US and UK magazine: Gonorrhea

The World Health Organization is warning medical providers around the world about the potential spread of a drug-resistant form of gonorrhea, urging them to be vigilant in spotting the disease and taking steps to stop its spread.

The health agency plans to issue a "global action plan," hoping to raise awareness of the disease and encouraging research efforts to find a cure.

"This organism has basically been developing resistance against every medication we've thrown at it," Dr. Manjula Lusti-Narasimhan, a scientist in the WHO's department of sexually transmitted diseases told The Associated Press.

She added that in a couple of years, the bacterium will no longer respond to treatment with cephalosporin antibiotics, the drugs currently used to treat gonorrhea.

Cases of antibiotic-resistant gonorrhea have so far been identified in Japan, United Kingdom, Australia, France, Sweden and Norway, the AP reported, but it's likely that there are undetected cases in other countries.

The Centers for Disease Control and Prevention warned about the rising rate of drug-resistant gonorrhea in an editorial published in the New England Journal of Medicine back in February. So far, there have been no reports of any cases of gonorrhea resistant to cephalosporins in the U.S., the agency says on its website, but it does have a surveillance system in place.

"There is much to do, and the threat of untreatable gonorrhea is emerging rapidly," the authors wrote.

In 2006, the prevalence of resistance to cephalosporins was about 0.1 percent, but by the middle of 2011, that number rose to 1.7 percent, the authors said. CDC's first warnings about drug resistance came in 2010.

The most alarming part of the story, they said, is that cephalosporins are the only remaining drugs of choice that work. They have to be taken along with two other antibiotics.

"A major component of the threat is that there really is no backup plan if - most likely when - these more resistant organisms become more prevalent," Dr. Kenneth Fife, an infectious disease expert and professor of medicine at Indiana University Medical School, told ABC News in response to the CDC's commentary. "There are very few new drugs that have activity against the gonococcus, no clinical trials to establish the efficacy of the few drugs that might have promise."

In many cases, there are no symptoms of gonorrhea, so an infected person can spread the disease without even knowing he or she has it.

Fife added that it's unlikely that experts will be able to prevent an outbreak from happening, so it's urgent to research and develop new treatments.

If the situation progresses to the point where we are in a "post-antibiotic era," Dr. William Schaffner, chair of preventive medicine at Vanderbilt University Medical Center, said experts will be "hard-pressed to provide quick and effective therapy to patients."

Drug-Resistant Gonorrhea Spreading

2:37 PM

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The health agency plans to issue a “global action plan,” hoping to raise awareness of the disease and encouraging research efforts to find a cure.

“This organism has basically been developing resistance against every medication we’ve thrown at it,” Dr. Manjula Lusti-Narasimhan, a scientist in the WHO’s department of sexually transmitted diseases told The Associated Press.

She added that in a couple of years, the bacterium will no longer respond to treatment with cephalosporin antibiotics, the drugs currently used to treat gonorrhea.

Cases of antibiotic-resistant gonorrhea have so far been identified in Japan, United Kingdom, Australia, France, Sweden and Norway, the AP reported, but it’s likely that there are undetected cases in other countries.

“There is much to do, and the threat of untreatable gonorrhea is emerging rapidly,” the authors wrote.

In 2006, the prevalence of resistance to cephalosporins was about 0.1 percent, but by the middle of 2011, that number rose to 1.7 percent, the authors said. CDC’s first warnings about drug resistance came in 2010.

The most alarming part of the story, they said, is that cephalosporins are the only remaining drugs of choice that work. They have to be taken along with two other antibiotics.

“A major component of the threat is that there really is no backup plan if — most likely when — these more resistant organisms become more prevalent,” Dr. Kenneth Fife, an infectious disease expert and professor of medicine at Indiana University Medical School, told ABC News in response to the CDC’s commentary. “There are very few new drugs that have activity against the gonococcus, no clinical trials to establish the efficacy of the few drugs that might have promise.”

In many cases, there are no symptoms of gonorrhea, so an infected person can spread the disease without even knowing he or she has it.

Fife added that it’s unlikely that experts will be able to prevent an outbreak from happening, so it’s urgent to research and develop new treatments.

If the situation progresses to the point where we are in a “post-antibiotic era,” Dr. William Schaffner, chair of preventive medicine at Vanderbilt University Medical Center, said experts will be “hard-pressed to provide quick and effective therapy to patients.”

