and successful treatment of gonorrhea is becoming more difficult 21. Analysis of recovery rates for groups of sexual consorts indicated that gonorrhea was contracted more frequently than chlamydial infection. In rare cases, this may lead to infertility 14. Gonorrhea in Throat, Mouth, or Eyes. one with HSV-2, the other without it -- the rate of transmission was about 5% per year. 5. Susceptibility testing for cefixime began in 1992, was discontinued in 2007, and was restarted in 2009. CDC estimates that approximately 1.14 million new gonococcal infections occur in the United States each year, and as many as half occur among young people aged 15-24.1 In 2018, 583,405 cases of gonorrhea were reported to CDC.2. Gonorrhea prevalence in pregnant women in the United States is generally low (less than 1%), although the prevalence in certain subsets of the population remains a matter of concern.