Increases in gonorrhea--eight western states, 2000--2005

Neisseria gonorrhoeae infection is the second most commonly reported notifiable disease in the United States. Gonorrhea increases the risk for pelvic inflammatory disease, infertility, ectopic pregnancy, and acquisition and transmission of human immunodeficiency virus (HIV). Nationally, reported gonorrhea incidence rates have been either declining or stable since 1996, although, in 2005, the national rate (115.6 cases per 100,000 population) increased for the first time since 1999. In recent decades, western states have had lower gonorrhea rates than other U.S. regions; however, from 2000 to 2005, rates in the West increased 42%, from 57.2 cases to 81.5 cases per 100,000 population. During that period, rates in the three other U.S. regions decreased (South: -22%, Northeast: -16%, and Midwest: -5%). This report describes the epidemiology of gonorrhea in eight western states that reported large increases in gonorrhea incidence rates from 2000 to 2005. The results indicated that both sexes and all specified age and racial/ethnic groups experienced increases in gonorrhea rates. Causes for these increases remain unclear; however, data suggest they likely resulted from a combination of increases in the number of tests performed, trends in the types of test performed, and actual increases in disease occurrence. CDC is collaborating with state and local health departments to further investigate and respond to these increases. Public health agencies should remain vigilant for early signs of increases in gonorrhea incidence in their areas.