Antibiotic-Resistant Gonorrhea Spreading: WHO

4:12 AM

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WEDNESDAY, June 6 (HealthDay News) -- Gonorrhea, the second most common sexually transmitted disease, is rapidly growing resistant to the last class of antibiotics that can effectively treat the infection, the World Health Organization warned Wednesday.

A number of countries, including Australia, France, Japan, Norway, Sweden and the United Kingdom, are reporting cases of antibiotic-resistant gonorrhea. The infection can lead to a series of serious health problems for both men and women, including infertility, increased risk of HIV infection, and potentially blinding eye infections in newborns, the WHO said.

Every year some 106 million people around the world are infected with gonorrhea, the U.N. health agency said.

According to the U.S. Centers for Disease Control and Prevention, more than 700,000 people in the United States get new gonorrhea infections each year and less than half of these infections are reported to the CDC.

In recommendations released Wednesday, the WHO called for greater oversight on the correct use of antibiotics and more research into alternative treatments for infections. The agency's Global Action Plan also urges increased monitoring and reporting of resistant strains of the disease, as well as better prevention, diagnosis and control of infections.

"Gonorrhea is becoming a major public health challenge, due to the high incidence of infections accompanied by dwindling treatment options," Dr. Manjula Lusti-Narasimhan, of WHO's Department of Reproductive Health and Research, said in a news release.

"The available data only shows the tip of the iceberg. Without adequate surveillance we won't know the extent of resistance to gonorrhea and without research into new antimicrobial agents, there could soon be no effective treatment for patients," she added.

Gonorrhea accounts for one quarter of the four major, curable sexually transmitted diseases, WHO noted, and it's the second most common sexually transmitted infection after chlamydia.

Since the development of antibiotics, gonorrhea has developed resistance to a variety of antibiotics, including penicillin and tetracyclines, and appears to be developing resistance to cephalosporins, the last line of drug defense, the agency said.

"We are very concerned about recent reports of treatment failure from the last effective treatment option -- the class of cephalosporin antibiotics --as there are no new therapeutic drugs in development," Lusti-Narasimhan said. "If gonococcal infections become untreatable, the health implications are significant."

Untreated gonorrhea can lead to health problems for men, women and newborns, the WHO said, including: infection of the urethra, cervix and rectum; infertility in both men and women; increased risk of HIV infection and transmission; ectopic pregnancies; miscarriage, stillbirths and premature deliveries; and severe eye infections in up to 50 percent of babies born to women with untreated gonorrhea that can lead to blindness.

Gonorrhea can be prevented through safe sex practices. Early detection and treatment, including of sex partners, is essential to control sexually transmitted diseases, WHO said.

Dr. Marc Siegel, an associate professor of medicine at the NYU Langone Medical Center in New York City, said, "WHO is right, gonorrhea is a rampant worldwide problem."

"It's also true that there are more resistant strains coming out," he said. But, in underdeveloped areas these strains are mostly sensitive to antibiotics, because in these areas there isn't a lot of antibiotic use, he added.

"We do need more public health measures, we need more education, and we need a heck of a lot more condom use," Siegel said.

Another leading U.S. infectious disease expert said the situation may not be as dire in America.

"The number of cases of gonorrhea in the U.S. has been significantly falling for a number of years. In 2009 there were 301,000 cases, representing a 10 percent decline from 2008. That trend has continued," said Dr. Pascal James Imperato, dean of the School of Public Health at State University of New York Downstate Medical Center. "I present this by way of background since gonorrhea, as a sexually transmitted disease, has been and continues to be on a downward decline in the U.S.

"Here in the U.S., a double antibiotic regimen has been in place over the past few years consisting of a cephalosporin and azithromycin or azithromycin and doxycycline," he explained.

"Thus far, organisms in the U.S. are still susceptible to some of the cephalosporins and remain susceptible to other antibiotics as well," Imperato said.

More information

For more on gonorrhea, visit the U.S. Centers for Disease Control and Prevention.

Wednesday, June 13, 2012

Baby Boomers and Drug-Resistant Gonorrhea

4:00 PM

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Baby boomers take heed: Drug-resistant gonorrhea may well be a topic of interest or concern to you.

STD Numbers on Upswing for Baby Boomers

A February report by UPI.com revealed that researchers in the United States, Canada and England discovered an upswing in the numbers of baby boomers reporting sexually transmitted diseases, including chlamydia, syphilis and gonorrhea. Researchers theorize that in addition to many people in this age group not practicing safe sex, post-menopausal women are at greater risk for micro-tears due to decreased lubrication, with the tiny tears providing entry portals for the infectious organisms.

