Public Health Scotland (PHS) recently published a report describing gonorrhea infections in Scotland from 2013-2022.
The main points of the report is as follows:
- In 2022, there were 5,641 diagnoses of gonorrhea in Scotland. This is higher than recent years and represents a 49% increase on that observed in 2019 (3,776).
- Most diagnoses were in men (3,793) and were more than two times higher than diagnoses in women (1,822).
- In 2022, 77% of diagnoses in women were in those aged less than 25 years compared to 39% in men. This compares to data in previous years when historically, gonorrhea diagnoses in women have been mostly in those aged less than 25 years, while in men, diagnoses are more likely to be in older age groups.
- Diagnoses of rectal gonorrhea in men, a marker for condomless anal intercourse (CAI), were at the highest levels over the last decade in 2022 (1,308), however, the percentage of episodes with a positive rectal sample was similar to previous years (36%).
- Incidence of diagnosed gonorrhea infection has increased rapidly since May 2021 from 3 positives per 100,000 people to a historical high of 17.2 per 100,000 in November 2022.
- At the end of December 2022, levels of testing for gonorrhea in sexual health clinics have not yet fully recovered to levels observed prior to the COVID-19 pandemic; there were 605 positive individuals per 10,000 people tested in the last quarter of 2022.
- The increase in the incidence of diagnosed gonorrhea infection beginning during 2021 was initially driven by gay, bisexual, and other men who have sex with men (GBMSM). However, since quarter two of 2022, gonorrhea diagnoses have decreased in GBMSM and increased in women and heterosexual men.
- There were no reports of ceftriaxone resistance in gonococcal isolates in 2020 or 2021 and there were no documented treatment failures during this time.
Dr Kirsty Roy, Consultant in Health Protection at Public Health Scotland explained:
“The recent increase in gonorrhea cases is concerning and likely reflects a real increase in new infections, as well as existing infections undiagnosed because of reduced access to testing during the COVID-19 pandemic.
“Gonorrhea is a sexually transmitted infection which can be easily treated and we would encourage everyone to practice safe sex. The best way to reduce your risk of catching gonorrhea and other sexually transmitted infection is the correct and consistent use of a condom for sex with new and casual partners.”
Many people with gonorrhea will not notice any symptoms. If symptoms do appear, they usually show up between 1 to 14 days after becoming infected by the organism.
Gonorrhea infection is caused by the bacteria Neisseria gonorrhoeae and is the second most common bacterial STI in Scotland and the UK. Gonorrhea can be transmitted through unprotected vaginal, anal, or oral intercourse with an infected partner. Infected individuals may have no symptoms but can still pass on the infection. Gonorrhea can be treated with antibiotics, but if left untreated can result in reproductive morbidities in women, including pelvic inflammatory disease (PID), ectopic pregnancy and tubal factor infertility, while men can experience epididymo-orchitis or prostatitis. Disseminated gonococcal infection can also occur leading to skin lesions, arthralgia, arthritis, and tenosynovitis.
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