HISTORY

The history of gonorrhea is thousand years back. It is the most common STD and has been described by
the variety of populations. This disease affects both females and males. And still no vaccine has been
discovered for it.

Originally, gonorrhea was called “clap” because of clapping sensation which was felt by the affected of
gonorrhea. A second thought is that “clap” was derived from French brothels which were called “les
calipers”. It was noticed that the infected were mostly those who visited the brothels.

The bacteria gonococcus “cause of infection” was discovered in 1879 by Nessier. This bacterium was
found in the body of patient of gonorrhea or having the symptoms of this disease.

Thread of infection:

1: Agent of infection: the germ bacteria is the cause of the disease is called the infectious agent which is
“Neisseria gonorrhea” .

2: Susceptible (Receptive host): A person who comes in contact with an infected person sexually or to
the infectious agent is susceptible receiver of the disease.

3: Portal of entry (Gateway): the germ enters through mucous membrane of genitals, anus or mouth. If
a baby is born during this disease he may have eye infection.

4: Means of transmission (transmission mode): As it is an STD so always transmitted when someone

come in contact with the body fluid of infected person.

5: Portal of exit: body fluid of infected area is the portal of exit.

6: reservoir (stockpile): Human beings are the stockpiles of disease.

Multi Drug Resistance:

Many drugs including Sulfonamide antimicrobials and penicillin were used in the early treatments of
gonorrhea (1930s to 1940s). at the beginning these drugs were working effectively but later the germ
became resistant to the drug and it required more dose to treat the disease over time. It is happening
over the decades. By 2006 only cephalosporin e.g. cefixime and ceftriaxone was the only drug
recommended by the United Nation for the treatment of gonorrhea. In 2010 CDC changed its
recommendation and advised to use a combination of drugs. Cephalosporin’s dosage was increased and
a second antimicrobial. Now Gonococcal Isolate Surveillance System (GISP) is collecting evidence about
the resistance of disease against cephalosporin in USA. It was witnessed in early 2000’s in East Asia and
also observed in U.S.

Strategies:

New Treatment Recommendations:

The recommendations of treatment of gonorrhea are recently changed by CDC. It includes azithromycin
in the combination with ceftriaxone. In case if ceftriaxone is unavailable due to some reasons or
someone is allergic of it then 400mg of cefixime is give with the combination of 1g of azithromycin as a
single dose. Or a single oral dose of 2g of azithromycin.

Condom usage and Monogamy:

A correct condom can prevent the disease and stop it from spreading .Government should start the
programs for awareness in public about the disease. Public should be educated about right usage of
condom. Although it is not 100% prevention from disease but it is good to use. If any symptom is found
in someone, one should immediately get one’s test and start the treatment early.

STD control programs and clinician responsibilities:

Early treatment of any disease can prevent many complications and also prevent the re-infection. That
is why communities should be developed for awareness to control the outbreak of the disease. Patients
should be get their checkup after the exposure to the disease. Clinician and doctors must inform
immediately report the case if any found, So that they must get proper treatment. Programs should be
developed to teach adult to have safe sex.

Introduction:

There are more than 25 Sexually Transmitted Diseases (STD), for example HIV is an STD and Gonorrhea
is one of them also which is spread by vaginal, oral or anal sex. It is also called Sexually Transmitted
Infection (STI). According to the report of World Health Organization daily more than one million
persons are getting infected by an STD. As most of the people do not have the symbols of STD so they
also don’t know that they can become a source of passing an STD.

If the patient does not get proper treatment then it can cause severe problem e.g. cervical cancer, liver
disease. Pelvic Inflammatory Disease (PID), infertility and pregnancy problem. An infected person with
some STD (such as chancroid, herpes, syphilis and tricomoniasis) is a greater risk on catching HIV. Any
person who is HIV negative when exposed to an HIV positive is more likely to catch or pass the STD to
others. Moreover they can face more difficulty to get rid of the STD.

USA is a country which has the highest rate of it. Each year about 20 million new infections are being
increased. Most of these infected persons belong to 15-24years age group. According to a report of
2010 two-thirds of the infected people are young people.

There are several reasons that why the young women and teenage girls get STD more likely:

1: there immune system is not enough strong against disease as the cervix is lined up with the cells
which are more likely to get infection.

2: They are not fully aware of the safe use of condoms and supplies which can prevent infection.
3: They may not have transportation facility to access the supplies or may not able to pay for such
services.

4: They may have a problem of confidentiality.

Teenage girls and women of color are at the highest rate of the STD especially chlamydia and gonorrhea
because

 Poverty
 They have less access to health care.
 Already have a high rate of STD
 And more likely to have sex with and infected person of color.

The STI screening is most important for women because they can suffer from more complicated and
severe health problems. But unfortunately more than half of them do not get STI’s screening.

Most of the time STD have no symptoms and infected person doesn’t know that he may be a source of
passing on the disease. So the risk can be reduced by getting tested on regular intervals by your doctor.
A person can reduce this risk by having safe sex. Although not all STD can be cured by treatment but
for the other STIs there are effective medication to control the conditions.