Also called blenorrhoea, gonorrhoea is the second most common sexually transmitted disease after Chlamydia Trachomatis

Gonorrhoea (also called Blenorrhoea) is a sexually transmitted disease

It is caused by the bacterium Neisseria Gonorroeae or Gonococcus.

Intrapartum transmission leads to serious consequences for the newborn child.

In Europe, gonorrhoea is the second most common sexually transmitted disease after Chlamydia Trachomatis; globally, there are an estimated 87 million new cases each year.

The male/female ratio is 3:1; in about 40% of cases the disease affects persons under 25 years of age and women of childbearing age.

The World Health Organisation has estimated that 4,000 infected infants go blind each year due to gonococcal conjunctivitis.

In adult males, the disease most frequently manifests as an inflammation of the urethra (which occurs within 2-5 days of infection; if left untreated, it can lead to infertility.

In adult women it generally causes infection of the urethra, cervix and Bartolini’s glands (within 2-7 days of infection).

Symptoms may be blurred, in some cases causing ‘pelvic inflammatory disease’, with internal abscesses and pelvic pain.

The fallopian tubes that allow the passage of eggs from the ovaries to the uterus can be damaged and cause infertility.

The incidence of gonococcal infection is related to the prevalence of infection in fertile women; the association with HIV and Chlamydia T is very common.

In 30-40% of cases transmission to the newborn occurs during passage through the birth canal or after rupture of the membranes.

Purulent conjunctivitis (the mucous membrane of the oral cavity and genital cavity may be affected with secretion of mucus pus) occurs in the unborn child within two to five days.

The diagnosis must rule out bacterial, viral or chemical causes (obstruction of the naso- lacrimal duct) causing conjunctivitis.

Rare forms of gonococcal septicaemia are known, as well as gonococcal endocarditis and meningitis, caused by the spread of ocular infection, which can cause joint inflammation and blindness.

In women, the diagnosis is based on microscopic examination of secretions coming from the urethra, while in infants it is mainly conjunctival secretions.

Nucleic acid amplification tests (so-called NAAT) are the most reliable today; they can also be performed on urine samples.

Culture tests on biological samples from the cervix, urethra, rectum or pharynx allow the sensitivity of the bacterium to antibiotics to be assessed.

In the case of uncomplicated gonorrhoea of the urethra, cervix and rectum, antibiotics are used according to well-defined protocols

In infants with suspected localised gonococcal infection (e.g. conjunctiva) a dose of cephalosporin i.v. or i.m. is administered.

Neisseria Gonorrhoeae is characterised by a high capacity to modify its own membrane molecules (antigens) and to inhibit the immune response.

These characteristics have made the development of an effective vaccine very difficult.

Although the incidence of the disease has been greatly reduced by prophylaxis according to Credé (instillation of a silver nitrate or silver proteinate solution in the conjunctiva of all newborns), which is compulsory at the time of delivery, prevention is particularly important.

Protocols require pregnant women to be screened during the gynaecological examination and again in the 3rd trimester.

Partners with whom the infected person has had sexual intercourse in the 60 days preceding the diagnosis of gonorrhoea must be tested and, if necessary, begin antibiotic treatment immediately.

As for adolescents, it is essential that they be informed at an early stage to make them aware that this infection, not unlike other diseases transmitted through sexual intercourse, especially if casual and promiscuous, can seriously harm their health.

For this reason, even more than mere instruction in the use of a means of protection, it becomes important to provide real educational action to help young people make correct and conscious choices regarding their sexual life.

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Source

Bambino Gesù