Syphilis

Infectious Diseases: The Trouble With Gonorrhea

TIME

March 8, 1963 12:00 AM GMT-5

Doctors have been disappointed more than once in their high hopes of eradicating gonorrhea with wonder drugs, but last week the U.S. Public Health Service reported that before the end of 1963 the anti-gonorrhea campaign may be made vastly more effective. This time it is not a new drug that is arousing new hope, but an improved and speedier way of detecting the disease.

No Immunity. Though gonorrhea is less dramatic than syphilis in its crippling and death-dealing powers, it is not to be taken lightly. It not only produces painful symptoms, but also can cause sterility, blindness in the newborn, crippling arthritis and fatal heart disease. And to public health crusaders trying to stamp out all venereal disease, gonorrhea presents some special problems. It is twice as prevalent as syphilis in the U.S., with about 250,000 cases reported annually and an estimated 1,250,000 unreported. It is much more highly contagious than syphilis, and easier to catch from a single indiscretion. The infection, even when effectively cured, confers no immunity. Repeated infections are the rule. The same victim can catch the dis ease again a few days after being cured —and often does.

Despite these difficulties, gonorrhea can be conquered, said Dr. William J. Brown of PHS's Communicable Disease Center, if only it can be detected promptly and surely. With a man, this is no problem once he goes to a doctor. In a woman, the gonococci may spread and hide, or mingle with other germs to make diagnosis extremely difficult. In the new detection method described by Dr. Brown, the gonococci are made fluorescent and visible through a microscope under ultraviolet light only a few minutes after a smear is taken from a patient. Hospitals across the U.S. Are now testing the test, and by the end of the year it should be ready for general use.

Massive Medication. Although VD researchers are still arguing over whether some strains of the gonococcus are now resistant to penicillin, cure is almost certain if the treatment is intensive enough. To give the germs no chance. PHS experts recommend minimal doses of 1,200,000 to 2,400,000 units of penicillin for simple cases of gonorrhea and as much as 20 million units a day for such serious complications as gonorrheal arthritis and heart infection. For the few patients who cannot tolerate penicillin, several other antibiotics are almost as good.

The World Health Organization has glumly reported "complete failure to control gonorrhea in spite of the very widespread use of antibiotics," but in the U.S., and other well-doctored countries, the available drugs and the new test should turn the tide. Elsewhere, the organization fears, the only hope lies in a protective vaccine, and none is yet in sight.

Guideline Adherence Is Suboptimal For Chlamydia, Gonorrhea Treatment

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FDA Clears OTC Test For Chlamydia, Gonorrhea And Trichomoniasis

The Food and Drug Administration (FDA) has cleared the Visby Medical Women's Sexual Health Test for use at home to test for chlamydia, gonorrhea and trichomoniasis.

The single-use, polymerase chain reaction (PCR) diagnostic test is intended for females with or without symptoms. It consists of a collection kit (self-collected vaginal swab) and a powered testing device. Test results are delivered in approximately 30 minutes; the Visby Medical App guides users through the testing process and helps interpret the results. 

The approval was based on a clinical study that included 2203 females aged 14 years and older. Study participants followed the instructions of the test and collected a sample via vaginal swap that was then tested using the Visby Medical Women's Sexual Health Test. Additional swabs were also taken for comparator testing.

Results showed Visby Medical Women's Sexual Health Test had a sensitivity of at least 95% (correctly identified 95.2%, 100%, and 96.4% of positive Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis samples, respectively) and a specificity of at least 98% (correctly identified 99%, 99.3%, and 98.4% of negative Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis samples, respectively). Accuracy was found to be comparable to traditional laboratory-based PCR machines. Additionally, lay users were able to successfully perform the test based on findings from human factors usability studies.

"The clinical significance of bringing a rapid, highly accurate PCR diagnostic test into the home environment cannot be overstated," said Gary Schoolnik, MD, Chief Medical Officer of Visby Medical. "Extensive clinical studies validate that this test empowers women to quickly understand what steps to take next, giving them the privacy, control, and confidence to seek the care they need. Importantly, many patients infected with these STIs are non-symptomatic, yet they can still suffer serious long-term health consequences. Our test directly addresses this silent epidemic by enabling detection and treatment."

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