Gonorrhea

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Gonorrhea
Other namesGonococcal infection, gonococcal urethritis, gonorrhoea, the clap
Gonococcal lesion on the skin PHIL 2038 lores.jpg
Gonococcal lesion on the skin
Specialty Infectious disease
SymptomsNone, burning with urination, vaginal discharge, discharge from the penis, pelvic pain, testicular pain [1]
Complications Pelvic inflammatory disease, inflammation of the epididymis, septic arthritis, endocarditis [1] [2]
Causes Neisseria gonorrhoeae typically sexually transmitted [1]
Diagnostic method Testing the urine, urethra in males, or cervix in females [1]
Prevention Condoms, having sex with only one person who is uninfected, not having sex [1] [3]
Treatment Ceftriaxone by injection and azithromycin by mouth [4] [5]
Frequency0.8% (women), 0.6% (men) [6]

Gonorrhea, colloquially known as the clap, is a sexually transmitted infection (STI) caused by the bacterium Neisseria gonorrhoeae . [1] Infection may involve the genitals, mouth, or rectum. [7] Infected men may experience pain or burning with urination, discharge from the penis, or testicular pain. [1] Infected women may experience burning with urination, vaginal discharge, vaginal bleeding between periods, or pelvic pain. [1] Complications in women include pelvic inflammatory disease and in men include inflammation of the epididymis. [1] Many of those infected, however, have no symptoms. [1] If untreated, gonorrhea can spread to joints or heart valves. [1] [2]

Sexually transmitted infection Infection transmitted through human sexual behavior

Sexually transmitted infections (STI), also referred to as sexually transmitted diseases (STD), are infections that are commonly spread by sexual activity, especially vaginal intercourse, anal sex and oral sex. Many times STIs initially do not cause symptoms. This results in a greater risk of passing the disease on to others. Symptoms and signs of disease may include vaginal discharge, penile discharge, ulcers on or around the genitals, and pelvic pain. STIs can be transmitted to an infant before or during childbirth and may result in poor outcomes for the baby. Some STIs may cause problems with the ability to get pregnant.

<i>Neisseria gonorrhoeae</i> species of bacterium

Neisseria gonorrhoeae, also known as gonococcus (singular), or gonococci (plural) is a species of Gram-negative diplococci bacteria isolated by Albert Neisser in 1879. It causes the sexually transmitted genitourinary infection gonorrhea as well as other forms of gonococcal disease including disseminated gonococcemia, septic arthritis, and gonococcal ophthalmia neonatorum.

Rectum final section of intestine

The rectum is the final straight portion of the large intestine in humans and some other mammals, and the gut in others. The adult human rectum is about 12 centimetres (4.7 in) long, and begins at the rectosigmoid junction, the end of the sigmoid colon, at the level of the third sacral vertebra or the sacral promontory depending upon what definition is used. Its caliber is similar to that of the sigmoid colon at its commencement, but it is dilated near its termination, forming the rectal ampulla. It terminates at the level of the anorectal ring or the dentate line, again depending upon which definition is used. In humans, the rectum is followed by the anal canal which is about 4 centimetres (1.6 in) long, before the gastrointestinal tract terminates at the anal verge. The word rectum comes from the Latin rectum intestinum, meaning straight intestine.

Contents

Gonorrhea is spread through sexual contact with an infected person. [1] This includes oral, anal, and vaginal sex. [1] It can also spread from a mother to a child during birth. [1] Diagnosis is by testing the urine, urethra in males, or cervix in females. [1] Testing all women who are sexually active and less than 25 years of age each year as well as those with new sexual partners is recommended; [3] the same recommendation applies in men who have sex with men (MSM). [3]

Urethra tube that connects the urinary bladder to the genitals

In anatomy, the urethra is a tube that connects the urinary bladder to the urinary meatus for the removal of urine from the body. In males, the urethra travels through the penis and also carries semen. In human females and other primates, the urethra connects to the urinary meatus above the vagina, whereas in non-primates, the female's urethra empties into the urogenital sinus.

