Wisconsin STD Program
Overview of Gonorrhea Epidemiology
and Program Prevention Efforts
Meeting February 2, 2010
Wisconsin Department of Health Services:
Protecting and Promoting the Health
and Safety of the People of Wisconsin.
Reported Cases of Gonorrhea by County
2008
1-100
Douglas
Wisconsin:
101-1000
>1000
26
72 Counties
Bayfield
Ashland
Washburn
2
Burnett
1
3
Polk
Vilas
Iron
Saywer
4
Price
Barron
3
Rusk
1
4
St. Croix
Dunn
9
5
Oconto
1
3
6
Menominee
Marathon
3
26
Shawano
6
10
Wood
Portage
6
5
2 Door
Waupaca
Kewaunee
2
Jackson
1
3
Trempealeau
6,062 = Total Cases
Langlade
Eau Claire
Pepin
Buffalo
8
2
3
Taylor
Chippewa
Marinette
Forest
Lincoln
Clark
Pierce
1
Florence
Oneida
Juneau
Monroe
LaCrosse
35
7
16
2
1
294
1
1
Fond du Lac
Columbia
Dodge
14
14
36
Iowa
20
Ozaukee
1
Green
3
19
21
Washington
Jefferson
453
2
LaFayette
12
Sheboygan
44
Dane
7
Calumet Manitowoc
11
Sauk
1
Grant
4
Marquette
Green Lake
Crawford
67
73
4
Vernon
Richland
Brown
Winnebago
Waushara
Adams
Outagamie
Waukesha
81
18
Rock
134
Walworth
15
Milwaukee --- 4,063
Racine – 277
Kenosha ---- 160
Reported Cases of Gonorrhea in Wisconsin
1999-2008
Cases
8000
7000
6989
6307
6000
5000
4773
6115
4000
4099
3000
2890
2000
1839
1534
1000
4276
6883
6362
5598
4687
3854
1675
1744
6794
6063
5069
5049
4896
4916
4027
4032
3299
1770
1922
1987
1878 2031
0
1999
Year
2000
2001
Wisconsin
2002
2003
2004
Milwaukee County
2005
2006
2007
WI w/o Milw County
2008
Reported Rates of Gonorrhea per 100,000 Pop
Wisconsin: 1999-2008
Rate
200
150
130.3
115.5
112.7
100
124.5
116.5
120
106.6
104
106.9
91.5
50
0
1999
2000
2001
2002
2003
Year
2004
2005
2006
2007
2008
Reported Rates of Gonorrhea per 100,000 Pop
Milwaukee County: 1999-2008
Rate
700
600
500
498
436
400
453
514
495
517
424
406
424
347
300
200
100
0
1999
2000
2001
2002
2003
Year
2004
2005
2006
2007
2008
WI Reported Rates of Gonorrhea per 100,000 Pop
by Gender: 1999-2008
Rate
180
160
140
120
100
154
143
115.5
110
130.3
135
106
112
88
80
135
116
119
104
87
97
106
92
76
123
106
89
145
144
125
120
105
96
133
106.5
84
60
40
20
0
1999
2000
Year
2001
2002
2003
Rate All
2004
Male
2005
Female
2006
2007
2008
Milwaukee County Reported Rates of Gonorrhea per
100,000 Pop by Gender: 1999-2008
Rate
700
600
500
400
549
498
430
492
436
370
523
453
371
518
495
439
406
347
411
300
383
347
305
449
424
369
593
595
514
459
517
527
427
424
370
200
100
0
1999
2000
Year
2001
2002
2003
Rate All
2004
Male
2005
Female
2006
2007
2008
Reported Age-specific Gonorrhea Rates*:
Wisconsin and Milwaukee County 2008
2500
2122
1985
2000
Rate
1500
1027
1000
509
493
500
420
260
2
5
1
1 31
133
131
251
69
27
101
17 72 4 17
0
0-4
5-9
10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50+
Age group
* Cases per 100,000 population.
Wisconsin
Milwaukee County
Reported Cases of Gonorrhea by Age & Gender
Milwaukee County & WI w/o Milwaukee County
2008
1000
999
900
800
742
700
Case Reports
600
500
438
434
473
472
400
249
300
162
200
100
2 2 0 3
75
29
13
0
0-9
10 14
320
263
226
171
317
256
238
173
0
15-19
20-24
25-29
Gonorrhea
Male Milw County
Female Milw County
