Denmark SSI: The Number of Gonorrhea Cases in Denmark is Increasing

 

Credit CDC PHIL

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Although most STIs (sexually transmitted infections) remain treatable by modern antibiotics, earlier this year in Massachusetts DPH: First Detection Of Gonorrhea Strain With Resistance To 5 Classes of Antibiotics we looked at growing concerns over antibiotic resistant gonorrhea in the United States.

While both of the above cases were ultimately cured, we've seen warnings for years (see 2011's The Path Of Increased Resistance and Going, Going, Gonorrhea) that our armamentarium against these all-too-common sexually transmitted diseases (STD) are eroding.

At the same time, the number of STDs continue to rise, both here in the United States and around the world (see UKHSA: Gonorrhoea and Syphilis at Record Levels in 2022).  Following this global trend, today Denmark's SSI (Staten Serum Institut) is reporting another large jump in cases in 2022.

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The number of gonorrhea cases in Denmark is increasing

From 2021 to 2022, the number of reported gonorrhea cases in Denmark has increased by 46 percent.

Last edited on 15 December 2023

While no increase in the number of gonorrhea cases was observed from 2020 to 2021, a sharp increase has been seen from 2021 to 2022.

The increase is 46 percent and occurs among heterosexual men and women as well as among homosexual men, but is steepest among young heterosexuals.

The most frequently occurring age group in 2021 was 30-39 years for men and 15-19 years for women, and in 2022 it was 30-39 years for men and 20-24 years for women.

The city of Copenhagen was the most frequently occurring district.

"It is important that if you have had condom-free sex with a new partner, you should be examined, and if you are diagnosed with gonorrhea (or another sexually transmitted disease), you must be treated and contribute to partner information. Only by using condoms and rapid infection detection with relevant treatment is it possible to break the chains of infection"Maria Wessman, doctor and section manager at Statens Serum Institut.

For a more detailed comparison between 2021 and 2022, we have this from the EPI-NEWS week 50 - 2023 report.  The increase in ciprofloxacin resistance is described as `slight', but it is worth noting that this data is now more than a year old.

Week 50 - 2023
Gonorrhea 2021 and 2022

Last edited on 14 December 2023

Gonorrhea 2021 and 2022

Gonorrhea diagnosed in 2021

• 3,570 cases of gonorrhea were registered in the Danish Microbiology Database (MiBa).
• 2,805 cases were reported to the Reporting System for Infectious Diseases (MIS), of which 1,856 were among men and 949 among women, distributed among 2,637 people.
• Among men, 1,015 (55%) were reported as homosexually infected. This figure was 20 (2%) for women.
• Information on HIV status was available for 2,210 (79%) of notified gonorrhea cases. Among 959 cases in MSM, 134 (14%) were HIV positive.
• 22 (2%) women reported with gonorrhea were pregnant.
• The most frequently occurring age group was 30-39 years for men and 15-19 years for women, and the city of Copenhagen was the most frequently occurring part of the country for gonorrhea among men and East Jutland for women.

Gonorrhea diagnosed in 2022

• 5,204 cases of gonorrhea were registered in MiBa.
• 3,916 cases were reported to the MIS, of which 2,538 were among men and 1,378 among women, distributed among 3,655 people, an increase of 46%, compared to 2021.
• Among men, 1,308 (52%) were reported as homosexually infected. This figure was 22 (2%) for women.
• Information on HIV status was available for 2,189 (56%) of the reported gonorrhea cases. Among 1,210 cases among MSM, 200 (17%) were HIV positive.
• 23 (2%) women reported with gonorrhea were pregnant.
• The most frequently occurring age group was 30-39 years for men and 20-24 years for women, and the city of Copenhagen was the most frequently occurring part of the country.

For a detailed epidemiological description of the incidence in 2021 and 2022, please refer to The annual report for gonorrhea in 2021 and 2022.

The number of gonorrhea cases has been increasing for a number of years, but the increase from 2021 to 2022 was exceptionally steep (46%). The large increase can be due, among other things, to the relaxation of covid-19 restrictions, but of course especially an increased incidence of condomless sex

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Health professionals are encouraged to pay special attention to gonococci as a cause of eye inflammation in newborns - especially in the first 14 days after birth. Gonorrheal conjunctivitis, which also occurs in people other than newborns, is a potentially very serious condition that, if left untreated, can lead to destruction of the eyeball.

These patients must therefore be referred urgently to a specialist department, so that correct and immediate treatment can be initiated to preserve sight.

The rate of ciprofloxacin resistance has increased slightly. The preparation can be used in case of proven sensitivity, see The annual statement for gonorrhea 2021-2022.

(S. Cowan, M. Wessman, Department of Infection Epidemiology and Prevention, K.D. Bjerre, Data Integration and Analysis Secretariat, T. Roland Pedersen, A. Skafte-Holm, S. Hoffmann, Department of Bacteria, Parasites & Fungi)