Gonorrhea in the emergency department: Management, case follow-up, and contact tracing of cases in women

Abstract From June, 1978, to June, 1979, all ten Columbus hospital emergency departments (EDs) participated in a program which provided test-of-cure, follow-up of untreated cases, and contact investigation of women infected with gonorrhea. Four hundred and eighty-nine women were found to be infected with gonorrhea; 99% of these were treated rapidly with recommended schedules. Sixteen percent of women with positive cultures required inpatient care for an average of 6.3 days. Seventy percent of women with positive cultures received counseling and test-of-cure for gonorrhea. Of 134 men treated as a result of these counseling efforts, 79 (59%) were asymptomatically infected. Source-spread analyses suggested that one third of asymptomatically infected male contacts had been infected for longer than 30 days. Only one fourth of women with gonococcal pelvic inflammatory disease (GC-PID) interviewed named male source contacts who were treated prior to her presentation with PID. Future approaches to GC-PID prevention must include cooperative efforts between health department clinics for sexually transmitted disease and hospital EDs.