Gonnorrhea Infection MasterClass

Dr Chinelo Animalu, Infectious Disease and HIV Specialist, host a masterclass in a series of podcast focused on Sexually Transmitted Diseases affecting at large our younger vunerable population. Gonorrhea is a sexually transmitted infection, also called sexually transmitted disease, caused my bacteria. 

Gonorrhea bacteria can infect the urethra, rectum, female reproductive tract, mouth, throat or eyes. Gonorrhea is commonly spread during vaginal, oral or anal sexualal activity.

@Medical Class 901

Transcript

SPEAKER_03 0:00

Hi, I'm Christy. Thanks for following Medical Class 901 with Dr. Ch, infectious disease specialist. Alongside the Shelby County Health Department, we're sounding the alarm in response to an increase in HIV and other STD cases in our community. The Shelby County Health Department is encouraging people to get tested. This comes after health officials say the county is experiencing a peak in a six-year trend of increasing HIV and syphilis infections. The most impacted group is those between the ages of 14 and 35. According to data from the Tennessee Department of Health, HIV rates in Shelby County have increased 36% since 2018. Syphilis rates have increased by 100%. This is not funny. And it is devastating to know that Memphis is ranked number two in the nation for HIV infections among young people like me. We can no longer believe that this is a gay disease. I am a heterosexual young woman, and my status is positive. Please practice safe intimacy and get tested. Thank you.

