gonorhea, gonnorhea, gonorrea, gonorea
Basic Information and Causes of Gonorrhea
Gonorrhea is a curable sexually transmitted disease (STD) caused
by a bacterium called Neisseria gonorrhoeae. These bacteria
can infect the genital tract, the mouth, and the rectum. In women,
the opening to the uterus, the cervix, is the first place of
infection.
Gonorrhea disease however can spread into the uterus and fallopian
tubes, resulting in pelvic inflammatory disease (PID). PID affects
more than 1 million women in this country every year and can cause
infertility in as many as 10 percent of infected women and tubal
(ectopic) pregnancy.
In 2000, 358,995 cases of gonorrhea were reported to the U.S.
Centers for Disease Control and Prevention (CDC). In the United
States, approximately 75 percent of all reported cases of gonorrhea
is found in younger persons aged 15 to 29 years. The highest rates
of infection are usually found in 15- to 19-year old women and 20-
to 24-year-old men. Health economists estimate that the annual cost
of gonorrhea and its complications is close to $1.1 billion.
Gonorrhea is spread during sexual intercourse. Infected women
also can pass gonorrhea to their newborn infants during delivery,
causing eye infections in their babies. This complication is rare
because newborn babies receive eye medicine to prevent infection.
When the infection occurs in the genital tract, mouth, or rectum of
a child, it is due most commonly to sexual abuse.
Gonorrhea Symptoms
The early symptoms of gonorrhea often are mild. Gonorrhea symptoms usually
appear within 2 to 10 days after sexual contact with an infected
partner. A small number of people may be infected for several months
without showing symptoms.
When women have gonorrhea symptoms, the first ones may include
- Bleeding associated with vaginal intercourse
- Painful or burning sensations when urinating
- Vaginal discharge that is yellow or bloody
More advanced gonorrhea symptoms, which may indicate development of PID,
include cramps and pain, bleeding between menstrual periods,
vomiting, or fever.
Men have symptoms more often than women, including
- Pus from the penis and pain
- Burning sensations during urination that may be severe
Symptoms of rectal infection include discharge, anal itching, and
occasional painful bowel movements with fresh blood on the
feces.
How Is Gonorrhea Diagnosed?
Doctors or other health care workers usually use three laboratory
techniques to diagnose gonorrhea: staining samples directly for the
bacterium, detection of bacterial genes or DNA in urine, and growing
the bacteria in laboratory cultures. Many doctors prefer to use more
than one test to increase the chance of an accurate diagnosis.
The staining test involves placing a smear of the discharge from
the penis or the cervix on a slide and staining the smear with a
dye. Then the doctor uses a microscope to look for bacteria on the
slide. You usually can get the test results while in the office or
clinic. This test is quite accurate for men but is not good in
women. Only one in two women with gonorrhea have a positive
stain.
More often, doctors use urine or cervical swabs for a new test
that detects the genes of the bacteria. These tests are as accurate
or more so than culturing the bacteria, and many doctors use
them.
The culture test involves placing a sample of the discharge onto
a culture plate and incubating it up to 2 days to allow the bacteria
to grow. The sensitivity of this test depends on the site from which
the sample is taken. Cultures of cervical samples detect infection
approximately 90 percent of the time. The doctor also can take a
culture to detect gonorrhea in the throat. Culture allows testing
for drug-resistant bacteria.
Gonorrhea Treatment
Doctors usually prescribe a single dose of one of the following
antibiotics to treat gonorrhea:
- Cefixime
- Ceftriaxone
- Ciprofloxacin
- Ofloxacin
- Levofloxacin
If you have gonorrhea and are pregnant or are younger than 18
years old, you should not take ciprofloxacin or ofloxacin. Your
doctor can prescribe the best and safest antibiotic for you.
Gonorrhea and chlamydial infection, another common STD, often
infect people at the same time. Therefore, doctors usually prescribe
a combination of antibiotics, such as ceftriaxone and doxycycline or
azithromycin, which will treat both chlamydial and gonorrhea disease.
