About Gonorrhea

A sexually transmitted disease (STD) is a disease that you get from having sexual contact with another person. All STDs can be treated, and some can be cured. They can be serious, however, and sometimes even fatal. Sexually transmitted diseases affect people all over the world. Millions of people, old and young, are infected with STDs every year. Hundreds of thousands are infected with gonorrhea.

Gonorrhea is a common and highly contagious STD. It is one of the world’s oldest diseases. Hippocrates, a Greek physician, wrote about patients with symptoms of gonorrhea as long ago as 500 BC. Even the word “gonorrhea” has existed for centuries. In the year AD 130, a doctor named Galen came up with the word, which is Greek for “flow of seed.” (Galen mistakenly thought that the abnormal discharge commonly associated with the disease was semen, or “seed.”)

Gonorrhea is also known by several slang terms you may have heard before, such as “the drip” or “the clap.” “The drip” refers to the symptom that Galen noticed, which is a puslike discharge. Nobody knows quite where the nickname “the clap” came from, but there are a few reasonable guesses. An old French word, clapier, meant a brothel, or a house of prostitution, where cases of gonorrhea were probably widespread. The name may also have come from a woman named Mother Clap, who ran a brothel in London in the 1700s.

What Causes Gonorrhea

Neisseria gonorrhoeae View Larger Image CDC

We now know that gonorrhea is caused by a bacterium called Neisseria gonorrhoeae, which grows in warm, moist areas of the body such as the cervix, urethra, throat, rectum, or even the eyes. Bacteria are tiny, single-celled organisms that live all around us. Most bacteria are not detrimental, but some are. When these harmful bacteria get inside your system, they can grow and multiply and cause health problems. Luckily, most of these are easily treated with antibiotics, so if a bacterial disease is caught and treated early, it won’t have any long-term effects.

Gonorrhea spreads very easily: the bacteria that cause it can move from one person to another through contact with semen or vaginal fluid. The delicate tissues of the genitals, rectum, and throat are vulnerable to infection by these bacteria. Any type of unprotected sexual contact with an infected partner, whether vaginal, oral, or anal, is enough to transmit the disease. It can also be spread from an infected pregnant mother to her baby during childbirth. Gonorrhea is not spread through physical contact like hugging or kissing. This means that only people who are sexually active are at risk of contracting the disease.

Rate of Infection

In the United States, local STD prevention programs—including hospitals, doctors, and STD clinics—are required to report how many patients they treat each year for certain sexually transmitted diseases to the Centers for Disease Control and Prevention (CDC). The CDC is part of the Department of Health and Human Services, the main agency in the U.S. government for protecting the health and safety of Americans. According to the CDC, more than 670,000 gonorrhea infections occurred in 2020 in the United States. During the initial COVID-19 shelter-in-place orders in March and April of 2020, the weekly number of cases of reported gonorrhea was lower compared to counts in 2019; however, later in the year, the number of reported gonorrhea cases increased. Overall, rates of gonorrhea have increased 111 percent since 2009. Similarly, data from the Government of Canada shows that the number of reported cases of gonorrhea among Canadians has risen more than 81 percent in the past ten years. Because some cases are never diagnosed and others do not get reported, the number of cases reported is less than the actual number of cases occurring.

Gonorrhea is the second most commonly reported infectious disease in the United States and Canada. Chlamydia—another sexually transmitted bacterial infection—takes the number one spot. The number of reported cases of chlamydia are almost three times that of gonorrhea. The number of chlamydia cases continues to rise every year. According to 2018 data from the CDC (the most recent year for which data is available), females aged 20–24 years had the most chlamydia cases of any age group at 4,064.6 cases per 100,000 females. Young females aged 15–19 had 3,306.8 reported cases per 100,000 females. The CDC can use statistics like these to show how levels of infection change over time and to help decide the most effective ways to prevent the spread of STDs.

Risk Factors

There are several high-risk behaviors that can increase your chances of contracting an STD like gonorrhea. These include:

• Unprotected sex—that is, sex of any kind without the use of a condom or dental dam (a small sheet of latex that acts as a barrier between the vagina or anus and the mouth).

• Unprotected sexual activity at an early age. The rate of STD infection in younger age groups is increasing, so there is a growing chance that by having sex at a young age, you could be having sex with someone who has an STD.

• Unprotected sex with multiple partners. Each sexual partner has a chance of having an STD. The greater number of partners you have, the greater number of chances you take.

• Drug injection, or having sex with a partner who injects drugs. Needles used for injecting drugs can also transmit disease, if they are shared with other people. In addition, drug use can lower inhibitions and cause you to do things you wouldn't normally do, like having sex without protection.

There are also certain populations that have a higher rate of gonorrhea and therefore have a higher risk of contracting the disease. According to the CDC, in 2018, the number of reported gonorrhea cases remained the highest among African Americans. The rate of infection among African American males and females was 7.7 times the rate among Caucasian males and females. Young people are also at a higher risk of contracting gonorrhea. The most recent recorded rates were highest among females aged 20–24 years and 15–19 years. Among males, the rate was highest among those aged 20–24 years.