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Gonorrhea in New York City Epidemiology, Disease Control Activities, and Challenges

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*.

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Gonorrhea in New York City Epidemiology, Disease Control Activities, and Challenges

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  1. 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

  2. Gonorrhea rates, by sex New York City, 1995-2009* 2004: NYC STD clinic QRNG prevalence exceeds 5% April 2004: NYC DOHMH QRNG health alert April 2007: CDC alert: Discontinue FQ use January 2008: NYC makes AST for GC reportable September 2006: NYC joins GISP Data based on cases reported to the NYC DOHMH; * Annualized based on half-year 2009 data

  3. *excludes persons for whom sex or age were not reported

  4. Male GC reported to the NYC DOHMH, 2000-2008, case rates, by age

  5. Female GC reported to the NYC DOHMH, 2000-2008, case rates, by age

  6. 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 13 560 5 378 347 44 28 58

  7. Male GC reported to the NYC DOHMH, 2000-2008, case rates, by race

  8. Female GC reported to the NYC DOHMH, 2000-2008, case rates, by race

  9. Male GC reported to the NYC DOHMH, 2000-2008, case rates, ages 15-19, by race

  10. Female GC reported to the NYC DOHMH, 2000-2008, case rates, ages 15-19, by race

  11. 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

  12. New York City United Hospital Fund (UHF) Neighborhoods

  13. Percent fluoroquinolone resistance among gonorrhea isolates detected among BSTDC clinic patients, 2001-2008

  14. NYC Bureau of STD ControlCurrent 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 • InSPOT • EZ Pass/VIP Program for core transmitters • HIV-GC co-infected, or 2 GC/12 mos eligible

  15. NYC Bureau of STD ControlCurrent 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 (SSuN project)

  16. 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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