Health Care Providers Put on Notice

On Wednesday, the United Nations' health agency, the World Health Organization, put health care providers around the world on notice about being vigilant in their surveillance of the antibiotic-resistant strain of gonorrhea that is expected to eventually be found throughout the world. According to an AP report, the drug-resistant strain of gonorrhea has currently been identified in nations such as Norway, Japan and Britain.

What's the Risk?

Currently, the drug-resistant strain that concerns health experts has been developing a resistance to all the antibiotics currently used to treat this STD. As this strain of gonorrhea continues to develop and mutate, it is likely to become immune to all current treatments, reports Forbes.com. This could result in an incurable form of a sexually transmitted disease that is the second-highest reported communicable disease in the United States.

Bottom Line

Baby boomers didn't have to be concerned about deadly types of STDs during the heyday of their youth, so it can seem like those "teenagers" diseases aren't a concern in mid-life. Safe sex is important for sexually active adults at any age, as well as taking antibiotics for any condition exactly as prescribed to help avoid the development of future "super germs."

Smack dab in the middle of the baby boomer generation, L.L. Woodard is a proud resident of "The Red Man" state. With what he hopes is an everyman's view of life's concerns both in his state and throughout the nation, Woodard presents facts and opinions based on common-sense solutions.

Tuesday, June 12, 2012

Gonorrhea growing resistant to drugs, WHO warns

6:53 PM

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GENEVA (AP) — A sexually transmitted disease that infects millions of people each year is growing resistant to drugs and could soon become untreatable, the World Health Organization said Wednesday.

The U.N. health agency is urging governments and doctors to step up surveillance of antibiotic-resistant gonorrhea, a bacterial infection that can cause inflammation, infertility, pregnancy complications and, in extreme cases, lead to maternal death. Babies born to mothers with gonorrhea have a 50 percent chance of developing eye infections that can result in blindness.

"This organism has basically been developing resistance against every medication we've thrown at it," said Dr. Manjula Lusti-Narasimhan, a scientist in the agency's department of sexually transmitted diseases. This includes a group of antibiotics called cephalosporins currently considered the last line of treatment.

"In a couple of years it will have become resistant to every treatment option we have available now," she told The Associated Press in an interview ahead of WHO's public announcement on its 'global action plan' to combat the disease.

Lusti-Narasimhan said the new guidance is aimed at ending complacency about gonorrhea and encouraging researchers to speed up their hunt for a new cure.

Once considered a scourge of sailors and soldiers, gonorrhea — known colloquially as the clap — became easily treatable with the discovery of penicillin. Now, it is the second most common sexually transmitted infection after chlamydia. The global health body estimates that gonorrhea is responsible for some 106 million infections annually. It also increases the chances of infection with other diseases, such as HIV.

"It's not a European problem or an African problem, it's really a worldwide problem," said Lusti-Narasimhan.

Scientists believe overuse or incorrect use of antibiotics, coupled with the gonorrhea bacteria's astonishing ability to adapt, means the disease is now close to becoming a super bug.

Bacteria that survive antibiotic treatment due to a mutation that makes them resistant then quickly spread their genes in an accelerated process of natural selection. This is a general problem affecting all antibiotics, but gonorrhea is particularly quick to adapt because it is good at picking up snippets of DNA from other bacteria, said Lusti-Narasimhan.

"If it didn't do so much damage it would actually be a fun organism to study," she said.

Resistance to cephalosporins was first reported in Japan, but more recently has also been detected in Britain, Australia, France, Sweden and Norway. As these are all countries with well-developed health systems, it is likely that cephalosporin-resistant strains are also circulating undetected elsewhere.

"I think this is probably only the tip of the iceberg," said Prof. Catherine Ison, who oversees the national surveillance program for treatment of resistant gonorrhea in England and Wales.

The over-the-counter availability of low potency antibiotics in some Asian countries is one of the reasons why resistance is increasing, she said.

Doctors in Britain are now switching to using a combination of antibiotics over a longer period of time to combat resistant gonorrhea, said Ison, who is based at the UK's Health Protection Agency.

The Geneva-based WHO wants countries not just to tighten their rules for antibiotic use but also to improve their surveillance systems so that the full extent of the problem can be determined.

Better sex education is also needed, as proper condom use is an effective means of stopping transmission, said Lusti-Narasimhan.

"We're not going to be able to get rid of it completely," she said. "But we can limit the spread."