Gonorrhea

Gonorrhea, colloquially known as the clap, is a bacterial sexually transmitted infection caused by the diplococcus Neisseria gonorrhoeae. The organism preferentially infects columnar epithelium, allowing establishment at mucosal surfaces including the urethra, endocervix, rectum, and oropharynx. The infection is classified under ICD-10 code A54 and ICD-11 code 1A72 for surveillance and clinical documentation purposes.

Clinical manifestations differ between sexes, though both may present with mucosal inflammation and purulent discharge. Infected males typically experience urethral symptoms including dysuria and penile discharge, with testicular pain indicating possible epididymal involvement. Females more commonly present with vaginal discharge, intermenstrual bleeding, and pelvic pain, though approximately half of infections in women remain asymptomatic. Pharyngeal infections are frequently asymptomatic (approximately 90% of cases), while rectal infection may cause pain, discharge, or constipation. The incubation period ranges from two to fourteen days, with symptom onset typically occurring between four and six days after exposure. Untreated infection may disseminate to cause arthritis, dermatitis, or rarely endocarditis and meningitis.

Gonorrhea exhibits a global distribution with an estimated prevalence of 0.8% among women and 0.6% among men worldwide. Approximately 33 to 106 million new infections occur annually, representing a substantial burden on healthcare systems. The disease caused approximately 700 deaths in 2015, primarily from complications of disseminated infection. Young adults, particularly those under 25 years of age, experience disproportionately higher infection rates, reflecting behavioral patterns of sexual network formation and partnership dynamics.

Transmission occurs primarily through direct sexual contact with an infected partner, encompassing vaginal, anal, and oral exposures. The bacterium is transmitted via contact with infected mucosal surfaces or infectious exudates. Vertical transmission from mother to infant during delivery can result in gonococcal ophthalmia neonatorum, which develops in approximately 28% of infants born to untreated infected mothers. The organism does not survive long outside the human host, making fomite transmission unlikely.

Sexually active individuals under 25 years of age constitute a primary risk group due to biological susceptibility and behavioral factors. Those with multiple sexual partners, inconsistent condom use, or new partnerships face elevated exposure risk. Men who have sex with men experience disproportionately higher rates due to sexual network characteristics and the efficiency of rectal transmission. Pregnant women risk vertical transmission with potential consequences for neonatal health. Individuals with prior or concurrent sexually transmitted infections may also exhibit increased susceptibility.

Prevention strategies center on barrier protection during sexual contact and prompt identification and treatment of infected individuals and their partners. Regular screening is recommended for sexually active women under 25 years of age, women with new or multiple sexual partners, and men who have sex with men. Partner notification and empirical treatment of exposed individuals interrupt transmission chains. Pregnant women should be screened and treated to prevent vertical transmission and neonatal ophthalmia.

Surveillance for gonorrhea requires consideration of the substantial asymptomatic reservoir, particularly among women, which limits case detection through passive symptom-based reporting. Laboratory-based confirmation using nucleic acid amplification testing of urine, urethral, vaginal, cervical, rectal, or oropharyngeal specimens provides the most sensitive detection. The emergence of antimicrobial-resistant Neisseria gonorrhoeae strains necessitates ongoing susceptibility monitoring to inform treatment guidelines. High-risk population screening and prevalence studies complement mandatory notification data in estimating true disease burden.

1. 1 Wikidata. gonorrhea.
2. 2 Wikipedia. Gonorrhea - Wikipedia.

ICD-10

A54

ICD-11

1A72

Total cases

5.6M

Total deaths

39

Peak month

2017-09

Coverage

2 reporting countries · 2010-01-01 → 2026-05-09