Abstract

Travel may be associated with a higher risk of gonorrhoea and infection by antibiotic-resistant strains. The objective of this study was to estimate the risk for gonorrhoea among travellers from four Nordic European countries using surveillance data and to identify at-risk travellers to help target interventions. We retrieved gonorrhoea surveillance data from Denmark, Finland, Norway and Sweden and tourism denominator data from the Statistical Office of the European Union. A travel-associated case of gonorrhoea was defined as one for which the reported country of infection differed from the reporting country. During 2008−2013, the four countries reported 3,224 travel-associated gonorrhoea cases, of which 53% were among individuals below 35 years of age. The overall risk associated with travel abroad was 2.4 cases per million nights abroad. The highest risk was observed with travel to Asia (9.4). Cases more likely to be reported as travel-associated were: males, heterosexuals of both sexes, people older than 65 years, and foreign-born individuals. More effective interventions targeting young adults and other at-risk groups are needed. The use of travel-planning websites and social media should be explored further.

Highlights

  • IntroductionGonorrhoea can be asymptomatic, in women and in pharyngeal and rectal infections, it is a major cause of urethritis in both men and women

  • Gonorrhoea is a common sexually transmitted infection (STI)

  • All diagnosed cases meeting the European Union (EU) case definition for gonorrhoea in the previous year are reported to The European Surveillance System (TESSy) database hosted by European Centre for Disease Prevention and Control (ECDC) [13]

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Summary

Introduction

Gonorrhoea can be asymptomatic, in women and in pharyngeal and rectal infections, it is a major cause of urethritis in both men and women. In 2013, 52,995 cases of gonorrhoea were reported in European Union (EU)/European Economic Area (EEA) countries (16.9 cases per 100,000 population) [3]. 2,701 (5.1%) were reported by Denmark, Finland, Norway and Sweden. Notification rate was close to the EU/EEA average in Denmark, Norway and Sweden (10– 15 cases per 100,000 population) but lower in Finland (4.9). In these countries, most cases were reported among 25–34 year olds (960 cases; 36%) and among young adults aged 15–24 (908 cases; 34%). The number of reported cases has increased by 61% since 2009

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