Gonorrhea is one of the commonest sexually transmitted diseases. With the invention of the microscope, as for other infections, the microbes causing gonorrhoea, which are called Neisseria gonococci, were also identified.

The general impression is that diseases like gonorrhea occur only in the people of lower strata of society. But this is a wrong perception. There are cases occurring among the rich affluent and educated people as well if they are not careful.

This is a disease which is acquired and transmitted through unprotected sexual activity, hence men and women both are affected A single unprotected act is enough to infect a person. It is more visibly manifest in men as a painful urethral discharge also called "bon jour drop”, as it is more in the morning. Along with this, there is pain during passing urine. In women it usually manifests as painful urination with or without discharge.

The infection can spread to other surrounding areas causing inflammation of other surrounding parts like vas deferens, penis and testes. The urethral stricture is a fairly common sequel in men due to gonorrhea. This causes retention of urine and necessitates dilatation of the urethra (outlet of urine from bladder to exterior) many times. In women it can result in inflammation of the tubes and uterine cervix. In both sexes, gonorrhea is a potential cause for sterility.

The germs that cause gonorrhea can travel from the genital parts via the blood stream infecting the joints. The affected joint becomes swollen and painful. The eyes can become infected by a finger contaminated by the discharge leading to conjunctivitis. This manifests as redness and swelling of the eyes with a mucopurulent discharge. Left untreated, it can result in blindness.

Rarely gonorrhea can infect the brain causing meningitis or encephalopathy. This manifests as loss of consciousness and other neurological disturbances.

Due to the genital discharge, one has a greater risk of acquiring HIV infection.

If gonorrhea occurs during pregnancy it can lead to perinatal distress and fetal death. There can also be premature rupture of membranes and premature delivery. The new-born baby can develop infection of the eyes (opthalmia neonatorum) which can result in permanent blindness. Apart from these children born to mothers having gonorrhea can develop neonatal sepsis.

Thus it can be seen that something which can be preventable can cause so much distress, if one is not cautious enough.

Diagnosis of gonorrhea is confirmed by a simple microscopic examination of the urethral discharge which reveals the bacteria. This examination also differentiates the illness from other germs causing urethritis like Chlamydia.

Treatment is by means of a suitable antibiotic. Gonorrhea like any other sexually transmitted disease can be prevented by simply using a condom. Long term ideal protection lies in staying faithful to one partner for life. But for reasons best known to themselves many educated people also ignore these precautions. The others who are ignorant do not know about the hazards of unprotected sex.

Some people think that after being treated once for gonorrhea, they are safe from the disease. It is not so.

Treatment taken for one episode of the illness treats that episode only. It does not offer any protection from subsequent infections. Hence a person is at risk of infection whenever exposed again. In fact the risk is present as number of times as one indulges in unprotected sex.

I have come across men who have taken treatment for this disease not once but number of times. But just by taking simple precautions such as using condoms one can avoid all suffering caused by gonorrhea.

Dr. Rachna Pande is a specialist in internal medicine at Ruhengeri Hospital