Disease surveillance in the ED: Factors leading to the underreporting of gonorrhea

Thomas D. Kirsch, Robert Shesser, Margaret Barron

Research output: Contribution to journalArticlepeer-review


Emergency departments (EDs) are potentially important surveillance sites. This study assessed reporting completeness for gonorrhea by hospital and gender and explored reasons for underreporting. A retrospective review was conducted of ED charts from three hospitals for 2 months. Potential gonorrhea cases were identified by history, physical examination, testing treatment, and diagnostic practices. Cases were divided into those tested only, those treated with or without testing, and these with positive tests. Reporting completeness was assessed for each. Of 936 cases included, 29.0% were tested without treatment and 71% received treatment. One third of treated patients were not tested, and none of these were reported. Two EDs reported cases themselves and reported 75.9% of confirmed cases. There were significant differences in testing and reporting between hospitals and genders. Underreporting of suspected and confirmed gonorrhea cases was common from these EDs. A major cause was physicians treating without testing for confirmation.

Original languageEnglish (US)
Pages (from-to)137-140
Number of pages4
JournalAmerican Journal of Emergency Medicine
Issue number2
StatePublished - 1998

ASJC Scopus subject areas

  • Emergency Medicine


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