As Christmas approaches with its traditional social get-togethers, the Department of Health is urging people not to include risky sexual behaviour among their festive over-indulgences.

"This holiday season spread holiday cheer, not #gonorrhea," read an ad posted on Twitter on Tuesday morning.

The province is still experiencing a provincial outbreak of the sexually transmitted disease, said Dr. Jennifer Russell, chief medical officer of health.

She hopes the blunt message is enough to get attention and a reaction.

"The fact that people are having unprotected sex puts everyone at risk," she said.

'A big wake-up call'

Before the outbreak started, there were 54 cases of gonorrhea in the province in the previous five years. In 2018, there were 96 cases in a single year.

"That was a big wake-up call that we had a problem and we needed to act," Russell said.

The numbers are still higher than usual, she said, but they might be starting to go down. There were 20 cases in the first quarter of 2019.

The outbreak won't be declared over until there have been three consecutive quarters with declining case numbers.

This holiday season spread holiday cheer, not <a href="https://twitter.com/hashtag/gonorrhea?src=hash&ref_src=twsrc%5Etfw">#gonorrhea</a>. <a href="https://twitter.com/hashtag/DYK?src=hash&ref_src=twsrc%5Etfw">#DYK</a> that New Brunswick is still experiencing a provincial gonorrhea outbreak? Learn more on how to protect yourself. <a href="https://t.co/flu4lV36ub">https://t.co/flu4lV36ub</a> <a href="https://twitter.com/hashtag/NBHealth?src=hash&ref_src=twsrc%5Etfw">#NBHealth</a> <a href="https://t.co/5U10pc5vGw">pic.twitter.com/5U10pc5vGw</a> —@NBHealth

Russell said she thinks the promotional campaign developed by Department of Health staff and an outside consultant is working.

"We're seeing an increase in testing across the province, and that's very encouraging," she said.

Those most at risk are men having sex with men, people having sex with sex trade workers, and people with multiple sexual partners.

How is gonorrhea spread?

Gonorrhea can be spread through oral, anal and vaginal sex, said Russell, and the effects can be serious.

"It can affect your fertility if you're a woman," she said. "And it can be transmitted from mom to baby."

That's besides a number of uncomfortable symptoms.

For men, those symptoms include white or yellow discharge from the penis and burning or pain while urinating.

Women can have unusual discharge from the vagina, burning while urinating, vaginal bleeding after sex and lower abdominal pain.

Sometimes there are no symptoms at all. But that doesn't mean the disease won't get passed on to someone else.

"If you're using dating apps and having anonymous, unprotected sexual encounters, then you really need to get tested even if you don't have any symptoms," said Russell.

And if you're getting checked for gonorrhea, she said, you should probably also get checked for syphilis, HIV and chlamydia.

"There are many opportunities to do that in terms of primary health-care providers. It's pretty straightforward."