Gonorrhoea in a Sydney house of prostitution

Seventy prostitutes were screened at their place of work, a Sydney house of prostitution, on a weekly basis over one year. Of these, 10% acquired new infections with gonorrhoea each week (53 episodes). Clinical guidelines (symptoms, contact history, physical signs) were found to be unreliable, in this context, for predicting the isolation of Neisseria gonorrhoeae. Of the 39 women observed over one month or more, 17 (44%) acquired gonorrhoea within the first month. Stability of the place of work appeared to be associated with a lower isolation rate (5.5%). Five asymptomatic, urethrally infected men (two clients, three boyfriends/husbands) were detected, and appeared to have an important role in the hyperendemicity of gonorrhoea in this environment.