1. Gonorrhea Epidemiology and Control Efforts in Louisiana Lisa Longfellow, MPH October 14, 2009

2. Gonorrhea Rates Louisiana 1988 - 2008

3. Reported Cases of Gonorrhea Louisiana 2000 - 2008

4. RankCounty / CityCasesRate 1St. Louis (City), MO2,577742.3 2Orleans County, LA1,529684.5 3Montgomery County, AL1,434641.4 4Richmond (City), VA1,183613.2 5Caddo County, LA1,496591.0 30East Baton Rouge County, LA 1,229286.4 U.S. Total = 355,991 cases or 118.9 cases per 100,000 population GONORRHEA – COUNTIES AND INDEPENDENT CITIES, UNITED STATES, 2007

5. Gonorrhea Rate per 100,000 27.6 – 95.7 95.7 – 157.2 157.2 – 233.7 233.7 – 310.8 310.8 – 521.6 Gonorrhea Case Rates by Parish – Louisiana, 2008

6. Gonorrhea By Region

22. Gonococcal Isolate Surveillance Project (GISP) New Orleans has participated in the GISP as a sentinel site since 1998. Monthly submission of: –(a) male urethral gonococcal isolates to its assigned GISP Regional Laboratory, and –(b) clinical/demographic data on GISP patients to CDC. At regional laboratories, the susceptibilities of these isolates to penicillin, tetracycline, spectinomycin, ciprofloxacin, ceftriaxone, cefixime, and azithromycin are determined by agar dilution. Minimum inhibitory concentrations (MICs) are measured, and values are interpreted according to criteria recommended by the National Committee for Clinical Laboratory Standards (NCCLS).

23. STD Surveillance Network (SSuN) Collect enhanced STD surveillance data not previously available in New Orleans since July 2009 –Increase understanding of risk behaviors associated with STDs –Detect and respond rapidly to emerging trends in STDs Phone interviews with gonorrhea patients diagnosed outside of the STD clinic Types of enhanced surveillance data collected: –Education and employment status –Sexual orientation –Partner information (number of partners, sex of partners) –Risk behaviors (drug use, internet use to meet sex partners, anonymous sex) –And much more…

24. Expedited Partner Therapy Act 449 - 2008 A. The purpose of this Section is to allow for the provision of medications or prescriptions by any physician licensed to practice medicine in this state or any advanced practice registered nurse who is licensed to practice nursing in this state, or any physician assistant, who is licensed to practice in this state, provided such physician or nurse or physician assistant has the authority to write prescriptions in this state, to individuals who may have been exposed to gonorrhea or chlamydia. Expedited partner therapy is hereby authorized absent a doctor-patient relationship and absent clinical assessment. B. Notwithstanding any other provisions of law to the contrary, any physician or any advanced practice registered nurse who diagnoses or does a nurse clinical assessment or any physician assistant who performs an examination of a case of chlamydia or gonorrhea in an individual patient may prescribe, furnish, or otherwise provide prescription antibiotic drugs to that patient's sexual partner or partners absent a doctor-patient relationship or absent an advanced practice registered nurse-patient relationship and without examination or nurse clinical assessment or physician assistant examination of that patient's sexual partner or partners.

25. Expanded Screening Sites Targeted –School Based Health Clinics –Juvenile Detention Centers –Pregnancy Test Only Visits