Cervix the lower part of the uterus in the human female reproductive system

The cervix or cervix uteri is the lower part of the uterus in the human female reproductive system. The cervix is usually 2 to 3 cm long and roughly cylindrical in shape, which changes during pregnancy. The narrow, central cervical canal runs along its entire length, connecting the uterine cavity and the lumen of the vagina. The opening into the uterus is called the internal os, and the opening into the vagina is called the external os. The lower part of the cervix, known as the vaginal portion of the cervix, bulges into the top of the vagina. The cervix has been documented anatomically since at least the time of Hippocrates, over 2,000 years ago.

Men who have sex with men (MSM), also known as males who have sex with males, are male persons who engage in sexual activity with members of the same sex, regardless of how they identify themselves; many such men do not sexually identify as gay, homosexual or bisexual.

Gonorrhea can be prevented with the use of condoms, having sex with only one person who is uninfected, and by not having sex. [1] [3] Treatment is usually with ceftriaxone by injection and azithromycin by mouth. [4] [5] Resistance has developed to many previously used antibiotics and higher doses of ceftriaxone are occasionally required. [4] [5] Retesting is recommended three months after treatment. [3] Sexual partners from the last 2 months should also be treated. [1]

Condom birth control device

A condom is a sheath-shaped barrier device, used during sexual intercourse to reduce the probability of pregnancy or a sexually transmitted infection (STI). There are both male and female condoms. With proper use—and use at every act of intercourse—women whose partners use male condoms experience a 2% per-year pregnancy rate. With typical use the rate of pregnancy is 18% per-year. Their use greatly decreases the risk of gonorrhea, chlamydia, trichomoniasis, hepatitis B, and HIV/AIDS. They also to a lesser extent protect against genital herpes, human papillomavirus (HPV), and syphilis.

Sexual abstinence

Sexual abstinence or sexual restraint is the practice of refraining from some or all aspects of sexual activity for medical, psychological, legal, social, financial, philosophical, moral, or religious reasons. Asexuality is distinct from sexual abstinence; and celibacy is sexual abstinence generally motivated by factors such as an individual's personal or religious beliefs. Sexual abstinence before marriage is required in some societies by social norms, or, in some countries, even by laws, and is considered part of chastity.

Ceftriaxone chemical compound

Ceftriaxone, sold under the trade name Rocephin, is an antibiotic used for the treatment of a number of bacterial infections. These include middle ear infections, endocarditis, meningitis, pneumonia, bone and joint infections, intra-abdominal infections, skin infections, urinary tract infections, gonorrhea, and pelvic inflammatory disease. It is also sometimes used before surgery and following a bite wound to try to prevent infection. Ceftriaxone can be given by injection into a vein or into a muscle.

Gonorrhea affects about 0.8% of women and 0.6% of men. [6] An estimated 33 to 106 million new cases occur each year, out of the 498 million new cases of curable STI – which also includes syphilis, chlamydia, and trichomoniasis. [8] [9] Infections in women most commonly occur when they are young adults. [3] In 2015, it caused about 700 deaths. [10] Descriptions of the disease date as far back as the Old Testament. [2]

Syphilis sexually transmitted infection

Syphilis is a sexually transmitted infection caused by the bacterium Treponema pallidum subspecies pallidum. The signs and symptoms of syphilis vary depending in which of the four stages it presents. The primary stage classically presents with a single chancre but there may be multiple sores. In secondary syphilis, a diffuse rash occurs, which frequently involves the palms of the hands and soles of the feet. There may also be sores in the mouth or vagina. In latent syphilis, which can last for years, there are few or no symptoms. In tertiary syphilis, there are gummas, neurological problems, or heart symptoms. Syphilis has been known as "the great imitator" as it may cause symptoms similar to many other diseases.

