Gonorrhea

In Illinois, the incidence of gonorrhea has declined significantly since 1975, when 59,000 cases were reported. Yet, almost 17,000 cases of the disease were reported in the state in 2011. It is estimated that another nearly 17,000 cases, mostly among teenagers and young adults, go unreported each year. The approximate annual cost of gonorrhea and its complications in Illinois is more than $3 million.

United States Centers for DC estimates that, annually, more than 700,000 people in the United States get new gonorrhea infections and less than half of these infections are reported to CDC. In 2010, nearly 322,000 cases of gonorrhea were reported to CDC.

Gonorrhea is a sexually transmitted disease (STD) caused by a bacterium, Neisseria gonorrhoeae(gonococcus), that grows and multiplies in moist, warm areas of the reproductive tract, including the cervix (opening to the womb), uterus (womb), and fallopian tubes (egg canals) in women, and in the urethra (urine canal) in women and men. The bacterium can grow in the mouth, throat, eyes and anus. In women, the cervix is the most common site of infection. However, the disease can spread to the uterus and fallopian tubes, resulting in pelvic inflammatory disease. This, in turn, can cause infertility and ectopic pregnancy.

Gonorrhea is a very common infectious disease. CDC estimates that, annually, more than 700,000 people in the United States get new gonorrheal infections, and less than half of these infections are reported to CDC. In 2011, 321,849 cases of gonorrhea were reported to CDC.

People get gonorrhea by having sex (anal, vaginal or oral) with someone who has the disease. Gonorrhea can still be transmitted via fluids even if a man does not ejaculate. Gonorrhea can be spread from an untreated mother to her baby during childbirth.

People who have had gonorrhea and have been treated may get infected again if they have sexual contact with a person infected with gonorrhea. When the infection occurs in children, it is most commonly due to child abuse.

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

Some men with gonorrhea may have no symptoms at all. However, common symptoms in men include a burning sensation when urinating, or a white, yellow or green discharge from the penis that usually appears one to 14 days after infection. Sometimes men with gonorrhea get painful or swollen testicles.

Most women with gonorrhea do not have any symptoms. Even when a woman has symptoms, they are often mild and can be mistaken for a bladder or vaginal infection. The initial symptoms in women can include a painful or burning sensation when urinating, increased vaginal discharge, or vaginal bleeding between periods. More advanced symptoms, which indicate progression to pelvic inflammatory disease, include abdominal pain, vomiting or fever. Women with gonorrhea are at risk of developing serious complications from the infection, even if symptoms are not present or are mild.

Symptoms of rectal infection in both men and women may include discharge, anal itching, soreness, bleeding, or painful bowel movements. Rectal infections may cause no symptoms. Infections in the throat may cause a sore throat, but usually cause no symptoms.

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

In women, gonorrhea can spread into the uterus (womb) or fallopian tubes (egg canals) and cause pelvic inflammatory disease (PID). The symptoms may be mild or can be very severe and can include abdominal pain and fever. PID can lead to internal abscesses (pus-filled pockets that are hard to cure) and chronic (long-lasting) pelvic pain. 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.

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.

If not treated, gonorrhea can spread to the blood or joints. This condition can be life-threatening.

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. Pregnant women should consult a health care provider for appropriate examination, testing, and treatment, as necessary.

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

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 for gonorrhea even if they do not have symptoms or know of a sex partner who has gonorrhea. 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 be tested for other STDs.

Most of the time, a urine test can be used to test for gonorrhea. However, if a person has had oral and/or anal sex, swabs may be used to collect samples from the throat and/or rectum. In some cases, a swab may be used to collect a sample from a man’s urethra (urine canal) or a woman’s cervix (opening to the womb).

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. 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.

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. This will reduce the risk that the sex partners will develop serious complications from gonorrhea and will 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 see Resources.

Not having sex is the best protection against gonorrhea and other STDs. Having sex with only one uninfected partner who only has sex with you is also safe. Latex male condoms, when used consistently and correctly, can reduce the risk of getting or giving gonorrhea. The surest way to avoid gonorrhea 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.

IDPH HIV/STD Hotline: 800-243-2437 (TTY 800-782-0423)

• Talking to Your Partner
• US Centers for Disease Control and Prevention
• American Sexual Health Association

• Gonorrhea Infographic