ABSTRACT
This chapter describes basic tenets of an outbreak investigation for sexually transmitted infections (STI), with a focus on gonorrhoea. Sexually transmitted infections have certain special features that need to be considered when managing an outbreak. STI outbreak is recognized by the observed number of cases over a defined period that exceeds the number expected in a given community. Effective management of an STI outbreak needs an effective multidisciplinary team. Neisseria gonorrhoeae is a nonmotile, non-spore-forming, Gram-negative coccus that characteristically grows in pairs. It is a fastidious organism with complex growth requirements; specimens must be cultured on an enriched medium with an added iron source, which is then incubated in a carbon dioxide-enriched environment with high humidity. Azithromycin is recommended as cotreatment, regardless of the results of chlamydia testing, to delay onset of widespread cephalosporin resistance. High-level azithromycin resistance is a rare phenotype previously observed only sporadically in the UK and elsewhere.