Trichomoniasis Gagoparasitic protozoa infectious disease that is caused by singled-celled protozoan parasites Trichomonas vaginalis or Trichomonas tenax, which infect the urogenital tract and mouth respectively

Trichomoniasis (trich) is an infectious disease caused by the parasite Trichomonas vaginalis. About 70% of women and men do not have symptoms when infected. When symptoms do occur they typically begin 5 to 28 days after exposure. Symptoms can include itching in the genital area, a bad smelling thin vaginal discharge, burning with urination, and pain with sex. Having trichomoniasis increases the risk of getting HIV/AIDS. It may also cause complications during pregnancy.

Old Testament First part of Christian Bibles based on the Hebrew Bible

The Old Testament is the first part of Christian Bibles, based primarily upon the Hebrew Bible, a collection of ancient religious writings by the Israelites believed by most Christians and religious Jews to be the sacred Word of God. The second part of the Christian Bible is the New Testament.

Signs and symptoms

If not treated gonococcal ophthalmia neonatorum will develop in 28% of infants born to women with gonorrhea. Gonococcal ophthalmia neonatorum.jpg
If not treated gonococcal ophthalmia neonatorum will develop in 28% of infants born to women with gonorrhea.

Half of women with gonorrhea do not have symptoms, whereas others have vaginal discharge, lower abdominal pain, or pain with sexual intercourse associated with inflammation of the uterine cervix. [12] [13] [14] Most infected men with symptoms have inflammation of the penile urethra associated with a burning sensation during urination and discharge from the penis. [13] In men, discharge with or without burning occurs in half of all cases and is the most common symptom of the infection. [15] Men and women can acquire gonorrhea of the throat from performing oral sex on an infected partner, usually a male partner. Such infection does not produce symptoms in 90% of cases, and produces a sore throat in the remaining 10%. [16] [17] In advanced cases, gonorrhea may cause a general feeling of tiredness similar to other infections. [15] It is also possible for an individual to have an allergic reaction to the bacteria, in which case any appearing symptoms will be greatly intensified. [15]

Asymptomatic condition or state of disease

In medicine, a disease is considered asymptomatic if a patient is a carrier for a disease or infection but experiences no symptoms. A condition might be asymptomatic if it fails to show the noticeable symptoms with which it is usually associated. Asymptomatic infections are also called subclinical infections. Other diseases might be considered subclinical if they present some but not all of the symptoms required for a clinical diagnosis. The term clinically silent is also used.

Vaginal discharge mixture of liquid, cells, and bacteria, produced in the vagina and cervix, lubricating and protecting the vagina; typically clear or white in color, with consistency varying from thin to thick, typically without a strong odor

Vaginal discharge is a mixture of liquid, cells, and bacteria that lubricates and protects the vagina. This mixture is constantly produced by the cells of the vagina and cervix and it exits the body through the vaginal opening. The composition, amount, and quality of discharge varies between individuals as well as through the various stages of sexual and reproductive development. Normal vaginal discharge may have a thinner, watery consistency or a thick, sticky consistency, and may be clear or white in color. Normal vaginal discharge may be large in volume but typically does not have a strong odor, nor is it typically associated with itching or pain. While most discharge represents normal functioning of the body, some changes in discharge can reflect infection or other pathological processes. Infections that may cause changes in vaginal discharge include vaginal yeast infections, bacterial vaginosis, and sexually transmitted infections. The characteristics of abnormal vaginal discharge vary depending on the cause, but common features include a change in color, a foul odor, and associated symptoms such as itching, burning, pelvic pain, or pain during sexual intercourse.

Dyspareunia is painful sexual intercourse due to medical or psychological causes. The pain can primarily be on the external surface of the genitalia, or deeper in the pelvis upon deep pressure against the cervix. It can affect a small portion of the vulva or vagina or be felt all over the surface. Understanding the duration, location, and nature of the pain is important in identifying the causes of the pain.

