Gonorrhea continues to be the most commonly reported communicable disease in the United States, although incidence has declined since 1984. Risk factors that may influence the probability of infection include number of sexual partners, lack of barrier contraceptives, and young age.

Gonorrhea is an infection spread by physical contact with the mucosal surfaces of an infected person, usually a sexual partner. The risk of infection depends on the anatomic site, the amount of substance containing bacteria, and the number of exposures. Variations in host susceptibility have not been well defined. In a small but significant proportion of infections, there are no symptoms. These individuals are important in the epidemiology of this disease because gonorrhea is usually spread by carriers who have no symptoms or have ignored symptoms.

Control of gonorrhea depends on early diagnosis, effective treatment, and identification of asymptomatic individuals. The last has been accomplished, in part, through screening programs. However, complete control has not been possible because of the emergence and spread of strains that are resistant to less-expensive antimicrobial treatments such as penicillin and tetracycline.

There is no evidence that infected individuals develop long-lasting immunity to reinfection, and vaccination is not available. Thus, the prevention of gonorrhea relies on behavior modification and risk reduction, use of appropriate screening and diagnostic tests, routine use of highly effective antibiotics, early identification and treatment of sexual partners of individuals with gonorrhea, and the appropriate use of barrier methods such as condoms.

An increasing proportion of infections are due to antibiotic-resistant strains of N. gonorrhoeae. Chromosomally mediated resistance to multiple antibiotics as well as plasmid-mediated resistance to beta-lactam antibiotics and tetracycline occurs in strains from both developed and developing countries. Nevertheless, infections can be effectively treated with third-generation cephalosporins (for example, ceftriaxone) or fluoroquinolones (for example, ciprofloxacin or ofloxacin). See also Sexually transmitted diseases.

A sexually transmitted disease of the genitourinary tract which is spread by direct contact with an infected person or fluids containing the infectious microorganism. The disease may also affect the conjunctiva, oral tissue, and other tissues and organ systems.

Gonorrhea is a sexually transmitted disease (STD) caused by Neisseria gonorrhoeae, a bacterium. Gonorrhea is spread through sexual contact (vaginal, oral, or anal). The organism can grow easily in mucous membranes of the body, including the cervix, uterus, and fallopian tubes in women, and the urethra, mouth, throat, and rectum in women and men. It can also invade the conjunctiva (e.g., during childbirth). Each year approximately 650,000 persons in the United States get gonorrhea. Approximately 75 percent of gonorrhea cases are found in persons age fifteen to twenty-nine years. About 50 percent of men have some initial symptoms, typically a burning sensation when urinating and a discharge from the penis. Many infected women are asymptomatic or have only mild symptoms. Initial symptoms include a painful or burning sensation when urinating and a vaginal discharge that is yellow or bloody. Untreated gonorrhea in women can develop into pelvic inflammatory disease (PID), which can cause infertility or increase the future risk of ectopic pregnancy. An infected pregnant woman can transmit the infection to her newborn during vaginal delivery.

N. gonorrhoeae in the male or female genital tract can be diagnosed in a laboratory using a urine specimen. Many of the currently used antibiotics can successfully cure gonorrhea. Persons who engage in sexual behaviors that place them at risk of STDs should use latex or polyurethane condoms every time they have sex, limit the number of sex partners, and not go back and forth between partners. All young, sexually active, nonmonogamous persons who do not use condoms every time they have sex should consider being screened for gonorrhea yearly. Infected persons should notify all sex partners so they can receive treatment.

(SEE ALSO: Sexually Transmitted Diseases)

Centers for Disease Control and Prevention (1998). "1998 Guidelines for Treatment of Sexually Transmitted Diseases." Morbidity and Mortality Weekly Report 47(RR-1):59–70.