Gonorrhoea infections are increasing, but doctors are running out of antibiotics that can fight the increasingly resistant bacteria causing the sexually-transmitted disease, the World Health Organisation (WHO) warned on Friday, July 7.
Gonorrhoea is caused by bacteria called Neisseria gonorrhoeae or gonococcus.
It is mainly found in discharge from the penis and in vaginal fluid and can easily pass between people through unprotected vaginal, oral or anal sex.
Two-thirds of the countries that report resistance data to the WHO have seen cases in recent years in which their antibiotics of last resort no longer worked against gonococci bacteria.
“These cases may just be the tip of the iceberg since systems to diagnose and report untreatable infections are lacking in lower-income countries where gonorrhoea is actually more common,” WHO expert, Teodora Wi, said in Geneva.
The UN health agency estimates that 78 million people are infected annually with the disease.
Britain and the U.S. reported increases of more than 10 per cent in 2015.
Cases among gay men in France doubled between 2013 and 2015.
Rates are highest in the African region, where one in 10 men is infected annually.
The main reasons for the increase are decreasing condom use, increased mobility as well as poor disease monitoring and inadequate treatment, according to the WHO.
Gonorrhoea can infect the genitals, rectum and throat. It can lead to inflammation of the pelvis and to infertility.
Currently, only three new drugs are being developed, because pharmaceutical companies know that the bacteria will soon become resistant to any new antibiotic.
To control gonorrhoea, doctors not only need new medicines, but also a rapid diagnostic tool and a vaccine, which are yet to be developed, WHO Antimicrobial expert, Marc Sprenger, said.
“Gonorrhoea is a very smart bug,” said Teodora Wi, a human reproduction specialist at the Geneva-based UN health agency.
“Every time you introduce a new type of antibiotic to treat it, this bug develops resistance to it.”
Wi, who gave details in a telephone briefing of two studies on gonorrhoea published in the journal PLOS Medicine, said one had documented three specific cases – one each in Japan, France and Spain – of patients with strains of gonorrhoea against which no known antibiotic is effective.
“These are cases that can infect others. It can be transmitted,” she told reporters. “And these cases may just be the tip of the iceberg, since systems to diagnose and report untreatable infections are lacking in lower-income countries where gonorrhoea is actually more common.”
The WHO’s programme for monitoring trends in drug-resistant gonorrhoea found in a study that from 2009 to 2014 there was widespread resistance to the first-line medicine ciprofloxacin, increasing resistance to another antibiotic drugs called azithromycin, and the emergence of resistance to last-resort treatments known as extended-spectrum cephalosporins (ESCs).
In most countries, it said, ESCs are now the only single antibiotics that remain effective for treating gonorrhoea. Yet resistance to them has already been reported in 50 countries.
Manica Balasegaram, director of the Global Antibiotic Research and Development Partnership, said the situation was “grim” and there was a pressing need for new medicines.
The pipeline, however, is very thin, with only three potential new gonorrhoea drugs in development and no guarantee any will prove effective in final-stage trials, he said.
“We urgently need to seize the opportunities we have with existing drugs and candidates in the pipeline,” he said. “Any new treatment developed should be accessible to everyone who needs it, while ensuring it is used appropriately, so that drug resistance is slowed as much as possible.”
.Additional Report from The Guardian