The incubation period is 2 to 14 days, with most symptoms appearing between 4 and 6 days after infection. Rarely, gonorrhea may cause skin lesions and joint infection (pain and swelling in the joints) after traveling through the blood stream (see below). Very rarely it may settle in the heart causing endocarditis or in the spinal column causing meningitis (both are more likely among individuals with suppressed immune systems, however). [17]

Incubation period time between an infection and the onset of disease symptoms

Incubation period is the time elapsed between exposure to a pathogenic organism, a chemical, or radiation, and when symptoms and signs are first apparent. In a typical infectious disease, incubation period signifies the period taken by the multiplying organism to reach a threshold necessary to produce symptoms in the host.

Endocarditis endocardium disease characterized by inflammation of the endocardium of the heart chambers and valves

Endocarditis is an inflammation of the inner layer of the heart, the endocardium. It usually involves the heart valves. Other structures that may be involved include the interventricular septum, the chordae tendineae, the mural endocardium, or the surfaces of intracardiac devices. Endocarditis is characterized by lesions, known as vegetations, which is a mass of platelets, fibrin, microcolonies of microorganisms, and scant inflammatory cells. In the subacute form of infective endocarditis, the vegetation may also include a center of granulomatous tissue, which may fibrose or calcify.

Meningitis inflammation of membranes around the brain and spinal cord

Meningitis is an acute inflammation of the protective membranes covering the brain and spinal cord, known collectively as the meninges. The most common symptoms are fever, headache, and neck stiffness. Other symptoms include confusion or altered consciousness, vomiting, and an inability to tolerate light or loud noises. Young children often exhibit only nonspecific symptoms, such as irritability, drowsiness, or poor feeding. If a rash is present, it may indicate a particular cause of meningitis; for instance, meningitis caused by meningococcal bacteria may be accompanied by a characteristic rash.

Gonorrhea is associated with increased risk of prostate cancer. [18]

Cause

Multiple views of a Neisseria gonorrhoeae bacterium, which causes gonorrhea. Neisseria gonorrhoeae micrograph.jpg
Multiple views of a Neisseria gonorrhoeae bacterium, which causes gonorrhea.

Gonorrhea is caused by the bacterium Neisseria gonorrhoeae . [13] Previous infection does not confer immunity - a person who has been infected can become infected again by exposure to someone who is infected. Infected persons may be able to infect others repeatedly without having any signs or symptoms of their own.

Spread

The infection is usually spread from one person to another through vaginal, oral, or anal sex. [13] [19] Men have a 20% risk of getting the infection from a single act of vaginal intercourse with an infected woman. The risk for men that have sex with men (MSM) is higher. [20] Active MSM may get a penile infection, while passive MSM may get anorectal gonorrhea. [21] Women have a 60–80% risk of getting the infection from a single act of vaginal intercourse with an infected man. [22]

A mother may transmit gonorrhea to her newborn during childbirth; when affecting the infant's eyes, it is referred to as ophthalmia neonatorum. [13] It may be able to spread through the objects contaminated with body fluid from an infected person. [23] The bacteria typically does not survive long outside the body, typically dying within minutes to hours. [24]

Diagnosis

Traditionally, gonorrhea was diagnosed with Gram stain and culture; however, newer polymerase chain reaction (PCR)-based testing methods are becoming more common. [14] [25] In those failing initial treatment, culture should be done to determine sensitivity to antibiotics. [26]

Tests that use polymerase chain reaction (PCR, aka nucleic acid amplification) to identify genes unique to N. gonorrhoeae are recommended for screening and diagnosis of gonorrhea infection. These PCR-based tests require a sample of urine, urethral swabs, or cervical/vaginal swabs. Culture (growing colonies of bacteria in order to isolate and identify them) and Gram-stain (staining of bacterial cell walls to reveal morphology) can also be used to detect the presence of N. gonorrhoeae in all specimen types except urine. [27] [28]

