Gonorrhea

Sexually Transmitted Disease Surveillance 2008

Division of STD Prevention

Gonorrhea — Rates: United States, 1941–2008

0

100

200

300

400

500

1941 46 51 56 61 66 71 76 81 86 91 96 2001 06

Rate (per 100,000 population)

Gonorrhea — Rates: Total and by sex: United States, 1989–2008

0

80

160

240

320

400

1989 91 93 95 97 99 2001 03 05 07

Rate (per 100,000 population)

MenWomenTotal

Gonorrhea — Rates by region: United States, 1999–2008

0

60

120

180

240

300

1999 2000 01 02 03 04 05 06 07 08

Rate (per 100,000 population)

WestMidwestNortheastSouth

Gonorrhea — Rates by state: United States and outlying areas, 2008

Note: The total rate of gonorrhea for the United States and outlying areas (Guam, Puerto Rico, and Virgin Islands) was 110.3 per 100,000 population.

Rate per 100,000population

Guam 62.8

Puerto Rico 6.9

Virgin Is. 109.3

<=19.0

19.1-100.0

>100

(n= 7)

(n= 24)

(n= 23)

VT 6.0NH 7.6MA 33.0RI 29.0CT 80.0NJ 61.0DE 120.8MD 118.6DC 451.5

210.5

84.6

54.4 159.2

70.5 77.3

127.8

170.5

47.5

12.5

160.9 138.2

56.9

81.9107.2

220.2

7.3

169.4

58.4

256.8

136.3

12.7

82.384.7

71.2

88.7

176.3

22.4

146.5

143.3

32.7

89.0

214.2

47.1

142.6

134.7

18.0134.0

48.3

41.2

108.7

23.7

Gonorrhea — Rates by county: United States, 2008

Rate per 100,000population

<=19.0 (n= 1,305)

19.1-100.0 (n= 1,136)

>100.0 (n= 700)

Gonorrhea — Age- and sex-specific rates: United States, 2008

Men Rate (per 100,000 population) Women

Age750 600 450 300 150 0 0 150 300 450 600 750

5.8 31.010-14278.3 636.815-19

433.6 608.620-24269.9 269.425-29

163.3 119.030-3499.6 55.235-39

71.7 28.940-4440.1 11.245-54

14.0 2.555-643.5 0.565+

103.3 119.7Total

Gonorrhea — Age-specific rates among women 15 to 44 years of age:United States, 1999–2008

0

200

400

600

800

1,000

1999 2000 01 02 03 04 05 06 07 08

Rate (per 100,000 population)

15-19 20-2425-29 30-3435-39 40-44

Gonorrhea — Age-specific rates among men 15 to 44 years of age:United States, 1999–2008

0

150

300

450

600

750

1999 2000 01 02 03 04 05 06 07 08

Rate (per 100,000 population)

15-19 20-2425-29 30-3435-39 40-44

Gonorrhea — Rates by race/ethnicity: United States, 1999–2008

0

180

360

540

720

900

1999 2000 01 02 03 04 05 06 07 08

Rate (per 100,000 population)

American Indian/AK NativeAsian/Pacific IslanderBlackHispanicWhite

Gonorrhea — Cases by reporting source and sex: United States, 1999–2008

0

40

80

120

160

200

1999 2000 01 02 03 04 05 06 07 08

Cases (in thousands)

non-STD Clinic Malenon-STD Clinic FemaleSTD Clinic MaleSTD Clinic Female

Gonorrhea — Positivity among 15- to 24-year-old women tested in family planning

clinics by state: United States and outlying areas, 2008

*States/areas not meeting minimum inclusion criteria.Note: Includes states and outlying areas that reported positivity data on at least 500 women aged 15-24 years screened during 2008.

DATA SOURCE: Prevalence Monitoring Project (Regional Infertility Prevention Projects), Office of Population Affairs, Local and State STD Control Programs, Centers for Disease Control and Prevention.

Positivity (%)

Puerto Rico 0.2

Virgin Is. 3.0

See*

<1.0

1.0-1.9

>=2.0

(n= 7)

(n= 23)

(n= 14)

(n= 9)

VT 0.0NHMARI 0.3CT 0.7NJ 1.3DE 1.4MDDC 2.0

2.7

0.2

0.6 1.9

0.8 0.4

1.7

2.2

0.8

0.1

1.4 1.4

0.5

1.00.6

2.4

0.0

1.4

0.5

2.9

1.0

1.0

0.91.8

0.6

0.5

1.4

1.6

0.8

0.9

2.50.8

2.1

0.31.20.4

3.8

0.4

Gonococcal Isolate Surveillance Project (GISP) — Location of participating sentinel sites and regional laboratories in the United States, 2008

Sentinel SitesSites and Regional Labs

Birmingham Phoenix

Los Angeles

Orange Co. San Diego

San Francisco Denver

Miami

Atlanta

Honolulu Tripler AMC

Chicago

New Orleans

Baltimore

Detroit Minneapolis

Kansas City

Las Vegas

Albuquerque

New York City

Greensboro

Cincinnati Cleveland

Oklahoma City

Portland

Philadelphia

Dallas

Richmond

Seattle

Gonococcal Isolate Surveillance Project (GISP) — Distribution of MICs to ceftriaxzone among GISP isolates, 2004–2008

Percent

MIC (µg/ml)

2004

2005

2006

2007

2008

0

20

40

60

80

100

<=0.008 0.015 0.03 0.06 0.125 0.25

Gonococcal Isolate Surveillance Project (GISP) — Distribution of MICs to azithromycin among GISP isolates, 2004–2008

Percent

MIC (µg/ml)

2004

2005

2006

2007

2008

0

12

24

36

48

60

<=0.03 0.06 0.125 0.25 0.5 1 2 4 8 16

Gonococcal Isolate Surveillance Project (GISP) — Percent of Neisseria gonorrhoeae isolates with resistance or intermediate resistance to ciprofloxacin,

1990–2008

Note: Resistant isolates have ciprofloxacin MICs ≥1 µg/ml. Isolates with intermediate resistance have ciprofloxacin MICs of 0.125 - 0.5 µg/ml. Susceptibility to ciprofloxacin was first measured in GISP in 1990.

Percent

ResistanceIntermediate resistance

0

4

8

12

16

1990 91 92 93 94 95 96 97 98 99 2000 01 02 03 04 05 06 07 08

Gonococcal Isolate Surveillance Project (GISP) — Penicillin, tetracycline, and ciprofloxacin resistance among GISP isolates, 2008

Note: PenR=penicillinase producing N. gonorrhoeae and chromosomally mediated penicillin-resistant N. gonorrhoeae; TetR=chromosomally and plasmid mediated tetracycline-resistant N. gonorrhoeae; QRNG=ciprofloxacin resistant N. gonorrhoeae.

Gonococcal Isolate Surveillance Project (GISP) — Drugs used to treat gonorrhea in GISP patients, 1988–2008

0

20

40

60

80

100

1988 1990 1992 1994 1996 1998 2000 2002 2004 2006 2008

Other Cephalosporins

Ceftriaxone 125 mgSpectinomycin

Ceftriaxone 250 mg

Cefixime

Penicillins

Ciprofloxacin

Tetracyclines

Ofloxacin

Other

Note: For 2008, “Other” includes no therapy (1.3%), azithromycin 2 g (1.2%), levofloxacin (0.02%), and other less frequently used drugs.