The Massachusetts Department of Public Health’s recent announcement about a strain of gonorrhea with reduced response to antibiotics has alarmed medical professionals.
As published in Wired, Gonorrhea affects almost 700,000 Americans yearly and overcoming the last antibiotics available to treat it poses a severe threat. Although gonorrhea is a well-known disease, it has a predictable history of gaining antibiotic resistance.
The Massachusetts discovery of the novel gonorrhea strain with resistance to the last-resort drug, an injectable cephalosporin antibiotic called ceftriaxone, has brought the iceberg, as medical professionals predicted. Rates of gonorrhea are at historic highs across the US, making it even more challenging to control the spread of the disease.
Gonorrhea’s nature makes it challenging to treat. Since the bacterium is good at amassing mutations that protect it against antibiotics, it has already overrun several antibiotics in the past. In the 1940s, sulfa drugs, the first antibacterial, were ineffective. By the 1980s, penicillin and tetracycline, some of the earliest antibiotics, were also ineffective. The mid-2000s replaced fluoroquinolones such as Cipro.
Successful treatment for the past two years relied on administering azithromycin, a macrolide introduced in the mid-1980s, alongside ceftriaxone. However, the CDC removed azithromycin from the regimen in 2020 after its resistance spiked. Academics and CDC researchers warned of “untreatable gonococcal infection” as early as 2012.The bacterium’s ability to protect itself is not the only challenge.
Due to the stigma around gonorrhea, people may be reluctant to see their regular physicians, so public health departments set up freestanding clinics. That imposed the need to deliver a cure in one dose in case people didn’t return. Public funding for sexual health has been repeatedly cut, impacting these clinics’ effectiveness.
Primary care practitioners aren’t thoroughly interrogating their patients’ sex lives either. Clinicians and patients often aren’t comfortable discussing sexual health, which means recommendations to be tested can get skipped. Although gay and bisexual men who take PrEP are likely to be tested for STDs periodically to maintain their prescriptions, it is equally likely to happen in private offices or group practices.
The Massachusetts department’s Director of STD Prevention and HIV Surveillance, Kathleen Roosevelt, called this situation a warning and an opportunity. Her agency has instructed every frontline healthcare professional in the state to change how clinics test patients for infection.
The Massachusetts discovery may serve as an opportunity to curb the spread of the disease, especially since rates of gonorrhea are at historic highs across the US. To control the trend, public health officials have urged patients to return to be sure they’re cured, and practitioners must encourage those who’ve received treatment.
Gonorrhea needs to be tackled seriously to prevent a return to a time when untreated gonorrhea caused severe damage, such as crippling arthritis, blindness, and infertility.