Gonorrhea, NIAID Fact Sheet: NIAID
Article title: Gonorrhea, NIAID Fact Sheet: NIAID
Conditions: Gonorrhea
Source: NIAID
October 2000
Gonorrhea
What is Gonorrhea?
Gonorrhea is a curable sexually
transmitted disease (STD) caused by a bacterium called
Neisseria
gonorrhoeae. These bacteria can infect the genital tract, the
mouth, and the rectum. In women, the opening (cervix) to the womb
(uterus) from the birth canal is the first place of infection. The
disease however can spread into the womb and fallopian tubes,
resulting in pelvic inflammatory disease (PID). PID affects more
than 1 million women in this country every year and can cause
infertility in as many as 10 percent of infected women and tubal
(ectopic) pregnancy.
In 1997, health care workers reported
324,901 cases of gonorrhea in the United States to the U.S. Centers
for Disease Control and Prevention (CDC). The Institute of Medicine,
however, estimates that 800,000 cases of gonorrhea occur annually in
the United States. Health economists estimate that the annual cost
of gonorrhea and its complications is close to $1.1
billion.
Gonorrhea is spread during sexual intercourse –
vaginal, oral, and anal. People who practice anal intercourse can
get gonorrhea of the rectum. Even women who do not engage in anal
intercourse can get gonorrhea of the rectum if the bacteria are
spread from the vaginal area.
Infected women can pass
gonorrhea to their newborn infants during delivery, causing eye
infections in their babies. This complication is rare because
newborn babies receive eye medicine to prevent infection. When the
infection occurs in the genital tract, mouth, or rectum of a child,
it is due most commonly to sexual abuse.
What Are the Symptoms of Gonorrhea?
The early symptoms of
gonorrhea often are mild. Symptoms usually appear within two to 10
days after sexual contact with an infected partner. A small number
of people may be infected for several months without showing
symptoms.
When women have symptoms, the first ones include:
- bleeding associated with vaginal intercourse;
- a painful or burning sensation when urinating; and/or
- vaginal discharge that is yellow or bloody.
More
advanced symptoms, which indicate development of PID, include cramps
and pain, bleeding between menstrual periods, vomiting, or fever.
Men have symptoms more often than women. Symptoms include:
- pus from the penis and pain, or
- a burning sensation during urination that may be severe.
Symptoms of rectal infection include discharge, anal
itching, and occasional painful bowel movements with fresh blood on
the feces.
How is Gonorrhea Diagnosed?
Doctors or other health care
workers usually use three laboratory techniques to diagnose
gonorrhea: staining biological samples directly for the bacterium,
detection of bacterial genes or nucleic acid (DNA) in urine, and
growing the bacteria in laboratory cultures. Many doctors prefer to
use more than one test to increase the chance of an accurate
diagnosis.
The staining test involves placing a smear of the
discharge from the penis or the cervix on a slide and staining the
smear with a dye. Then the doctor uses a microscope to look for
bacteria on the slide. You usually can get the test results while in
the office or clinic. This test is quite accurate for men but is not
good in women. Only one in two women with gonorrhea have a positive
stain.
More often, doctors use urine or cervical swabs for a
new test that detects the genes of the bacteria. These tests are as
accurate or more so than culturing the bacteria, and many doctors
use them.
The culture test involves placing a sample of the
discharge onto a culture plate and incubating it up to two days to
allow the bacteria to multiply. The sensitivity of this test depends
on the site from which the sample is taken. Cultures of cervical
samples detect infection approximately 90 percent of the time.
The doctor also can take a culture to detect gonorrhea in
the throat. Culture allows testing for drug-resistant bacteria.
How is Gonorrhea Treated?
Doctors usually prescribe a single
dose of one of the following antibiotics to treat gonorrhea:
- Ceftriaxone
- Cefixime
- Ciprofloxacin
- Ofloxacin
If you have gonorrhea and are pregnant or
are younger than 18 years old, you should not take ciprofloxacin or
ofloxacin. Your doctor can prescribe the best and safest antibiotic
for you.
Gonorrhea and chlamydial infection, another common
STD, often infect people at the same time. Therefore, doctors
usually prescribe a combination of antibiotics, such as ceftriaxone
and doxycycline or azithromycin, which will treat both diseases.
If you have gonorrhea, all of your sexual partners should
get tested and then treated if infected, whether or not they have
symptoms of infection.
What Can Happen if Gonorrhea is Not Treated?
In untreated
gonorrhea infections, the bacteria can spread up into the
reproductive tract, or more rarely, can spread through the blood
stream and infect the joints, heart valves, or the brain.
The
most common result of untreated gonorrhea is PID, a serious
infection of the female reproductive organs. Gonococcal PID often
appears immediately after the menstrual period. PID causes scar
tissue to form in the fallopian tubes. If the tube is only partially
scarred, the fertilized egg cannot pass into the uterus. If this
happens, the embryo may implant in the tube causing a tubal
pregnancy. This serious complication results in a miscarriage and
can cause death of the mother. Rarely, untreated gonorrhea can
spread through the blood to the joints.
If you are infected
with gonorrhea, your risk of getting HIV infection increases (HIV,
human immunodeficiency virus, causes AIDS). Therefore, it is
extremely important for you to either prevent yourself from getting
gonorrhea or get treated early if you already are infected with it.
Can Gonorrhea Affect a Newborn Baby?
If you are pregnant and
have gonorrhea, you may give the infection to your baby as it passes
through the birth canal during delivery. A doctor can prevent
infection of your baby's eyes by applying silver nitrate or other
medications to the eyes immediately after birth. Because of the
risks from gonococcal infection to both you and your baby, doctors
recommend that pregnant women have at least one test for gonorrhea
during pregnancy.
How Can I Prevent Getting Infected With Gonorrhea?
By using
male latex condoms correctly and consistently during vaginal or
rectal sexual activity, you can reduce your risk of getting
gonorrhea and its complications.
What Research is Going On?
Scientists supported by the
National Institute of Allergy and Infectious Diseases (NIAID) are
continuing to learn more about the bacterium that causes gonorrhea
and are working on better methods to prevent, diagnose, and treat
the disease. The dramatic rise of antibiotic-resistant strains of
the gonococcus bacterium emphasizes the need for an effective means
of preventing gonorrhea. Scientists have developed a laboratory
method to detect these resistant strains, which helps the doctor
select an appropriate treatment.
Developing topical
microbicides (preparations that can be inserted into the vagina to
prevent infection) and an effective vaccine against gonorrhea remain
key research priorities for NIAID-supported scientists.
NIAID, a component of the National Institutes
of Health (NIH), supports basic and applied research to prevent,
diagnose and treat infectious and immune-mediated illnesses,
including HIV/AIDS and other sexually transmitted diseases,
tuberculosis, malaria, autoimmune disorders, asthma and allergies.
Prepared by:
Office of Communications and Public
Liaison
National Institute of Allergy and Infectious
Diseases
National Institutes of Health
Bethesda, MD 20892
Public Health Service
U.S. Department of Health and
Human Services
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Gonorrhea: DSTD
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