The World Health Organization (WHO) released a warning on Friday, which includes data from 77 countries that shows antibiotic resistance is making gonorrhoea nearly impossible to treat.
Gonorrhoea is a common sexually transmitted infection (STI) that infects 78 million people a year. Gonorrhoea can infect the genitals, rectum, and throat. Complications of gonorrhoea disproportionally affect women, including pelvic inflammatory disease, ectopic pregnancy and infertility, as well as an increased risk of HIV (in men and women).
“The bacteria that cause gonorrhoea are particularly smart. Every time we use a new class of antibiotics to treat the infection, the bacteria evolve to resist them,” said Dr Teodora Wi, Medical Officer, Human Reproduction, at WHO.
WHO reported widespread resistance to older and cheaper antibiotics, and found cases that were untreatable by all known antibiotics.
WHO said that these cases may just be the tip of the iceberg.
The report states, “[Decreased] condom use, increased urbanization and travel, poor infection detection rates, and inadequate or failed treatment all contribute to this increase [in resistance].”
According to WHO, the Research and Development pipeline for gonorrhoea is relatively empty, with only three new candidate drugs in various stages of clinical development: solithromycin, for which a phase III trial has recently been completed; zoliflodacin, which has completed a phase II trial; and gepotidacin, which has also completed a phase II trial.
“To address the pressing need for new treatments for gonorrhoea, we urgently need to seize the opportunities we have with existing drugs and candidates in the pipeline. In the short term, we aim to accelerate the development and introduction of at least one of these pipeline drugs, and will evaluate the possible development of combination treatments for public health use,” said Dr Manica Balasegaram, Global Antibiotic Research and Development Partnership Director. “Any new treatment developed should be accessible to everyone who needs it, while ensuring it’s used appropriately, so that drug resistance is slowed as much as possible.”
Experts said that this warning is not a “scare tactic” as many on social media have proclaimed. Experts said, “It is fact that there is a decrease in the use of condoms among those who are promiscuous.”
Some men with gonorrhea may have no symptoms at all. However, men who do have symptoms, may have:
- A burning sensation when urinating;
- A white, yellow, or green discharge from the penis;
- Painful or swollen testicles (although this is less common).
Most women with gonorrhea do not have any symptoms. Even when a woman has symptoms, they are often mild and can be mistaken for a bladder or vaginal infection. Women with gonorrhea are at risk of developing serious complications from the infection, even if they don’t have any symptoms.
Symptoms in women can include:
- Painful or burning sensation when urinating;
- Increased vaginal discharge;
- Vaginal bleeding between periods.
Rectal infections may either cause no symptoms or cause symptoms in both men and women that may include:
- Anal itching;
- Painful bowel movements.
You should be examined by your doctor if you notice any of these symptoms or if your partner has an STD or symptoms of an STD, such as an unusual sore, a smelly discharge, burning when urinating, or bleeding between periods.
Centers for Disease Control and Prevention 2015 Sexually Transmitted Diseases Surveillance Statistics (Racial and Ethnic Minorities)
CDC – Among 45 states submitting race and ethnicity data consistently according to OMB standards for all years from 2011–2015, rates of reported gonorrhea cases increased 75.1% among Whites (26.1 to 45.7 cases per 100,00 population), 71.3% among American Indians/Alaska Natives (104.5 to 179.0 cases per 100,000 population), 70.0% among Asians (14.0 to 23.8 cases per 100,000 population), 61.0% among Native Hawaiians/Other Pacific Islanders (72.6 to 116.9 cases per 100,000 population), and 53.8% among Hispanics (52.4 to 80.6 cases per 100,000 population). The gonorrhea rate decreased 4.0% among Blacks (451.3 to 433.3 cases per 100,000 population).
In 2015, 50 states submitted data on race and ethnicity according to the OMB standards. The following data pertain to those states:
Blacks — In 2015, 42.2% of reported gonorrhea cases with known race and ethnicity occurred among Blacks (excluding cases with missing information on race or ethnicity, and cases whose reported race or ethnicity was Other). The rate of gonorrhea among Blacks in 2015 was 424.9 cases per 100,000 population, which was 9.6 times the rate among Whites (44.2 cases per 100,000 population). Although the calculated rate ratio for 2015 differs when considering only the 45 jurisdictions that submitted data in race and ethnic categories according to the OMB standards for each year during 2011–2015, this disparity has decreased slightly in recent years. In 2015, this disparity was similar for Black men (9.6 times the rate among White men) and Black women (9.7 times the rate among White women). As in previous years, the disparity in gonorrhea rates for Blacks in 2015 was larger in the Midwest and Northeast than in the West or the South.
Considering all racial/ethnic and age categories, rates of gonorrhea were highest for Blacks aged 20–24, 15–19, and 25–29 years in 2015. Black women aged 20–24 years had a gonorrhea rate of 1,760.5 cases per 100,000 females, which was 9.0 times the rate among White women in the same age group (195.8 cases per 100,000 females). Black women aged 15–19 years had a gonorrhea rate of 1,547.3 cases per 100,000 females, which was 11.3 times the rate among White women in the same age group (136.4 cases per 100,000 females). Black men aged 20–24 years had a gonorrhea rate of 1,681.5 cases per 100,000 males, which was 9.5 times the rate among White men in the same age group (176.1 cases per 100,000 males). Black men aged 25–29 years had a gonorrhea rate of 1,415.0 cases per 100,000 males, which was 8.2 times the rate among White men in the same age group (173.6 cases per 100,000 males).
American Indians/Alaska Natives — In 2015, the gonorrhea rate among American Indians/Alaska Natives was 192.8 cases per 100,000 population, which was 4.4 times the rate among Whites. The disparity between gonorrhea rates for American Indians/Alaska Natives and Whites was larger for American Indian/Alaska Native women (6.1 times the rate among White women) than for American Indian/Alaska Native men (3.0 times the rate among White men). The disparity in gonorrhea rates for American Indians/Alaska Natives in 2015 was larger in the Midwest than in the West, Northeast, and South.
Native Hawaiians/Other Pacific Islanders — In 2015, the gonorrhea rate among Native Hawaiians/Other Pacific Islanders was 123.0 cases per 100,000 population, which was 2.8 times the rate among Whites. The disparity between gonorrhea rates for Native Hawaiians/Other Pacific Islanders and Whites was the same for Native Hawaiian/Other Pacific Islander women (2.8 times the rate among White women) and Native Hawaiian/Other Pacific Islander men (2.8 times the rate among White men). The disparity in gonorrhea rates for Native Hawaiians/Other Pacific Islanders in 2015 was lower in the West than in the Midwest, Northeast, and South.
Hispanics — In 2015, the gonorrhea rate among Hispanics was 80.5 cases per 100,000 population, which was 1.8 times the rate among Whites. This disparity was similar for Hispanic women (1.7 times the rate among White women) and Hispanic men (1.9 times the rate among White men). The disparity in gonorrhea rates for Hispanics in 2015 was higher in the Northeast than in the Midwest, South, and West.
Asians — In 2015, the gonorrhea rate among Asians was 22.9 cases per 100,000 population, which was 0.5 times the rate among Whites. This difference is larger for Asian women than for Asian men. In 2015, rates among Asians were lower than rates among Whites in all four regions of the United States.