{"id":10245,"date":"2025-03-01T14:03:16","date_gmt":"2025-03-01T19:03:16","guid":{"rendered":"https:\/\/dhss.delaware.gov\/dph\/dhan277\/"},"modified":"2025-03-02T00:50:56","modified_gmt":"2025-03-02T05:50:56","slug":"dhan277","status":"publish","type":"page","link":"https:\/\/dhss.delaware.gov\/dph\/php\/alerts\/dhan277\/","title":{"rendered":"php\/alerts\/dhan277 ~  Division of Public Health &#8212; Health Alert  &#8211; Delaware Health and Social Services &#8211; State of Delaware"},"content":{"rendered":"<div data-swiftype-index=\"true\">\n\n\n\n  <br>\n\n\n\n  <div class=\"container\" id=\"main_header\"> \n\n    <!-- BEGIN readspeaker div -->\n\n    <div class=\"rs_skip rsbtn rs_preserve\" id=\"readspeaker_button1\">\n\n      <a accesskey=\"L\" class=\"rsbtn_play\" href=\"https:\/\/app-na.readspeaker.com\/cgi-bin\/rsent?customerid=7262&#038;lang=en_us&#038;readid=main_content&#038;url=https:\/\/dhss.delaware.gov\/dph\/php\/alerts\/dhan277.html\" title=\"Listen to this page using ReadSpeaker\">\n\n        <span class=\"rsbtn_left rsimg rspart\"><span class=\"rsbtn_text\"><span>Listen<\/span><\/span><\/span>\n\n        <span class=\"rsbtn_right rsimg rsplay rspart\"><\/span>\n\n      <\/a>\n\n    <\/div>\n\n    <!-- END readspeaker div -->\n\n\n\n    \n\n    <header class=\"pull-left\">\n\n      <h1>Delaware Health Alert Network #<!--[type=EDIT name=\"DHAN Number\"]-->277 <!--[END]--> <\/h1>\n\n      <h2> <!--[type=EDIT name=\"DHAN Date\"]-->September 6, 2012 9:50 am <!--[END]--> <\/h2>\n\n    <\/header>\n\n  <\/div><br>\n\n \n\n  <div class=\"container\">\n\n    <div class=\"row\">\n\n      <div class=\"col-md-3\" id=\"leftCol\">\n\n        <div class=\"panel-group\" id=\"accordion\">\n\n          <div class=\"panel sectionmenu_panel\">\n\n            <div class=\"panel-heading\">\n\n              <p class=\"panel-title\"><a class=\"agency_nav\" data-parent=\"#accordion\" data-toggle=\"collapse\" href=\"#collapseOne\"><strong><i class=\"fa fa-align-justify fa-fw\"><\/i> Public Health Menu<\/strong><\/a><\/p>\n\n            <\/div>\n\n\n\n            <div class=\"panel-collapse collapse in\" id=\"collapseOne\">\n\n              <div class=\"panel-body\" id=\"clf_nav\">\n\n                  <ul class=\"nav nav-stacked nav-pills-clf\" id=\"agency_sidebar\">\n    <li><a href=\"\/dph\/\"><h2>Home <i class=\"fa fa-home fa-fw\"><\/i><\/h2><\/a><\/li>\n    <li class=\"toplevel\"><a data-parent=\"#agency_sidebar\" data-toggle=\"collapse\" href=\"#HomeMenu\"><h2>About <i class=\"fa fa-caret-right fa-fw\"><\/i><\/h2><\/a>\n      <ul class=\"panel-collapse collapse\" id=\"HomeMenu\">\n        <li><a href=\"\/dph\/about.html\">About DPH<\/a><\/li>\n        <li><a href=\"\/dph\/sections.html\">Sections &#038; Programs<\/a><\/li>\n        <li><a href=\"\/dph\/ofclocations.html\">Office Locations<\/a><\/li>\n        <li><a href=\"\/dph\/contact.html\">Contact Info<\/a><\/li>\n      \n        <li><a href=\"\/calendars.html\" target=\"_blank\">Calendar<\/a><\/li>\n      <\/ul>\n    <\/li>\n    <li class=\"toplevel\"><a data-parent=\"#sidebar\" data-toggle=\"collapse\" href=\"#ServicesMenu\"><h2>Services <i class=\"fa fa-caret-right fa-fw\"><\/i><\/h2><\/a>\n      <ul class=\"panel-collapse collapse\" id=\"ServicesMenu\">\n        <li><a href=\"\/dph\/servicesaz.html\">A-Z Services<\/a><\/li>\n        <li><a href=\"\/dph\/hsp\/environmental.html\">Air &#038; Water Quality<\/a><\/li>\n        <li><a