Select Page

Home  ›  Gonorrhoea

Gonorrhoea

What is Gonorrhoea

Gonorrhoea is a sexually transmissible infection (STI) caused by the bacterium Neisseria gonorrhoeae. It can infect the urethra, cervix, rectum, throat — and less commonly, the eyes, particularly in newborns exposed at birth 1.

Incidence in Australasia

Gonorrhoea is a growing public health concern across Australasia. In Australia, over 44,000 cases were reported in 2024, with the highest notification rates observed among Aboriginal and Torres Strait Islander populations, younger age groups (15–24 years), and in remote regions 2,3. In New Zealand, surveillance data from 2024 reported 7,581 gonorrhoea cases, with a disproportionate burden among Māori and Pacific peoples, young adults, and men who have sex with men 4. While population-level data for Pacific Island nations are limited, available studies indicate that gonorrhoea continues to affect some communities, though underreporting and limited testing make accurate estimates challenging 5, 6. These trends highlight the need for targeted, culturally appropriate interventions, routine screening, and accessible treatment across the region.

Signs and Symptoms

Clinical presentation varies by infection site, and many cases remain asymptomatic — especially among women or when throat or rectal infection occurs. Symptomatic cases in men often present with urethral discharge and dysuria, while women may report vaginal discharge, pelvic pain, or intermenstrual bleeding. Rectal infection can cause anal discomfort, and throat infections may manifest as a sore throat. Neonatal infection, although rare, can result in conjunctivitis or serious systemic illness if untreated. Symptoms typically emerge within 1 to 14 days post-exposure 1.

Transmission

Transmission occurs via vaginal, anal, or oral sexual contact without barrier protection; sharing of sex toys without appropriate cleaning or protection can also facilitate spread. Vertical transmission from parent to infant during childbirth is a concern. Importantly, individuals can transmit the infection even when asymptomatic, reinforcing the importance of screening among at-risk populations 1.

Populations at Risk

Anyone sexually active may acquire gonorrhoea; however, key risk groups include people with multiple or new sexual partners, men who have sex with men, sex workers, and individuals with other STIs. In Australia, notification rates are disproportionately higher among Aboriginal and Torres Strait Islander peoples — particularly in remote regions — highlighting health inequities and the need for culturally appropriate outreach and services 2,3.

Prevention

Prevention strategies include consistent and correct use of condoms or dental dams, limiting sexual partners, avoiding sharing sex toys (or using protection on them), and routine sexual health screening for individuals at elevated risk. Antenatal screening during pregnancy is also recommended to prevent perinatal transmission, including to newborns. Education, partner notification, and accessible sexual health services remain central to control efforts 1,2.

Diagnosis

Diagnosis is established via laboratory testing, typically using nucleic acid amplification tests (NAATs) performed on urine or swab specimens from potentially infected sites (urethra, cervix, rectum, throat). Given many infections are asymptomatic — especially at extragenital sites — routine screening is particularly important for people in high-risk groups 1.

Treatment

Appropriate and timely antibiotic therapy — typically a single intramuscular injection plus oral therapy- as per national STI management guidelines — can cure gonorrhoea. Partner notification, testing, and treatment are critical to preventing reinfection and onward transmission. For some individuals at ongoing risk, follow-up testing may be indicated post-treatment 1.

Complications

If untreated, gonorrhoea can lead to serious health consequences: in women, pelvic inflammatory disease, infertility, and ectopic pregnancy; in men, epididymitis and possible infertility; disseminated infection affecting joints, heart, or meninges; and in newborns exposed during birth — conjunctivitis/blindness or systemic disease. Gonorrhoea infection may also increase susceptibility to acquiring or transmitting HIV 1,3.

References

  1. Australian Government Department of Health and Aged Care. (2023). Sexually transmissible infections (STIs) – Gonorrhoea. Australian STI Management Guidelines for Primary Care. https://sti.guidelines.org.au/sexually-transmissible-infections/gonorrhoea/
  2. Australian Government Department of Health and Aged Care. (2023). Fifth National Sexually Transmissible Infections Strategy 2024–2030 https://www.health.gov.au/resources/publications/fifth-national-sexually-transmissible-infections-strategy-2024-2030?language=en
  3. Better Health Channel. (2023). Gonorrhoea. Victorian Government. https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/gonorrhoea
  4. New Zealand Ministry of Health. (2024). STI surveillance report 2024. https://www.health.govt.nz/publications/health-and-independence-report-2024-online-version
  5. Pacific Community (SPC). (2022). Assessment of current STI response in Fiji and Vanuatu and exploration of models to strengthen access to STI and sexual health services. https://www.aidsdatahub.org/sites/default/files/resource/assessment-current-sti-response-fiji-and-vanuatu-and-exploration-models-strengthen-access-sti-and.pdf
  6. Escholarship. (2020). Epidemiology of sexually transmitted infections in the Pacific. https://escholarship.org/content/qt061025gn/qt061025gn.pdf

 

PUBLISHED 18 DECEMBER 2025