County calling

When the phone rings in a Spokane household, the conversation may be a bit startling. Actually, this is th case in many counties within the state. Washington is one of a few who will notify ex-sexual partners of people diagnosed with Syphilis or HIV that they may have been exposed and should take medical measures. But as a result of a profoundly significant rise in cases of gonorrhea, some counties have added this sexually transmitted disease to the list.

Normal cases of the STD can be cured with a course of antibiotics, but there’s a disturbing trend rising: a “super” gonorrhea has emerged that is antibiotic resistant. As it is, it’s taking more powerful antibiotics to combat the disease. It used to be that simple penicyllin taken for two weeks while avoiding alcohol for the same period would kill gonorrhea. These days drugs like ciprofloxicin might be employed, or another more potent antibiotic.

The Spokane County Health Department is taking notification very seriously, using mail, email, Facebook, Twitter and even in-person visits to establish contact with those who’ve been exposed. Historically, people with an STD aren’t anxious to notify those they possibly or even definitely have infected. Having an uninvolved third party making the notification often defuses what could be an explosive situation. When notified, some people accept the information quietly, others shed tears and squeal in humiliation. Still others react in anger, denigrating the messenger and hanging up. Sadly, a percentage of people refuse to believe that this could happen to them and don’t take steps to seek medical help. With gonorrhea already a serious and rising threat, denial only adds to the exposure numbers. Unfortunately, many of the infected are teens and young adults –althugh the Health Department is quick to say that those infected are not manifested in any social strata or age group. It’s an equal opportunity problem with the only people immune are totally celibate. 

The gonorrhea bacterium is spread through fluid exchange. That doesn’t mean the male needs to ejaculate, saliva, perspiration, tears and, of course, blood, can transmit the disease. This ease of transfer is one of the reasons the STD is so problematic. While oral, anal and vaginal sex are sure transmission vectors, much less intimate contact can spread the bacterium. Pregnant women can even transmit the disease to their unborn children. Having previously been infected and cured of the disease does not limit the ability to be reinfected. Some people believe that infection and cure makes one resistant. This is patently false. 

The notification process is to be applauded because the disease is not always recognizable to those who contract it. From the Centers for Disease Control:

Some men with gonorrhea may have no symptoms at all. However, common symptoms in men include a burning sensation when urinating, or a white, yellow, or green discharge from the penis that usually appears 1 to 14 days after infection. Sometimes men with gonorrhea get painful or swollen testicles.

Most women with gonorrhea do not have any symptoms. Even when a woman has symptoms, they are often mild and can be mistaken for a bladder or vaginal infection. The initial symptoms in women can include a painful or burning sensation when urinating, increased vaginal discharge, or vaginal bleeding between periods. Women with gonorrhea are at risk of developing serious complications from the infection, even if symptoms are not present or are mild.

Symptoms of rectal infection in both men and women may include discharge, anal itching, soreness, bleeding, or painful bowel movements. Rectal infections may also cause no symptoms. Infections in the throat may cause a sore throat, but usually cause no symptoms.

Untreated gonorrhea can cause serious and permanent health problems in both women and men.

In women, gonorrhea can spread into the uterus (womb) or fallopian tubes (egg canals) and cause pelvic inflammatory disease (PID). The symptoms may be mild or can be very severe and can include abdominal pain and fever. PID can lead to internal abscesses (pus-filled pockets that are hard to cure) and chronic (long-lasting) pelvic pain. PID can damage the fallopian tubes enough that a woman will be unable to have children. It also can increase her risk of ectopic pregnancy. Ectopic pregnancy is a life-threatening condition in which a fertilized egg grows outside the uterus, usually in a fallopian tube.

In men, gonorrhea can cause a painful condition called epididymitis in the tubes attached to the testicles. In rare cases, this may prevent a man from being able to father children.

If not treated, gonorrhea can also spread to the blood or joints. This condition can be life-threatening.