Gonorrhea is a sexually transmitted infection caused by the bacteria Neisseria gonorrhoeae. Gonorrhea often goes undiagnosed because many infected people have no symptoms or have symptoms not recognized to be caused by gonorrhea. It is common for people with gonorrhea to be infected with chlamydia at the same time. In recent years, gonorrhea has become resistant to the last class of drugs previously used to treat it, therefore the treatment guidelines in Ontario have changed as of 2013. For more information, see the health unit's fact sheet on gonorrhea. The health unit offers confidential sexual health clinics in eight locations for counseling, testing and treatment of sexually transmitted infections.
By Age Group
The following graph shows the number of gonorrhea cases in Simcoe Muskoka between 2000 and 2015. Between 2000 and 2013, there were between 21 and 58 cases of gonorrhea reported every year in Simcoe Muskoka. Starting in fall 2013, there has been a significant increase in the reported incidence of gonorrhea in Simcoe Muskoka and Ontario. The proportion of positive tests at public health labs has also increased during this time indicating that this is unlikely due to increased testing. Antibiotic resistance may be contributing to this increase. In 2015, 126 cases of gonorrhea were reported to Simcoe Muskoka. The most commonly reported risk factors among local gonorrhea cases are
- Sex with opposite sex
- No condom use
- Multiple partners in past six months
- New partner in past two months.
The following graph shows age-standardized incidence rates (ASIR) of gonorrhea in Simcoe Muskoka and Ontario between 2000 and 2015. The ASIR of gonorrhea in Simcoe Muskoka is lower than the Ontario rate. For 2015, the ASIR in Simcoe Muskoka was 25.0 cases per 100,000 population. There has been a significant increase in gonorrhea incidence in Ontario since September 2013, similar to the Simcoe Muskoka increase. In Ontario, the ASIR of gonorrhea for 2015 was 43.4 cases per 100,000 population. At the provincial level, there was an increase in the proportion of cases reporting “anonymous sex” in addition to the risk factors reported by local cases (see Simcoe Muskoka section).
The graph below shows the age-specific incidence rates of gonorrhea in Simcoe Muskoka between 2000 and 2015. The highest rate is among 15-24 year olds at 63.4 cases per 100,000 population. The rate among 25-39 year olds has increased sharply in recent years to 61.0 cases per 100,000 population in 2015.
The following graph shows the sex-specific incidence rates of gonorrhea in Simcoe Muskoka from 2000 to 2015. Unlike chlamydia,there has been very little difference between the rates among females and males because a larger percentage of males infected with gonorrhea experience symptoms than with chlamydia, prompting more infected males to seek testing. However, in the last three years, the incidence rate of gonorrhea in males has been consistently higher than the rate in females. In 2015, the incidence rate of gonorrhea for females in Simcoe Muskoka was 17.4 cases per 100,000 population, while the male-specific incidence rate was 28.6 cases per 100,000 population.
More detailed data for Ontario and each health unit can be found on Public Health Ontario’s interactive Snapshots tool, by clicking on “Select Indicator”.
There are many factors that influence how many cases are reported to the health unit, as explained on the Infectious Diseases page.
The incidence rate of gonorrhea varies significantly between age groups so standardization is necessary to compare rates between two populations. For example, the highest incidence rate of gonorrhea is found among 15-24 year olds and Simcoe Muskoka may have a different proportion of people in this age group than Ontario, so both rates must be applied to a standard population to make comparisons.