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Incurable Gonorrhea Is Lurking—and We May Not See It Coming, WHO ...

Stats, stat

Still, just because a drug-resistant strain has appeared somewhere, maybe just in one year's worth of data, doesn't mean it's widespread. And this data is not enough to discern the changing prevalence of drug-resistant infections in many of those reporting countries. The WHO did provide maps of some of the most recent prevalence figures. But the graphs represented data from a hodgepodge of years (from 2011 to 2014) because many countries don't report data consistently.

Prevalence of azithromycin resistance.

Prevalence of resistance to cephalosporins.

Prevalence of ciprofloxacin resistance.

Prevalence of resistance to cephalosporins.

Prevalence of ciprofloxacin resistance.

Without year-by-year breakdowns, there's no way to identify trends. In all, the data doesn't show if, where, or at what rate drug resistance is increasing. And this problem of incomplete data doesn't seem to be improving, either. In fact, although the organization had collected data from 77 countries total from 2009 to 2014, the number of countries reporting data each year actually fell during that time, from 56 countries reporting in 2009 to 52 in 2014.

In a teleconference with reporters, WHO officials admitted that they simply don't have the data they need to assess the scope of the problem. High-income countries with solid surveillance may act as a barometer for global gonorrhea trends, the officials noted. But many countries thought to have the highest rates of gonorrhea infections and drug resistance, including many in Africa, reported no data to the organization at all.

The data we have is likely "the tip of the iceberg," according to Dr. Teodora Wi, medical officer of human reproduction at the WHO and first author on one of the new reports.

Smacking the clap

Dr. Wi emphasized that, despite the dearth of data, we have every reason to suspect that drug-resistant gonorrhea is indeed on the rise and a critical problem. Gonorrhea is caused by Neisseria gonorrhoeae bacteria, which can infect the genitals, rectum, and throat. N. Gonorrhoeae strikes an estimated 78 million people each year worldwide, and many countries are seeing upswings in infections. Yet, many infections go undetected, and the bacteria can easily develop resistance.

Gonorrhea May Become Incurable, Experts Fear - Fox News

Workers at a Canadian clinic have discovered that almost 7 percent of their patients with gonorrhea had a strain of the bacteria against which all oral antibiotics are useless. This alarming report suggests gonorrhea may become an untreatable disease, warn public health experts.

Antibiotic-resistant strains of gonorrhea have been reported in outbreaks throughout Europe and Japan, according to US News, but the Canadian study, published in the Journal of the American Medical Association, marks the first time the strain has been seen in a large North American population.

"We've been very concerned about the threat of potentially untreatable gonorrhea," Dr. Gail Bolan of the Centers for Disease Control and Prevention (CDC) told Fox News. "We feel it's only a matter of time until resistance will occur in the United States.

Dr. Vanessa Allen of Public Health Ontario and colleagues identified 291 patients at the clinic who tested positive for gonorrhea between May 2010 and April 2011. The Canadian patients whose gonorrhea was resistant to cephalosporin — the most commonly used antibiotic for gonorrhea — were eventually cured by a powerful injectable antibiotic, ceftriaxone. But experts fear even that drug has its limits, since doctors are seeing a rise in resistance to ceftriaxone, too.

"The next threat is when, not if, the same thing happens with ceftriaxone. And then what?" lead researcher Allen told US News. "I think without a doubt this will become a bigger problem."

Gonorrhea, caused by the bacterium Neisseria gonorrhea, is one of the most common sexually transmitted diseases in the world. Symptoms include a burning sensation when urinating and a discharge from the genitals, though some people with the condition have no symptoms at all. The CDC estimates about 700,000 people in the United States have the disease.

"Its arrival is deeply troubling," write CDC experts in an accompanying JAMA editorial, referring to the antibiotic-resistant strains showing up in North America. "Clinicians now face the emergence of cephalosporin-resistant N. Gonorrhoeae without any well-studied, effective backup treatment options."

Left untreated, gonorrhea can cause infertility and chronic pelvic pain in women, according to the CDC. Among men the infection can lead to epididymitis, a painful inflammation of the ducts attached to the testicles that may result in infertility. In 3 percent to 4 percent of cases, untreated infections can spread to the skin, blood, joints or heart and may cause potentially fatal infections.

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"Incurable" Gonorrhea Hits North American Shores - CBS News

At least nine Canadian patients have contracted a strain of "incurable" gonorrhea, according to a study released on Jan. 7 in the Journal of the American Medical Association.

Researchers found that nine of the 133 patients with gonorrhea who were treated at a Toronto clinic still had the disease after being treated with the oral antibiotic cephalosporins. This marks the first time that cephalosporin-resistant gonorrhea has been found on the continent.

"We've heard of such cases in Asia and Europe. Now it's happening in North America," Dr. Robert Kirkcaldy, medical epidemiologist in the Division of STD Prevention at CDC's National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, said to NPR. "It's very concerning."

Gonorrhea is a sexually transmitted infection caused by the Neisseria gonorrhoeae bacteria. It can be spread through contact with the mouth, vagina, penis or anus and thrives in warm, moist areas of the body.

Symptoms in men include burning and pain while urinating, increased urinary frequency or urgency, penis discharge, red or swollen opening of the penis, tender or swollen testicles and/or a sore throat. Women experience vaginal discharge, burning and pain while urinating, increased urination, sore throat, painful sexual intercourse, pain in the lower abdomen and fever. Arthritis-like symptoms and rashes can occur if the infection has spread in to the blood stream.

Health care providers in the U.S. Are required by law to tell the State Board of Health about anyone they have found that has contracted the bacteria so the patients can get the proper follow-up care and alert their sexual partners. However, out of the more than 700,000 people in the United States who get new gonorrhea infections each year, less than half of these infections are reported to CDC.

The cephalosporins-resistant strain has been going around globally. In June 2012, the World Health Organization warned doctors about the potential problem, and urged medical professionals to keep a closer eye on the disease. They felt that in a couple of years gonorrhea could potentially be resistant to all treatment currently available.

However, all nine patients in the study were eventually cured. Six were treated with an injectable antibiotic called ceftriaxone and the last three had to take twice the usual dose of cephalosporins. This led some scientists to question if the latter really had the cephalosporin-resistant strain, the CBC reported.

Lead author Dr. Vanessa Allen, a medical microbiologist and infectious diseases consultant with Public Health Ontario, told NPR that the takeaway still remains that people should be cautious about antibiotic overuse.

"We need to rethink our strategy of antibiotic use," Allen said. "We don't have luxury of just switching to another antibiotic (for gonorrhea)."

Michelle Castillo

Michelle Castillo is an associate editor for CBSNews.Com.

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