How is gonorrhea transmitted: the most frequently asked questions about routes of infection. Statistics of the infectious disease syphilis

Having appeared in Europe since the 15th century, this disease confidently continues its march and is not going to give up even in the most developed countries. The sad statistics about syphilis have a lot of data, but at the same time they claim that this infectious disease has no economic, climatic or national barriers to its spread.

Syphilis is found all over the world and, despite the fact that it responds well to treatment in the early stages, it ranks third (alas, not at all honorable) among sexually transmitted infectious diseases, behind only chlamydia and trichomoniasis. Almost 12 million new patients are registered in clinics every year, although in fact these figures are significantly underestimated. Some modern people, like in the Middle Ages, try to heal themselves or through illegal medicine. Unfortunately, statistics have no information about these cases of syphilis.

As a rule, this infectious disease most often affects people whose age is from 15 to 40 years, although the peak incidence occurs between the ages of 20 and 29 years. The number of patients has tended to decrease since the advent of penicillin. Men traditionally have a higher incidence of infectious diseases such as syphilis than women. This is probably due to the dynamics of the disease's growth among homosexuals in large cities in Europe and America. In some countries the disease has almost become extinct. The UK and the Scandinavian countries can boast of this today.

Russian statistics: syphilis exists

In Russia, employees of the Ministry of Health report that there is no uniform record of all patients with syphilis. It is believed that in 2008 there were only 60 cases per 100,000 people. Their number seems to be decreasing compared to previous years, however, not in all regions. Perhaps somewhere the standard of living is not high enough. Among people with this diagnosis, there are often people who do not have a permanent job, income, or even place of residence. Many of the infected are service workers and small businessmen. According to statistics from recent years, the highest incidence of syphilis occurs in the Far Eastern, Siberian and Volga districts.

In recent years, the proportion of infected children has decreased significantly, which is regarded as an improvement in health care and an increase in the educational culture of expectant mothers. The increasing number of cases of neurosyphilis, which are no longer treatable, is alarming. In some regions, such cases increased from 0.12 to 1.1%.

Gonorrhea is transmitted in 90 percent of cases through sexual contact. Moreover, infection will occur through any type of sexual contact. Even unprotected oral sex with a prostitute can lead to infection with gonorrhea, because a common type of gonorrhea among them is gonococcal pharyngitis, which does not show symptoms.

Ways of infection with gonorrhea

There is a possibility of a newborn becoming infected with gonorrhea when passing through the birth canal. In this case, the mucous membrane of the newborn’s eyes is affected and infection will lead to the development of gonococcal conjunctivitis.

There are many articles on the Internet devoted to gonorrhea infection. But they are divided: some believe that household infection almost never happens. Others provide statistics on how many people are infected with gonorrhea through household means. Some say that in open air without moisture, the gonococcus bacterium dies within a few minutes, while others claim that the bacterium can live there for up to several hours. It's hard to say who's right and who's wrong, but what's clear is that it can't hurt to practice good hygiene and be careful in public areas. In unfavorable living conditions, when a child sleeps with his parents and shares hygiene items with parents infected with gonorrhea - towels, underwear, it is possible to become infected with gonorrhea through household means.

How does gonorrhea become infected?

After sexual intercourse with a man with gonorrhea, the woman has a 50 percent chance of becoming infected. And for a man, sexual contact with an infected woman can result in infection with gonorrhea with a probability of 30-40 percent. This is explained by the different anatomy of men and women. The urethral canal in men is narrow, gonococci can be washed away, for example, with urine, and gonorrhea infection will not occur. The likelihood of a man contracting gonorrhea increases when a woman menstruates.

In maternity hospitals, immediately after birth, newborn babies’ eyes are treated first with sterile cotton wool, then with a solution of sodium sulfacyl. For girls, in addition to the eyes, the genitals are also treated to block the routes of gonorrhea infection.

There is still a danger of contracting gonorrhea from a person who does not even suspect that he is sick. This is the case of latent gonorrhea. The chronic form of gonorrhea also does not produce symptoms, only during an exacerbation. But in women, gonorrhea manifests itself much weaker, and if a woman did not consult a doctor during an exacerbation (for example, she mistook the symptoms of gonorrhea for thrush), then until the next exacerbation she will sleep peacefully, not even knowing that she has gonorrhea.

Incubation period of gonorrhea

The incubation period begins from the moment a person becomes infected from a carrier of the infection and ends when clinical symptoms appear, if, of course, they appear. After all, this infection may turn out to be latent.

