Revisiting gonorrhoea transmission

Abstract

In two Personal Views in The Lancet Infectious Diseases, Christopher Fairley and colleagues 1 Fairley CK Cornelisse VJ Hocking J S Chow EPF Models of gonorrhoea transmission from the mouth and saliva. Lancet Infect Dis. 2019; (published online July 16.)http://dx.doi.org/10.1016/S1473-3099(19)30304-4 Summary Full Text Full Text PDF PubMed Scopus (30) Google Scholar and Edward Hook and Kyle Bernstein 2 Hook EW Benstien K Kissing, saliva exchange, and transmission of Neisseria gonorrhoeae. Lancet Infect Dis. 2019; (published online July 16.)http://dx.doi.org/10.1016/S1473-3099(19)30306-8 Summary Full Text Full Text PDF PubMed Scopus (9) Google Scholar discuss the pros and cons relating to the proposal that oropharyngeal infection is an important factor in the transmission of Neisseria gonorrhoeae between men who have sex with men. Models of gonorrhoea transmission from the mouth and salivaThis Personal View argues for a new framework of gonorrhoea transmission in men who have sex with men in which the oropharynx plays a major role in transmitting gonorrhoea to, or acquiring gonorrhoea from, their partner's oropharynx, penis, or anorectum through either direct contact or via saliva. To avoid preconceived notions of transmission dynamics, we ask readers to imagine that they are investigating a new sexually transmitted infection. On the basis of the existing clinical and epidemiological data for gonorrhoea at the penis, oropharynx, and anorectum site, we develop two models for transmission: the so-called penile model and the so-called oropharyngeal model. Full-Text PDF Kissing, saliva exchange, and transmission of Neisseria gonorrhoeaeData from mathematical models suggest that kissing and saliva exchange during sexual activity might be major contributors to community gonorrhoea morbidity. Although there is little evidence to support this, it provokes discussion of the potential role of the oropharynx in gonorrhoea control. Improved sensitivity and ease of diagnostic testing, as well as increased screening for extragenital infections among men who have sex with men, have increased awareness of the high frequency of oropharyngeal gonorrhoea. Full-Text PDF