The Role of the Clinician in Surveillance

Please use the Pennsylvania SURRG Culture Criteria to determine when culture is recommended. Clinicians are strongly urged to perform an FDA-Approved Nucleic acid amplification test, NAAT, and/or culture when indicated according to the culture criteria. Remember each site of sexual exposure should be evaluated individually if the risk assessment indicates sexual exposure.

• If you would like a Gonorrhea Risk Assessment for your practice, please contact Robyn Gordon, SURRG Coordinator at robygordon@pa.gov. 
• The Department of Health maintains a network of STD clinical sites, including our state health departments, that have gonorrhea culture testing capabilities and laboratory support for the performance of antibiotic resistance testing. All STD services offered at these sites are free and confidential. If resistance is suspected, please call the number below for additional information and for assistance in making appropriate referrals. 
• View the SURRG Culture Decision Process.
  

Clinicians are asked to report any gonorrhea specimen with decreased cephalosporin susceptibility and any gonorrhea cephalosporin treatment failure to CDC through their state or local public health authority. The following individuals should be contacted at the Pennsylvania Department of Health:

Stephen J. Kowalewski | Senior Public Health Administrator
Department of Health | STD Program
c-skowalew@pa.gov
Direct Desk Number 717-547-3443

OR

Robyn Gordon I Public Health Program Administrator/SURRG Coordinator
Department of Health I STD Program
robygordon@pa.gov
Cell: 717-329-6350

Treatment and Care

The CDC treatment recommendations are linked below.

https://www.cdc.gov/std/treatment-guidelines/pid.htm

In addition to the CDC recommended treatment for uncomplicated gonorrhea, the Pennsylvania Department of Health is recommending the following:

1. Providers statewide are strongly encouraged to ask patients about their sexual practices and to offer, when indicated, throat and rectal cultures. Use this link for specific patient education.
2. Any patient with persistent symptoms after initiating pharmaceutical therapy with Ceftriaxone after three days should be cultured at the appropriate anatomical site.
3. A test of cure by culture is strongly recommended.
4. All gonorrhea positive cultures should be tested for drug resistance, including Ceftriaxone resistance.
   

Management of Sex Partners

Effective clinical management of patients with treatable STDs will require treatment of recent sex partners to prevent reinfection and curtail further transmission. Patients should be instructed to refer their sex partners for evaluation and treatment. Sex partners of patients with gonorrhea infection whose last sexual contact with the patient was within 60 days before onset of symptoms or diagnosis of infection in those patients should be evaluated and treated for gonorrhea. If a patient's last sexual encounter was >60 days before onset of symptoms or diagnosis, the patient's most recent sex partner should be treated. Patients should be instructed to avoid all sexual activity until therapy is completed and until they and their sex partners have received a test of cure.

Current Gonorrhea Reported Cases

Statewide Data

The most recently published reported figures on gonorrhea cases in Pennsylvania are available online at: https://www.phaim1.health.pa.gov/EDD/

National Data

Additional data on gonorrhea is also available online at: https://www.cdc.gov/std/statistics/2020/overview.htm#Gonorrhea

For additional data please contact:
Pennsylvania Department of Health 
Bureau of Communicable Diseases
Division of TB/STD
STD Program
717-787-3981
8:00 A.M. – 5:00 P.M

Reporting Requirements

Physicians are reminded that gonorrhea is a reportable to include the reporting of treatment for any positive case. For more information on the reporting requirements please see the Pennsylvania Bulletin at  www.pacodeandbulletin.gov and the online reference guide for registering in PA-NEDSS.