Recent trends in gonorrhoea
This report summarises the recent epidemiology of uncomplicated gonococcal infection in England, Wales, and Northern Ireland using information from two data sources; aggregated diagnoses made in genitourinary medicine (GUM) clinics, and voluntary reports of laboratory diagnosed Neisseria gonorrhoeae.
N. gonorrhoeae is the second most common bacterial STI in the UK. Men are more likely to show signs of infection such as urethral discharge, whereas most women show no symptoms and so can be unaware of their infection. As with genital chlamydial infection, women can develop pelvic inflammatory disease, which can lead to chronic abdominal pain, infertility and ectopic pregnancy. In men, local complications include epididymitis, urethral stricture, and acute prostatitis.
Recent trends from GUM reporting
In England, Wales, and Northern Ireland, national data on gonorrhoea diagnoses are based on statistics submitted to the Health Protection Agency Centre for Infections, Communicable Disease Surveillance Centre Wales and Communicable Disease Surveillance Centre Northern Ireland from GUM clinics on the KC60 statistical return. Between 1995 and 2002 the total number of gonorrhoea diagnoses in England, Wales, and Northern Ireland has more than doubled, rising from 10,186 diagnoses in 1995 to 24,918 in 2002. Since 2002 there has been a gradual decrease in the diagnoses of gonorrhoea. In 2005, 18,665 gonorrhoea infections were diagnosed in GUM clinics, a decrease of 14% since 2004 (from 21,597 to 18,665) in England, Wales, and Northern Ireland. This comprised of an 11% decrease among all men (15,093 to 13,406), of which 18% were among heterosexual men (11,375 to 9,367), and a 19% decrease among women (6,504 to 5,259). However a 9% increase in gonorrhoea diagnoses was seen among men who have sex with men (MSM) (3,718 to 4,039).
Rates of diagnosis of gonorrhoea have decreased in all age groups since 2002. The rate of diagnosis by age group has not varied over time, with the highest rates observed among men aged 20 to 24 years (213/100,000) and women aged 16 to 19 years (145/100,000) in 2005.
In 2005, London accounted for the highest percentage of new diagnoses of gonorrhoea in both men (38%) and women (30%). Among MSM, over half (55%) of diagnoses reported in GUM clinics in England and Wales were from London. Rates of diagnoses were also much higher in London than elsewhere
in the UK at 139/100,000 in men and 43/100,000 in women. Outside London, the highest rate in men was in the Yorkshire and Humberside and the North West regions (49/100,000). Rates in women outside London were highest in the Yorkshire and Humberside region (25/100,000). All regions show a decrease in the rate of gonorrhoea diagnoses between 2004 and 2005. Northern Ireland, showed an annual increase from 13/100,000 to 19/100,000 in men and from 2.2/100,000 to 2.3/100,000 in women. However, Northern Ireland remains the country with the lowest rate of gonorrhoea diagnoses for both men and women.