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This Weeks Health Topic:Gonorrhea – CDC Fact Sheet (Detailed Version)

Source: CDC

Basic Fact SheetDetailed Version

What is gonorrhea?

Gonorrhea is a sexually transmitted disease (STD) caused by  infection with the Neisseria gonorrhoeae bacterium. 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. N. gonorrhoeae can also infect the  mucous membranes of the mouth, throat, eyes, and anus.

How common is gonorrhea?

Gonorrhea is a very common infectious disease. CDC  estimates that, annually, 820,000  people in the United States get new  gonorrheal infections, and less than half of these infections are detected  and  reported to  CDC. CDC estimates that 570,000 of them were among young people 15-24 years of age. In 2012,  334,826  cases of gonorrhea were reported to CDC 2.

How do people get gonorrhea?

Gonorrhea is transmitted through sexual contact with the  penis, vagina, mouth, or anus of an infected partner. Ejaculation does not have  to occur for gonorrhea to be transmitted or acquired. Gonorrhea can also be  spread perinatally from mother to baby during childbirth.

People who have had gonorrhea and received treatment may be  reinfected if they have sexual contact with a person infected with gonorrhea.

Who is at risk for gonorrhea?

Any sexually active person can be infected with  gonorrhea. In the United States, the highest reported rates of infection are  among sexually active teenagers, young adults, and African Americans 2.

What are the signs and symptoms of gonorrhea?

Many men with gonorrhea are asymptomatic 3, 4. When present, signs and symptoms of urethral infection  in males include dysuria or a white, yellow, or green urethral discharge that  usually appears one to fourteen days after infection 5. In cases where urethral infection is complicated by  epididymitis, men with gonorrhea may also complain of testicular or scrotal  pain.

Most women with gonorrhea are asymptomatic 6, 7. 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. The initial symptoms and signs in women include dysuria,  increased vaginal discharge, or vaginal bleeding between periods. Women with  gonorrhea are at risk of developing serious complications from the infection,  regardless of the presence or severity of symptoms.

Symptoms of rectal infection in both men and women may  include discharge, anal itching, soreness, bleeding, or painful bowel movements  10. Rectal infection also may be asymptomatic. Pharyngeal infection  may cause a sore throat, but usually is asymptomatic 11, 12.

What are the complications of gonorrhea?

Untreated gonorrhea can cause serious and permanent  health problems in both women and men.

In women, gonorrhea can spread into the uterus or  fallopian tubes and cause pelvic  inflammatory disease (PID).  The symptoms may be quite mild or can be very  severe and can include abdominal pain and fever 13. PID can lead to internal abscesses and chronic pelvic  pain. PID can also damage the fallopian tubes enough to cause infertility or  increase the risk of ectopic pregnancy.

In men, gonorrhea may be complicated by epididymitis.  In rare cases, this may lead to infertility 14.

If left untreated, gonorrhea can also spread to the blood and cause  disseminated gonococcal infection (DGI). DGI is usually characterized by  arthritis, tenosynovitis, and/or dermatitis 15. This condition can be life threatening.

What about Gonorrhea and HIV?

Untreated gonorrhea can increase a person’s risk of  acquiring or transmitting HIV, the virus that causes AIDS 16.

How does gonorrhea affect a pregnant woman and her baby?

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 blindness, joint infection, or a life-threatening  blood infection in the baby 17. Treatment of gonorrhea as soon as it is detected in  pregnant women will reduce the risk of these complications. Pregnant women  should consult a health care provider for appropriate examination, testing, and  treatment, as necessary.

Who should be tested for gonorrhea?

Any sexually active person can be infected with  gonorrhea.  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.

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.

Some people should be tested (screened)External Web Site Icon for gonorrhea even if they  do not have symptoms or know of a sex partner who has gonorrhea 18.  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.

People who have gonorrhea should also be tested for other STDs.

How is gonorrhea diagnosed?

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.  It can also be  diagnosed using gonorrhea culture, which requires endocervical or urethral swab  specimens.

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.

What is the treatment for gonorrhea?

Gonorrhea can be cured with the right treatment. CDC now  recommends dual therapy (i.e. using two drugs) for the treatment of gonorrhea. It  is important to take all of the medication prescribed to cure gonorrhea.  Medication for gonorrhea should not be shared with anyone. Although medication  will stop the infection, it will not repair any permanent damage done by the  disease. Antimicrobial resistance in gonorrhea  is of increasing  concern, and successful treatment of gonorrhea is becoming more difficult 21. If a person’s symptoms continue for more than a few  days after receiving treatment, he or she should return to a health care  provider to be reevaluated.

What about partners?

If a person has been diagnosed and treated for gonorrhea,  he or she should tell all recent anal, vaginal, or oral sex partners (all sex  partners within 60 days before the onset of symptoms or diagnosis) so they can  see a health provider and be treated 20. This will reduce the risk that the sex partners will  develop serious complications from gonorrhea and will also reduce the person’s  risk of becoming reinfected. A person with gonorrhea and all of his or her sex  partners must avoid having sex until they have completed their treatment for  gonorrhea and until they no longer have symptoms. For tips on talking to  partners about sex and STD testing, visit http://www.gytnow.org/talking-to-your-partnerExternal Web Site Icon.

How can gonorrhea be prevented?

Latex condoms, when used consistently  and correctly, can reduce the risk of transmission of gonorrhea 22. The surest way to avoid transmission of gonorrhea or other STDs is to  abstain from sexual intercourse, or to be in a long-term mutually monogamous  relationship with a partner who has been tested and is known to be uninfected.

Where can I get more information?

Division of STD Prevention (DSTDP)               Centers for Disease Control and Prevention www.cdc.gov/std