Oral sex spreading new strains of super-gonorrhoea

According to two recent papers from the World Health Organization (WHO), oral sex is producing dangerous new strains of gonorrhoea, and decreased condom use is helping these new strains to spread.
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What is gonorrhoea

Gonorrhoea (also sometimes spelled “gonorrhea”) is a sexually transmitted infection (STI) caused by the bacterium Neisseria gonorrhoeae. This bacterium is usually spread through sexual contact with an infected person, for example through oral, anal and/or vaginal sex.

While many people infected with gonorrhoea display no symptoms, infected males often experience burning with urination, discharge from the penis, or testicular pain; while infected women often experience burning with urination, vaginal discharge, vaginal bleeding between periods, or pelvic pain. If left untreated, gonorrhoea can spread to joints or heart valves, and potentially cause infertility. Gonorrhoea can be diagnosed by testing the urine, urethra in males, or cervix in females.

Gonorrhea can be prevented with the use of condoms, having sex with only one person who is uninfected, and by not having sex.

Gonorrhoea is usually treated with the antibiotics ceftriaxone (by injection) and/or azithromycin (by mouth). However some new strains of gonorrhoea have developed antibiotic resistance, necessitating higher-dose antibiotic treatments.


The WHO papers, published in PLOS Medicine, are entitled “Antimicrobial resistance in Neisseria gonorrhoeae: Global surveillance and a call for international collaborative action” and “Multidrug-resistant gonorrhoea: A research and development roadmap to discover new medicines”.

These papers warn that gonorrhoea infections are now much harder to treat, and in some cases impossible. In fact, there have even been three cases (in Japan, France and Spain) wherein gonorrhoea infections were completely untreatable.

Researchers believe that antibiotic-resistant gonorrhoea (aka super-gonorrhoea) is often created as a result of oral sex. Specifically, antibiotics are commonly used to treat infections like a normal sore throat, which is caused by species of bacteria that include relatives of gonorrhoea, and these species of bacteria can consequently develop antibiotic resistance. Introducing gonorrhoea bacteria into the throat through oral sex can then lead to the creation of super-gonorrhoea, as the gonorrhoea bacteria mixes with the antibiotic-resistant species of bacteria in the throat.

Potential vaccine

On the bright side, a paper just published in The Lancet medical journal indicates that a vaccine has for the first time been shown to protect against gonorrhoea. The paper, entitled “Effectiveness of a group B outer membrane vesicle meningococcal vaccine against gonorrhoea in New Zealand: a retrospective case-control study”, observed the effects of a vaccine originally developed to stop an outbreak of meningitis B, and found that gonorrhoea cases had fallen 31% in those vaccinated. According to researchers, “[w]e are still a long way before we develop a vaccine for gonorrhoea, but we have now some evidence that it is possible.”

The WHO believes that developing a vaccine is vital in stopping the global spread of super-gonorrhoea, which could otherwise soon become untreatable as antibiotics fail.

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