Epidemiology and control of gonorrhoea in Sheffield

During the period 1977-83, the fall in the yearly incidence of gonorrhoea in the United Kingdom was greatly exceeded by the fall that occurred in Sheffield (p less than 0.001). This local fall occurred despite a large rise in the yearly number of people with sexually transmitted diseases (STDs) presenting at this clinic, and was associated with falls in the incidence of complications of the disease and ratios of men to women with gonorrhoea, and with significantly improved success in tracing contacts of infected persons (p less than 0.001). Although penicillinase producing strains of Neisseria gonorrhoeae, were rare, the number of local isolates exhibiting relative resistance to penicillin (MIC greater than or equal to 0.3 mg/l) rose significantly (p less than 0.001) and were more often isolated from well defined "at risk" groups: homosexual men (p less than 0.001), patients with repeat infections (p less than 0.01), and people infected outside Sheffield (p less than 0.05). The relevance of these observations in the assessment of control of gonorrhoea and to the development of an antibiotic treatment policy are discussed.