Risk of Acquiring Gonorrhea and Prevalence of Abnormal Adnexal Findings Among Women Recently Exposed to Gonorrhea

Human Immune Responses and the Natural History of Neisseria gonorrhoeae Infection

“…Studies that provide insight into the natural history of N. gonorrhoeae infection suggest that prior infection with N. gonorrhoeae induces little protective immune responses to the pathogen. Platt's study of N. gonorrhoeae acquisition by women exposed to men with gonococcal urethritis demonstrated that 1–7 women exposed and uninfected had prior history of N. gonorrhoeae infection while 10 of 19 exposed and infected individuals had prior history of N. gonorrhoeae , which is consistent with prior infection not leading to protective immune response (10). An epidemiologic study of N. gonorrhoeae infections in rural North Carolina found 14.8% of N. gonorrhoeae infected individuals experienced a second infection during the study period.…”

“…Risk of infection after exposure in these women increased with number of exposures to the infection (sexual encounters with the infected contact): 6/12 women with one exposure were found to be infected while 6/7 women with two exposures and 7/7 women with more than two exposures were found to be infected. Of the 19 infected subjects, 9 subjects had clinically defined pelvic inflammatory disease or tenderness of the adnexa suggestive of inflammation in the upper reproductive tract (10). Because of the risk for ascending infection, study of the natural history of asymptomatic infection in women, once identified is not considered ethically acceptable.…”

The transmission dynamics of gonorrhoea: modelling the reported behaviour of infected patients from Newark, New Jersey

“…The relative transmissibility or the duration of untreated asymptomatic infections has not, to our knowledge, been documented. In studies of the transmission probability of gonorrhoea, no distinction was made between symptomatic and asymptomatic sources of infection (Hooper et al 1978;Platt et al 1983). If the transmission probability depends on whether infections are asymptomatic, then the observed transmission probabilities will, in part, have depended upon the fraction of the source population that was asymptomatic.…”

“…This relationship is illustrated in ¢gure 4, where the prevalence of symptomatic and asymptomatic infections in men in the model is shown as a function of the proportion of incident infection in men that are asymptomatic. With 5^7% of incident infections remaining asymptomatic, a six month mean duration of asymptomatic infection compared to a 12 day mean duration of symptomatic (Hooper et al 1978;Platt et al 1983) relationship between transmission probability per sex partnership and the number of sex acts within the partnership for transmission probabilities per sex act. The transmission probability from men to women per act has been estimated as 0.5, and that from women to men at 0.25. infection would give the empirically observed 40^60% proportion of prevalent cases as asymptomatic (Hands¢eld et al 1974;Potterat et al 1983).…”

“…In these equations k is the transmission probability per sex-partnership from sex k' to sex k (an estimate for these transmission probabilities was based on earlier studies (Hooper et al 1978;Platt et al 1983). The value & kij refers to the probability that when someone of sex k from group i forms a sex-partnership, it is with someone from group j.…”