SPEAKER_02 0:59

Welcome to Medical Class 901 with Dr. Chi. I am Dr. Shinelo Anemalo, infectious disease and HIV specialist and a professor of medicine. So we have been talking about HIV, the effects in our communities here in Memphis as well as over the United States and the world. But there are other infections that are also plaguing our people that we need to talk about. And so today our topic is going to focus on other STDs or STIs, that means sexually transmitted infections that are very common in our communities. And so we will talk about gonorrhea today. So gonorrhea, I'm sure every adult has said about gonorrhea, is the second most common sexually transmitted infection in the United States, and you have about 1.5 million cases every year. And what is surprising actually is that more than 50% of these cases you also see in the young populations from the ages of 14 to 24 years. And so that kind of falls in within our high school and college kids and young adults. So what is it? What is gonorrhea? How do we get this? So this is a medical class. So bring out your pens and your papers and you're gonna take notes. All right. So let's start with gonorrhea. What is gonorrhea? So gonorrhea is a bacterial infection that is transmitted sexually and is caused by a particular bacteria that's called Nyseria gonorrhea. So the commonest mode of transmission is through sexual intercourse. It could be, you know, vaginal, um, you know, seminal fluid where you kind of share, you know, and fluids, bodily fluids. And regardless of the mode, um, so it could be through vaginal sex, it could be through anal sex, or it could be through oral sex. So whichever way it is, it doesn't really matter. What happens is that if someone is infected, you can easily pass it on to the next person whom you've had um some kind of sexual relationship with, with and is unprotected. So let's talk about um the modes of transmission. Okay, so how do we get it from one person to another? Like I said, you have to have been in a kind of um, you know, close relationship with somebody. Uh it doesn't matter, somebody you're dating, you're not dating, but again, there has to be some kind of um, you know, exchange of body fluids, all right? And so the commonest question we tend to see is okay, how do I know that I have this infection? Like, how would I know that my partner or you know, the people I'm involved with, they have this infection, or how do I know that I, as Dr. Chi, do I have this infection or not? So here's the thing, okay. So this is one of those infections that we call a silent infection because it doesn't really cause issues, it doesn't cause a lot of symptoms. So almost 50% of these cases, remember we talked about about a million cases diagnosed yearly. More than 50% do not even know. So it's mostly asymptomatic. What does this mean? It means that it doesn't come with symptoms. So it's gonna be so hard for you to know, right? So, how do I know, Dr. Chi? How do I know that I have this infection? So there are a few symptoms that you might experience. So, we're gonna talk about what symptoms we see in females and what symptoms we're gonna see in males. So, let's talk about females, right? Okay, so you're having some vaginal discharge, something that is not normal for you. Remember that we know our bodies more than anybody else. So you can tell when something's not really sitting right, or you're having some abnormal bleeding or spotting when it's not your period, and you're gonna wonder, like, what's going on? Or you could have what we call um you know urinary symptoms. These are things like dysuria. Dysuria means painful urination. You're not going to pee, but then you notice that it's kind of uncomfortable, you're having a little pain, and you know, there could be some discharge, or you're going to the battery more frequently. And the common person would be like, Oh, maybe I have a UTI. If you are sexually active, then you have to get checked out by your doctor. It could be a simple UTI, it could be an STI, and gonorrhea would be one of the top two ones to worry about. So, what about the male? What kind of symptoms are we gonna expect in a male? The commonest one would be painal discharge. What this means is that you have some kind of whitish or milkish discharge when you try to pee, or you could also have some painful uh urination, and you notice that it's a little bit uncomfortable, you know, when I go to pee, or you could have some swelling and pain in the testicle, um, the testicular areas. So when this happens, then you're worried like, hmm, something's not right somewhere. What do we do about this? All right. So, what are the risk factors for gonorrhea? One, the major risk factors would be women under the ages of 25. This would be, you know, again, like we talked about, we're looking at our um teenagers in our high schoolers, we're looking at our college students. So that's the highest risk where you're gonna see that. And the second highest risk is gonna be amongst, we call it MSM, it just means males that have sex with males. So those would be the highest uh risk factors for contracting gonorrhea. So now let's talk about, let's move on and say, hey, okay, if I have this or if I have this suspicion that, you know, you okay, doctor, I have one of these symptoms. What do I do? Where do I go? They is so easy to diagnose. This is so easy to you know to take care of. So, what I would recommend you do would be to go to your doctor or the nearest health center or somewhere, um, you know, an acute cares, you know, some kind of healthcare facility. And what happens is that there are two tests that we can do. One would be just a simple urine test, and we run it through a process is called the NAT test, the nucleate acid amplification test, the NAAT. And that is the quickest test, and it tells us immediately, you know, if you have gonorrhea, if it's gonorrhea, it's gonna show up there, and then your doctor is gonna put you on antibiotics. So another thing would be, oh, okay, I can just take antibiotics. Absolutely not. Why? Because they are just specific types of antibiotics that would work for this infection. So let's say, for instance, that you have um some you know leftover antibiotics from your sore throat or something, and you know, you decide, oh, okay, I have antibiotics, I'm gonna take it. Is it gonna take care of the infection? No, because um there are different types of antibiotics. We have so many antibiotics, but they are just a specific group of antibiotics that can treat this infection. So we will go over to the treatment um in a short while. Another thing I wanted to um talk about again, this will be to addressing women. So you can say, hmm, I've been in this relationship with this guy or this woman or you know, whoever, whatever, whatever it is. And um how do I know? I feel like something is wrong somewhere, maybe I have some symptoms, but you know, I have not stepped out of this relationship or or whatever. So, you know, in real life, you know, the you can only vouch for yourself. I'm not saying there's anything, you know, wrong with your partner or whatever, but once there's something, you feel like something is not right, or you notice that in your partner, maybe there's a rash, maybe there's a wound, an ulcer, or there's some discharge, something's not right, then you guys need to get yourself checked out. Mind you, that if you have this infection and you have unprotected sexual intercourse, you will definitely pass it along to whoever it is, you know, be it one partner, two partners, or whatever. Risk factors, another major risk factor will be multiple sexual partners. So this show is not about you know telling you what to do, it's how to stay safe and how to keep your partners safe. So we're gonna take a short break. When we come back, we will continue and we're gonna take questions from the audience and then we will talk about treatment and what to do when you are diagnosed. Welcome to Fun Facts with Dr. Chi. I am Dr. Chinello, Animal Infectious Disease Specialist and Professor of Medicine. So we're gonna talk about just some basic points now about HIV. So, what does HIV mean? Human immunodeficiency virus, which is a virus that we can you know pass from one person to another through sexual intercourse, or share, you know, sharing body fluids or through blood transfusions or by sharing needles. About 39 million people are affected worldwide, and it's a major cause of mortality in the world, meaning dead because it's dead. And um, the the end part of HIV is called the AIDS, and this means somebody that has untreated HIV infection, and this would have run for many, many, many years, and sometimes some decades. You do not get HIV from kitting, from hugging, from sharing um utensils, you know, in the household with people. I am Dr. Chinello, Animal, infectious disease and HIV specialist and professor of medicine. So today we are talking about gonorrhea, the second most common STI, meaning sexually transmitted infection, that we see here in our communities, not just in Memphis, but all over the country as well as all over the world. So we're gonna start this segment by um taking questions from the audience. So, how would I know if I have gonorrhea? So that's an excellent question. It's sometimes so hard to know because, like I said, um majority of cases are asymptomatic, meaning that you actually do not have any symptoms. And um from the time, and you don't have any specific time period where you're gonna say, oh, in three days' time, you're gonna have symptoms. So it can range from the time that you were exposed to, you know, perhaps someone that had the infection and did not know they were infected. You could take anywhere from seven days up until three months. And you know, when you have those, you know, the you can you might have a little, you know, mild symptoms like talked about that you could think, oh, maybe I'm just having a UTI, because you know, you have some pain reurination, or you have some pelvic pain, and you might think, oh, my period is coming or something, and then it goes away, right? And then it lays there. So you don't even know, you know, for most times, most um periods you don't even know that you have this infection, and that goes for whoever your partner is. So it's not like for most times, oh, um, I'm trying to infect you. No, they do not know. It could be something that you contracted five years ago, and now you are in a new relationship, and you know, somehow somebody's manifesting. And so, you know, I can see how this would be a problem. Oh, did you cheat on me? Oh, you did not, oh, oh, hell no. How did this happen? And um, I just want you guys to know that again, it's not something that that you know perhaps happened immediately. It could have been something that you were exposed to years back, but just laid in a very silent. So it's so hard to know. But what I always tell people is sometimes your body will always tell you that something's wrong somewhere. For women, if you start having discharges, if you start having pain during sexual intercourse, if you start noticing that you're having spots of bleeding, it's not your period. You know, something's off in that genital area. Please go get yourself checked out. Next question.