Male WI w/o Milw Co.
Female WI w/o Milw Co.
30+
Reported Cases of Gonorrhea by Race & Gender
Wisconsin 2008
Reported Cases
2000
1800
1600
1400
1200
1000
800
600
400
200
0
1859
1505
1042
668
510
205
White
Race/Gender
72
Black
Male
107
Hispanic
Unknown
Female
Asians and Native Americans were less than 3% of Total
Reported Cases of Gonorrhea by Race & Gender
Wisconsin w/o Milwaukee County 2008
Reported Cases
1000
800
561
600
400
200
326
294
205
155
37
113
44
0
White
Race/Gender
Black
Male
Hispanic
Unknown
Female
Asians and Native Americans were less than 7% of Total
Reported Gonorrhea Cases by Gender & Race
Milwaukee County 2008
Reported Cases
1565
1600
1400
1179
1200
1000
837
800
600
397
400
200
50
107
35
63
0
White
Race/Gender
Black
Male
Hispanic
Unknown
Female
Asians and Native Americans were less than 1% of Total
% of Total GC Cases Reported in Females by Race
Wisconsin w/o Milwaukee County vs. Milwaukee County
2008
Percent of Total
Percent of Total
Females
Females
WI w/o Milw Co
Milw County
Unknown, 17.5%
Nat. Amer., 3.5%
White, 4.1%
White, 48.0% Unknown,
32. 4%
Hispanic, 3.8%
Nat. Amer, 0.2%
Black, 25.0%
Asian females were less than 1% of total
Black, 60.6%
Hispanic, 2.4%
Asian females were less than .1%of total
% of Total GC Cases Reported in Males by Race
Wisconsin w/o Milwaukee County vs. Milwaukee County
2008
Percent of Total
Percent of Total
Males
Males
WI w/o Milw County
Milw County
Unknown, 23.8%
White, 3.0%
White, 24.0%
Unknown, 17.5%
Hispanic, 5.8%
Hispanic, 2.1%
Black, 70.6%
Black, 51.0%
Asian and Native American Males
were less than 3% of Total
Asian and Native American Males were
less than 1% of Total
Reported Gonorrhea Rates* by Race
Wisconsin, 2008
1,500
Rate*
52 – fold difference
1,000
941
500
108
22
18
Asian/Pacific Is.
White
0
African American
Am. Indian
* Cases reported with race specified per 100,000 population.
Reported Gonorrhea Rates* by Race
Milwaukee County 2008
1,500
36 – fold difference
Rate*
1,019
1,000
500
113
28
28
Asian/Pacific Is.
White
0
African American
Am. Indian
* Cases reported with race specified per 100,000 population.
Reported Cases of Gonorrhea by WI County
2008
1-100
Douglas
Wisconsin:
101-1000
>1000
26
72 Counties
Bayfield
Ashland
Washburn
2
Burnett
1
3
Polk
Vilas
Iron
Sawyer
4
Price
Barron
3
Rusk
1
4
St. Croix
Dunn
9
5
Oconto
1
3
6
Menominee
Marathon
3
26
Shawano
6
10
Wood
Portage
6
5
2 Door
Waupaca
Kewaunee
2
Jackson
1
3
Trempealeau
6,062 = Total Cases
Langlade
Eau Claire
Pepin
Buffalo
8
2
3
Taylor
Chippewa
Marinette
Forest
Lincoln
Clark
Pierce
1
Florence
Oneida
Juneau
Monroe
LaCrosse
35
7
16
2
1
294
1
1
Fond du Lac
Columbia
Dodge
14
14
36
Iowa
20
Ozaukee
1
Green
3
19
21
Washington
Jefferson
453
2
LaFayette
12
Sheboygan
44
Dane
7
Calumet Manitowoc
11
Sauk
1
Grant
4
Marquette
Green Lake
Crawford
67
73
4
Vernon
Richland
Brown
Winnebago
Waushara
Adams
Outagamie
Waukesha
81
18
Rock
134
Walworth
15
Milwaukee --- 4,063
Racine – 277
Kenosha ---- 160
Milwaukee City Zip Code Areas
Zip Codes with Over 100
Reported Cases of GC in 2008:
Zip Code – Number of Cases

