Record-Breaking Gonorrhoea Rates Spark Concern

Landspítali national hospital

According to the Directorate of Health, 213 individuals have been diagnosed with gonorrhoea in the first eight months of 2023, surpassing last year’s total of 158 cases, which had broken a 30-year record. The surge in cases, particularly among men aged 25-34 and women aged 25-29, has sparked debate over declining condom use and the rise of antibiotic-resistant strains.

Underlying cause remains uncertain

In the first eight months of this year, 213 individuals have been diagnosed with the sexually transmitted disease gonorrhoea, surpassing the total number of cases recorded last year, according to the Directorate of Health. The 2022 figure broke a three-decade record; after 1990, the incidence of the disease had greatly decreased.

Data from the Directorate of Health reveals that the most significant uptick in cases occurred among men aged 25 to 34 and women aged 25 to 29. While gonorrhoea cases are generally less frequent in women, year-to-year fluctuations are more pronounced.

The underlying cause of this surge remains uncertain, sparking debate over whether declining condom usage should be investigated, particularly in neighbouring countries. Another theory posits that asymptomatic individuals may unknowingly transmit the infection, especially in the absence of condom use.

The Directorate of Health notes that similar trends have been observed across continental Europe and other Nordic countries. Growing alarm surrounds antibiotic-resistant strains of gonorrhoea, heightening concerns over their potential spread. “Increased antibiotic resistance complicates the treatment of gonorrhoea with antibiotics, thereby hindering efforts to contain and eradicate the disease,” the Directorate warns.

As noted by the Directorate of Health: “In men, the most common symptom is burning or discomfort when urinating (urethritis) with pus-like discharge from the urethra. Asymptomatic infection in men is less common than in women. Symptoms of infection in the urinary and genital organs of women are often altered or increased discharge and pain around the lower abdomen. Other symptoms include abnormal bleeding between menstrual periods, burning sensations or discomfort when urinating. Women are often asymptomatic or mildly symptomatic.”

STIs On the Rise in Iceland

Cases of syphilis and gonorrhoea continued to increase in Iceland in the first half of 2020, despite gathering bans and social distancing due to the COVID-19 pandemic. A bulletin on infectious diseases from the Directorate of Health says the two sexually transmitted infections “continue to be of particular concern,” and that men are the “driving force” behind their spread.

In the first six months of 2020, 43 individuals were diagnosed with syphilis, a significant increase compared to previous years. The vast majority, or 91%, were men, and almost half were Icelandic citizens.

Gonorrhoea is also on the rise, with 68 individuals diagnosed between January and June of this year, an increase from previous years. Most, or 69%, were men, and 81% were Icelandic citizens.

Chlamydia remains the most widespread sexually transmitted infection in Iceland. In the first six months of 2020, 834 individuals were diagnosed with the infection, a number similar to previous years. Women represented slightly more than half of cases, or 56%. Iceland’s Chief Epidemiologist noted earlier this year that while increased social distancing and hygiene had brought down the number of influenza and stomach flu cases in the country, the same was not true for STIs.

Chief Epidemioligist Wants Condoms in Primary Schools

Iceland’s Chief Epidemiologist Þórólfur Guðnason wants condoms to be distributed in primary schools in an effort to stop the spread of STIs, RÚV reports. Recent research has shown that there are more cases of syphilis in Iceland proportionally than anywhere else in Europe. Chlamydia is also relatively common in Iceland compared to other countries in the region.

According to a new report from the European Centre for Disease Prevention and Control, Iceland has a rate of syphilis diagnosis of 15.4 of every 100,000 residents. Of all European countries, Iceland’s rate is proportionally the highest. If left untreated, the sexually transmitted infection can cause disorders of the heart, brain, and nervous system.

Syphylis, gonnorhoea rates rise

The number of syphilis diagnoses in Iceland has fluctuated significantly in recent years. While it dropped in 2011 and 2013, it showed a large increase in 2017 with 52 diagnoses. In 2018, 30 were diagnosed with the STI.

“Sex has become freer and people are not using condoms. That’s really the only explanation for this,” stated Þórólfur. “Other sexually transmitted diseases have increased in Iceland as well, such as gonorrhoea. And the frequency of chlamydia is high here, probably the highest in Europe.”

According to Þórólfur, chlamydia rates are highest in Iceland among those between 18-25. Syphilis, on the other hand, is more common among homosexual men, as is the case elsewhere abroad. “It is worth noting that the increase here [in syphilis diagnoses] has primarily been explained by the migration of people to Iceland, foreigners,” Þórólfur adds, “which has raised these numbers.”

Parents oppose condoms in primary schools

Þórólfur wants to see condoms distributed in primary schools as well as secondary schools to prevent the spread of STIs. “There are many who are opposed to that, many parents,” he says. “But we need to discuss this very well and we need to do everything we can to stop the spread of these diseases, which can be very serious. People can have chlamydia and have few symptoms or be asymptomatic. But the access here to diagnosis and treatment is very good. There has been much talk about bringing screening, research, and diagnosis out into society, to at-risk groups. There are debates about doing that, and that’s one part of trying to find as many people as possible in the early stages so they don’t infect others.”