Gonorrhea (also known as “the clap” or “drip”) is a
highly contagious sexually transmitted disease, one of the most
common and oldest known. It is caused by the Neisseria gonorrhoeae bacteria which is a
gram-negative, intracellular diplococcus that grows best in the
laboratory in an environment rich in carbon dioxide.
Gonorrhea can be spread from person to person through sexual contact
but also from mother to child during childbirth. The
gonorrhea germs are found in the mucous areas of the body (the
vagina, penis, throat and rectum).
Gonorrhea is the second most
commonly reported infectious disease in the United States, after
Chlamydia. There are approximately 700,000 cases reported each year
in the United States. Within the United States infection rates are
highly dependent on the geographical area, the racial and ethnic
group, and sexual preferences. The South-Eastern States have the
highest rates of infection, with the Midwest and Northeast being
much lower. Disease rates are unknown for most developing countries.
In much of Western Europe, rates are approximately the same as those
in the United States. Also, frequency is increased in the poor and
minorities of any population due to decreased access to diagnosis
and treatment. Lack of adequate care (education, diagnosis, and
treatment) leads to increased transmission rates. Men who have sex
with men (MSM) are much more likely to acquire and carry Gonorrhea,
and in addition have far higher rates of antibiotic-resistant
bacteria. The highest incidence in the United States is for persons
aged 15-24 years.
Gonorrhea has an incubation period
of 2-7 days after exposure to an infected person, but it could take
as long as 30 days for the symptoms to appear.
SIGNS AND SYMPTOMS
The first place to be infected in
women is the cervix. From the cervix it moves up to the uterus and
into the fallopian tubes, resulting in pelvic inflammatory disease (PID).
Women are most likely to be asymptomatic, as many as 50 % of the
women infected with Gonorrhea experience few or no symptoms. If they
have symptoms, these include: dysuria (pain or burning sensation
when urinating), vaginal discharge that is yellow or bloody,
abnormal vaginal bleeding (spotting)
for example, after sex, cramps, dyspareunia (painful intercourse),
need to urinate more frequently, proctitis (inflammation
of the rectum) and/or pharyngitis (inflammation
of the mucous membrane and underlying parts of the pharynx),
slow onset and progression of lower abdominal pain, nausea or
vomiting and fever.
In men Gonorrhea symptoms include:
dysuria accompanied by thick, copious, urethral pus-like discharge
(white, yellow or green in colour), also known as “gleet”. Men may
also experience swollen testicles and the penis will probably look
tender and redder that usual and also a swelling in the groin area.
Gonorrhea can also infect the anus
and the throat. The symptoms of the anal infection include painful
bowel movements, itching, discharge and bloody stool. Symptoms of
the oral infection include: a sore throat, a pus-like material on
the tonsils or on the back of the throat. These two last types of
infection with Neisseria gonorrhoeae bacteria can easily spread to
other parts of the body so treatment is compulsory.
TREATMENT
Gonorrhea is easily treated.
Medical therapy requires an antibiotic
with efficacy against N gonorrhoeae such as:
Ciprofloxacin (Cipro), Cefixime (Suprax) and Ceftriaxone (Rocephin),
Ofloxacin (Floxin), Spectinomycin (Trobicin), Erythromycin (E-Mycin),
Azithromycin (Zithromax), Doxycycline (Bio-Tab, Vibramycin, Doryx).
COMPLICATIONS
Left untreated, Gonorrhea may have
serious consequences.
In men it can cause epididymitis
(inflammation of the epididymis, the
elongated, cordlike structure along the posterior border of the
testes), prostatitis (inflammation of the prostate gland
which can lead to infertility) and urethritis (inflammation of the
urethral structure).
Women infected with Gonorrhea can
develop pelvic inflammatory disease (PID), which damages the
fallopian tubes and can cause infertility. Gonorrhea increases the
risk of an ectopic pregnancy. It can also cause bartholinitis (cyst
and abscess formation in one or more of the greater vestibular
glands) and also Fitz-Hugh-Curtis syndrome (perihepatitis).
Both sexes may develop
disseminated gonococcal infection (DGI) that can lead to multiple
distant sites of infection which include the brain, heart and
joints.
Neonatal infection of the eyes can
lead to permanent damage and blindness.
PREVENTION
Proper education can be more
effective than simple instructions to avoid sex, especially for
teenagers because, even though it is the most effective prevention,
it is often an unrealistic expectation (where
88% of teens who pledged abstinence in middle and high school still
engaged in premarital sex). Nevertheless, abstinence from sex
should be explained as the best option, but a more practical
solution is abstinence from sex with someone known or suspected of
having an STD until treatment is obtained and completed.
It is important to stress that
oral or anal sex also can transmit the disease. Another means of
preventing contracting an STD is to avoid unprotected sex.
All of the materials on this site have been included for the purpose of
providing general information, and they should not be relied on as a
substitution for professional advice.
