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June 19, 1981

Asymptomatic Gonorrhea

Author Affiliations

Prison Health Services Cook County Hospital/Jail Chicago

JAMA. 1981;245(23):2395. doi:10.1001/jama.1981.03310480015015

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To the Editor.—  The report by John J. Potterat and Richard D. King, MD, and the editorial by A. Eugene Washington, MD (1981;245:578, 609) indicated that fully asymptomatic men may be a substantial hidden reservoir of gonorrhea. This report is entirely consistent with a recent screening of 737 consecutive men admitted to the Cook County jail. All were questioned about past history of gonorrhea and present history of dysuria or a urethral discharge. Urethral cultures using calcium alginate swabs on flexible aluminum shafts were taken for all of the men admitted. The percentage of men that had positive Thayer-Martin cultures for gonorrhea was 5.2%. Not a single one of these patients had complained of dysuria or a urethral discharge in spite of direct questioning. On examination and urethral milking, 32.1% of those with positive gonorrhea cultures were found to have discharges. The elicited discharge was generally whitish and watery—more consistent