Two cases of a multi-resistant strain of gonorrhea have recently been detected in Australia - one in Queensland and one in Western Australia. This 'super gonorrhea' is incredibly resilient to the standard first-line drug treatment to the disease. It's not quite a public health emergency yet, though the emergence of a highly resistant strain should
Here's what you need to know.
What Is Gonorrhea?
Gonorrhea is a sexually-transmitted infection that is caused by a gram-negative bacterium known as Neisseria gonorrhoeae. It is able to be spread through oral, vaginal and anal intercourse. Once inside the body, it dwells within a specific subset of white blood cells, known as 'neutrophils'.
Over the past five years, major cities have seen a 63 percent increase in gonorrhea cases. Worldwide, 78 million infections occur each year.
Unchecked, gonorrhea can have nasty consequences. It may result in pelvic inflammatory disease and increase infertility in women, while in men it has been shown to increase the risk of prostate cancer. In rare cases, the bacterium can spread to other parts of the body, resulting in inflammation in the meninges (meningitis) and of even of the heart.
The key preventative measure is practicing safe sex - using condoms, dental dams, limiting sexual activities to single partners and routine STI testing.
For females, lower abdominal pain, pain during sex and inflammation of the uterine cervix may occur. Females may also experience vaginal discharge. Similarly, for males, symptoms include inflammation of the urethra and a burning sensation when you pee. Penile discharge may also occur and is one of the most common symptoms of infection.
Symptoms may appear in a couple of days or a couple of weeks post-intercourse.
Notably, gonorrhea infection may be asymptomatic - meaning you don't even know that you are infected. Up to 80% of women and 10-15% of men have no genital symptoms.
Originally, penicillin was used to treat gonorrhea infections, but in the early 1970s resistant strains had emerged. Treatment now traditionally utilises two specific antibiotics, ceftriaxone and azithromycin or doxycycline, which are able to kill the bacteria in two distinct ways. Ceftriaxone is able to stop the bacteria from effectively building a cell well, effectively causing the bacteria to disintegrate. Azithromycin prevents the bacteria from synthesizing proteins it need to survive.
Over time, bacteria are able to counteract the way these antibiotics work due to mutations in their genes or via acquiring it from another bacterium. We've seen that occur with gonorrhea's resistance to penicillin and now, we're in a microscopic arms race with the bacteria - we're trying to find ways to kill them, they're trying to find ways to evade our defences.
Thus, we get super gonorrhea.
What Is Super Gonorrhea?
Super gonorrhea is a media buzz word to describe a particularly resistant of the bacteria that does not respond to treatment with the currently used antibiotics. In late March, Public Health England detailed a case of the infection that displayed these traits and was picked up in South East Asia and the patient did not respond to azithromycin. It was dubbed the "world's worst case of super-gonorrhea".
Is there cause for alarm?
The idea of a 'gonorrheal superbug' has been around for several years - ever since the bacteria started to show signs of resistance to our front-line antibiotics. This new strain is particularly aggressive in its fight against our current treatment measures.
Currently, one of the two Australian cases seems to have been picked up by a traveller in South East Asia. The second case is currently being investigated. It's important to remember to practice safe sex while travelling overseas, regardless of where you are headed. The ability for the resistant strain to propagate through the population can only be prevented with effective prevention mechanisms - rather than treatment.
In short, it's a little bit of a worry, but a good reminder that practicing safe sex is the best method we currently have to prevent the spread of STI's.