Gonorrhea cases spike in Alaska

Natives accounted for 68% of the 2009 cases

Posted: Wednesday, March 10, 2010

ANCHORAGE - Alaska's reported gonorrhea cases jumped 69 percent last year, prompting state health officials to issue warnings for how to detect and control the disease.

The Department of Health and Social Services reported Tuesday that 997 cases of genital gonorrhea cases were reported in Alaska in 2009, up from 578 in 2008.

That's a rate of 114 cases per 100,000 people, compared to 85 cases per 100,000 people in 2008. Susan Jones, manager of the Epidemiology Section's sexually transmitted disease program, said it's the biggest single-year increase in gonorrhea cases in Alaska since the 1970s. No one knows why, she said, but there are hints.

"Providers are telling us that their patients are coming in with milder symptoms of gonorrhea than they've seen in gonorrhea cases in the past," Jones said. "In some cases, the symptoms are mild enough, or not annoying enough, that people are not coming in to seek care, or delaying coming in. So that means they have gonorrhea for a longer period of time and are able to transmit it more."

Gonorrhea is a common sexually transmitted disease caused by bacterium that can grow and multiply easily in warm moist areas of a woman's reproductive tract, including the cervix, uterus and fallopian tubes, or in the urethra, or urine canals, of women and men, according to the Centers for Disease Control.

Some infected men have no symptoms, or symptoms that don't show appear for 30 days. Symptoms include a burning sensation when urinating, a white, yellow, or green discharge from the penis, or painful, swollen testicles.

Most infected women have no symptoms, or symptoms that can be mistaken for a bladder or vaginal infection. The initial signs include a painful or burning sensation when urinating, increased vaginal discharge, or vaginal bleeding between periods.

Alaska Natives accounted for 68 percent of the 2009 Alaska cases.

Females accounted for a just more than half of the cases. The age group with the highest rates were women and men age 20-24.

The rate of reported cases went up in all regions of Alaska last year except the Interior but was especially pronounced in southwest Alaska, including Bethel and surrounding communities.

In 2007, the region had 118 reported cases per 100,000 persons. That jumped to 373 in 2008 and to 662 cases per 100,000 persons last year - an increase in two years of more than 460 percent.

Disease increases could not be attributed to increased testing, the department concluded.

The department recommends prompt treatment for patients and encouraging them to participate in "partner services activities."

"It's a process in which sexual partners are identified and notified that they could be part of a disease investigation," Jones said.

The state epidemiologist, Dr. Joe McLaughlin, said health care providers should watch certain groups.

"Providers should screen sexually active women younger than 25 years of age, those with multiple or new sex partners, those who have had gonorrhea or chlamydia infection in the past 12 months, and those who have been told they were exposed to gonorrhea," he said.

The bulletin made one other grim finding: Nearly 300 people detected with gonorrhea were co-infected with another STD, chlamydia, the No. 1 cause of pelvic inflammatory disease. Like gonorrhea, chlamydia is caused by bacteria and symptoms can be mild or absent.

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