GONORRHEA

Gonorrhea is a sexually transmitted bacterial disease (STD) caused by Neisseria gonorrhoeae. In males, it is usually characterized by a purulent urethral discharge and dysuria. In females, initially there is a urethritis or cervicitis often so mild it may pass unnoticed. Depending upon sexual practices, pharyngeal and anorectal infections can occur. In males, the urethral infection is usually self-limiting; however, it may progress to epididymitis, and in rare cases, it can disseminate into an arthritis-dermatitis syndrome, endocarditis, and meningitis. Twenty percent of women infected with gonorrhea may progress to uterine infection, which may lead to endometritis or salpingitis (PID-Pelvic Inflammatory Disease) and the subsequent risk of infertility. Laboratory Criteria for Confirmation: Isolation of typical Gram-negative, oxidase-positive diplococci (presumptive N. gonorrhoeae) from clinical specimen, OR Demonstration of N. gonorrhoeae in a clinical specimen by detection of antigen or nucleic acid, OR Observation of Gram-negative intracellular diplococci in a urethral smear from a man.

Case Classification Confirmed: A case that is laboratory confirmed. Probable: a) Demonstration of gram-negative intracellular diplococci in an endocervical smear obtained from a female or b) a written morbidity report of gonorrhea submitted by a physician. Gonorrhea Incidence, Kentucky 1994-2003
150
Cases per 100,000

100 50 0
Rate

1994 116.6

1995 109.9

1996 108.9

1997 103.7

1998 96.9

1999 85.1

2000 88.4

2001 88.8

2002 92.8

2003 87.4

Year

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Epidemiology Kentucky 2003 Cases 3565 Cases by Gender Female 1839 Male 1720 Rate per 100,000 88.2 88.9 87.1 U.S. Rate (2003) per 100,000* 114.7

Gender not specified on six cases. The highest incidence of gonorrhea by race was 635.8 cases per 100,000 in AfricanAmericans. The Caucasian rate was 26.5 cases per 100,000. The combined rate for all other races was 57.2. Race was not specified on 18.3% of the reports.

Gonorrhea, Age-Specific Incidence, Kentucky 2003

500 450 400 350 300 250 200 150 100 50 0
0-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-54 55-64 65+

Cases C ases p per er 10 100,000 0,000

Age Group

The 20-24 year age group reported the highest number of cases, 445.9 per 100,000 followed by the 15-19 year age group, 327.3 cases per 100,000. This is a slight decrease from 2002 rates for these two age groups. Age was not specified for 23 cases. *from Sexually Transmitted Disease Surveillance 2003. 2003 CDC-HHS.

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Gonorrhea Incidence by District , Kentucky 2003

Cases per 100,000 0-15 16-40 41-100 101-180
NORTHERN KENTUCKY
BUFFALO TRACE
FIVCO
BLUEGRASS

NORTH CENTRAL

GATEWAY

GREEN RIVER

LINCOLN TRAIL
KENTUCKY RIVER

BIG SANDY

PENNYRILE

BARREN RIVER

LAKE CUMBERLAND

PURCHASE

CUMBERLAND VALLEY

The highest reported incidence occurred in the North Central District (172.7 cases per 100,000), followed by the Pennyrile District (135.5 cases per 100,000). District Purchase Pennyrile Green River Barren River Lincoln Trail North Central Northern Kentucky Buffalo Trace Gateway Fivco Big Sandy Kentucky River Cumberland Valley Lake Cumberland Bluegrass Annual Incidence Rate 94.6 135.5 121.5 74.1 34.3 172.7 78.9 43.5 22.3 15.5 5.0 9.9 18.0 17.6 87.0

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