Gonorrhea in New York City Epidemiology Disease Control
- Slides: 18
Gonorrhea in New York City Epidemiology, Disease Control Activities, and Challenges Presented by: Julia A. Schillinger, MD, MSc CAPT USPHS Bureau of STD Control New York City Department of Health and Mental Hygiene jschilli@health. nyc. gov
Gonorrhea rates, by sex New York City, 1995 -2009* 2004: NYC STD clinic QRNG prevalence exceeds 5% April 2007: April 2004: NYC DOHMH QRNG health alert CDC alert: Discontinue FQ use September 2006: NYC joins GISP Data based on cases reported to the NYC DOHMH; * Annualized based on half-year 2009 data January 2008: NYC makes AST for GC reportable
*excludes persons for whom sex or age were not reported
Male GC reported to the NYC DOHMH, 2000 -2008, case rates, by age
Female GC reported to the NYC DOHMH, 2000 -2008, case rates, by age
GC reported to the NYC DOHMH (n=10, 483); case rates by race/ethnicity and sex, 2008 2, 186 Other = 187 Unknown race/eth = 5, 011 1, 665 13 5 560 378 347 58 44 28
Male GC reported to the NYC DOHMH, 2000 -2008, case rates, by race
Female GC reported to the NYC DOHMH, 2000 -2008, case rates, by race
Male GC reported to the NYC DOHMH, 2000 -2008, case rates, ages 15 -19, by race
Female GC reported to the NYC DOHMH, 2000 -2008, case rates, ages 15 -19, by race
Case rate (per 100, 000 population) of Neisseria gonorrhea reported to the New York City DOHMH, with percent reported from Bureau of STD clinics, 2000 -2008, by sex
New York City United Hospital Fund (UHF) Neighborhoods
Percent fluoroquinolone resistance among gonorrhea isolates detected among BSTDC clinic patients, 2001 -2008
NYC Bureau of STD Control Current GC Activities I • GC (& CT) screening in NYC high schools • Partner notification – GC cases dx’d in NYC school screening program – HIV-GC coinfected at select NYC facilities – In. SPOT • EZ Pass/VIP Program for core transmitters – HIV-GC co-infected, or 2 GC/12 mos eligible
NYC Bureau of STD Control Current GC Activities II • Sentinel surveillance for antimicrobial resistance – Culture at Fort Greene clinic – Gonococcal Isolate Surveillance Project (GISP) • Routine surveillance for antimicrobial resistance • Sentinel surveillance network – Extract behavioral and clinical information on GC cases diagnosed in BSTDC clinics – Interview sample of non-BSTDC dx’d cases (SSu. N project)
Challenges in GC control • Large number of infections – Universal interventions unsustainable – Focused interventions staff-intensive • Syphilis & HIV interview and PN consume staff resources • NAATs commonly used test – Provide no information on resistance – Not approved for anorectal specimens • Antibiotic resistance – Opted not to pursue EPT legislation for GC
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