Originally received from CDPH, Jan 15, 2021:
In recent months, the California Department of Public Health (CDPH) has received increasing reports of disseminated gonococcal infections (DGI), an uncommon but severe complication of untreated gonorrhea. CDPH is working with local health departments to investigate these cases of DGI, where some of the patients have reported experiencing homelessness and/or using illicit drugs, particularly methamphetamine. It is possible the increase in DGI cases reflects a decrease of STD screening, testing and treatment as a result of the impact of the COVID-19 pandemic as opposed to a more virulent strain of gonorrhea being transmitted. Medical providers should reinstate routine screening recommendations for STDs in females <25 years of age, pregnant females, men who have sex with men, and individuals with HIV. Additional, providers should increase their clinical suspicion for DGI in patients with joint pain and follow the guidance in the CDPH DGI Dear Colleague Letter for Clinicians.