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Overview of Gonorrhea Epidemiology and Program
Prevention Efforts
Melinda SalmonProgram Manager
STD Control ProgramPhiladelphia Department of Public Health
Reported Cases of Gonorrhea: Philadelphia, 1990 - 2008
19,554
11,914
10,580
6,565 6,415 6,5047,271
7,776 8,0617,277
5,7315,206 5,053 5,218 5,246 4,950
8,1708,026
15,429
0
3,000
6,000
9,000
12,000
15,000
18,000
21,000
1990 1992 1994 1996 1998 2000 2002 2004 2006 2008
Year
Nu
mb
er
of
Ca
ses
Rate of Gonorrhea per 100,000 Population: Philadelphia, 1990 - 2008
0
200
400
600
800
1,000
1,200
1,400
1990 1992 1994 1996 1998 2000 2002 2004 2006 2008
Year 2010 Objective
(19 per 100,000)
Rates for 1990 to 1999 calculated with 1990 Census denominator. Rates for 2000 to present calculated with 2000 Census denominator.
Year
Ra
te p
er
100
,00
0 p
op
ula
tio
n
Rates of Gonorrhea per 100,000 Population, by Gender: Philadelphia, 1996 – 2008
0
100
200
300
400
500
600
1996 1998 2000 2002 2004 2006 2008
Female
Male
Rates for 1995 to 1999 calculated with 1990 Census denominator. Rates for 2000 to present calculated with 2000 Census denominator.
Year
Ra
te p
er
100
,00
0 p
op
ula
tio
n
Race/Ethnicity* among Gonorrhea Cases, by Sex: Philadelphia, 2008
Hispanic4.7%
American Indian (non-
Hispanic)0.1%
Asian (non-Hispanic)
0.9%
White (non-Hispanic)
5.1%
Black (non-Hispanic)
89.2%
N=2,528
Female Gonorrhea Cases
Black (non-Hispanic)
91.1%
Asian (non-Hispanic)
0.7%
American Indian (non-
Hispanic)0.2%
Hispanic3.4%
White (non-Hispanic)
4.6%
N=2,422
Male Gonorrhea Cases
* Race and ethnicity are combined. Persons identified as Hispanic, alone or in combination with any US Census race category, are included in the Hispanic category. Persons in all other race categories are non-Hispanic.
* “Asian” category includes Asian / Pacific Islander / Native Hawaiian groups.
* “American Indian” category includes American Indian and Alaska Native groups.
* Distribution represent cases with a specified race/ethnicity. In 2008, 29.8% of Gonorrhea cases (22.6% male, 36.7% female) had neither race nor ethnicity specified in the disease report. Total N includes cases with unknown race/ethnicity.
Top ZIP codes by Case Counts:•19143: 454 cases•19121: 306 cases•19132: 297 cases•19139: 286 cases (Rate: 542.9/100,000)
•19140: 277 cases (Rate: 447.9/100,000)
Top ZIP codes by Rate:•19121: 815.8/100,000•19138: 814.2/100,000 (161 cases)
•19132: 779.2/100,000•19143: 693.6/100,000•19123: 598.9/100,000 (56 cases)
2008 GC Morbidity by Provider TypeProvider Type # Cases % Morbidity
STD Clinic 1,116 23%
Hosp/EDs 1,116 23%
Family Planning 834 17%
Other – Screening 542 11%
Other – Non-Screening 504 10%
Corrections 369 7%
PMD 221 4%
High School/HRC 129 3%
Prenatal 118 2%
TOTAL 4,950 100%
GC Screening Program Treatment Verification
0%
20%
40%
60%
80%
100%
FPC STD Prison/YSC Other
Rx <=14 days Rx <= 30days Rx'ed No Rx
Philadelphia’s Gonorrhea Screening Program
• Started ~1972
• 1994 - expanded to include chlamydia screening (FP and STD Clinics)
• 1996 – CT testing expanded to all GC screening sites
• 1997 – DNA probe instituted
• 2000 – added the juvenile detention center, began including males in testing
• 2002 – expanded to adult prisons to include asymptomatic males and females
Philadelphia’s Gonorrhea Screening Program
• 2003 – High School STD Screening Program begins
• >95% of those who test positive through city-wide screening program have documented Rx (2877/2996 in 2008)
• 64% of city-wide morbidity is currently identified through GC screening program
• Participation in GISP since ~ 1990
Possible Areas for Program Expansion
• No treatment verification for those testing positive outside the screening program
• No active partner notification for GC except for those who test positive through HS screening
• Expedited Partner Therapy currently not legal in PA
Thank you!