SPEAKER_01 14:14

Dr. Chi, what if I was pregnant and you know, pregnant women are not allowed to take medication? And do I carry it throughout my nine months and will it affect my baby?

SPEAKER_02 14:27

That is um, that is a very deep question, and thank you for bringing that up because this is one of the major, major complications that we see in gonorrhea when you have this infection in pregnant women. So, gonorrhea can affect a pregnant woman, you know, just like any, you know, any normal thing. The the bacteria is not gonna ask you, are you pregnant, are you not pregnant? It will affect anybody, including pregnant women. And this is so important. Why? Because the pregnant woman who is untreated is gonna transmit disinfection to the baby. We don't want that to happen. And so what happens is that this child comes out, complications will include things like blindness, things like meningitis, meaning the infection goes to the brain and will you know either kill this child or cause you know damages to the brain cell, and then you have an abnormal baby. It can also um cause what we call sores or ulcers all over the head. So for pregnancy, the good news is that here in the United States and hopefully in major parts of the world, at least the developing the developed parts of the world, um, if you are getting your prenatal treatments or care, they will always check you for things like gonorrhea, for chlamydia, for syphilis. And if you test positive, they're gonna go ahead and treat you. Now, what happens to women who for some reason um did not get prenatal care, meaning that they never you know followed up with their OBGYN or established care with your primary care doctor or OBGYN to care for their pregnancy, and therefore they were not tested. So there is something that the government, US government has in place. I'm sure you guys, you know, anybody that's had a baby would notice that when you give birth, for every child born in the United States, they are going to put some ointment in their eyes. It's called erythromycin ointment. This, you know, a type of antibiotics. And what that does is to prevent that child from picking up beat gonorrhea, beat chlamydia, whatever sexually transmitted infection that the mother has. And so that would be a way, this way, it kind of covers everybody, whether you got um you followed up with your OBGYN, you got prenatal care, or you did not. So that's kind of a safeguard that's been put in place by the government to ensure that every baby that is born, at least majority of the babies that are born here in the United States and all over the world, uh, receive prophylactic care. And um, you know, and then they go ahead and treat the woman, um, obviously, if you know, subsequently they find out there's evidence that she had this infection. So this is something that's very important for every pregnant woman. I'm sure, you know, as mothers, we do not want to transmit any infection to our baby. So even if you're not doing it for yourself, you're gonna do it for that unborn child. Okay, so so that's something I really um thank you for that question. Um, so hopefully, every mother pay attention, get your prenatal care if you're pregnant, and you know, they're not just gonna check you for gonorrhea, they will check you for other um STDs. We talked about syphilis, um, we talked about chlamydia.

SPEAKER_00 17:56

Any questions? Any more questions? Yes, uh, thank you so much, Dr. Chief, for this show. It is so informative. Um, my question about gonorrhea is it true that if a woman has gonorrhea and is left unchecked, that it can cause infertility or cause her not to be able to have babies? Oh, absolutely.

