No matter how old you are or how careful you may be, those who are sexually active always have some risk of contracting a sexually transmitted infection (STI). Moreover, the pathogens that cause STIs may evolve over the years, making them more transmissible and increasingly challenging to treat. One such example making recent headlines is super gonorrhoea. You may be wondering, "What is super gonorrhoea? Where did it come from? Who does it affect? How does it differ from ‘regular' gonorrhoea?” Well, you’re about to find out!
What is Super Gonorrhoea?
Super gonorrhoea is like regular gonorrhoea on steroids. It's a strain of bacteria that has mutated over time to become resistant to the medications traditionally used to cure gonorrhoea (including penicillins, fluoroquinolones, sulphonamides, tetracyclines, and macrolides). Although drug-resistant STIs can easily reach every corner of the world (border security be damned!), so far, cases have only been reported in Japan, France, Spain, Australia, and the UK.
When/Where was it First Identified?
The UK reported the first case of super gonorrhoea back in 2016. After having sex with a woman in Southeast Asia, a man returned to the UK with a strain of gonorrhoea that could not be cured with the usual combination of antibiotics (azithromycin and ceftriaxone). However, one of the most troubling aspects of this case is that he didn’t develop any symptoms until nearly a month later. Since symptoms of gonorrhoea typically present within seven days, this delay in symptom onset makes it easier for those who are infected to unknowingly spread the infection to others, as they may not even realise they have it.
So super gonorrhoea continues to spread. There have now been 12 documented cases in the UK, including three new cases in 2022 alone, causing increasing concern amongst experts.
Causes of Super Gonorrhoea
Gonorrhoea is a common STI that is usually curable with a combination of antibiotics. Yet one of the biggest challenges when it comes to tackling STIs is a lack of education and awareness. Studies have shown that only 56% of adults know that gonorrhoea is curable, whilst the vast majority remain uncomfortable discussing STIs with their doctors (84%) or sexual partners (75%), further compounding the problem.
The rise of super gonorrhoea has been attributed to:
- Incorrect use or overuse of antibiotics, resulting in a phenomenon known as antimicrobial resistance
- Inherent genetic mutations within the bacteria gonorrhoea
- Extragenital gonorrhoea infections (specifically anorectal and pharyngeal)
Signs and Symptoms of Super Gonorrhoea
The signs and symptoms of super gonorrhoea are basically the same as regular gonorrhoea. The main differences are that the symptoms can take longer to show (up to one month!) and the infection is much tougher to treat.
Gonorrhoea symptoms in men include unusual penile discharge (yellow, white, or green), dysuria (a burning sensation on urination), and/or swelling around the foreskin.
Alternatively, most women (up to 80%!) with gonorrhoea experience no symptoms at all! Those who do develop symptoms can experience unusual vaginal discharge (watery, green, or yellow), dysuria (a burning sensation on urination), and/or heavy bleeding between periods.
Why Does it Matter?
Drug-resistant infections, like super gonorrhoea, represent a serious public health problem – not only because they’re easier to spread, but also because ineffectively treated gonorrhoea infections can become chronic, leading to a number of long-term health issues, such as:
- Pelvic inflammatory disease (PID)
And even though there may be a few remaining treatment options for super gonorrhoea, those treatments won’t reverse the chronic health complications that may develop before someone even realises that they have an infection.
Since super gonorrhoea is an infection that can take weeks or months to diagnose, that can be very difficult to treat, and that can result in a range of serious, long-term health consequences, sexual health experts are focusing all efforts on prevention!
To help prevent the spread of super gonorrhoea (and STIs in general), we recommend:
- Having Candid Conversations: Open and honest conversations with your sexual partner(s) is key. Tell them if you are sexually active with others and ask them to do the same. You may want to make an agreement to let each other know if anything about your sexual history changes in real-time.
- Getting Tested Regularly: Share your most recent STI results, or consider getting tested together!
- Using Barrier Contraception: Use barrier methods of contraception, such as condoms, female condoms, and dental dams during oral, vaginal, or anal sex.
In summary, super gonorrhoea is an infection you want to avoid! So for those who are sexually active, we recommend you get tested regularly, use barrier methods of contraception to minimise the risk of transmission, and always remember to have open, honest conversations about with your partner(s). And remain optimistic! Although there isn’t a simple solution for super gonorrhoea just yet, scientists are hopeful that one will be developed in the near future!