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Background: Gonorrhea is the second most commonly reported notifiable disease in the United States (US), and is associated with important health sequelae, including pelvic inflammatory disease, tubal infertility, ectopic pregnancy, and facilitated transmission of HIV. After reaching an historic low in 2009, the US gonorrhea rate increased each year during 2009–2012. We examined national gonorrhea case report data to identify the populations most impacted by the increase in gonorrhea.
Methods: Gonorrhea case report data were extracted from the National Electronic Telecommunications System for Surveillance, the system through which the Centers for Disease Control and Prevention receives notifiable STD data from all 50 states and the District of Columbia. Rates were calculated using population estimates obtained from the US Census Bureau.
Results: During 2009–2012, the national gonorrhea rate increased 9.6%, from 98.1 to 107.5 cases per 100,000 population. Gonorrhea rates increased substantially in the Northeast (38.2%) and West (39.1%), but increased just 0.4% in the South and decreased 1.2% in the Midwest. However, in 2012, gonorrhea rates remained highest in the South (131.9) and Midwest (114.6) and lower in the Northeast (92.6) and West (73.3). Nationwide, the rate among men increased 16.3% while the rate among women increased 4.0%. The increase among males was seen in all regions, but was most marked in the Northeast (43.9%) and West (45.4%) compared with the South (4.8%) and Midwest (4.3%). Rates among females increased in the Northeast (32.3%) and West (31.0%), but decreased in the South (3.1%) and Midwest (4.7%).
Conclusions: While the overall gonorrhea rate increased in the US during 2009–2012, the observed increase in national gonorrhea rate during 2009–2012 was largely attributable to increased rates in the Northeast and West and among males.