Gonorrhea infection in girls comes from a hot spring: a case study

TORONTO – An 11-year-old Austrian girl who contracted gonorrhea after bathing in a hot spring reminds authorities investigating similar cases that these types of infections are not always an automatic indicator of sexual abuse, suggests a new case study.

The report, published in September in the Journal of Medical Case Reports, details the case of an 11-year-old girl diagnosed with gonorrhea two weeks after a family vacation in Italy in August 2020.

The family had spent some of it in hot springs next to a crater lake known as Specchio di Venere, or “Mirror of Venus,” on the island of Pantelleria off the coast of southern Greece. Italy.

Two days after the hot spring visit, the girl began to develop itching and burning, which was alleviated with an antifungal cream, but after the trip she saw a pediatrician who was able to diagnose her with gonorrhea after a few tests.

“The child categorically denied any sexual contact,” the authors wrote in the case study. “The family was traveling together on vacation when the symptoms started, and there was no evidence or identified opportunity for sexual transmission. It was therefore concluded that she must have acquired the infection from swimming pool water contaminated with gonococcus.

The child was treated for the infection and eventually made a full recovery.

The authors indicate that this case study is an example of why authorities should not automatically assume sexual abuse in such cases.

“A presumption that gonococcal infection is a diagnosis of sexual abuse can be disastrous, with children wrongly removed from the care of their parents and their caregivers facing false charges of sex crimes,” the study said. “Our case serves to illustrate that the very rare diagnosis of gonorrhea in a child may be the result of non-sexual transmission of the infection, and that contaminated hot swimming pools are a very rare source of infection that should be taken into account. account.”

The study says there have been cases in Canada, Australia, New Zealand, the United States and Denmark where experts told the court that genital gonorrhea in a child could not have occurred. produced only by any form of sexual activity, when it was later found that the infection had actually spread through non-sexual means.

Children’s hospitals have in the past linked outbreaks of gonorrhea to common baths, towels, washcloths, and diapers, to name a few. Other cases have linked transmission to contaminated toilet seats and shared beds.

As for the hot springs, the researchers note that the hot, acidic water, in addition to the mineral content found in these pools, could potentially increase the survival of the bacteria.

“This rare event is likely due to a number of unique factors, including the timing of the infant’s bath versus that of an infected visitor, but those using these pools should be alerted to the possibility of such. exposure, including the risk of possible conjunctival infection, on occasion, ”the researchers note.

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