Epidemiology of gonorrhea: current perspectives.

Once considered a public nuisance of the developed countries, gonorrhea is now established as a leading worldwide public health problem. The rapid increase in reported disease in many developed countries noted in the 1960s and 1970s has been followed by stable or declining disease rates. This may reflect improved gonorrhea control programs or changes in sexual behavior. The assault on the developed countries by imported antibiotic-resistant strains of N. gonorrhoeae has increased, however, indicating the need for intensive control programs. New methods of identifying strains of gonococci have allowed investigation of the distribution and patterns of transmission of gonorrhea. Future studies using these methods will provide valuable knowledge of the ecology and epidemiology of gonorrhea. Within the developing countries, gonorrhea caused by resistant strains of N. gonorrhoeae has become hyperendemic. The current decreases of gonorrhea incidence in the developed countries may not be maintained unless some success is attained in the control of gonorrhea in developing countries.