Epidemiology and control of gonorrhoea in Sheffield

Abstract

During the period 1977-83, the fall in the yearly incidence of gonorrhoea in the United Kingdom was greatly exceeded by the fall that occurred in Sheffield (p<0.001). This local fall occurred despite a large rise in the yearly number of people with sexually transmitted diseases (STDs) presenting at this clinic, and was associated with falls in the incidence of complications of the disease and ratios of men to women with gonorrhoea, and with significantly improved success in tracing contacts of infected persons (p<0.001). Although penicillinase producing strains of Neisseria gonorrhoeae, were rare, the number of local isolates exhibiting relative resistance to penicillin (MIC ≥0.3 mg/l) rose significantly (p<0.001) and were more often isolated from well defined 'at risk' groups: homosexual men (p<0.001), patients with repeat infections (p<0.01), and people infected outside Sheffield (p<0.05). The relevance of these observations in the assessment of control of gonorrhoea and to the development of an antibiotic treatment policy are discussed.