September 14, 2016
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Gonorrhea cases increase fivefold in Utah from 2011-2014

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The rate of reported gonorrhea infections in Utah increased dramatically from 2011 to 2014, according to data recently published in MMWR.

Although men who have sex with men had previously been most likely to contract gonorrhea, researchers from the CDC wrote that reported infection rates were on the rise among women and heterosexual men.

“Since 2011, the gonorrhea rate in Utah has increased substantially, with a much larger percentage increase among women than among men,” Joanna Watson, DPhil, of the CDC Epidemic Intelligence Service, and colleagues wrote. “The proportion of male patients self-reporting as MSM has decreased each year since 2009, indicating an expansion of heterosexual transmission of gonorrhea in Utah.”

Researchers calculated the number of gonorrhea cases for each year by dividing the number of laboratory-confirmed cases by U.S. Census Bureau population estimates. The gonorrhea rate in Utah declined from 2009 to 2011, Watson and colleagues reported, from 12.3 cases per 100,000 population to 9.7 cases per 100,000. In 2014, however, researchers reported 48.9 cases per 100,000 population — a nearly fivefold increase from the 2011 infection rate.

The increase during this period was much greater in women than in men. In 2009, women comprised 21% of gonorrhea cases, while in 2014, that proportion rose to 39%. Overall, women saw a 715% increase from 2011 to 2014, while prevalence in men increased 297% in the same period. The proportion of male patients who identified as MSM decreased steadily, falling from 66.8% in 2009 to 41.7% in 2014, Watson and colleagues wrote. Black patients had the highest rate of infection during the time period studied, although non-Hispanic whites, who make up the vast majority of the population in Utah, had the highest absolute number of cases.

According to the researchers, the data indicated MSM were more likely than women and heterosexual men to be diagnosed by an STD clinic, and it pointed to a study in California that suggested STD clinics were more likely to follow CDC treatment guidelines than other health care facilities.

“Because of increasing numbers of gonorrhea cases in Utah, identifying populations at high risk is important to develop effective public health interventions,” Watson and colleagues wrote. “With likely increased heterosexual transmission and changes in the way patients are accessing services in Utah, health departments need to work with providers to ensure populations at high risk are being screened and properly treated for gonorrhea.” – by Andy Polhamus

Disclosure: The researchers report no relevant financial disclosures.