More commonly known as gonorrhea, infection is the world's second most common sexually transmitted disease. Offenders are gonococci, spherical bacteria that live only in humans and are transmitted almost exclusively by direct mucosal contact, ie unprotected sexual intercourse.
Of microbes and humans
Every year more than 60 million people are infected worldwide. Since the mid-1990s, a significant increase in new cases has been observed, as their number has steadily declined over the years.
There are probably several reasons - including mass and sex tourism in distant countries, especially Asia, the relapse into reckless sexual behavior after the demise of anti-AIDS campaigns and increasing resistances of the pathogens. A tendency that gives some researchers cause for concern. Critical voices suggest that the disease, which is currently still easy to treat, may become a problem child in the future, similar to other infections where common antibiotics are already failing. The prevention would be comparatively easy.
For the pathogens, also known as Neisseria gonorrhoeae in technical terms, humans are the only reservoir. Since they are extremely sensitive to dehydration and cold, they have almost no chance of survival outside of their human host. Their eradication would be theoretically possible. And since the germs are transmitted almost exclusively during intercourse, the risk of infection is minimized with a condom.
Hard facts and dark numbers
Until the year 2001 the gonorrhea in Germany was notifiable. However, an estimated dark figure of 80-90% was added to the then officially known annual 2, 200 disease cases. Experts believe that these numbers are still valid or even higher. In particular, younger adults of both sexes are affected. On the one hand, this is due to the earlier and earlier start of sexual activity - 45% of girls and 36% of boys - up to the age of 16, coupled with a higher number of sexual partners and, on the other hand, the willingness to experiment for various sexual practices both hetero- and homosexual type as well as the reluctance to use condoms.
In addition, the anatomy and hormone balance of younger girls appear to increase the risk of ascending infections. In addition, gonorrhea is very contagious. About one third of the men become infected with a single sexual contact with a sick woman. For women, the risk is even 60-90% if they have intercourse with an infected man. Not infrequently infected with gonorrhea are also infected with the AIDS virus or the syphilis virus.
The symptoms in man and woman
- Women: If symptoms occur, they are usually unspecific and manifest as burning urination, unpleasant smelling vaginal discharge and swelling of the labia. The germs can rise through the uterus in the fallopian tubes and ovaries and lead to inflammation with fever and lower abdominal complaints to infertility. Pregnant women suffering from gonorrhea can infect their child during childbirth and lead to eye inflammation, formerly one of the leading causes of childhood blindness in the Western world.
- Men: The disease begins with burning pain on urination, followed by mucous, later yellowish-green discharge from the urethra. His morning collection at the first urination also gave him the name "Bonjour drops". The pathogens can migrate to the prostate and epididymis, causing inflammation, followed by infertility.
Depending on the location of the transmission path, it can also lead to inflammation of the rectum or the oral mucosa. Rarely, the pathogens enter the bloodstream and trigger rashes, arthritis, fever and chills. Rare but serious complications include brain, myocardial, ophthalmic and bone marrow infections.
Proof and therapy
The diagnosis is made by smearing of secretions from the vagina and urethra and the detection of the pathogen under the microscope. Bacterial cultures can also be created. The level of the number of pathogens in the blood can be determined by means of a nucleic acid amplification test. Therapy with antibiotics tablets is usually fast and successful. Only rarely do they have to be injected.
Unfortunately, pathogens (mainly from Asia and Africa) have become increasingly resistant to common antibiotics in recent years, so that reserve resources have to be used. Mandatory is the co-treatment of the sexual partner to avoid a "ping-pong effect". One week after the end of the treatment the success of the therapy should be checked with a smear.
In a nutshell
- The disease can initially run symptom-free and so unknowingly carried on.
- The infection occurs almost exclusively through vaginal, anal or oral intercourse.
- If diagnosed early, a rapid and complete cure by antibiotics is possible, otherwise it can lead to infertility and other complications in men and women.
- The antibiotics must be taken correctly and long enough to avoid resistance to the pathogens.
- The sexual partners must be treated.
- You can always get infected with gonorrhea.