SPEAKER_02 18:20

Excellent question, also. So let's talk about the complications of gonorrhea. So I'm gonna go ahead and address that. So, yes, absolutely. That uh when a woman has this infection, especially if you are in the childbearing age, uh, one of the commonest complications, if not the commonest complication of gonorrhea, is what we call PID, pelvic inflammatory disease. And so this is where you have, we call it an ascending infection, where it goes from you know the vagina area and goes all the way to the cervix, to the fallopian tube. And so your entire, you know, system as a woman, reproductive system has an infection. And usually when that would be like the, will I say long-term sequel of this type of infection, and usually this person is gonna end up in the hospital because it's gonna come with severe pain, it's gonna come with fevers. You will know immediately that something is terribly wrong. And what is the complication of PID infertility? How does this happen? Because this infection kind of messes up with the fallopian tube, and so the fallopian tube is the tube where they, you know, like if a woman is pregnant where the eggs travel up to and um, you know, all the way to the uterus and all that, so they get inflamed and then blocked. So that way, that woman is said to be infertile, she's not going to be able to get pregnant and carry that baby on her own because now you have damage to the fallopian tube. Another complication that you will see in this infection is ectopic pregnancy. Ectopic pregnancy is when a woman gets pregnant, but instead of the instead of the fetus to embed in the uterus, it goes and embeds in the fallopian tube and then it ruptures and you know it's is it's a terrible thing because at the end of the day, to save the woman's life, they're gonna have to cut off, cut off that um fallopian tube or have to do major surgeries. So you can see these are all the long-term effects of having untreated infection. So the question now would be what do we do from here? Now you have this information. What are you gonna do? If you are sexually active and you are not using protective measures, things like condoms or other barrier methods, then you have to um, you know, get yourself checked. The CDC would recommend if you're up to 25 years or so, go ahead once a year and have yourself checked out for, you know, get these STD panels. We have places around in our city of Memphis, as well as other cities where that offer free check-ins. So I don't know, some healthcare, um, some clinics, you can go there that's run by the state, that's run by the government, and you don't have to pay anything. And they can run a full panel of um STIs as sexually transmitted infections. This would include things like HIV, um, herpes, which we would talk about, you know, in a different show. HPV, the HPV you have to get from your OBGYN doctor. That would be a different topic on its own. Um, gonorrhea that we're talking about, um, and then things like chlamydia. Okay, we have time for one more question from the audience.

SPEAKER_00 21:44

Okay, now, Dr. Chi, we all know that you know, children may be sexually active, as you said, at young age. They don't call home to ask for permission, right? They just do it. So what Would be the best way for a parent that don't know their child is sexually active, they may have been infected. What do you propose for those parents if they even think or not that their child is sexually active?

SPEAKER_02 22:15

So that that is a very deep question. It's you know, in the way we were raised, you know, is completely different from how you know the kids these days are. They do their own thing. And what you said is absolutely true because most parents do not even know that your young teenagers are sexually active. And um they don't they don't ask for permission. So the first thing, you know, one of my famous, you know, quotes is my people perish for lack of knowledge. So one thing that's very important is to actually sit down with your teenagers and have this talk, regardless of you know, if they're sexually active or not, is it's a very uncomfortable conversation to have, but it's something that I do encourage all parents to do. I have a teenage daughter, and you know, I try to sit her down and have this conversation, and oh, she's like, Mom, kill me. Like, they don't want to hear it, okay? But we have to let them know because at the end of the day, these are things that would destroy their lives, if not kill them. So, kids, uh, what I'm gonna say to our teenagers out there, to our you know, high schoolers out there, to our college kids out there, um, even if you don't want your parents to know, you should still be able to go into one of the free clinics and still get yourself checked if you are having unprotected sexual intercourse. Again, it doesn't matter if it's you know oral sex, if it's you know, the normal, you know, vaginal sex or you know, um anal sex. It doesn't matter the the type of sex it is, as long as it's unprotected and this exchange of bodily fluids, you are at high risk of contracting this. And again, you know, you can imagine something that you contract when you were very young, and now you know you're grown, you're married, you want to have kids, and the doctors are, oh, your fallopian tubes are blocked. And you know, you can imagine how devastating that is. So even if you don't want to discuss this with your parents, you should still, you know, check out those sites that offer free testing and take yourself and you know, hopefully convince your partners and have you guys tested. Um, it's always good to do that background test at first. So, you know, let's say you're going into a brand new relationship with someone or some, you know, some people, you know, know your own status first. You know, make sure you don't have any infection. Like I said, this is uh one of those infections that doesn't really come with lots of symptoms. So you won't even know majority of the time that you have something. So check yourself out. And then your new partner, how you know, could find a way to convince them to, you know, both of you go get tested, you know, prior to you know, even studying anything deep. So both of you will know what your status is. Anybody that has any kind of infection, you take care of that. Um, if you are close to your parents, you know, you can have that conversation. But parents, they, you know, they, you know, one of the whole thing lies on us as mothers, as fathers that are raising young kids in this generation, in this age. Be the one to have that uncomfortable conversation with them and keep keep them safe. This is Medical Class 901 with Dr. Chi, and today we talked about gunnery. And on our next episode, we will address clam media. So, thank you for joining us today. Please make sure you check us out on our social media. You're gonna see the links downstairs, and we'll see you next time. Bye.