The Canary Islands registered in 2016 a gonococcal infection or gonorrhea rate of 8.4 cases per 100,000 inhabitants, which translates into 182 cases, according to the latest report of Epidemiological Surveillance of communicable diseases, published by the National Center of Epidemiology.
In Spain, a total of 6,456 cases were reported in 2016 gonococcal infection or gonorrhea, 24.87 percent more than a year earlier when there were 5,170 cases, and 222 percent more than in 2005, when 1,155 cases were reported.
In data of affected by population, the incidence in 2016 – last year registered by the institution dependent on the Carlos III Health Institute– It was 13.89 cases per 100 thousand inhabitants, higher than the previous year, which was 11.14 cases per 100 thousand, and to 2014 when the incidence was 9.82 cases per 100 thousand. Anyway, all are alarming data comparing them with the 5.01 cases of 2010 and the 2.66 per 100 thousand inhabitants of 2005.
Even so, the number of infections is lower than the European average, which is established in 20 cases per 100 thousand people, according to the European Center for Disease Prevention and Control. Therefore, not only Spain has suffered a worrying increase in cases, all of Europe has been affected. In general data, the average has doubled since 2008 – when the rate was 8 infections per 100 thousand inhabitants.
In total, in 2014 in the 27 Member States of the EU 66,413 infections were reported. UK tripled the European average with 60 cases per 100 thousand inhabitants, followed him among the five most affected countries: Ireland (28.3), Denmark (20.3), Lithuania (18.2) and Sweden (13,9).
The Experts They have no doubts, the data show a continuous and alarming increase in cases of gonorrhea. The reasons, as explained to Europa Press by Dr. Jorge del Romero, member of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC), are a greater diagnosis, thanks to "the improvement of the tests" and, undeniably, an increase in risky sexual practices, promoted by the "loss of fear of AIDS" and "the use of drugs that reduce the perception of risk in sex".
Asked if it should be considered this situation as a public health problem, is emphatic when stating that "the data put on the table that it is." "Overall, it is clearly significant the rise in the incidence of sexually transmitted diseases (STIs), regardless of which groups are more frequent, and requires special attention from the health authorities."
Spain: Cases by Autonomous Community and profile
Regarding the incidence by Autonomous Community, there are very wide and distant ranges between them, ranging from 2.04 to 28.97 cases per 100 thousand inhabitants. Thus, the highest rates were registered in Catalonia with 2,147 (28.97 cases per 100 thousand inhabitants), Asturias with 292 (28,14), Madrid with 1,519 (23,58), and Balearics with 181 (15.8).
Under, Valencian Community with 633 (12.7), Basque Country with 219 (10.1), Navarre with 61 (9.5), The Rioja with 28 (8.8), Canary Islands with 182 (8.4), Andalusia with 724 (6.2), Aragon (6), Galicia with 148 (5.4), Cantabria with 26 (4.3) and Estremadura with 30 (4.1). Meanwhile, they close Castilla y León with 52 (3.5). Melilla with 3 (3.5), Castilla la Mancha with 87 (2.5) and Murcia with 30 (2.04). Single Ceuta did not notify any case.
These data can give us an idea of the magnitude of the problem, that everything points will be worse in 2017, according to the information published by the Ministry of Health of the Balearic Islands warning of 485 cases of gonorrhea, 66 percent more than in 2016.
The report, to which Europa Press has had access, had individualized information on age and sex in 92 percent of the cases declared. Of these, 83.7 percent were male – 5,006 men compared to 974 women-; 60.3 percent were between 25 and 44 years old, 38.9 percent between 25 and 34 years old, and 21.4 percent of 35-44.
As can be seen, men are the most affected due to the risky sexual practices of the homosexual population or of bisexual men. This is clearly seen in a recent work by the Sandoval Health Center, specialized in STI, presented to the SEIMC, where an increase of 201 percent is observed between 2013 and 2017. Specifically, "out of every 10 diagnoses, at least 8 They identified men with men, regardless of whether they also had relationships with women. "
Regarding age, del Romero laments that "every time you see younger cases." The mean age at diagnosis was 31.64 years, and the incidence rates in men were higher than in women in all age groups. Thus, the highest rates were observed between 20 and 24 years old, being 89.24 cases per 100 thousand male inhabitants and of 21.56 in women.
In Europe the same line is followed, also the proportion of infected men was higher, from 35 per 100 thousand (45,328 cases) to 10 infections per 100 thousand women (16,490 cases). And also the largest proportion of reported cases corresponded to young adults from 15 to 24 years of age, who accounted for 38% of cases; followed by those from 25 to 34 years of age (34%).
Regarding the forms of transmission, almost half (44%) of the gonorrhea diagnoses reported in the EU were reported among men who have sex with men (MSM). This is only slightly lower than the proportion of heterosexual men and women combined (49%).
Gonorrhea, the second
Gonorrhea is a frequent STI that can affect the genitals, rectum and throat. The most common symptoms are a burning sensation when urinating, a discharge at the end of the penis and there may be pain in the testicles. However, 10 percent of men with gonococcal infection have no symptoms.
Romero's doctor, who is also director Sandoval Health Center, remembers that the gonococcal infection can be contracted when having sex without a condom with a person who has the infection through anal, vaginal or oral sex; also, fellatio is also a risky practice for gonococcal infection.
Gonorrhea is one of the four most common STIs in the world, and the second most contagious, along with chlamydia, syphilis or trichomoniasis. Some 357 million people in the world contract any of these four, of them up to 78 million will be new diagnoses of gonorrhea, according to the World Health Organization data that sets the global incidence rate in 19 cases per 1,000 women and 24 by 1,000 men, with the highest number of incidents in the western regions of the Pacific and Africa.
The organization has been warning for years about the increase in cases and, in particular, the resistance to antibiotics, which is limiting treatment options. The development of a lower sensitivity of gonorrhea to the "last line" therapeutic option (oral and injectable cephalosporins), together with the antimicrobial resistance revealed above with respect to penicillins, sulfonamides, tetracyclines, quinolones and macrolides make the gonorrhea in a multidrug-resistant organism.
Another reason to be alert, says the expert, is the increase of confections with other STIs. "Sometimes the infection does not go alone," says the expert, noting that, according to the data obtained in the clinic of which he is director, "a third of people infected by gonocócia was also infected with HIV."