If you have gonorrhea, all of your sexual partners should get
tested and then treatment for gonorrhea if infected, whether or not they have
symptoms of gonorrhea.
What Can Happen If Gonorrhea Is Not Treated?
Without treatment, gonorrhea infections will only get worse.
The bacteria can spread up
into the reproductive tract, or more rarely, can spread through the
blood stream and infect the joints, heart valves, or the brain.
The most common result of untreated gonorrhea is PID, a serious
infection of the female reproductive tract. Gonococcal PID often
appears immediately after the menstrual period. PID causes scar
tissue to form in the fallopian tubes. If the tube is partially
scarred, the fertilized egg may not be able to pass into the uterus.
If this happens, the embryo may implant in the tube causing a tubal
(ectopic) pregnancy. This serious complication may result in a
miscarriage and can cause death of the mother.
Rarely, untreated gonorrhea can spread through the blood to the
joints. This can cause an inflammation of the joints which is very
serious.
If you are infected with gonorrhea, your risk of getting HIV
infection increases (HIV, human immunodeficiency virus, causes
AIDS). Therefore, it is extremely important for you to either
use preventative measures or get gonorrhea treatment early if you
already are infected with it.
Can Gonorrhea Affect A Newborn Baby?
If you are pregnant and have gonorrhea, you may give the
infection to your baby as it passes through the birth canal during
delivery. A doctor can prevent infection of your baby's eyes by
applying silver nitrate or other medications to the eyes immediately
after birth. Because of the risks from gonococcal infection to both
you and your baby, doctors recommend that pregnant women have at
least one test for gonorrhea during pregnancy.
How Can I Prevent Getting Infected With Gonorrhea?
By using latex condoms correctly and consistently during vaginal
or rectal sexual activity, you can reduce your risk of getting
gonorrhea and its complications.
What Research Is Going On?
The National Institute of Allergy, Immunology and Infectious
Diseases (NIAID) continues to support a comprehensive,
multidisciplinary program of research on N. gonorrhoeae
(gonoccoci). Researchers are trying to understand how gonoccoci
infect cells while evading human immune defenses (immune response).
Studies are ongoing to determine
- How this bacterium attaches to host cells
- How it gets inside them
- Gonococcal surface structures and how they can change
- Human response to infection by gonococci
All of these efforts, together, will eventually lead to
development of an effective vaccine against gonorrhea. They also
have led to, and will lead to further, improvements in diagnosis and
gonorrhea treatment.
Another important area of gonorrhea research concerns antibiotic
resistance. This is particularly important because strains of N.
gonorrhoeae that are resistant to recommended antibiotic
therapies have spread from Southeast Asia to Hawaii and are now
starting to appear on the West Coast. These events add urgency to
NIAID efforts to develop effective microbicides (antimicrobial
preparations that can be applied inside the vagina) to prevent
infections.
Recently, scientists have determined the sequence of the N.
gonorrhoeae genome. They are using this information to find
promising new leads to help us better understand how the organism
causes disease and becomes resistant to antibiotics.
Keeping on Top of Your Condition
Keeping in tune with your disease or condition not only makes treatment less intimidating but also increases its chance of success, and has been shown to lower a patients risk of complications. As well, as an informed patient, you are better able to discuss your condition and treatment options with your physician.
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More Information on Gonorrhea
National Institute of Allergy and Infectious Diseases
National
Institutes of Health
31 Center Drive, MSC 2520
Bethesda, MD
20892-2520
http://www.niaid.nih.gov/
National Library of Medicine
MEDLINEplus
8600 Rockville
Pike
Bethesda, MD 20894
1-800-338-7657
http://medlineplus.gov/
National STD and AIDS Hotline
1-800-227-8922 or 1-800-342-2437
(24 hours a day, 7 days a week)
American Social Health Association
P.O. Box 13827
Research
Triangle Park, NC 27709-9940
http://www.ashastd.org/
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