Super Drug-Resistant Gonorrhea Coming to U.S., Experts Say
WEDNESDAY, April 4, 2018 (HealthDay News) -- Americans should expect that a super-resistant form of gonorrhea like that found in the United Kingdom will soon reach these shores, health experts say.
Earlier this year, doctors diagnosed a man in England with a case of gonorrhea that could not be cured with antibiotics commonly deployed against the sexually transmitted bacteria.
This was shocking to the public, but not unexpected to those in the know, health officials said.
"The development of antibiotic resistance by gonorrhea is an inexorable process," said Dr. Edward Hook, an infectious disease expert with the University of Alabama at Birmingham. "It began soon after the first antibiotics were used to treat gonorrhea, and has continued since that time. It's progressive and relatively predictable."
Unless new antibiotics are developed against gonorrhea, or a vaccine created, these kinds of extreme cases will begin showing up in the United States, said Hook.
Dr. Bruce Farber agreed. He is chief of infectious diseases at North Shore University Hospital in Manhasset, N.Y., and at Long Island Jewish Medical Center in New Hyde Park, N.Y.
"Resistant gonorrhea already is all over the United States," Farber said. "It's maybe not a strain like that you've just read about from the U.K., which is extraordinary, but nevertheless generally these cases are occurring."
Gonorrhea, also called "the clap," is one of the most common sexually transmitted diseases worldwide.
It infects an estimated 78 million people globally each year, according to the World Health Organization.
In the United States, gonorrhea is on the rise, jumping nearly 19 percent in 2016 from the year before, according to the U.S. Centers for Disease Control and Prevention.
Dr. Amesh Adalja is a senior scholar at the Johns Hopkins Center for Health Security, in Baltimore. "Rates of gonorrhea are increasing and are tied to unsafe sexual behaviors, and these resistant strains could make inroads into the gonorrhea epidemic in the U.S.," he said.
"Highly antibiotic-resistant gonorrhea is one of the most urgent infectious disease threats we face. There truly is the prospect of clinicians encountering untreatable strains of the bacteria," Adalja warned.
Hook said the infection mostly affects young people aged 15 to 24, particularly those who are very sexually active or engaged in relations with a number of partners.
Gonorrhea is rarely fatal, but can cause sterility and miscarriage in young women, he added.
The unnamed Englishman developed symptoms of gonorrhea about a month after he had sexual contact with a woman in Southeast Asia, U.K. health officials said.
The bacterial infection fended off two front-line antibiotics, azithromycin (Zithromax) and ceftriaxone (Rocephin), officials said.
Intravenous treatment with another antibiotic called ertapenem (Invanz) appeared to be working, the Washington Post reported.
This sort of resistance is unique to gonorrhea among sexually transmitted infections, Farber said. Other common infections, such as chlamydia and syphilis, still respond to garden-variety antibiotics like penicillin.
"Gonorrhea is pretty much in a class unto itself," Farber said.
According to Hook, there are two new antibiotics in the development pipeline that could be deployed against gonorrhea, since they are unrelated to those that are powerless against the strain reported in the United Kingdom.
"In the past, people were able to just increase the doses more and more and more" to overcome resistance, Hook explained. "Now they really need something that's unrelated, when we get to these levels."
New Zealand researchers are working on a vaccine for gonorrhea. They found that a meningitis vaccine called MeNZB prevented about one-third of potential gonorrhea transmissions in people who received it, according to a report last year in The Lancet.
In the meantime, you can prevent the spread of gonorrhea by using condoms, Hook and Farber said.
Don't think you're free from gonorrhea just because you aren't experiencing symptoms like burning sensations while urinating or discharges from your penis or vagina. Many people either don't have symptoms or don't realize they have it, Hook noted.
"Persons who have sex with more than one person over a set period of time owe it to themselves to get a sexual health checkup, even in the absence of symptoms," Hook said. "One of the great barriers to addressing this problem is that sometimes people are a little embarrassed about asking to be checked for sexually transmitted infections. I think we need to get over that."
The U.S. Centers for Disease Control and Prevention has more about gonorrhea.
SOURCES: Edward Hook, M.D., infectious disease specialist, University of Alabama at Birmingham; Bruce Farber, M.D., chief, infectious diseases, North Shore University Hospital, Manhasset, N.Y., and Long Island Jewish Medical Center, New Hyde Park, N.Y.; Amesh Adalja, M.D., senior scholar, Johns Hopkins Center for Health Security, Baltimore