Neisseria gonorrhoeae bacteria, which cause gonorrhea, are seen in a scanning electronic micrograph. The image was captured by the Research Technologies Branch of the National Institute of Allergy and Infectious Diseases' Rocky Mountain Laboratories in Hamilton, Montana. Alaska officials have now recorded a death from disseminated gonococcal infection, a rare complication of the sexually transmitted disease. (Image provided by the National Institute of Allergy and Infectious Diseases)
An Alaska woman has died from a severe complication of gonorrhea that is rare but has increased in frequency in the state, health officials reported.
The woman, in her 50s, had disseminated gonococcal infection, or DGI, in which the bacteria that causes gonorrhea spreads to bodily organs, according to a bulletin issued Monday by the Department of Health’s epidemiology section. She arrived in the spring at the emergency department of an Anchorage hospital with septic shock and heart failure, and the DGI diagnosis followed before she died, the bulletin said.
She was one of eight Alaskans identified with DGI between January and May of this year, according to the bulletin. Patients ranged in age from 32 to 59. Five were women. All were treated in Anchorage, according to the bulletin.
The woman who died had been treated twice in the prior six months for opioid abuse, but there was no record of her being tested for gonorrhea in the year prior to her death, the bulletin said.
While gonorrhea is curable with antibiotics, some infected people may have no symptoms and therefore miss testing and treatment, said Dr. Liz Ohlsen, a staff physician with the Alaska Department of Health who authored the bulletin.
That puts those people at risk that their untreated gonorrhea will develop into much more serious DGI, she said.
As state health officials track DGI cases, there are concerns that a particular strain may be circulating in Alaska that is less likely to cause symptoms, Ohlsen said.
“We think the most likely explanation for the rise in DGI cases is that more people with gonorrhea are not getting tested and treated in a timely manner. Asymptomatic infections are thought to pose a greater risk of persistent untreated infection because people are less likely to have sought care,” she said by email.
Through a public-education effort, the department is urging Alaskans with multiple sexual partners — or anyone who has a partner with multiple partners — to be tested for gonorrhea regularly, every three to six months, she said.
Alaska has consistently had among the nation’s highest rates of gonorrhea and other sexually transmitted infections. Last year, the state recorded a spike in DGI, with 27 cases reported in 2024 after having had three in 2022 and eight in 2023. That represented 1.3% of total reported gonorrhea cases in 2024, a much higher percentage than what has been reported in earlier years.
In cases of DGI, the gonorrheal infections that are normally confined to mucus membranes of the genital, rectal or mouth areas spread internally. Potential effects include joint or tendon problems, heart infections and meningitis, a potentially fatal inflammation of the brain and spinal cord.
“Deaths from disseminated gonococcal infection are rare, but DGI can cause serious complications like heart problems that can lead to death. The more cases of DGI we have, the more likely it is that some people have serious complications or death as a result,” Ohlsen said.
Statistics about DGI and DGI-related deaths are difficult to pinpoint, however.
While diagnosed cases of gonorrhea are required to be reported in Alaska, as in other states, cases of DGI are not, Ohlsen said.
There are a few available studies that give some information about DGI occurrences.
One study from California found that from mid-2020 to mid-2021, 0.24% of reported gonorrhea cases had developed into DGI.
Another study of cases in several Western U.S. states found that of 274 confirmed and probable DGI cases reported between 2020 and 2022 to the U.S. Centers for Disease Control and Prevention, 2.2% of the patients died.
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