Major STD concern of super bugs from unprotected sex

[davephx]

A strain of antibiotic-resistant gonorrhea has arrived

Gonorrhea is a bacterial infection that's the second most commonly diagnosed STI in the world.

If you have a penis, you might deal with burning while peeing, white, yellow, or green discharge, and less commonly, painful or swollen testicles. Rectal gonorrhea infections don’t always cause symptoms either, but if they do, signs can include discharge, itching, soreness, bleeding, and pain during bowel movements. The only sign of throat gonorrhea, which the man had in addition to gonorrhea of the genitals, is a sore throat.

The CDC estimates that about 820,000 people in the United States contract gonorrhea each year. Although many patients go undiagnosed because they may not have obvious symptoms, the disease is becoming more difficult to treat. Cheaper, older antibiotics that have been misused and overused are now failing. Of the three most common STIs—the others being chlamydia and syphilis—gonorrhea is the most antibiotic resistant.

Recent infections believed to have started in Southeast Asia, likely after engaging in unprotected sex. But is highly contagious and could spread worldwide.

The 'super gonorrhea' strain, a bug called Neisseria gonorrhoeae, is highly difficult to treat given its resistance to the antibiotics that are often used to treat the infection.

For the British man, the only antibiotic the strain showed susceptibility to in the lab tests was spectinomycin, which doctors prescribed next. (According to the CDC, spectinomycin can be useful for people who don’t tolerate first-line treatments well, but it’s expensive and not highly effective for throat infections.)

In 2014 and 2016 other cases were reported that were resistant to the two typically cheap drugs used for treatment and since then both drugs are often given. Now neither are effective in some new cases.

National Geographic reports a case in the U.K. - in early 2018 - of a man after sex with a female began showing symptoms one month later. His U.K. girlfriend so far has tested negative. Health officials are tracing back the man's past partners to see if any of them has been infected.

Although this may be the first time a case of gonorrhea has been reported "incurable," the disease has steadily become more drug-resistant over the years. In 2016 the United Nations declared antibiotic resistance "the greatest and most urgent global risk," the CDC announced gonorrhea was going down an untreatable path.

Superbugs can also spread their genes to other bacteria as they evolve, according to the CDC. According to some studies, antibiotic-resistant bugs could lead to 10 million deaths by 2050 if doctors and policymakers cannot figure out a way to address the problem.

Of the two million people in the United States who are infected with antibiotic-resistant bacteria each year, 23,000 of them die as a result.

National Geographic reported that the disease is picking up human DNA. After the onset of infection, the bacteria invade human cells, where they copy themselves, and some research suggests the bacteria may even advance into deeper tissue.

The bacteria have acquired the ability to destroy the antibiotic in order to protect themselves. A genetic mutation might enable a bacteria to produce enzymes that inactivate antibiotics. Or [a mutation] might eliminate the target that the antibiotic is supposed to attack."

Margaret Chan, former director-general of the World Health Organization, put it well at the UN meeting in 2016: "We are running out of time."

The long-term issue is that we could run out of effective medicines for gonorrhea, Erna Kojic, M.D., chief of the Division of Infectious Diseases at Mount Sinai St. Luke’s and Mount Sinai West, tells SELF. “What we’re seeing is the emergence of an infection that we really have no good treatments for,” Dr. Kojic says. WHO issued a similar warning last year.

While experts are studying new drugs, they will likely take years to hit the market. In the meantime, Dr. Kirkcaldy notes, “Our best course of action is [to] prevent gonorrhea in general and to slow the emergence and spread of resistant infections.”

Practicing safe sex to prevent the spread of STIs means using barrier methods—yes, even during oral—to cut down on the exchange of sexual fluids and skin-to-skin contact. But that isn’t enough. You should also be getting screened for gonorrhea at least as often as the CDC recommends. The specifics depend on your age and risk factors; if you’re a sexually active woman under 25 or a woman older than that with new or multiple sex partners, or who has a partner with an STI, you should get tested for gonorrhea at least once a year. Same goes if you’re a man.

So, while public health experts and medical researchers are working on large-scale strategies, everyone who is sexually active can help prevent new gonorrhea infections—thus cutting down on potential antibiotic resistance—by taking care of their own sexual health. “Always use a [barrier method] if you can, and be screened every time you have a new partner or have engaged in a sexual activity with risk,” Dr. Cepin advises. “Those things have not changed—and that’s the most important thing to keep in mind.”

Sources: National Geographic. BusinessInsider, UK Guardian, Self, and other reports all in 2018.