Drug-Resistant Gonorrhea Spreading, Says World Health Organization

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."

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Drug-Resistant Gonorrhea Spreading

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.”

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Antibiotic-Resistant Gonorrhea Spreading: WHO

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.

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