Gonorrhoea on the rise in Denmark since 2022:distinct clones drive increase in heterosexual individuals

Neisseria gonorrhoeae is one of the most common pathogens responsible for sexually transmitted infections (STIs) globally, with over 80 million annual cases worldwide [1]. In Denmark, surveillance of gonorrhoea has shown a drastic increase in cases from 2022 onwards, similar to other countries across Europe [2]. In Denmark, this has particularly been observed in the Capital region and in the Northern region of Jutland in women and heterosexual men, i.e. men who have sex with women (MSW). Here, we use national surveillance data and genomics to aid our understanding of dissemination and potential drivers of N. gonorrhoeae infections.
A surge in gonorrhoea in Denmark has occurred since 2022, a 46% increase from 2021. National surveillance, leveraging mandatory reporting and epidemiological data, highlights three distinct clades linked to heterosexual transmission. Despite the rise, these exhibit high susceptibility, contrasting MSM-associated strains. Geographical hotspots and age-specific patterns further illuminate transmission dynamics. The combination of genomic and epidemiological data provides novel insights into the evolving landscape of gonorrhoea, indicating potential shifts in infection dynamics and transmissibility.