Background In January 2011, an increased number of gonococcal (GC) isolates was noted within the local bacteriology department. A “look back” exercise was initiated for all incidences of GC infections during the previous 13 months, while new episodes of GC infection were monitored to ascertain whether this increase represented an outbreak.
Aims To determine the epidemiology of GC infection observed during an outbreak of Neisseria gonorrhoeae within the local area.
Methods Cases of GC infection within our Health Board area were identified by culture or nucleic acid amplification test (NAAT) for the period December 2009 to April 2011. N gonorrhoeae multi-antigen sequence typing (NG-MAST) was performed on positive isolates or NAAT samples. Patient demographics were gathered at the local sexual and reproductive health (SRH) clinic.
Results 73 episodes of GC infection were recorded in one geographically distinct area of our Health Board between December 2010 and April 2011 (the outbreak). Nineteen cases were documented for the same period the previous year. No similar increase in GC diagnoses was observed in neighbouring areas. Chlamydia cases remained relatively stable. Patient demographics were available for 62 of the 67 cases diagnosed at the local SRH clinic. Of these, the majority of cases were male (66.1%) (of which 22% were MSM), under 25 years of age (71%), heterosexual (78.5%) and of White Scottish ethnicity (95.2%). 40 (64.5%) patients (29 male and 11 female) presented with symptoms of GC infection and 19 (29.2%) as GC contacts. The predominant NG-MAST sequence type was ST26.
Discussion The epidemiology of this outbreak is atypical, since GC infection and NG-MAST ST26 has been more commonly found in men who have sex with men in Scotland. Despite enhanced surveillance, no sexual networks or links to specific venues were identified. A gonorrhoea awareness campaign was launched in May 2011.