Unsafe oral sex is causing a rise in cases of untreatable ‘super-gonorrhoea’

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Consistent and correct condom use can prevent gonorrhoea.
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The World Health Organization has warned that cases of untreatable, antibiotic-resistant gonorrhoea are on the rise due to unsafe oral sex and a decline in condom use.

Data from 77 countries showed that when someone contracts the common sexually-transmitted infection – which infects roughly 78 million people each year – it is now “much harder, and sometimes impossible, to treat,” according to the WHO.

This is because the infection is rapidly developing a resistance to antibiotics.

Gonorrhoea is spread by unprotected vaginal, oral, and anal sex. It can infect the genitals, rectum, and throat. The BBC reported that the WHO is most concerned about the throat, stating that “thrusting gonorrhoea bacteria into this environment through oral sex can lead to super-gonorrhoea,” the untreatable form of the disease.

Complications disproportionally affect women, according to WHO, including “pelvic inflammatory disease, ectopic pregnancy and infertility, as well as an increased risk of HIV.” “The bacteria that cause gonorrhoea are particularly smart,” said Dr Teodora Wi, a medical officer in human reproduction at WHO.

The rise in the infection is due to “decreasing condom use, increased urbanisation and travel, poor infection detection rates, and inadequate or failed treatment all contribute to this increase,” according to WHO.

It added that there are no “affordable, rapid, point-of-care diagnostic tests for gonorrhoea,” and since many people infected do not have symptoms, cases often go undiagnosed and untreated.

Two papers, set to be published before the STI & HIV World Congress in Rio from July 9 to 12, will show that while in many instances the resistance is to older and cheaper antibiotics, in some countries cases of the infection are untreatable by all known antibiotics.

“These cases may just be the tip of the iceberg, since systems to diagnose and report untreatable infections are lacking in lower-income countries where gonorrhoea is actually more common,” WHO said.

In most countries, there is only a single antibiotic that remains effective for treating gonorrhoea, but resistance to it now been reported by the WHO in more than 50 countries.

The quest for new antibiotic treatment

According to the BBC, the outlook is “fairly grim” with only three new candidate drugs “in various stages of clinical development.” The WHO said the development of new antibiotics is “not very attractive for commercial pharmaceutical companies” because they are taken for short periods, become less effective as resistance develops, and constantly need replenishing.

In order to address the issue, the WHO and The Drugs for Neglected Diseases initiative (DNDi) have launched a Global Antibiotic Research and Development Partnership (GARDP), a not-for-profit research and development organisation with a mission of “developing new antibiotic treatments and promoting appropriate use while ensuring access for all in need.”

Dr Manica Balasegaram, GARDP director, said: “To address the pressing need for new treatments for gonorrhoea, we urgently need to seize the opportunities we have with existing drugs and candidates in the pipeline.

“In the short term, we aim to accelerate the development and introduction of at least one of these pipeline drugs, and will evaluate the possible development of combination treatments for public health use.”

The WHO added: “Today, lack of public awareness, lack of training of health workers, and stigma around sexually transmitted infections remain barriers to greater and more effective use of these interventions.”

The organisation added that the infection can be prevented through “safer sexual behaviour, in particular, consistent and correct condom use.”