Background Gonorrhoea is the second most frequently reported STI in the European Union and European Economic Area (EU/EEA). Detection of multi- or extensively-drug resistant Neisseria gonorrhoeae isolates and cases of treatment failure to the first-line recommended therapy have been reported in the region. We present main epidemiological trends and implications for gonorrhoea prevention and control.

Methods The European Centre for Disease Prevention and Control (ECDC) collects data from EU/EEA countries on gonorrhoea diagnoses through the European Surveillance System and monitors antimicrobial resistance through the European Gonococcal Antimicrobial Surveillance Programme (Euro-GASP). Annual ECDC reports on gonorrhoea epidemiology and gonococcal antimicrobial susceptibility aim to inform public health control efforts and evidence-based clinical guidelines in the EU/EEA. Most recent surveillance and Euro-GASP data are summarised.

Results In 2017, 89,239 gonorrhoea cases were reported by 27 EU/EEA countries, a 17% increase compared to 2016. The EU/EEA notification rate was 22/100,000 population, but national rates varied between 0.2 and 74.7. Of cases with available information, 76% were males, 62% aged 20–34 years, 52% MSM, 24% heterosexual men and 24% women. HIV-positivity was 13.6% overall, 22.2% for MSM, 1.4% for heterosexual men and 0.6% for women. Between 2013–2017, gonorrhoea diagnoses increased by 67%, 31% and 13% among MSM, women and heterosexual men, respectively. The 2017 Euro-GASP data reported by 27 EU/EEA countries indicate stable levels of resistance to cefixime (1.9% vs 2.1%), azithromycin (7.5 vs 7.5%) and ciprofloxacin (46.5% vs 46.5%) and no resistance to ceftriaxone, compared to 2016.

Conclusions, recommendations Enhanced testing of populations at high-risk, appropriate treatment of cases and partner notification can facilitate prevention and control of gonorrhoea and should be optimally complemented with novel technology approaches adapted to deliver prevention interventions among MSM, a population that displays the highest burden and most accelerated increase in recent years. New therapeutic drugs and ideally a vaccine are needed.

Disclosure No significant relationships.