Changing epidemiology of gonococcal disease in Australia 1981-1988

Abstract

In Australia dramatic changes have recently occurred in the incidence and patterns of gonococcal infections. These changes were consequent upon increasing awareness of HIV infection and its transmission and were monitored by the Australian Gonococcal Surveillance Programme (AGSP). This is a continuing laboratory based scheme which has surveyed and reported on more than 30,000 gonococcal infections in an unchanged sample examined since 1981. A significant decrease in the incidence of gonorrhoea has been observed with a decline from the peak annual rate of 6600 infections in 1982-83 to 1675 cases in 1987-88 representing a 75% reduction in overall numbers. Rapid rates of decline were noted in periods in 1983, 1985 and 1987. Further, the rates of decrease were different in men and women so that the male:female ratio of the disease changed from 3.4 in 1981-82 to 2.3 in 1987-88. A disproportionate decrease in rectal isolates occurred in male patients with the most rapid decline occurring in 1985. The rate of rectal gonorrhoea was then only 10% of that recorded in 1981-82. No further decrease in this rate has been observed subsequently, an observation with obvious relevance to HIV transmission. In women, increases in the rates of pharyngeal gonorrhoea were also observed. In Australia reliable statistics on sexually transmissible diseases were for many years unavailable or unreliable. The AGSP statistics on gonorrhoea help to provide this information and also reflect changes occurring in the wider spectrum of venereal diseases.