Published: 06.10.05 Updated: 06.10.2005 11:42:53
Hans Blystad, Lars Blad, Johan Giesecke, Swedish Institute for Infectious Disease Control, Sweden, the Steering Group of the project Building a Network for Infections Disease Surveillance in the Baltic Sea Region
From 2001, gonorrhoea is no longer a notifiable disease in Germany. However, in all other countries in the region, gonorrhoea is a notifiable disease. In the Nordic countries cases are reported anonymously.
Due to an increase in private and informal health systems, the number of non-reported cases in Russia has probably increased during the last few years.
In the Nordic countries and Germany, gonorrhoea incidence continued to fall during the early 1990s. The slight increase, noted around 1997, was followed by a decrease in the number of cases particular in the last two years. The increase was mainly due to more cases among men who have sex with men. Poland has reported falling incidence of gonorrhoea and the level of reported cases was relative low in recent years. In the early 1990s the Baltic countries and all regions of Northwest Russia experienced record high incidence rates of gonorrhoea. This may be attributed to political and social changes, resulting in changing sexual behaviour patterns and delays in treatment which cause patients communicability for longer periods. In Northwest Russia, the incidence peaked around 1993-94. For the three Baltic countries, the incidence has decreased since 1999. The incidence rates are still generally very high in the eastern part compared with the western part of the region.
In the Nordic countries and Germany men who have sex with men are still a high-risk group for contracting gonorrhoea. In addition, a large number of the cases occur in heterosexuals travelling to countries in the Far East. In the Baltic countries and Northwest Russia heterosexual transmission dominates with high number of cases among the young and the unemployed persons.
Condom availability, contact tracing and risk information are essential parts of the preventive strategies in the entire region. In the Nordic countries and Germany much emphasis is put on active contact tracing and prevention among high-risk groups. In Russia active contact tracing has in recent years suffered a weaker legal support.