How long is the incubation period for gonorrhea infection?

Infection with gonorrhea occurs during sexual contact of any type, even if the penis did not penetrate the vagina, but only contact. Girls are more often exposed to gonorrhea at home when using hygiene items from a sick person. It happens that the incubation period of gonorrhea is so long that during childbirth the infection is transmitted to the child.

The duration of the incubation period depends on the person’s health, the resistance and state of the immune system, whether the person has any other diseases, the number of pathogens, and the susceptibility of the mucous membranes. Also, the duration of the period may be affected by taking antibiotics.

For men, the incubation period of gonorrhea is typically 3-5 days, for women it is longer – up to ten days. But under the influence of many factors it can drag on, and sometimes, on the contrary, it manifests itself very quickly.

Development of gonorrhea

Gonococci are paired cocci, similar in appearance to coffee beans. They are located with concave sides facing each other and are motionless. Reproduction - by dividing into two equal parts. Their location inside the cell is a sign by which gonorrhea can be identified. Gonococci destroy white blood cells by multiplying inside the cell. They can also be located outside the cell, but this does not exclude gonorrhea. The viability of these bacteria and the incubation period depend on external factors. A humid environment at human body temperature is optimal. Gonococcus can exist outside the human body. It is alive in pus until the pus dries completely. In a humid environment it can last up to a day. In a soap solution - about two hours. Humans have neither congenital nor acquired immunity to gonococci. Even someone who has had this disease can become infected with gonorrhea again.

Gonococci start from the mucous membrane of the urethra, then involve nearby tissues. They can reach the epididymis, uterine appendages, prostate gland, seminal vesicles, and rectum. In the bloodstream and lymphatic tract, the bacterium quickly dies, but can move into the peritoneum, joints, heart, and even into the meninges. If the infection is localized far from the primary infected site, then this is already a complicated form of gonorrhea.

Ways of infection with gonorrhea: due to non-standard methods of sexual contact, infection can begin to develop in the rectum, on the mucous membrane of the mouth, in the pharynx and tonsils.

I regularly, on average once every two to three months, have to read in the popular science press that antibiotic-resistant, barely curable gonorrhea is sweeping the planet. There really is something to worry about: in the modern arsenal of venereologists there are very few drugs against gonorrhea, strictly speaking, there are only two of them - the antibiotics cefixime and ceftriaxone. Between people and bacteria there is almost a hundred-year war, in which the former invent new antibiotics, and the latter - methods of protection. Neisseria gonorrhoeae, the causative agent of gonorrhoeae, has always been particularly successful in this area: already in the 1940s, it developed resistance to sulfonamides, in the 1980s - to penicillin and tetracyclines, and literally about five years ago - to fluoroquinolones. The latest generation of cephalosporins, which include cefixime and ceftriaxone, also seem to be rapidly losing ground in the battle against the “French runny nose.”

“We are monitoring throughout the country, and have not yet found strains resistant to cefixime and ceftriaxone,” Margarita Rakhmatulina, acting director, told me. Head of the Department of Sexually Transmitted Infections.

– Is this rather good news or rather bad? – I clarified.

- Rather good. True, it is possible that these cases simply passed us by; the patient could have gone to a commercial clinic and not been included in the official statistics. Either he simply did not come for a repeat test, he was not fully treated, but we did not know about it. I am seeing her and I see that the gonococcal infection has decreased significantly. Although, of course, we have room for improvement: in Sweden, for example, there are two cases throughout the country per year. Compared to them, we don't look very good.

One circumstance personally prevented me from being happy that this infection was not found in our country: the list of countries - according to press reports, this hardy strain was found only in developed countries with powerful medicine. Nothing is reported about Africa and Asia, where the level of sexually transmitted diseases is off the charts. It turns out that in Sweden, where two people in the entire country get sick a year, this strain has already been found, but in Russia, where more than fifty thousand people suffer from gonorrhea, it seems to be missing.

“The problem is that in Russia there is no regular monitoring program at all,” Mikhail Eidelshtein, head of the antibiotic resistance laboratory at the Research Institute of Antimicrobial Chemotherapy (Smolensk), explained to me. “This is simply impossible to say based on the protocols that we have adopted. Typically, multicenter monitoring of a specific infection occurs every three to four years, and for less significant infections like gonorrhea, even once every five years. This study involves 20–30 hospitals in 10–30 cities. The data we have on gonorrhea was collected about five years ago.” In addition, according to Eidelstein, a relatively small study is being done for gonorrhea, about ten centers around the country, from which it is impossible to get a real picture. Finally, according to VTsIOM (2009), only a little more than half of Russians, when sick, go to state clinics and hospitals.

