title: Surveillance for repeat gonorrhea infection, San Diego, California, 1995-2001: establishing definitions and methods.
abstract: BACKGROUND
  Persons with repeat gonorrhea (GC) infection often participate in sexual networks that maintain and spread GC throughout the community. However, there are no established methods for collecting repeat GC surveillance data that are needed to monitor trends and risk factors for repeat infection.
  
  
  OBJECTIVE
  The goal of this study was to evaluate definitions and methods for establishing surveillance for repeat gonorrhea infection.
  
  
  METHODS
  During a 7-year period (1995-2001), all reported GC cases in San Diego County, California, were reviewed to identify persons with >2 GC infections that occurred >30 but <365 days apart. Various matching criteria and definitions of repeat infection were evaluated.
  
  
  RESULTS
  Overall, 12,287 GC infections were reported; 509 persons accounted for 551 episodes of repeat infection and 9.7% of all GC infections. The mean annual repeat GC case rate was 2.8 per 100,000 population (range, 1.5-4.1) and repeat cases were 4.5% of total GC (range, 2.7-5.5%). Temporal trends in both repeat measures mirrored the overall county reported GC case rate. Young, inner-city males were more likely to have reported repeat GC infection.
  
  
  CONCLUSIONS
  Simple, uniform repeat GC measures can be used to establish a surveillance system for monitoring trends, risk factors, and the impact of interventions directed toward preventing repeat GC infections.
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia, USA. robert.gunn@sdcounty.ca.gov
authors.forename: Robert A
authors.initials: RA
authors.lastname: Gunn
authors.forename: Azarnoush
authors.initials: A
authors.lastname: Maroufi
authors.forename: Kimberly K
authors.initials: KK
authors.lastname: Fox
authors.forename: Stuart M
authors.initials: SM
authors.lastname: Berman
mesh_terms: D000328:Adult; D002140:California / Q000453:epidemiology; D004812:Epidemiologic Methods; D015340:Epidemiologic Research Design; D005260:Female; D006069:Gonorrhea / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D008297:Male; D011159:Population Surveillance / Q000379:methods*; D012008:Recurrence