If Gram-negative, oxidase-positive diplococci are visualized on direct Gram stain of urethral pus (male genital infection), no further testing is needed to establish the diagnosis of gonorrhea infection. [29] [30] However, in the case of female infection direct Gram stain of cervical swabs is not useful because the N. gonorrhoeae organisms are less concentrated in these samples. The chances of false positives are increased as Gram-negative diplococci native to the normal vaginal flora cannot be distinguished from N. gonorrhoeae. Thus, cervical swabs must be cultured under the conditions described above. If oxidase positive, Gram-negative diplococci are isolated from a culture of a cervical/vaginal swab specimen, then the diagnosis is made. Culture is especially useful for diagnosis of infections of the throat, recutum, eyes, blood, or joints – areas where PCR-based tests are not well established in all labs. [31] [30] Culture is also useful for antimicrobial sensitivity testing, treatment failure, and epidemiological purposes (outbreaks, surveillance). [30]

In patients who may have disseminated gonococcal infection (DGI), all possible mucosal sites should be cultured (e.g., pharynx, cervix, urethra, rectum). [31] Three sets of blood cultures should also be obtained. [32] Synovial fluid should be collected in cases of septic arthritis. [31]

All people testing positive for gonorrhea should be tested for other sexually transmitted diseases such as chlamydia, syphilis, and human immunodeficiency virus. [26] Studies have found co-infection with chlamydia ranging from 46 to 54% in young people with gonorrhea. [33] [34] For this reason, gonorrhea and chlamydia testing are often combined. [27] [35] [36] People diagnosed with gonorrhea infection have a fivefold increase risk of HIV transmission. [37] Additionally, infected persons who are HIV positive are more likely to shed and transmit HIV to uninfected partners during an episode of gonorrhea. [38]

Screening

The United States Preventive Services Task Force (USPSTF) recommends screening for gonorrhea in women at increased risk of infection, which includes all sexually active women younger than 25 years. Extragenital gonorrhea and chlamydia are highest in men who have sex with men (MSM). [39] Additionally, the USPSTF also recommends routine screening in people who have previously tested positive for gonorrhea or have multiple sexual partners and individuals who use condoms inconsistently, provide sexual favors for money, or have sex while under the influence of alcohol or drugs. [12]

Screening for gonorrhea in women who are (or intend to become) pregnant, and who are found to be at high risk for sexually transmitted diseases, is recommended as part of prenatal care in the United States. [40]

Prevention

As with most sexually transmitted diseases, the risk of infection can be reduced significantly by the correct use of condoms and can be removed almost entirely by limiting sexual activities to a mutually monogamous relationship with an uninfected person. [41] [42]

Those previously infected are encouraged to return for follow up care to make sure that the infection has been eliminated. In addition to the use of phone contact, the use of email and text messaging have been found to improve the re-testing for infection. [43]

Newborn babies coming through the birth canal are given erythromycin ointment in the eyes to prevent blindness from infection. The underlying gonorrhea should be treated; if this is done then usually a good prognosis will follow. [44]

Treatment

Antibiotics

Penicillin entered mass production in 1944 and revolutionized the treatment of several venereal diseases. PenicillinPSAedit.jpg
Penicillin entered mass production in 1944 and revolutionized the treatment of several venereal diseases.

