Disease In Focus: Gonorrhea

Hold it!

Before swiping away to look for a nearby "match", you probably should read my very first Disease In Focus issue.

Because we will talk about a nasty, sexually transmitted infection that can give you a yellowy-green pus-like discharge from the penis, swollen sore and red genitals, and possible infertility.

Today's Disease In Focus is about the 2nd most common sexually transmitted disease known as "clap" or Gonorrhea. It is caused by the bacterium Neisseria gonorrhoeae also known as gonococcus.

According to World Health Organization (WHO), it infects 78 million people worldwide annually. In the US, Centers for Disease Control and Prevention (CDC) estimates 820,000 new cases each year.

_{an illustration of gonococcus, vircell}

It can be transmitted by having vaginal, anal, and oral sex with someone infected with the disease. Mothers can also pass the disease to their babies during childbirth. It can infect the genitals, throat, cervix, and rectum. In rare and worst cases, it can spread out to joints, heart, and even to the central nervous system. It can also increase your chance of acquiring HIV.

Some men and women may not have symptoms, but men with symptoms may have a burning sensation when urinating; a white, yellowish, or green discharge from penis; and painful or swollen testicles.

Women are less likely to develop symptoms and even if they have, symptoms are often mild and can be mistaken for a bladder or vaginal infection. If left untreated, women have more risk in developing serious complications like long-term abdominal pain and pelvic inflammatory disease which could cause ectopic pregnancy and infertility. Symptoms in women include painful or burning sensation when urinating, increased vaginal discharge, and vaginal bleeding between periods.

In case of rectal infections, men and women may show symptoms including discharge, anal itching, soreness, bleeding, and painful bowel movements.

Scared? You should be!

Because gonorrhea is now officially a superbug! It means that it is now resistant to most of the drugs that were usually used to treat it.

In the 1940s, gonorrhea is succesfully treated with penicillin, the world's first antibiotic substance developed by Alexander Fleming. Penicillin and tetracylcine remained effective until the bacterium developed a resistance to the drugs and in the 1980s they were no longer recommended for treatment. The penicillin resistant strain in the 1980s were successfully treated with spectinomycin. Fluoroquinolones became the leading drug to treat gonorrhea in the 1990s but the bacteria adapted to the drugs throughout the decade. In 2000s, CDC stopped recommending the drug to treat people in Asia and Pacific Islands. The recommendation extended to California in 2002 and was again extended for men who have sex with men (MSM) in the United States in 2004. By 2007, resistance is so widespread that CDC stopped recommending Fluoroquinolones to treat gonorrhea to anyone in the US.

By that time, only one class of antibiotics remains to be effective in treating the infection - Cephalosporins. The two main cephalosporins used to treat gonorrhea is the oral drug Cefixime and the injectable Ceftriaxone. To combat resistance, CDC takes additional measures in 2010 recommending dual treatment using either Cefixime, or an increased dosage of Ceftriaxone; and Azithromycin, or Doxycycline.

And in 2012, CDC declared that Cefixime is no longer effective to treat gonorrhea making the infection harder and harder to beat.

Today, only one treatment is left to battle gonorrhea:

The combination of injection of Ceftriaxone and an oral dose of azithromycin. But it may not take too long before these drugs stop working because resistance to ceftriaxone and azithromycin is being reported. While resistance to drugs is steadily rising, new drugs are not being developed.

What can you do?

If you are sexually active, having one sexual partner will cut the risk. Using protection such as latex condom during sex will also help. Visiting your doctor for screening is recommended. Obviously, the best way to avoid it and any other STIs is sexual abstinence.

If you or your partner is infected, you should get proper treatment that would not lead to further resistance.

_{Disclaimer: Disease in Focus is written to provide information and should not be used as basis for diagnosis and treatment. If you have symptoms of any disease discussed here, please seek advice from medical professionals.}

_{Sources: | Men'sHealth | Wikipedia | CDC | STDAware | CNN |}

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