ABSTRACT
EPIDEMIOLOGY/INCIDENCE Worldwide, it is estimated that 106.1 million new cases of gonorrhea occur annually [1]. The highest incidences of gonorrhea and its complications occur in developing countries. As a result of a national gonorrhea control program implemented in the United States in the 1970s, the national rate of gonorrheal infection has decreased >75% over the last three
decades. The number of cases reported in the United States reached a low of 301,174 cases, or 99.1/100,000; however, the rate has increased slightly each year since. In 2013, there were 333,004 cases of gonorrhea reported to the Centers for Disease Control (CDC) with approximately 44,000 of these infections occurring in pregnant women. The CDC estimated that fewer than half of all infections are reported, and the true rate is estimated to be 820,000 cases annually [2]. The incidence is substantially lower in all countries of Western Europe than in the United States, but high and rising rates have been documented in Eastern Europe. Gonorrhea disproportionately affects African-Americans with the reported rate of infection in this population being 12.4 times greater than that in whites; however, as a result of both declining rates of infection in blacks and increasing rates in whites, this disparity is declining [2,3]. The median prevalence of gonorrhea in unselected populations of pregnant women has been estimated to be 10% in Africa, 5% in Latin America, and 4% in Asia [4].