As of 2010, injectable ceftriaxone is one of the few effective antibiotics. [26] This is typically given in combination with either azithromycin or doxycycline. [45] As of 2015 and 2016 the CDC and WHO only recommends both ceftriaxone and azithromycin. [4] [46] Because of increasing rates of antibiotic resistance local susceptibility patterns must be taken into account when deciding on treatment. [26] [47]

Adults may have eyes infected with gonorrhoea and require proper personal hygiene and medications. [44] Among persons in the United States between 14 and 39 years of age, 46% of people with gonorrheal infection also have chlamydial infection. [48]

Sexual partners

It is recommended that sexual partners be tested and potentially treated. [26] One option for treating sexual partners of people infected is patient-delivered partner therapy (PDPT), which involves providing prescriptions or medications to the person to take to his/her partner without the health care provider's first examining him/her. [49]

The United States' Centers for Disease Control and Prevention (CDC) currently recommend that individuals who have been diagnosed and treated for gonorrhea avoid sexual contact with others until at least one week past the final day of treatment in order to prevent the spread of the bacterium. [50]

Antibiotic resistance

Many antibiotics that were once effective including penicillin, tetracycline, and fluoroquinolones are no longer recommended because of high rates of resistance. [26] Resistance to cefixime has reached a level such that it is no longer recommended as a first-line agent in the United States, and if it is used a person should be tested again after a week to determine whether the infection still persists. [45] Cases of resistance to ceftriaxone have been reported but are still rare, [5] [26] though public health officials are concerned that an emerging pattern of resistance may predict a global epidemic. [51] The UK's Health Protection Agency reported that 2011 saw a slight drop in gonorrhea antibiotic resistance, the first in 5 years. [52]

Prognosis

Disability-adjusted life year for gonorrhea per 100, 000 inhabitants.
no data
<13
13-26
26-39
39-52
52-65
65-78
78-91
91-104
104-117
117-130
130-143
>143 Gonorrhoea world map - DALY - WHO2004.svg
Disability-adjusted life year for gonorrhea per 100, 000  inhabitants.

Gonorrhea if left untreated may last for weeks or months with higher risks of complications. [13] One of the complications of gonorrhea is systemic dissemination resulting in skin pustules or petechia, septic arthritis, meningitis, or endocarditis. [13] This occurs in between 0.6 and 3% of infected women and 0.4 and 0.7% of infected men. [13]

In men, inflammation of the epididymis, prostate gland, and urethra can result from untreated gonorrhea. [53] In women, the most common result of untreated gonorrhea is pelvic inflammatory disease. Other complications include inflammation of the tissue surrounding the liver, [53] a rare complication associated with Fitz-Hugh–Curtis syndrome; septic arthritis in the fingers, wrists, toes, and ankles; septic abortion; chorioamnionitis during pregnancy; neonatal or adult blindness from conjunctivitis; and infertility. Men who have had a gonorrhea infection have an increased risk of getting prostate cancer. [18]

Epidemiology

Gonorrhea--Rates: United States, 1941-2007 Chart of gonorrhea infection rates (USA, 1941-2007).png
Gonorrhea—Rates: United States, 1941–2007

About 88 million cases of gonorrhea occur each year, out of the 448 million new cases of curable STI each year – that also includes syphilis, chlamydia and trichomoniasis. [9] In 2013, it caused about 3,200 deaths, up from 2,300 in 1990. [54]

In the United Kingdom, 196 per 100,000 males 20 to 24 years old and 133 per 100,000 females 16 to 19 years old were diagnosed in 2005. [13] In 2013, the CDC estimated that more than 820,000 people in the United States get a new gonorrheal infection each year. Fewer than half of these infections are reported to CDC. In 2011, 321,849 cases of gonorrhea were reported to the CDC. After the implementation of a national gonorrhea control program in the mid-1970s, the national gonorrhea rate declined from 1975 to 1997. After a small increase in 1998, the gonorrhea rate has decreased slightly since 1999. In 2004, the rate of reported gonorrheal infections was 113. 5 per 100,000 persons. [55]

In the US, it is the second-most-common bacterial sexually transmitted infections; chlamydia remains first. [56] [57] According to the CDC African Americans are most affected by gonorrhea, accounting for 69% of all gonorrhea cases in 2010. [58]

The World Health Organization warned in 2017 of the spread of untreatable strains of gonorrhea, following analysis of at least three cases in Japan, France and Spain, which survived all antibiotic treatment. [59]

History

During World War II, the U.S. government used posters to warn military personnel about the dangers of gonorrhea and other sexually transmitted infections. SheMayLookCleanBut.jpg
During World War II, the U.S. government used posters to warn military personnel about the dangers of gonorrhea and other sexually transmitted infections.

