Gonorrhea Information for Health Care Professionals

Gonorrhea rates in the Northwestern Health Unit (NWHU) area have been increasing over the last four years; NWHU incidence rates were:

139.8 per 100,000 in 2021
176.8 per 100,000 in 2022
222.3 per 100,000 in 2023
236.2 per 100,000 in 2024.

Early appropriate testing and treatment, along with contact tracing and monitoring are crucial to reducing the spread of gonorrhea. NWHU follows and recommends the use of the Canadian Guidelines on Sexually Transmitted Infections for testing, treatment, and follow-up.

As of January 2025, the updated Canadian Guidelines now recommend monotherapy: a single dose of 500mg Ceftriaxone IM. This is a shift from the previous recommendation of 250mg Ceftriaxone IM combined with 1 gm Azithromycin PO

Actions for health care providers include

Test when indicated, and consider testing for other STBBI whenever possible
Note special testing recommendations related to pregnancy in the Guidelines
For all STBBIs, gather detailed information from the case including the best way to reach the case and those exposed- public health nurses will also follow up, but it can often be difficult to locate clients after the fact, resulting in lost follow-up opportunities, delays in testing and treatment, and higher rates of spread; get as much information as possible while the patient is present, including best ways to contact them, which could be a messaging app or a place the person goes, not relying on a phone number and address provided at registration
Report to NWHU
Facilitate treatment
Educate about treatments (e.g. ensuring clients are aware there is treatment for all STBBI including HIV and Hep C), morbidity risks if the spread of the disease is not curtailed, and prevention of spread and future reinfection
Recommend follow-up with a family health care provider or the NWHU for more prevention counselling

Reporting and Case and Contact follow-up

Gonorrhea is a Disease of Public Health Significance, which means by law it must be reported to public health.

Public health nurses then:

May contact you to collect further information that may be in notes (ideally, include all the details you know of on the report you send in)
When indicated, will follow up with the client seeking additional contacts and following up on treatment compliance, test of cure and ongoing monitoring testing. Report through the provincial repository on case and contact details including diagnosis, treatment, contact tracing and other follow-up
This reported data is incorporated into the body of evidence from all parts of Ontario, Canada, and at a global level
Data from our area is used to analyze trends in disease spread, risk factors, demographics, drug resistance
Advisory bodies such as Public Health Ontario and the National Advisory Committee on STBBI make recommendations based on data
Local public health helps disseminate and support the early adoption of current recommendations