The CDC said there were 81.1 cases per 100,000 people in Hawai'i in 2005. The total number of reported cases was 1,024.

That compared with the 39.8 rate six years earlier, and marked the second-biggest gain in the ratio nationwide, the agency said. Only Utah, where the number of reported cases per 100,000 almost tripled, had a bigger jump.

The CDC highlighted Hawai'i and seven other Western states in a report released today, noting the group generally has had a lower rate than the rest than other regions in recent decades. The actual rate of infection is probably higher since the CDC estimates that only one-half of cases are reported nationally.

Gonorrhea can lead to life-threatening conditions and greater risk for contracting HIV, the virus that causes AIDs. The disease symptoms can include a painful or burning sensation while urinating and discharges from sexual organs.

Hawai'i's rate, while higher than 2000 levels, is lower than the national average of 115.6. The reported noted some of the increase in Western states might be attributed to increased testing and the use of more sensitive tests.

It also noted the spread of the disease among methamphetamine users or inmates also may have contributed.