Lisa Baldoz, who is one of four field investigators for the Washington Department of Health, said special phone apps for men to hook up with one another seem to be fueling the spread of disease. The largest jumps have been among men having sex with men, and in cases of oral and rectal gonorrhea.
One of the problems is diagnosis can be missed in cases of oral or rectal gonorrhea because a urine test can be negative. "That's why the numbers are higher," said Baldoz. Treatment is also more complicated, requiring an injection and then a follow-up of oral medication.
"Just three months ago there were a group of married men who were engaging in high-risk sexual behavior with other married men," told ABCNews.com. "They were downloading special phone apps specifically for other married men. What was even more interesting was the wives were engaging with the men."
"The difficulty," she said, "is getting men to talk openly about those male sex partners."
Miller faces the same problem trying to get infected patients to reveal their sexual history. Some readily agree to tell their former partners themselves, but others don't disclose. "It's a mixed bag," he said.
"They make up all kinds of reasons why it happened -- that it wasn't sexual," said Miller. "One guy said it was because he didn't brush his teeth and that's how he gave it to his girlfriend. She totally bought it. ... Sometimes people are in denial and will buy whatever they are told."