Many doctors in Ireland are seeing an increase in the number of patients presenting with the sexually transmitted infection (STI), gonorrhoea, and there is now an urgent need to get this condition under control, a specialist in public health medicine has warned.

Gonorrhoea is caused by the bacterium, Neisseria gonorrhoea. It is most commonly spread during sexual intercourse with an infected partner, although it can also be passed from mothers to babies during birth. If left untreated, it can lead to pelvic inflammatory disease and infertility in women and prostatitis (inflammation of the prorate gland) in men.

According to Dr Fionnuala Cooney, chairperson of the Gonorrhoea Control Group, many doctors are now seeing more patients with this STI and national surveillance information confirms that there has been a ‘significant increase' in cases in recent years.

In 2012, 1,110 cases were notified - a 33% increase on 2011's figure.

"This situation is a major public health concern. Since 2010, there has been a steady increase in gonorrhoea notifications. The situation in HSE East is of particular note, as this area accounts for almost three-quarters of all notifications nationally," Dr Cooney explained.

In terms of national trends, the STI is on the increase among both men and women. Since 2009, there has been a 30% year on year increase in men. While this increase was initially not as pronounced in women, a 50% increase did occur between 2011 and 2012.

Meanwhile, between 2010 and 2012, the notification rate jumped by almost 90% among people aged 20-29, by 69% in those aged 30-39 and by 53% in those aged 40 or older.

"Information to date for the first half of 2013 indicates that gonorrhoea notifications continue to increase," Dr Cooney pointed out.

She said that these increases are of concern because drug resistance is becoming a major issue and ‘it is possible that multi-drug resistant gonorrhoea may become untreatable in the near future'.

She also emphasised that around half of cases of gonorrhoea in women and one in 10 cases in men are asymptomatic - in other words, no symptoms appear. As a result, the infection may be left untreated, leading to major health issues, such as infertility, later on.

The Gonorrhoea Control Group was convened at the end of 2012 to look at this issue. It is a multidisciplinary group, which includes infectious disease specialists, GPs, laboratory service personnel and representatives of patient advocacy groups.

This group has investigated the recent increase in cases and has identified an outbreak among two specific groups - men who have sex with men and young heterosexuals.

This surveillance focused on 223 cases of confirmed gonorrhoea. It found that the average age of heterosexuals with the infection was 23, while among men who have sex with men, it is 29.

In fact, among heterosexuals with gonorrhoea, 80% of females and 42% of males were under the age of 25. Almost two in three of the females were asymptomatic. This, Dr Cooney insisted, shows the importance of raising awareness regarding the need for an STI screen if there has been unprotected sex.

"In contrast, the majority of male cases were symptomatic and over half of these men had two or more sexual partners in the previous three months. Worryingly, one-third of all heterosexuals were co-infected with another STI," Dr Cooney said.

She noted that the Gonorrhoea Control Group is now in the ‘advanced stages' of planning a range of control measures, including an information campaign targeted at the two at-risk groups.

"The group is also alerting clinicians regarding the increase in gonorrhoea and requesting that additional resources are to be allocated for STI services at all levels,' she noted.

She said that ‘timely action is required to control the spread' of gonorrhoea.

"This situation clearly demonstrates the need for a national strategy on sexual health," she added.

Dr Cooney made her comments in Forum, the Journal of the Irish College of General Practitioners.