The Alaska Section of Epidemiology (SOE) is reporting a significant increase in gonorrhea cases that is occurring concurrently with a national trend of increasing sexually transmitted disease rates.
In 2017, 2,190 gonorrhea cases were reported to SOE; the incidence rate was 297 cases per 100,000 persons, representing a 51% increase compared to 2016. Preliminary data indicate that Alaska’s 2017 gonorrhea rate was the second highest in the nation.
This increase may be attributed to one or more of the following factors: a) providers doing a better job of screening for infection, including extra-genital testing at oropharyngeal and rectal sites; b) a true increase in incidence, especially among men due to changes in their sexual networks and behaviors; c) a decrease in access to health care; and d) a decline in public health resources that support disease control efforts.
Of the 2,190 gonorrhea cases reported in 2017, 1,266 (58%) were in persons aged <29 years; 1,090 (50%) were in females, 65 (6%) of whom were diagnosed with pelvic inflammatory disease (PID).
Rates by race were highest in Blacks, followed by American Indian/Alaska Native people, Native Hawaiian/Pacific Islanders, Whites, and Asians (1126, 1024, 519, 117, and 98 cases per 100,000 population, respectively). Rates by region were highest in the Southwest, followed by the Northern and Anchorage/Mat-Su regions.
Untreated gonorrhea can result in pelvic inflammatory disease (PID), pre-term labor, ectopic pregnancy, and infertility in women; epididymitis and infertility in men; and conjunctivitis in neonates. Gonorrhea also facilitates the transmission and acquisition of human immunodeficiency virus (HIV).