Increase in Disseminated Gonococcal Infections - Alaska, 2023-2024
MMWR. Morbidity and Mortality Weekly Report
|July 16, 2026
Summary
An increase in disseminated gonococcal infection (DGI) cases in Alaska was observed, with no resistance to ceftriaxone detected. Early diagnosis and treatment are crucial for managing this serious Neisseria gonorrhoeae complication.
Area of Science:
- Infectious Diseases
- Epidemiology
- Microbiology
Background:
- Disseminated gonococcal infection (DGI) is a severe complication of Neisseria gonorrhoeae.
- An increase in suspected DGI cases was noted in Anchorage, Alaska, in April 2024.
- Enhanced surveillance was implemented to investigate the rise in DGI.
Purpose of the Study:
- To investigate the increase in DGI cases in Alaska.
- To characterize the clinical and microbiological features of identified DGI cases.
- To assess antimicrobial susceptibility and genetic relatedness of Neisseria gonorrhoeae isolates.
Main Methods:
- Reviewed DGI cases reported to the Alaska Section of Epidemiology (SOE) from January 2023 to December 2024.
- Utilized state gonorrhea surveillance data and electronic health records.
- Performed antimicrobial susceptibility testing and whole-genome sequencing on available isolates.
Main Results:
- Thirty-five DGI cases were identified, representing an increase in proportion from 2023 to 2024.
- The majority of patients were adults, with a significant proportion having substance use disorders and lacking mucosal symptoms.
- Septic arthritis and endocarditis were observed complications; no deaths were reported.
- Whole-genome sequencing identified a cluster of related isolates with a novel MLST type (MLST-18036) and virulence markers.
- No resistance to ceftriaxone, the first-line therapy, was detected in the analyzed isolates.
Conclusions:
- Clinicians must maintain a high suspicion for DGI, especially in at-risk individuals, even without typical symptoms.
- Prompt diagnosis, treatment, reporting, and partner services are essential to reduce DGI morbidity and prevent transmission.
- The identified DGI cluster warrants continued monitoring, although current first-line treatments remain effective.
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