If you pretty much only heard about gonorrhea once or twice in a health class, the prevalence of this sexually transmitted infection might come as a surprise. There are an estimated 78 million new cases of gonorrhea globally every year, according to the World Health Organization (WHO). That’s a lot of gonorrhea.
In the United States, gonorrhea is the second most commonly reported sexually transmitted infection, with over 468,000 cases reported to the Centers for Disease Control and Prevention (CDC) in 2016. (Chlamydia is the most commonly reported, though HPV is thought to be the most common overall, since most people clear the virus on their own before it’s ever diagnosed). Rates of gonorrhea may be even higher than reported, since the CDC estimates that there are actually around 820,000 new cases every year, many of which go undiagnosed and unreported.
It’s true that gonorrhea is increasingly one of the top antibiotic resistance threats in the United States. But what does that actually mean?
Antibiotic resistance occurs when a strain of bacteria mutates and develops the ability to survive the drugs intended to kill it. This stronger strain can then multiply itself and potentially be transmitted, leading to more cases that won’t respond to the usual treatments.
Luckily, this is something the CDC is very committed to monitoring. In 2013, the organization, which has been collecting and analyzing gonorrhea lab samples for signs of emerging resistance since 1986, designated gonorrhea as one of the three most urgent antibiotic resistance threats facing the United States. Then, in 2016, the agency began a new collaborative effort to help health departments around the country “detect resistant gonorrhea and act quickly to stamp out transmission through rapid field investigations,” Bob Kirkcaldy, M.D., M.P.H., an epidemiologist in the CDC’s Division of STD Prevention, tells SELF in a statement.
If you’ve ever had gonorrhea (or if you were actually paying attention in health class), you know that it’s pretty easy to cure with antibiotics. Treatment guidelines vary by country, but the CDC, WHO, and governmental agency Public Health England (PHE) all recommend a dual-therapy of antibiotics: one injection of ceftriaxone and one oral dose of azithromycin.
The idea behind this approach is to simultaneously attack the Neisseria gonorrhoeae bacteria that causes the infection in two different ways, because experts have already seen strains develop a resistance to one drug or the other, Ana Cepin, M.D., an ob/gyn at NewYork-Presbyterian Hospital and Columbia University Irving Medical Center, tells SELF. “We give both, because if you’re resistant to one, the other one will do the job,” she explains.
So, when news emerged recently that standard antibiotic treatment failed to get rid of one man’s gonorrhea, public health experts around the world took note. You might have seen the headlines, too, and wondered if this means that gonorrhea has officially mutated and is now laughing in the face of our antibiotics. Here’s what you need to know about that recent case and how worried you should actually be about antibiotic-resistant gonorrhea.
What’s unique about this case in England is that researchers tested isolates from his strain of gonorrhea in a lab and found that it was resistant to both of the first-line treatments we have available. Then, even when they found an antibiotic that this strain showed susceptibility to, his gonorrhea wasn’t cured the first time around.