19/01/2022
GONORRHEA
(Gonorrhoea)
ICD-10 A54: Gonococcal infection
Gonorrhea belongs to group C in the Law on Prevention and Control of Infectious Diseases.
1. Characteristics of the disease
1.1. Case definition:
- Clinical case: Gonorrhea is an infection of the ge****ls - urinary tract, a**s and throat caused by gonorrhea (Neisseria gonorhoeae) which is a Gram (-) dicycocci, only the host is human. The disease is usually transmitted by direct s*xual contact.
+ Gonorrhea in men (Gonorrhea urethritis)
Incubation period: 3-5 days.
Manifestations: pus draining from the urethra, the amount is large, solid yellow or greenish yellow, painful urination, may be accompanied by urination. Inflammation of the entire urethra: urinary incontinence, difficulty urinating with fever, fatigue.
Complications: Epididymitis is usually unilateral and manifests as hot, red, painful swelling with fever. Inflammation on both sides can cause infertility. Prostatitis, inflammation of the seminal vesicles and vas deferens.
Gonorrhea in women (cervicitis and gonorrhea urethritis)
Characteristics of gonorrhea in women do not show obvious symptoms but often discreetly, even without symptoms (over 50% of cases), so they do not know they are sick, so they can easily spread it to others.
Acute manifestations: painful urination, pus draining from the urethra, from the cervix is solid yellow or yellow-green in quantity, with a foul odor. The patient has pain during in*******se, pain in the lower abdomen.
Examination revealed a red, edematous cervix, bleeding to the touch. Purulent discharge from the cervical ca**l. The urethra may be red, with pus coming out from the inside or sometimes only cloudy fluid.
Complications: Inflammation of Skène's gland, Bartholin's gland, inflammation of the fallopian tubes, ovaries and pelvic inflammatory disease can cause ectopic pregnancy, infertility, inflammation of the a**s, re**um.
- Confirmed case: Gonorrhea was determined when Gram staining showed Gram (-) chromophores inside and outside the neutrophils and gonococcal culture was isolated. Currently, it is possible to detect gonorrhea by PCR with high sensitivity and specificity.
1.2. Differential diagnosis with some similar diseases: urethritis in men and cervicitis in women caused by infection with Chlamydia trachomatis and non-gonococcal urethritis caused by other pathogens.
1.3. Test:
- Type of specimen: Collect fluid or pus from the cervix, urethra, a**s and Skène, Bartholin glands in women. Urethral purulent collection in men. Can collect urine by centrifugation.
- Test method:
+ Make a Gram-stained slide for microscopy.
+ Isolating bacteria on a medium specific to gonorrhea such as Thayer Martin's medium and making antibiograms.
2. Pathogens
Agent name: Neisseria gonorhoeae
- Morphology: Gonococci is a Gram (-) dicocci, pea-shaped, 0.8-1mm in size, non-motile, non-spore forming, growing in pairs with flattened faces facing each other. in the cytoplasm of neutrophils.
- Ability to survive in the external environment: gonorrhea is easily killed by temperature, dry environment and by commonly used antiseptics.
3. Epidemiological characteristics: Gonorrhea is transmitted mainly through s*xual contact. In addition, the disease can be transmitted from mother to child during childbirth, causing neonatal gonorrhea; other non-s*xual transmissions are possible but very rare. Gonorrhea is common in young people who are s*xually active. According to a report of the National Institute of Dermatology, the rate of people aged 15 - 49 years with s*xually transmitted diseases in general, including gonorrhea, is from 93 to 98% (Statistics from 1995-2007). ). A study on the prevalence of gonorrhea in some populations in Hanoi in 2003 showed that female s*x workers are 3%, young men are examined for military service is 2% and male patients go to health clinics for medical examination. s*xually transmitted diseases is 2.5%. The disease is common in urban areas and densely populated areas. The rate of men infected after having s*x with a woman with vaginal gonorrhea is about 20-30%, this rate for women when having s*x with an infected man is 60-80%. Using condoms correctly will prevent gonorrhea.
4. Source of disease transmission
- Reservoir: Humans are the sole host of gonorrhea. Gonorrhea is localized in the genitourinary tract of an infected person and is transmitted mainly through s*xual contact. In men, gonorrhea resides mainly in the urethra. In women, gonorrhea is found in the cervix, urethra, Skene and Bartholin glands. In both s*xes, gonorrhea can reside in the re**um and throat.
- Incubation period: Usually gonorrhea has a short incubation period of 2-5 days, ranging from 1-14 days.
- Period of transmission: Gonorrhea can be transmitted when an infected person is in the incubation period when there are no symptoms and many patients have gonorrhea but have no symptoms, which is an important source of infection. in the community.
5. Mode of transmission: Gonorrhea is transmitted mainly through s*xual contact. Transmitted through vaginal, a**l and oropharyngeal s*x. In addition, the disease can be transmitted from mother to child during childbirth, causing neonatal gonorrhea; other non-s*xual transmissions are possible but very rare.
6. Susceptibility and immunity: Gonorrhea can be found in all ages, men and women. There is no immunity to gonorrhea, and there is currently no vaccine to prevent gonorrhea.
7. Disease control measures
7.1.Preventive measures: Propaganda and health education on healthy s*x, safe s*x to prevent infection with gonorrhea and other s*xually transmitted diseases, including HIV/AIDS. Condoms are effective in preventing gonorrhea when used correctly.
7.2. Anti-epidemic measures:
- Organization: gonorrhea does not cause epidemics, so we mainly take professional measures to prevent the disease.
- Specialize:
+ Patients with gonorrhea when going to medical facilities are examined, treated, consulted and kept confidential.
+ Patients with gonorrhea do not have an isolation regime.
+ Disease prevention: strengthen examination, detection and treatment of disease cases through integration into reproductive health care programs, general medical network at all levels, cooperation with private healthcare. Subjects with high-risk behaviors such as s*x workers, drug addicts, and prostitutes should receive health education, medical examination and treatment.
gonorrhea examination and treatment in Korea
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