A client comes to the outpatient department complaining of vaginal discharge, dysuria, and genital irritation. Suspecting a sexually transmitted disease (STD), Dr. Smith orders diagnostic tests of the vaginal discharge. Which STD must be reported to the public health department?
A. Chlamydia
B. Gonorrhea
C. Genital herpes
D. Human papillomavirus infection
Correct Answer: B. Gonorrhea
Gonorrhea must be reported to the public health department. Public health control of gonorrhea depends upon suitable antimicrobial therapy, in tandem with generalized and targeted prevention interventions, use of accurate diagnostic assays, partner notification procedures, and epidemiological surveillance. When treating individuals with suspected or confirmed cephalosporin resistance, clinicians are recommended to consult an infectious disease consultant and report treatment failure to the Centers for Disease Control within 24 hours of laboratory culture confirmation of the diagnosis of antimicrobial-resistant N. gonorrhoeae.
Option A: In the United States, C. trachomatis is considered a notifiable infection. Local and state laws regarding disease reporting apply. Sexual partners should be notified, examined, and treated if an STI is found in the index patient. Expedited partner therapy may also be available in certain settings. Expedited partner therapy allows providers to prescribe antibiotics to sexual contacts without establishing a physician-patient relationship.
Option C: Herpes genitalis can be caused by the herpes simplex virus type 1 or type 2 and manifests as either a primary or recurrent infection. Most commonly, viral replication occurs in epithelial tissue and establishes dormancy in sensory neurons, reactivating periodically as localized recurrent lesions. It remains one of the most common sexually transmitted infections (STI) but continues to be underestimated, given the vague presentation of its symptoms.
Option D: HPV is known to cause lesions of the mucous membranes and skin. There are over 100 subtypes of HPV, and some are associated with an increased risk of malignancy. HPV diagnosis and treatment is best done with an interprofessional team. According to the Center for Disease Control and Prevention (CDC), the most recent studies show the prevalence of genital HPV for adults aged 18 to 59 to be approximately 45.2% in men and 39.9% in women.
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