1. Click to edit Master title style GonorrheaGonorrhea

2.  Gonorrhea is a sexually transmitted disease caused by the bacterium Neisseria gonorrhoeae.  The infection can be spread by contact with the mouth, vagina, penis, or anus.  Gonorrhea is a very common infectious disease. Source CDC, 2011 What is Gonorrhea ?

3. Click to edit Master title style  If not treated, gonorrhea can also spread to the blood or joints. This condition can be life-threatening.  Annually, more than 700,000 people in the United States get new gonorrhea infections and less than half of these infections are reported (CDC) Source CDC, 2011 What is Gonorrhea ?

4. Click to edit Master title style Source CDC, 2011 Neisseria gonorrhoeae.

5. Click to edit Master title style Source : CDC Symptoms and Pathogenesis

6. Click to edit Master title style  Symptoms of gonorrhea usually appear 2 - 5 days after infection.  In men, symptoms may take up to a month to appear.  Some people do not have symptoms and completely unaware of their infection and therefore do not seek treatment. Source CDC

7. Click to edit Master title style  The signs of rectal or eye infection are similar for both sexes.  Rectal infection is often associated with discharge, anal itching, and painful, bloody bowel movements.  Eye infection may cause burning, itching, or discharge. Source CDC

8. Click to edit Master title style  Absence of treatment increases the risks of complication and transmission.  If not treated, gonorrhea can also spread to the blood or joints. This condition can be life-threatening.  In most cases, men will have symptoms more often than women.  Symptoms in women can be very mild or nonspecific, and may be mistaken for another type of infection. Source CDC

9. Click to edit Master title style  Absence of treatment increases the risks of complication and transmission  Untreated gonorrhea can cause serious and permanent health problems in both women and men.  In men, gonorrhea can cause a painful condition called epididymitis in the tubes attached to the testicles. In rare cases, this may prevent a man from being able to father children. Source CDC

10. Click to edit Master title style  In women, gonorrhea can spread into the uterus (womb) or fallopian tubes (egg canals) and cause pelvic inflammatory disease (PID).  PID can lead to internal abscesses (pus-filled pockets that are hard to cure) and chronic (long-lasting) pelvic pain. Source CDC

11. Click to edit Master title style  PID can damage the fallopian tubes enough that a woman will be unable to have children.  It also can increase her risk of ectopic pregnancy.  Ectopic pregnancy is a life-threatening condition in which a fertilized egg grows outside the uterus, usually in a fallopian tube. It is a life threatening condition. Source CDC

12. Click to edit Master title style  If a pregnant woman has gonorrhea, she may give the infection to her baby as the baby passes through the birth canal during delivery.  This can cause serious health problems for the baby. Treating gonorrhea as soon as it is detected in pregnant women will make these health outcomes less likely. Source CDC

13. Click to edit Master title style  Symptoms in men include:  Burning and pain while urinating  Increased urinary frequency or urgency  Discharge from the penis (white, yellow, or green in color)  Red or swollen opening of penis (urethra)  Tender or swollen testicles  Sore throat (gonococcal pharyngitis) Source CDC

14. Click to edit Master title style Gonorrhea in the eye

15. Click to edit Master title style  Symptoms in women include:  Vaginal discharge  Burning and pain while urinating  Increased urination  Sore throat  Painful sexual intercourse Source CDC

16. Click to edit Master title style  Symptoms in women include:  Severe pain in lower abdomen (if the infection spreads to the fallopian tubes and stomach area)  Fever (if the infection spreads to the fallopian tubes and stomach area) Source CDC

17. Click to edit Master title style Cutaneous lesions due to a disseminated Gonorrhea infection

18. Click to edit Master title style Gonorrhea In the eyes of babies

19. Click to edit Master title style EpidemiologyEpidemiology

20.  In 2010, 309,341 cases of gonorrhea were reported to CDC.  For every case of gonorrhea reported there is one undiagnosed.  About half of the women with gonorrhea are also infected with chlamydia, another very common sexually transmitted infection. Source CDC

21. Click to edit Master title style  In 2010, 50% of reported gonorrhea cases occurred in just 63 counties or independent cities.  The highest reported rates of infection are among sexually active teenagers, young adults, and African Americans. Source CDC

22. Click to edit Master title style  In 2010, 1,307,893 Chlamydial infections were reported to CDC.  Under-reporting is substantial because most people with Chlamydia are not aware of their infections and do not seek testing.  Women are frequently re-infected if their sex partners are not treated. Source CDC

23. Gonorrhea: Rates, United States, 1941–2010

24. Gonorrhea: Rates by Age and Sex, United States, 2010

25. Gonorrhea: Rates by Age Among Women Aged 15–44 Years, United States, 2001–2010

26. Gonorrhea: Rates by Age Among Men Aged 15–44 Years, United States, 2001–2010

27. Gonorrhea: Rates by Race/Ethnicity, United States, 2001–2010

29. Gonorrhea: Rates per 100,000 population by State, United States and Outlying Areas, 2010

30. Gonorrhea: Rates by counties, United States, 2010

31. Click to edit Master title style Source MDH 2011 HIV/AIDS in M Minnesota : Annual Review Overview of Gonorrhea in Minnesota

