Increase in Gonorrhea Incidence Associated With Enhanced Partner Notification Strategy

Area of Science:

• Public Health
• Infectious Disease Epidemiology
• Sexually Transmitted Infections

Background:

• Partner notification services for sexually transmitted infections (STIs) are variable.
• Neisseria gonorrhoeae (gonorrhea) reporting and contact tracing methods differ by jurisdiction.
• Enhanced notification and follow-up are crucial for managing STIs.

Purpose of the Study:

• To evaluate the impact of enhanced contact tracing on case finding for Neisseria gonorrhoeae.
• To determine if increased notification activities improved gonorrhea detection rates.
• To assess changes in gonorrhea incidence following enhanced partner notification in Nova Scotia.

Main Methods:

• Implemented enhanced contact tracing for Neisseria gonorrhoeae in May 2015.
• Utilized N. gonorrhoeae multiantigen sequence typing (NG-MAST) for strain analysis.
• Compared case numbers, rates, and NG-MAST profiles pre- and post-intervention.

Main Results:

• A significant increase in monthly reported gonorrhea cases was observed post-intervention.
• The gonorrhea rate in 2016 was 2.9 times higher than in 2014, particularly among women.
• Enhanced tracing identified larger clusters of cases with identical NG-MAST profiles.

Conclusions:

• Enhanced Neisseria gonorrhoeae contact tracing successfully increased case finding and reported incidence.
• The program's effectiveness led to its adoption as standard public health practice.
• Interpreting gonorrhea trends requires understanding case-finding efforts due to asymptomatic infections.