Content Information
A. Isolation and Quarantine Requirements
None.
B. Protection of Contacts of a Case
The Iowa Department of Public Health may initiate a voluntary partner notification/referral service with persons who have been diagnosed with N. gonorrhoeae infection. Healthcare providers can facilitate this process by describing the program to the patient and encouraging the patient to meet with the Department’s Disease Prevention Specialist assigned to his or her region.
Patient’s names and times of exposure are not used when notifying partners. Referral for testing and treatment are offered to all partners. Appropriate referrals for other services are provided.
Physicians may assist the Disease Prevention Specialist with collecting partner information for notification. In such cases, the healthcare provider should collect the following information: Partner name, address, home phone number, age and/or date of birth, race, sex, partner’s marital status, height, size/build, general physical description, dates of first and last exposure, and any other information that may help in locating and counseling the partner, such as medical conditions, place of employment, cell phone number, or other unusual circumstances/situations. Providers should also report any partner treatment.
Patient-delivered partner therapy/ Expedited Partner Therapy: When a patient has partners who may not be willing or who may be unable to submit to testing, patient-delivered partner therapy is an option. A physician, physician assistant, or advanced registered nurse practitioner who diagnoses a sexually transmitted chlamydial or gonococcal infection may prescribe, dispense, furnish, or otherwise provide prescription oral antibiotic drugs to that patient's sexual partner or partners without examination of the partner(s) (see Iowa Code 139A.41). If the infected individual patient is unwilling or unable to deliver such prescription drugs to a sexual partner or partners, a physician, physician assistant, or advanced registered nurse practitioner may dispense, furnish, or otherwise provide the prescription drugs to the department or local disease prevention investigation staff for delivery to the partner or partners. Medications or prescriptions should be provided for all partners who have been sexually exposed to the patient within the two months prior to diagnosis or within the two months prior to the onset of symptoms, whichever is greater. However, expedited partner therapy should not be used if the partner is a pregnant woman or if the patient is a man who has sex with other men (MSM).
C. Managing Special Situations
Reported Incidence Is Higher than Usual/Outbreak Suspected
Report unusual cases to the Iowa Department of Public Health at (515) 281-3031, including antimicrobial resistant cases.
D. Preventive Measures
Preventive Measures/Education
Risk reduction counseling/education and testing should be offered to all persons with risk factors for N. gonorrhoeae infections and transmission.
The surest way to avoid transmission of sexually transmitted diseases is to abstain from sexual contact, or to be in a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected.
Latex male condoms for vaginal, oral or anal sex, when used consistently and correctly, can reduce the risk of transmission of N. gonorrhoeae.
N. gonorrhoeae screening is recommended for all sexually active women 25 years of age and younger. All pregnant women should have a screening test for N. gonorrhoeae. Women older than 25 years whose sexual practices put them at risk for N. gonorrhoeae infection should be tested at least once a year. It has been shown that screening and treatment of women with N. gonorrhoeae infection of the cervix reduces the likelihood of PID.
The Centers for Disease Control and Prevention’s 2010 STD Treatment Guidelines provide specific recommendations for STD prevention services that should be available to all sexually active men who have sex with men (MSM). The first recommendation for this population is that STD screening be performed at least annually.
Any genital symptoms such as discharge or burning during urination or unusual sore or rash should be a sign to stop having sex and consult a healthcare provider immediately. In cases of rectal or anal infection, symptoms may include anal or rectal itching, discharge and pain during defecation. Symptoms for N. gonorrhoeae of the mouth or throat include soreness and redness. If N. gonorrhoeae infects the eye, men and women might experience conjunctivitis (redness, itching and discharge from the eye). If a person has been treated for N. gonorrhoeae (or any other STD), he or she should notify all recent sex partners so they can see a healthcare provider and be treated. This will reduce the risk that the sex partners will develop serious complications from N. gonorrhoeae and the person’s risk of becoming re-infected. The person and all sex partners must avoid sex until they have completed treatment for N. gonorrhoeae.
An infected patient should be tested for other sexually transmitted diseases.
See www.hivtest.org/STDTesting.aspx for a current list of sites that can provide STD testing.
Iowa Dept. of Public Health, Reviewed 7/15