by Verity Sullivan
19 APRIL 2016
The words “Super Gonorrhoea!” have been splattered across the pages of every news outlet this week. The STI that affects 35,000 people in the UK every year, we’re told, is outsmarting our modern day cures and promises to spread through the population like wildfire. But what’s all the fuss really about? And is our increasingly weary health system equipped to curb this ‘epidemic’?
Fondly referred to as “The Clap,” gonorrhoea has been around for many a moon, with old-school treatments including such horrors as injecting mercury directly into the penis or the gentler sounding application of dried fruits to the genitals.
The discovery of antibiotics to cure the infection in the 1940s happily changed the face of treatment forever – but within the same decade penicillin-resistant cases had been found. Gonorrhoea’s continuous ability to develop resistance to multiple antibiotics has been observed for decades and it’s now a global public health concern.
The infection is currently treated with a combination of two antibiotics: Ceftriaxone given by injection and Azithromycin in the form of tablets. The use of this ‘dual therapy’ has a protective effect and reduces the risk of developing resistance.
But now comes a new strain: meet HL-AziR. First discovered in Leeds in November 2015, it has thus far been difficult to curtail and has now spread to the West Midlands and the South of England (cities, of course, have higher numbers of people online dating –something it’s been suggested could be linked to higher rates of STIs, with experts urging apps to invest more time in pushing a safe sex message). The 34 cases that have been confirmed nationwide are thought to be merely the tip of the iceberg.
The super-strain is resistant to Azithromycin, meaning that injectable Ceftriaxone is the only treatment option. And without the protection of dual therapy, experts predict it’s only a matter of time before the bug becomes resistant to Ceftriaxone, too. The result will be a highly contagious infection for which we currently have no cure.
Untreated gonorrhoea can lead to infertility, chronic pelvic pain and, more rarely, skin and joint problems. It can also be passed on from mother to baby. In 2014, a 19 per cent increase in infections was reported in the UK, making it the second most common STI after chlamydia.
The situation appears grave, prompting Public Health England to issue a safe sex reminder, in an effort to curb spread of HL-AziR.
These events are frightening enough. However, the outbreak also highlights the troubling issue of the huge budget cuts currently being faced by UK sexual health services, the very people responsible for managing resistant gonorrhoea.
Despite George Osborne’s recent statement that “antimicrobial resistance will present a greater danger to humankind than cancer by the middle of the century” and warning the world of its huge economic costs, the Government does not appear to be taking the necessary action to safeguard the public.
In July 2015, the Chancellor announced a £200 million slash to the UK public health budget, coupled with an additional 3.9 per cent ‘public health savings’ in his 2015 Autumn Spending Review.
These cash restrictions have heavily impacted sexual health services in what’s been described as a “desperate false economy”, leading to clinic closures, reduced expertise and an inexcusable loss of safe sex education. It’s estimated that every £1 cut from sexual health could actually generate £86 in costs for the wider health system, due to countless numbers of new STIs, unwanted pregnancies and reduced support for victims of sexual violence – to name just a few.
“It is essential that every effort is made to contain further spread of this strain,” says Dr. Elizabeth Carlin, president of the British Association for Sexual Health and HIV (BASHH).
“We must ensure rigorous partner notification measures, tests of cure, responsible antibiotic prescribing and the promotion of safe sex messages are all in place. BASHH reiterates the importance of providing appropriate funding for sexual health services to enable us to deliver the expertise crucial to halting the growing threat of antimicrobial resistance.”
Super gonorrhoea: What you need to know
- Gonorrhoea can affect the genital tract, throat and anus and can be passed on through oral, vaginal and anal sex.
- Not everyone gets symptoms, but they can include pain when urinating, unusual discharge from the vagina or penis, abdominal pain or unusual bleeding in women.
- Protect yourself by wearing a condom with new partners.
- Get tested regularly for STIs, even if you don’t have symptoms. Find your local clinic here.
- If you test positive for gonorrhoea you must be managed a sexual health clinic. They will ensure you receive the correct tests, treatment and help you to notify your sexual partners (anonymously if you wish).