32. Data Source: Minnesota STD Surveillance System STDs in Minnesota: Annual Review 2011 Minnesota Gonorrhea Rates by County Rate per 100,000 persons City of Minneapolis 211 City of St. Paul 132 Suburban # 30 Greater Minnesota 14 (91 cases missing residence information) # 7-county metro area, excluding the cities of Minneapolis and St. Paul St. Louis Itasca Cass Lake Polk Beltrami Aitkin Pine Cook Koochiching Otter Tail Clay Roseau Marshall Becker Todd Stearns Kittson Swift Lyon Pope Morrison Wilkin Renville Carlton Martin Rice Wright Norman Fillmore Mower Nobles Murray Grant Sibley Brown Rock Redwood Douglas Jackson Meeker Goodhue Winona Isanti Faribault Dakota Freeborn Olmsted Scott Stevens Anoka Nicollet McLeod Chippewa Wabasha Carver Pennington Hubbard Crow Wing Lake of the Woods Clearwater Kandiyohi Lincoln Blue Earth Mille Lacs Houston Steele Traverse Dodge Wadena Hennepin Kanabec Lac qui Parle Benton Big Stone Cottonwood Waseca Chisago Le Sueur Mahnomen Yellow Medicine Pipestone Red Lake Sherburne Watonwan Washington Ramsey > 100 30 - 100 11 - 29 0 - 10

33. Data Source: Minnesota STD Surveillance System STDs in Minnesota: Annual Review Gonorrhea Rates by Gender Minnesota, 2001-2011

34. Data Source: Minnesota STD Surveillance System STDs in Minnesota: Annual Review Gonorrhea Rates by Age Minnesota, 2001-2011

35. Data Source: Minnesota STD Surveillance System STDs in Minnesota: Annual Review Age-Specific Gonorrhea Rates by Gender Minnesota, 2011

36. Data Source: Minnesota STD Surveillance System STDs in Minnesota: Annual Review Gonorrhea Rates by Race/Ethnicity Minnesota, 2001-2011 * Persons of Hispanic ethnicity can be of any race. 2011 rates compared with Whites: Black = 26x higher American Indian = 6x higher Asian/PI = 0x higher Hispanic = 2x higher

37. Data Source: Minnesota STD Surveillance System STDs in Minnesota: Annual Review Gonorrhea Rates by Race/Ethnicity Minnesota, 2001-2011 * Persons of Hispanic ethnicity can be of any race.

38. Click to edit Master title style  Gram stain: done by staining a sample of tissue or discharge and then looking at it under a microscope.  Cultures: (cells that grow in a lab dish) provide absolute proof of infection. Results provided within 24 to 72 hours.  Samples for a culture are taken from the cervix, vagina, urethra, anus, or throat. Diagnosis of Gonorrhea Infection

39. Click to edit Master title style Risk factors

40. Click to edit Master title style  Any sexually active person can be infected with gonorrhea.  Thus, transmission may occur from persons who are unaware of their infection. TransmissionTransmission

41. Click to edit Master title style  Transmission of the organism occurs during vaginal, anal, or oral sex.  Transmission of the organism occurs during vaginal, anal, or oral sex.  Pregnant women with the disease can pass it to the babies they are carrying. TransmissionTransmission

42. Click to edit Master title style  You are more likely to develop this infection if you:  Have multiple sexual partners  Have a partner with a past history of any sexually transmitted infection  Do not use a condom during sex  Abuse alcohol or illegal substance TransmissionTransmission

43. Click to edit Master title style  In Summary: there are 3 modes of transmission  Sexual transmission : most frequent  Vertical transmission mother ‐ to ‐ infant or transmission during parturition: only major exception to sexual  Transmission via inanimate objects : extremely uncommon. TransmissionTransmission

44. Click to edit Master title style  Untreated gonorrhea can increase a person’s risk of acquiring or transmitting HIV. Gonorrhea and HIV

45. Click to edit Master title style PreventionPrevention

46.  Abstain from sexual activity or be faithful (be in a long- term mutually monogamous relationship with an uninfected partner).  Limit your number of sex partners : the fewer partners you have, the less likely you are to get infected.  Notify sex partners immediately if infected.  Make sure partners are tested and treated.

47. Click to edit Master title style  Correct and consistent condom use. Latex condoms are highly effective at preventing transmission of HIV and some other sexually transmitted diseases.  Get tested and treated and insist that your partners do too.  Get a test from a medical provider if infection is suspected and obtain medical treatment immediately if you think you were exposed.

48. Click to edit Master title style  Do not inject drugs. If you inject drugs, you should get counseling and treatment to stop or reduce your drug use.  If you cannot stop injecting drugs, use clean needles and works when injecting.  Pregnant women should consult a health care provider for appropriate examination, testing, and treatment, as necessary.

49. Click to edit Master title style  Health care providers in every state in the U.S. are required by law to tell their State Board of Health about anyone diagnosed with gonorrhea.  The goal of this law is make sure the patient gets proper follow-up care and that their sexual partners are found and tested.

50. Click to edit Master title style TreatmentTreatment

51.  Gonorrhea can be cured with the right treatment.  Although medication will stop the infection, it will not repair any permanent damage done by the disease.  Chlamydia is treated at the same time as a gonorrhea infection Source CDC

52. Click to edit Master title style  Drug-resistant strains of gonorrhea are increasing, and successful treatment of gonorrhea is becoming more difficult.  If a person’s symptoms continue for more than a few days after receiving treatment, he or she should return to a health care provider to be reevaluated. Source CDC