Some scholars translate the biblical terms zav (for a male) and zavah (for a female) as gonorrhea. [60]

It has been suggested that mercury was used as a treatment for gonorrhea. Surgeons' tools on board the recovered English warship the Mary Rose included a syringe that, according to some, was used to inject the mercury via the urinary meatus into any unfortunate crewman suffering from gonorrhea. The name "the clap", in reference to the disease, is recorded as early as the sixteenth century. [61]

In 1854, Dr. Wilhelm Gollmann addressed gonorrhea in his book, Homeopathic Guide to all Diseases Urinary and Sexual Organs. He noted that the disease was common in prostitutes and homosexuals in large cities. Gollmann recommended the following as cures: aconite to cure "shooting pains with soreness and inflammation;" mercury "for stitching pain with purulent discharge;" nux vomica and sulphur "when the symptoms are complicated with hemorrhoids and stricture of the rectum. Other remedies include argentum, aurum (gold), belladonna, calcarea, ignatia, phosphorus, and sepia. [21]

Silver nitrate was one of the widely used drugs in the 19th century. However, It became replaced by Protargol. Arthur Eichengrün invented this type of colloidal silver, which was marketed by Bayer from 1897 on. The silver-based treatment was used until the first antibiotics came into use in the 1940s. [62] [63]

The exact time of onset of gonorrhea as prevalent disease or epidemic cannot be accurately determined from the historical record. One of the first reliable notations occurs in the Acts of the (English) Parliament. In 1161, this body passed a law to reduce the spread of "...the perilous infirmity of burning". [64] The symptoms described are consistent with, but not diagnostic of, gonorrhea. A similar decree was passed by Louis IX in France in 1256, replacing regulation with banishment. [65] Similar symptoms were noted at the siege of Acre by Crusaders.

Coincidental to, or dependent on, the appearance of a gonorrhea epidemic, several changes occurred in European medieval society. Cities hired public health doctors to treat afflicted patients without right of refusal. Pope Boniface rescinded the requirement that physicians complete studies for the lower orders of the Catholic priesthood. [66]

Medieval public health physicians in the employ of their cities were required to treat prostitutes infected with the "burning", as well as lepers and other epidemic victims. [67] After Pope Boniface completely secularized the practice of medicine, physicians were more willing to treat a sexually transmitted disease. [68]

Research

A vaccine for gonorrhea has been developed that is effective in mice. [69] It will not be available for human use until further studies have demonstrated that it is both safe and effective in the human population. Development of a vaccine has been complicated by the ongoing evolution of resistant strains and antigenic variation (the ability of N. gonorrhoeae to disguise itself with different surface markers to evade the immune system). [47]

As N. gonorrhoeae is closely related to N. meningitidis and they have 80–90% homology in their genetic sequences some cross-protection by meningococcal vaccines is plausible. A study published in 2017 showed that MeNZB group B meningococcal vaccine provided a partial protection against gonorrhea. [70] The vaccine efficiency was calculated to be 31%. [71]

Related Research Articles

Bacterial vaginosis Smelly vaginal bacteria

Bacterial vaginosis (BV) is a disease of the vagina caused by excessive growth of bacteria. Common symptoms include increased vaginal discharge that often smells like fish. The discharge is usually white or gray in color. Burning with urination may occur. Itching is uncommon. Occasionally, there may be no symptoms. Having BV approximately doubles the risk of infection by a number of other sexually transmitted infections, including HIV/AIDS. It also increases the risk of early delivery among pregnant women.