href=\"\/dph\/ss\/vitalstats.html\">Birth, Death, &#038; Marriage Records<\/a><\/li>\n        <li><a href=\"\/dph\/clinics.html\">Clinics<\/a><\/li>\n        <li><a href=\"\/dph\/healthdatastats.html\">Health Data &#038; Statistics<\/a><\/li>\n        <li><a href=\"\/dph\/php\/emsps.html\">Emergency Preparedness<\/a><\/li>\n        <li><a href=\"\/dph\/healthandwellness.html\">Health &#038; Wellness<\/a><\/li>\n        <li><a href=\"\/dph\/hsp\/healthyhomes.html\">Healthy Homes<\/a><\/li>\n        <li><a href=\"\/dph\/hsp\/healthywp.html\">Healthy Workplaces<\/a><\/li>\n        <li><a href=\"\/dph\/lab\/labs.html\">Laboratory<\/a><\/li>\n        <li><a href=\"\/dph\/hsp\/feir.html\">Restaurant Inspections<\/a><\/li>\n        <li><a href=\"\/dph\/screen.html\">Screening and Testing<\/a><\/li>\n        <li><a href=\"\/dph\/chca\/dphwichominf01.html\">WIC<\/a><\/li>\n        <li><a href=\"\/dph\/servicesadd.html\">Additional Services<\/a><\/li><li>\n      <\/li><\/ul>\n    <\/li>\n    <li class=\"toplevel\"><a data-parent=\"#sidebar\" data-toggle=\"collapse\" href=\"#InformationMenu\"><h2>Information <i class=\"fa fa-caret-right fa-fw\"><\/i><\/h2><\/a>\n        <ul class=\"panel-collapse collapse\" id=\"InformationMenu\">\n        <li><a href=\"\/dph\/factsheetsaz.html\">A-Z Fact Sheets<\/a><\/li>\n        <li><a href=\"\/dph\/pubreportsaz.html\">A-Z Publications &#038; Reports<\/a><\/li>\n        <li><a href=\"\/dph\/diseasesandconditions.html\">Diseases &#038; Conditions<\/a><\/li>\n        <li><a href=\"\/dph\/faq.html\">FAQ&#8217;s<\/a><\/li>\n        <li><a href=\"\/dph\/php\/alerts.html\">Health Alerts<\/a><\/li>\n        <li><a href=\"\/dph\/healthylifestyles.html\">Healthy Lifestyles<\/a><\/li>\n        <li><a href=\"\/dph\/hipaa.html\">HIPAA<\/a><\/li>\n        <li><a href=\"\/dph\/regs.html\">Regulations<\/a><\/li>\n        <li><a href=\"\/dph\/forms.html\">Request Forms<\/a><\/li>\n        <li><a href=\"\/dph\/links.html\">Links &#038; Resources<\/a><\/li>\n        <li><a href=\"http:\/\/delaware.gov\/help\/foia_request.shtml\">FOIA Request Form<\/a><\/li>\n      <\/ul>\n    <\/li>\n    <li><a id=\"SocialMenuHeader\"><h2>Connect <i class=\"fa fa-thumbs-o-up fa-fw\"><\/i><\/h2><\/a>\n      <ul id=\"SocialMenu\">\n        <li class=\"facebook\"><a href=\"https:\/\/www.facebook.com\/DEPublicHealth\" target=\"_blank\" title=\"Division of Public Health Facebook Page\"><i class=\"fa fa-facebook-square fa-lg\"><\/i> Facebook<\/a><\/li>\n        <li class=\"twitter\"><a href=\"https:\/\/twitter.com\/Delaware_DHSS\" target=\"_blank\" title=\"Delaware Health and Social Services Twitter Account\"><i class=\"fa fa-twitter-square fa-lg\"><\/i> Twitter<\/a><\/li>\n        <!-- <li class=\"googleplus\"><a href=\"#\"><i class=\"fa fa-google-plus-square fa-lg\"><\/i> Google +<\/a><\/li>\n        <li class=\"flickr\"><a href=\"#\"><i class=\"fa fa-flickr fa-lg\"><\/i> Flickr<\/a><\/li>\n        <li class=\"youtube\"><a href=\"#\"><i class=\"fa fa-youtube-square fa-lg\"><\/i> Youtube<\/a><\/li>\n        <li class=\"instagram\"><a href=\"#\"><i class=\"fa fa-instagram fa-lg\"><\/i> Instagram<\/a><\/li>\n        <li class=\"linkedin\"><a href=\"#\"><i class=\"fa fa-linkedin-square fa-lg\"><\/i> Linkedin<\/a><\/li>\n        <li class=\"pinterest\"><a href=\"#\"><i class=\"fa fa-pinterest-square fa-lg\"><\/i> Pinterest<\/a><\/li> -->\n      <\/ul>\n    <\/li>\n  <\/ul>\n\n              <\/div>\n\n            <\/div>\n\n          <\/div>\n\n        <\/div><br>\n\n      <\/div>\n\n\n\n      <div class=\"col-md-9\" id=\"main_content\"> \n\n  \n\n<h2 class=\"center\">Health\n\n<!