53206 – 548

53209 – 402

53210 – 400

53212 – 390

53218 – 376

53216 – 333

53208 – 312

53225 – 175

53205 – 149

53204 – 127

53224 – 116

53233 – 115
These 12 zip codes represent 57%
of all the gonorrhea reported
in Wisconsin in 2008.
Out of 4,032 cases reported from
Milwaukee County in 2008
3,443 were reported from
the 12 zip codes in the
City of Milwaukee
noted in the table –
this represents 85.4% of the
reported cases in
Milwaukee County.
(12/43 Zip Code areas in Milwaukee City)
Milwaukee Zip Code GC Data 2008

53217
53209
Capitol Dr.
53211
53206
Hwy 43
27th St
53216
53212
53210
North Ave.
53208
Top Four Zip
Code Areas for
Reported Cases
GC in 2008:
53205
53202
Zip Code – Cases
 53206 – 548
 53209 – 402
 53210 – 400
 53212 – 390
Disease Intervention Activities in Wisconsin

Public health officers in each health
department jurisdiction in WI are statutorily
responsible to investigate each case of
gonorrhea, including eliciting partners and
other at-risk individuals for testing and
treatment as necessary.
 Two counties use limited criteria to follow-up
on cases [Milwaukee and Brown (Green Bay)]

Milwaukee Criteria:

F/u GC+ <= 16 males and females OR any pregnant
female to verify Rx and notify partners
Milwaukee Field Activity for Gonorrhea Cases
2007 & 2008
Indicator
2007
2008
Percent Change
Cases Reported to the
Program
4,662: 11% cases
Interviewed
4,259:10% cases
interviewed
-9% # cases reported
-1% cases
interviewed
Cases Interviewed/FR
Initiated ( that met the
criteria for Interview)
539/607 (89%)
426/541 (78%)
-11%
Cases Interviewed
within 3 days
196/539 (36%)
163/426 (38%)
+2%
Total Partners Initiated
391
290
-26%
Partners Examined
198/391 (51%)
(101/391 already Rx)
(58/198 not infected)
156/290 (54%)
(64/290 already Rx)
(39/156 not infected)
+3%
Partners Infected
Brought to Treatment
61/198 (31%)
51/156 (33%)
+2%
Partners Preventively
Treated
66/198 (33%)
63/156 (40%)
+7%
Partners Examined
within 3 days
34/198 (17%)
39/156 (25%)
+8%
Timeliness to Treatment
Family Planning Treatment Rates
Jan-June 2009
Females
 Milwaukee County:


GC: 61%
Wisconsin w/o Milwaukee County:

GC: 87%
Gonorrhea Positivity by Provider Type
Wisconsin RVIPP Data 2008
% Positive
20
Male
Female
15
11
10
10
6.5
4.5
5
3
2.6
1.9
0.6 0.13
0.8
0.2
0.2
0
Adult Corr.
FP
Juve. Det.
STD
Gonorrhea
Teen Clinic
Univ
Health
University of WI-Madison GC
2009: Enrollment 42,000
24/3326 Tests Positive
Female (4/24) cervical NAAT 0.3%
 Male (20/24) urine NAAT 0.6%
rectal culture 2.6%
pharyngeal culture 3.1%

Demographic characteristics of positives
63% MSM (15/20)
 21% African American (5/24)
46% non-genital specimens (11/20 males)
