GONORRHEA
Sexually Transmitted Disease Surveillance 2009
Division of STD Prevention
Gonorrhea—Rates, United States, 1941–2009
Rate (per 100,000 population)
500
400
300
200
100
0
1941 1946 1951 1956 1961 1966 1971 1976 1981 1986 1991 1996 2001 2006
Year
Gonorrhea—Rates by Sex, United States, 1990–2009
Rate (per 100,000 population)
400
Men
Women
Total
300
200
100
0
1990 1992 1994 1996 1998 2000 2002 2004 2006 2008
Year
Gonorrhea—Rates by Region, United States, 2000–2009
Rate (per 100,000 population)
300
West
Midwest
250
Northeast
South
200
150
100
50
0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
Year
Gonorrhea—Rates by State, United States and
Outlying Areas, 2009
34.9 VT 8.0
8.3 23.5 10.9 NH 8.6
44.1
29.4 MA 30.4
RI 30.6
7.2 92.4
42.8 87.2 CT 73.1
Guam 13.9 147.0 NJ 54.8
33.5 55.2 81.4 DE 111.2
66.4 77.2
139.2 MD 113.5
12.5 154.7
107.2 DC 432.7
63.2 57.2 26.2 100.3
89.4 89.6
109.8
150.4
127.5 Rate per 100,000
50.0 128.3 156.2 185.7
54.5 population
246.4 141.3
160.8 100.0 (n = 22)
Puerto Rico Islands
49.0 5.8 104.7
NOTE: The total rate of gonorrhea for the United States and outlying areas (Guam, Puerto Rico, and Virgin Islands)
was 97.8 per 100,000 population.
Gonorrhea—Rates by County, United States, 2009
Rate per 100,000
population
100.0 (n = 607)
Gonorrhea—Rates by Age and Sex, United States,
2009
Men Rate (per 100,000 population) Women
750 600 450 300 150 0 Age 0 150 300 450 600 750
5.0 10–14 25.3
250.0 15–19 568.8
407.5 20–24 555.3
238.9 25–29 229.4
145.0 30–34 106.2
85.6 35–39 47.6
60.8 40–44 22.9
33.6 45–54 8.7
11.4 55–64 2.1
2.7 65+ 0.5
92.2 Total 105.7
Gonorrhea—Rates by Age Among Women Aged 15–44 Years,
United States, 2000–2009
Rate (per 100,000 population)
Age Group
1,000
15–19 30–34
20–24 35–39
800 25–29 40–44
600
400
200
0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
Year
Gonorrhea—Rates by Age Among Men Aged 15–44 Years,
United States, 2000–2009
Rate (per 100,000 population)
Age Group
750
15–19 30–34
20–24 35–39
600 25–29 40–44
450
300
150
0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
Year
Gonorrhea—Rates by Race/Ethnicity,
United States, 2000–2009
Rate (per 100,000 population)
800
700
600
500
American Indians/Alaska Natives
400 Asians/Pacific Islanders
Blacks
300 Hispanics
Whites
200
100
0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
Year
Gonorrhea—Cases by Reporting Source
and Sex, United States, 2000–2009
Cases (in thousands)
200 Non-STD* Clinic, Men
Non-STD Clinic, Women
STD Clinic, Men
160 STD Clinic, Women
120
80
40
0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
Year
* STD = sexually transmitted disease.
Gonorrhea—Percentage of Reported Cases by Sex and
Selected Reporting Sources, United States, 2009
Percentage
Private Physician/HMO*
STD* Clinic
Other HD* Clinic
Family Planning Clinic
Emergency Room
Men Women
* HMO = health maintenance organization; STD = sexually transmitted disease; HD = health department.
NOTE: These categories represent 71.9% of cases with known reporting source. Of all cases, 10.3% had a
missing or unknown reporting source.
Gonorrhea—Positivity Among Women Aged 15–24 Years Tested
in Family Planning Clinics, by State, Infertility Prevention Project,
United States and Outlying Areas, 2009
0.3
VT 0.2
1.1 0.0
0.3 0.4 NH
0.1 MA
2.7 RI 0.3
0.1 0.5
CT 0.6
0.2 1.4
NJ 1.2
0.5 0.8
0.8 DE 1.3
3.4 1.8
0.3 1.4 1.1 MD
1.0 0.4 0.2 1.0 DC 2.5
1.0 0.5
1.0
1.2
0.6 Positivity
0.4 0.8 1.9
1.6 2.0 (%)
2.4 2.0
1.8 * (n = 4)
2.0 2.1
0.2 2.0 (n = 9)
* States/areas not meeting minimum inclusion criteria.
NOTE: Includes states and outlying areas that reported positivity data on at least 500 women aged 15–24 years
who were screened during 2009.
Gonococcal Isolate Surveillance Project (GISP)—Location of
Participating Sentinel Sites and Regional Laboratories,
United States, 2009
Seattle
Minneapolis
Portland
Detroit
New York City
San Cleveland Philadelphia
Chicago
Francisco Cincinnati Baltimore
Las
Vegas Denver Kansas City Richmond
Greensboro
Los Angeles Oklahoma
Orange Co. Phoenix
Albuquerque City
San
Diego Atlanta
Birmingham Sentinel Sites
Dallas
Sites and Regional Labs
Tripler AMC
New Orleans
Honolulu
Miami
Gonococcal Isolate Surveillance Project (GISP)—Distribution
of Minimum Inhibitory Concentrations (MICs) to Ceftriaxone
Among GISP Isolates, 2005–2009
Percentage
100 2005
2006
80 2007
2008
2009
60
40
20
0
1 µg/ml. Isolates with
intermediate resistance have ciprofloxacin MICs of 0.125–0.5 µg/ml. Susceptibility to ciprofloxacin was first
measured in GISP in 1990.
Gonococcal Isolate Surveillance Project (GISP)—
Penicillin, Tetracycline, and Ciprofloxacin Resistance
Among GISP Isolates, 2009
0.9% 1.1%
2.2%
5.5%
2.1%
Susceptible
7.9% PenR
TetR
3.8%
QRNG
PenR/TetR
PenR/QRNG
76.5% TetR/QRNG
PenR/TetR/QRNG
NOTE: PenR = penicillinase producing Neisseria gonorrhoeae and chromosomally mediated penicillin-resistant
N. gonorrhoeae; TetR = chromosomally and plasmid mediated tetracycline-resistant N. gonorrhoeae; and
QRNG = quinolone-resistant N. gonorrhoeae.
Gonococcal Isolate Surveillance Project (GISP)—Drugs Used
to Treat Gonorrhea Among GISP Participants, 1988–2009
Percentage
100
Tetracyclines Other
Penicillins
Ofloxacin
80
Ciprofloxacin
60
Cefixime
Ceftriaxone 250 mg
40
20
Spectinomycin Ceftriaxone 125 mg
Other Cephalosporins
0
1988 1990 1992 1994 1996 1998 2000 2002 2004 2006 2008
Year
NOTE: For 2009, “Other” includes no therapy (1.5%), azithromycin 2 g (1.7%), and other less frequently
used drugs.
For more information please contact Centers for Disease Control and Prevention
1600 Clifton Road NE, Atlanta, GA 30333
Telephone, 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348
E-mail: cdcinfo@cdc.gov Web: www.cdc.gov
The findings and conclusions in this report are those of the authors and do not necessarily represent the official
position of the Centers for Disease Control and Prevention.
National Center for HIV/AIDS, Viral Hepatitis, STD & TB Prevention
Division of STD Prevention