--[type=EDIT name=\"DHANType\"]-->\n\n\n\n   Alert<!--[END]-->\n\n<br>\n\n<!--[type=EDIT name=\"DHAN Heading\"]-->\n\n\n\nANNOUNCEMENT OF CHANGES TO GONORRHEA TREATMENT GUIDELINES<!--[END]-->\n\n<\/h2>\n\n\n\n<!--[type=HTMLEDIT name=\"Content\"]-->\n\n\n\n<p>\n\n\n  The Delaware Division of Public Health wishes to alert the medical community of clarifications to CDC recommendations for the treatment\n\n\n  of Gonorrhea.\n\n\n<\/p>\n\n\n<p>\n\n\n  On August 10, 2012 the Centers for Disease Control and Prevention (CDC) published weekly <a class=\"anchors_link\" href=\"http:\/\/www.cdc.gov\/mmwr\/preview\/mmwrhtml\/mm6131a3.htm?s_cid=mm6131a3_e#box\">MMWR # 61<\/a>.\u00a0 &#8220;Update to\n\n\n  CDC\u2019s Sexually Transmitted Diseases Treatment Guidelines, 2010: Oral Cephalosporins No Longer a Recommended Treatment for\n\n\n  Gonococcal Infections&#8221;\n\n\n<\/p>\n\n\n<p>\n\n\n  <strong>This notice clarifies when and how a test of cure is performed.<\/strong>\n\n\n<\/p>\n\n\n<p>\n\n\n  According to the updated guidelines, when an <strong>ALTERNATIVE REGIME<\/strong> of treatment is prescribed (see below), a test-of-cure\n\n\n  should be obtained in 1 week. According to published information from the CDC, the test of cure can be performed <strong>with a culture\n\n\n  OR with a NAAT for N. gonorrhoeae.<\/strong> \u00a0If the repeat NAAT is positive, \u00a0<strong>indicating a treatment failure<\/strong>,\n\n\n  every effort should be made to perform a confirmatory culture.\n\n\n<\/p>\n\n\n<p>\n\n\n  <strong>Alternative regimens<\/strong>\n\n\n<\/p>\n\n\n<p>\n\n\n  <strong>If ceftriaxone is not available:<\/strong>\n\n\n<\/p>\n\n\n<p>\n\n\n  Cefixime 400 mg in a single oral dose\n\n\n<\/p>\n\n\n<p>\n\n\n  <em>PLUS<\/em>\n\n\n<\/p>\n\n\n<p>\n\n\n  Azithromycin 1 g orally in a single dose\n\n\n<\/p>\n\n\n<p>\n\n\n  <em>OR<\/em>\n\n\n<\/p>\n\n\n<p>\n\n\n  Doxycycline 100 mg orally twice daily for 7 days*\n\n\n<\/p>\n\n\n<p>\n\n\n  <em>PLUS<\/em>\n\n\n<\/p>\n\n\n<p>\n\n\n  Test-of-cure in 1 week (This can be done by culture <strong>OR<\/strong> NAAT {Nucleic Acid Amplification test})\n\n\n<\/p>\n\n\n<p>\n\n\n  <strong>If the patient has severe cephalosporin allergy:<\/strong>\n\n\n<\/p>\n\n\n<p>\n\n\n  Azithromycin 2 g in a single oral dose\n\n\n<\/p>\n\n\n<p>\n\n\n  <em>PLUS<\/em>\n\n\n<\/p>\n\n\n<p>\n\n\n  Test-of-cure in 1 week (This can be done by culture <strong>OR<\/strong> NAAT {Nucleic Acid Amplification test})\n\n\n<\/p>\n\n\n<p>\n\n\n  It is important to note that there has been no evidence of Cefixime resistance in the United States thus far, but from 2006 to 2010, the\n\n\n  minimum concentrations of Cefixime needed to inhibit the growth in vitro of N. gonorrhoeae strains in the United States and many other\n\n\n  countries increased, suggesting Cefixime may be becoming less effective. In addition, CDC reports that recent reports from Europe have\n\n\n  described patients with uncomplicated gonorrhea infection not cured by treatment with Cefixime 400 mg orally.\n\n\n<\/p>\n\n\n<p>\n\n\n  In preparation for the possibility of Cefixime resistance in the United States the CDC has made bold moves over the past 2 years to\n\n\n  combat gonorrhea. The first was to recommend dual therapy for the treatment of both gonorrhea and chlamydia in 2010 and now to recommend\n\n\n  that Cefixime no longer be considered first line treatment for the disease unless there is no other choice.