Gonorrhea

I

Introduction

Gonorrhea, infectious sexually transmitted disease of humans caused by bacteria called Neisseria gonorrhoeae. Gonorrhea is almost always spread through sexual contact with the vagina, penis, anus, or mouth, although ejaculation is not necessary for infection to occur. Symptoms are usually present two to seven days after infection, but in some cases, the first symptoms may not appear for 30 days. In the United States, more than 300,000 cases of gonorrhea are reported each year, but the Centers for Disease Control estimates that at least as many cases go unreported.

II

Symptoms and Diagnosis

Gonorrhea is much more obvious in males, who develop pain and an acute discharge of pus from the urethra. Scant at the start, the discharge becomes progressively thicker and heavier and causes frequent urination, often with a burning sensation. Should the prostate become infected, the passage of urine is partly obstructed. In females the infection occurs in the urethra, the vagina, or the cervix. Although discharge and irritation of the vaginal mucous membranes may be severe, more often few or no early symptoms appear.

Gonorrhea can be diagnosed by examining discharge from the parts of the body likely to be infected (urethra, rectum, cervix, or throat) for the presence of the bacteria. A urine test can also detect the bacteria in the cervix or urethra. Treatment in the early stages is usually effective. If the disease is untreated in the male, the early symptoms may subside but the infection may spread to the testicles, causing sterility. In the untreated female the infection usually spreads from the cervix into the uterus and fallopian tubes, causing pelvic inflammatory disease. Severe pain may occur, or the infection may linger with few or no symptoms, gradually damaging the tubes and rendering the woman sterile. In both sexes the gonococcus may enter the bloodstream, resulting in arthritis, heart inflammation, or other diseases. Gonorrhea in pregnant women may be transmitted to the infant during birth and may, if untreated, cause a serious eye infection. Some studies suggest that gonorrhea raises the risk of bladder cancer for men.

III

Treatment

Antibiotics are commonly used against gonorrhea, although over the years an increasing number of antibiotic-resistant strains of the gonorrhea bacteria have developed. Still effective are antibiotics that are administered in a single dose, including ceftriaxone, cefixime, ciprofloxacin, levofloxacin, and ofloxacin.

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Gonorrhea increased greatly in the U.S. in the 1970s and early 1980s, almost reaching epidemic proportions in adolescents and young adults. Since the 1980s, the rate of gonorrhea infection has declined by over 74 percent. Most cities have clinics where young people can get treatment for gonorrhea and other sexually transmitted diseases. One of the most difficult tasks in controlling gonorrhea is locating all recent sexual contacts of an infected person to prevent further spread of the disease. Abstaining from sexual activity is the surest way to avoid contracting gonorrhea. Latex condoms, when properly used, decrease the risk of infection.

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