People who have symptoms of gonorrhea (painful urination, discharge from the penis or vagina) can be treated with antibiotics. Unfortunately, gonorrhea in many men goes unnoticed and up to 80 percent of all women infected with gonorrhea don't know they have the infection. This type of unnoticed infection is called an asymptomatic infection.
Many of these asymptomatic infections are eliminated by the person's immune system with no complications. However, a significant number of women with asymptomatic or untreated symptomatic gonorrhea can develop very severe complications. Many of these infections can spread from the vagina and cervix to their uterus, fallopian tubes, ovaries, abdomen, bloodstream and the surface of their liver. Extensive scarring of these organs can occur, resulting in infertility, ectopic pregnancy (the fertilized egg implants in places other than the uterus), chronic pelvic pain, peritonitis (infection of the space around the internal organs in the abdomen), blood stream infections, shock and, sometimes, death.
This very severe complication of Neisseria gonorrhoeae infection is called Pelvic Inflammatory Disease or PID. In the U.S., about 850,000 women report symptoms of PID, requiring more than 212,000 hospital admissions and 115,000 surgical procedures each year.
In 1998 the Centers for Disease Control reported that the number of gonorrhea cases increased 8.9 percent over 1997. This was the first increase in the number of gonorrhea cases since 1985. The 1998 increase was reported in all demographic groups defined by age, sex and race/ethnicity; and it occurred in all major geographic regions except the Northeast. When the number of gonorrhea cases go up the number of PID cases usually go up in number as well. This is not good news.
Now, not all women with untreated gonorrhea infections get PID. Previous studies have demonstrated that there are different strains of Neisseria gonorrhoeae. Some strains remain in the vagina and on the outer surfaces of the cervix, and they are called localized infections. Other strains of Neisseria gonorrhoeae have the ability to spread to other areas of the body and have the potential to cause PID if untreated. The problem has been knowing which strains are likely to remain in localized infections and which will spread.
A group of researchers from the University of Texas Medical Branch of Galveston (K. Nguyen, A. Hart, P. Urvil, B. Nowicki and S. Nowicki) reported at the General Meeting of the American Society for Microbiology in Los Angeles (May 2000) that they have found a gene that is unique to the variety of Neisseria
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