What is the incidence of gonorrhea in the US?

Updated: Sep 07, 2018
  • Author: Brian Wong, MD; Chief Editor: Pranatharthi Haran Chandrasekar, MBBS, MD  more...
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An estimated 820,000 new gonococcal infections occur annually in the United States, with a significant number of cases likely unreported. [14] Per the CDC, gonorrhea is the second most commonly reported communicable disease. [15] The national average in 2009 was 99.1 cases per 100,000 population, a 10.5% decrease from 2008, with considerable state-to-state variation (see the figure below). [16, 17] Men were apparently less likely than women to be tested for gonorrhea, 20.7% vs 50.9%, respectively. [18] However, the infection rates between men and women were similar (105.8 vs 108.7 cases per 100,000). [19]

Gonorrhea rates, United States, 1941-2016. Courtes Gonorrhea rates, United States, 1941-2016. Courtesy of the Centers for Disease Control and Prevention (CDC).

One report estimated the annual cost of gonorrhea and its complications to be $162.1 million (range, $81.1 million to $243.2 million). [20]

In the United States, the number of gonococcal infections peaked in the 1970s, the era of the sexual revolution. With the onset of the HIV epidemic and the practicing of safe sex techniques, the incidence dramatically decreased from 468 cases per 100,000 population in 1975 to 100-150 cases per 100,000 population at the turn of the century. The rate of reported gonorrhea cases was at its lowest in 2009 but has been increasing overall since then. [21] Since 2016, more than 450,000 cases have been reported to the CDC, with a rate of 145.8 cases per 100,000 people, an increase of 18.5% from 2015. [22] The increased numbers have been attributed to increased cases in males and persistently high rates in adolescents, young adults, and certain racial/ethnic groups in defined geographic areas. [22]

Within the United States, carriage rates highly depend on the geographic area, the racial and ethnic group, and sexual preferences. The rate of gonorrhea is much higher in African Americans than in other racial groups [23] and is much higher in the rural southeastern United States and in inner cities, presumably because of an association with socioeconomic and behavioral factors, as well as with social networks.

In 2016, rates of infection ranged from about 479.9 cases per 100,000 population in the District of Columbia to 20.1 cases per 100,000 population in Vermont. [24] The CDC supports a campaign (Healthy People 2020) that targets a decreased incidence rate of 251.9 cases per 100,000 population among females aged 15-44 years and 194.8 per 100,000 population among males of the same age by the year 2020.

Rates of gonococcal infection per 100,000 by state Rates of gonococcal infection per 100,000 by state and outlying regions (2016). Courtesy of the Centers for Disease Control and Prevention (CDC).

In children who have been sexually abused, rates of recovery of gonorrhea range from 1% to 30%. In female adolescents who are sexually active, asymptomatic carriage of gonorrhea occurs in 1-5%.

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