\n\n\n<\/p>\n\n\n<p>\n\n\n  <strong>Report suspected treatment failure.<\/strong> Treatment failure should be reported to the Division of Public Health, STD Program\n\n\n  by fax at 302-857-5086.\n\n\n<\/p>\n\n\n<p>\n\n\n  * Because of the high prevalence of tetracycline resistance among Gonococcal Isolate Surveillance Project isolates, particularly those\n\n\n  with elevated minimum inhibitory concentrations to Cefixime, the use of Azithromycin as the second antimicrobial is preferred.\n\n\n<\/p>\n\n\n<p>\n\n\n  For additional information about this or any other STD or to report a case, call the DPH, Sexually Transmitted Disease Program at\n\n\n  302-744-1050 or visit our web page @ <a href=\"\/dph\/dpc\/stds.html\">http:\/\/dhss.delaware.gov\/dph\/dpc\/stds.html<\/a>.\n\n\n<\/p>\n\n\n<p>\n\n\n  **************************************\n\n\n<\/p>\n\n\n<p>\n\n\n  You are receiving this message because you are a registered member of the Delaware Health Alert Network. If you are not a member and\n\n\n  would like to subscribe, please register at <a href=\"https:\/\/healthalertde.org\">https:\/\/healthalertde.org<\/a>\n\n\n<\/p><!--[END]-->\n\n  \n\n        <div class=\"panel panel-danger\">\n\n          <div class=\"panel-heading\">    \n\n      <h2>Categories of Health Alert messages:<\/h2>\n\n       <\/div>\n\n       <div class=\"panel-body\">\n\n      <ul>\n\n        <li><strong>Health Alert:<\/strong> Conveys the highest level of importance; warrants immediate action or attention.<\/li>\n\n        <li><strong>Health Advisory:<\/strong> Provides important information for a specific incident or situation; may not require immediate action.<\/li>\n\n        <li><strong>Health Update:<\/strong> Provides updated information regarding an incident or situation; unlikely to require immediate action.<\/li>\n\n            <\/ul>\n\n         <div><strong>NOTE: This page is for informational purposes only and dated material (e.g. temporary websites) may not be available.<\/strong><\/div>\n\n          <\/div> \n\n        <\/div><br>  \n\n\n\n      <\/div>\n\n    <\/div>\n\n  <\/div><!-- \/container -->\n\n  <\/div>","protected":false},"excerpt":{"rendered":"<p>Listen Delaware Health Alert Network #277 September 6, 2012 9:50 am Public Health Menu Home About About DPH Sections &#038; Programs Office Locations Contact Info Calendar Services A-Z Services Air &#038; Water Quality Birth, Death, &#038; Marriage Records Clinics Health Data &#038; Statistics Emergency Preparedness Health &#038; Wellness Healthy Homes Healthy Workplaces Laboratory Restaurant Inspections [&hellip;]<\/p>\n","protected":false},"author":8,"featured_media":0,"parent":9294,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"class_list":["post-10245","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10245","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/comments?post=10245"}],"version-history":[{"count":1,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10245\/revisions"}],"predecessor-version":[{"id":11421,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10245\/revisions\/11421"}],"up":[{"embeddable":true,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/9294"}],"wp:attachment":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/media?parent=10245"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}