While the bacterium itself has not even been registered in Russia, WHO released a Global Prevention Plan for the spread of antibiotic-resistant Neisseria gonorrhoeae more than a year ago. It calls gonorrhea the most dangerous sexually transmitted infection. Firstly, it is transmitted with a 70-80 percent probability through unprotected sex. Secondly, the main effective medicine is rapidly ceasing to be so. When the standard dose of cefixime did not help, Canadian doctors from Clinics Without Borders simply doubled the dose. This common practice, which works for now, can only be a temporary measure, since sooner or later, as the dose increases, the toxicity of the drug will exceed its effectiveness.

“In fact, gonorrhea is far from the most serious problem,” Eidelstein reassured me. – I’ll tell you a secret that even if cefixime completely stops working on her, there are, for example, carbapenems - antibiotics that are now used only to treat severe infections, which do not include gonorrhea. Although the professional literature has already discussed the possibility of treating resistant gonorrhea with these antibiotics. The situation is much worse with the more common, but less publicized hospital-acquired infections; some of them are not affected by any existing antibiotics at all. They occur in isolated cases, however, unlike resistant gonorrhea, they have already been officially registered in Russia.”

There is not a word about carbapenems in the WHO plan. It says millions of people are at risk of being left without effective treatment. One way or another, the experience of the hundred-year war shows that infections find a way to protect themselves from antibiotics faster than people create new secret weapons. Therefore, before you start using a completely new remedy, it would be nice to pay attention to what WHO experts write about: early accurate diagnosis, scrupulous monitoring, affordable medications. And, of course, condoms, which, by the way, according to the latest data from researchers from Indiana University, do not at all reduce sensitivity during sex.

Many people ask about what symptoms of chronic gonorrhea exist in medical practice. In this case, there is no need to talk about any individual signs. Symptoms of chronic gonorrhea can vary. First of all, the symptoms of chronic gonorrhea depend on in which part of your body the gonococcus has settled permanently.

The main symptoms of chronic gonorrhea may not manifest themselves in the form of purulent discharge or pain when urinating. They most often manifest themselves in the form of independent diseases of various organs and systems of the human body. There are gonococcal tonsillitis, gonococcal pneumonia, cystitis, pyelonephritis, hepatitis and even meningitis.

The clinical picture depends, first of all, on the localization of the inflammatory process. There is a clear pattern. Usually, when treating such patients, after complete cure of one inflammatory disease, an inflammatory process immediately occurs in another organ.

This means only one thing: this clinical picture is symptoms of chronic gonorrhea. It is extremely difficult to cure, but it is possible. This will likely require years of treatment. But it's worth it.

The main symptoms of chronic gonorrhea have been discovered, what next?

If the patient has symptoms of chronic gonorrhea, then a detailed examination and clarification of the diagnosis follows. You will most likely be asked to take multiple smears to determine your microflora. You will also be given a challenge with a gonococcal vaccine. It forces the gonococcus to come out of the shadows and appear fully.
You will then have regular blood tests to check for syphilis and HIV. This is a preventive diagnosis. It is believed that patients with gonorrhea are highly likely to be infected with other sexually transmitted diseases.

There are very rare cases when a gonococcus carrier turns out to be not infected with syphilis or HIV. The doctor should exercise special caution in the case when he complains about the clinical picture of acute cystitis. The fact is that in a doctor’s practice there are very rarely cases of pure cystitis in men. The physiology of the structure of their urethra is such that infection can only enter the bladder downwards. In this case, the symptoms of pyelonephritis come to the fore. And only then does acute cystitis begin to appear. If everything is fine with the kidneys, and the man complains of symptoms of acute cystitis, a mandatory examination by a venereologist should be prescribed.

The main symptoms of chronic gonorrhea are not obvious at first glance

According to statistics, chronic gonorrhea is extremely rare among the population of our country. But we very often have children born with congenital deformities and intrauterine development defects. All this is a consequence of the fact that the symptoms of chronic gonorrhea are not obvious at first glance and most doctors simply do not pay attention to them. A person is treated for the disease that most closely matches the clinical picture described by the patient. Nobody even thinks about additional examination. This is how a person with chronic gonorrhea lives and does not suspect its existence.

Then children are born who suffered in utero from gonococcus. You should know that this pathogen very easily penetrates the placental barrier and feeds very well on the tissues of the still immature embryo of the future human being.