The infection more commonly known as gonorrhea is the second most common sexually transmitted disease worldwide. Offenders are gonococci, bullet bacteria that live only on humans and are transmitted almost exclusively through direct mucosal contact, that is, unprotected sexual intercourse.
Of microbes and humans
Each year, more than 60 million people become infected worldwide. Since the mid-1990s, a significant increase in the number of new cases can be observed again, after their number had been continuously declining for years. There are probably several reasons for this – among others, mass and sex tourism to faraway countries, especially Asia, the relapse into reckless sexual behavior after the anti-AIDS campaigns died down, and increasing resistance of the pathogens are held responsible. It’s a trend that gives some researchers cause for concern. Critical voices note that the disease, which is currently still easy to treat, could develop into a problem child in the future, similar to other infections for which common antibiotics already fail. Prevention would be comparatively simple. Humans are the only reservoir for the pathogens, also known as Neisseria gonorrhoeae. Since they are extremely sensitive to dehydration and cold, they have virtually no chance of survival outside their human host. Their eradication would thus be theoretically possible. And since the germs are transmitted almost exclusively during sexual intercourse, the risk of infection can be minimized with a condom.
Hard facts and dark numbers
Until 2001, gonorrhea was notifiable in Germany. However, an estimated unreported number of 80-90% was added to the 2,200 annual cases of the disease officially known at that time. Experts assume that these figures are still valid or even higher. Younger adults of both sexes are particularly affected. This is due on the one hand to the increasingly earlier start of sexual activity – by the age of 16, 45% of girls and 36% of boys – combined with a higher number of sexual partners, and on the other hand to the willingness to experiment with different sexual practices, both heterosexual and homosexual, and the reluctance to use condoms. In addition, the anatomy and hormonal balance of younger girls appear to increase the risk for ascending infections. In addition, gonorrhea is highly contagious. About one-third of men become infected during a single sexual contact with an infected woman. For women, the risk is as high as 60-90% if they have sexual intercourse with an infected man. It is not uncommon for people with gonorrhea to also be infected with the AIDS virus or the syphilis pathogen.
Symptoms in men and women
- Women: If symptoms occur, they are usually nonspecific and manifest as burning during urination, unpleasant-smelling vaginal discharge, and swelling of the labia. The germs can ascend via the uterus into the fallopian tubes and ovaries and lead to inflammation with fever and lower abdominal discomfort and even infertility. Pregnant women suffering from gonorrhea can infect their child during birth and lead to eye inflammation, formerly one of the most common causes of blindness in children in the Western world.
- Men: The disease begins with burning pain during urination, followed by mucous, later yellowish-green discharge from the urethra. Its morning accumulation during the first urination has also helped it get the name “bonjour drops”. The pathogens can migrate to the prostate and epididymis, where they also cause inflammation, followed by infertility.
Depending on the site of transmission, inflammation of the rectum or oral mucosa may also occur. Rarely, the pathogens enter the bloodstream and trigger skin rashes, joint inflammation, fever and chills. Rare but severe complications include meningitis, myocarditis, ocular inflammation, and bone marrow inflammation.
Detection and therapy
Diagnosis is made by smears of secretions from the vagina and urethra and detection of the pathogens under the microscope. Bacterial cultures may also be obtained. The level of pathogens in the blood can be concluded by nucleic acid amplification test. Therapy with antibiotic tablets is usually fast and successful. Only rarely do these have to be injected.Unfortunately, in recent years pathogens (especially from Asia and Africa) have become increasingly resistant to common antibiotics, so that it is necessary to resort to reserve drugs. Co-treatment of the sexual partner is mandatory in order to avoid a “ping-pong effect”. One week after the end of treatment, the success of therapy should be checked with a smear test.
To the point
- The disease can initially run symptom-free and thus be passed on unknowingly.
- Infection occurs almost exclusively through vaginal, anal or oral sexual intercourse.
- If diagnosed early, a rapid and complete cure with antibiotics is possible, otherwise it can lead to infertility and other complications in both men and women.
- Antibiotics must be taken correctly and long enough to avoid development of resistance of pathogens.
- The sexual partners must also be treated.
- You can always get infected with gonorrhea.