Chlamydia infection sexually transmitted infection caused by the bacterium Chlamydia trachomatis.

Chlamydia infection, often simply known as chlamydia, is a sexually transmitted infection caused by the bacterium Chlamydia trachomatis. Most people who are infected have no symptoms. When symptoms do develop this can take a few weeks following infection to occur. Symptoms in women may include vaginal discharge or burning with urination. Symptoms in men may include discharge from the penis, burning with urination, or pain and swelling of one or both testicles. The infection can spread to the upper genital tract in women causing pelvic inflammatory disease which may result in future infertility or ectopic pregnancy. Repeated infections of the eyes that go without treatment can result in trachoma, a common cause of blindness in the developing world.

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Urethritis is inflammation of the urethra. The most common symptom is painful or difficult urination. It is usually caused by infection with bacteria. The bacterial infection is often sexually transmitted, but not in every instance; it can be idiopathic, for example.

Conjunctivitis inflammation of the outermost layer of the eye and the inner surface of the eyelids

Conjunctivitis, also known as pink eye, is inflammation of the outermost layer of the white part of the eye and the inner surface of the eyelid. It makes the eye appear pink or reddish. Pain, burning, scratchiness, or itchiness may occur. The affected eye may have increased tears or be "stuck shut" in the morning. Swelling of the white part of the eye may also occur. Itching is more common in cases due to allergies. Conjunctivitis can affect one or both eyes.

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<i>Chlamydia trachomatis</i> species of bacterium

Chlamydia trachomatis, commonly known as chlamydia, is a bacterium that can replicate only in human cells. It causes chlamydia, which can manifest in various ways, including: trachoma, lymphogranuloma venereum, nongonococcal urethritis, cervicitis, salpingitis, pelvic inflammatory disease. C. trachomatis is the most common infectious cause of blindness and the most common sexually transmitted bacterium.

Azithromycin chemical compound

Azithromycin is an antibiotic used for the treatment of a number of bacterial infections. This includes middle ear infections, strep throat, pneumonia, traveler's diarrhea, and certain other intestinal infections. It may also be used for a number of sexually transmitted infections, including chlamydia and gonorrhea infections. Along with other medications, it may also be used for malaria. It can be taken by mouth or intravenously with doses once per day.

Endometritis inflammation of inner lining of uterus

Endometritis is inflammation of the inner lining of the uterus (endometrium). Symptoms may include fever, lower abdominal pain, and abnormal vaginal bleeding or discharge. It is the most common cause of infection after childbirth. It is also part of spectrum of diseases that make up pelvic inflammatory disease.

Neonatal conjunctivitis

Neonatal conjunctivitis, also known as ophthalmia neonatorum, is a form of conjunctivitis and a type of neonatal infection contracted by newborns during delivery. The baby's eyes are contaminated during passage through the birth canal from a mother infected with either Neisseria gonorrhoeae or Chlamydia trachomatis.

Antibiotic resistance in gonorrhea

The Gonorrhea bacterium Neisseria gonorrhoeae has developed antibiotic resistance to many antibiotics.

Tubal factor infertility

Tubal factor infertility (TFI) is female infertility caused by diseases, obstructions, damage, scarring, congenital malformations or other factors which impede the descent of a fertilized or unfertilized ovum into the uterus through the Fallopian tubes and prevents a normal pregnancy and full term birth. Tubal factors cause 25-30% of infertility cases. Tubal factor is one complication of Chlamydia trachomatis infection in women.

Mutual monogamy is a form of monogamy that exists when two partners agree to be sexually active with only one another. Being in a long-term mutually monogamous relationship reduces the risk of acquiring a sexually transmitted infection (STI). It is one of the most reliable ways to avoid STIs. Those who choose mutual monogamy can be tested before the sexual relationship to be certain they are not infected. This strategy for the prevention of acquiring a sexually transmitted infection requires that each partner remain faithful and does not engage in sexual activity with another partner.

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