The World Health Organization is issuing a warning of what could be the beginning of a world gonorrhea pandemic.
The number of cases of gonorrhea that is resistant to all known antibiotics is rising, according to the organization, and very few new drugs are being developed to combat these quickly evolving superbugs.
In two studies spanning 5 years and 77 countries, the WHO confirmed that first-response antibiotic treatments are losing the fight against gonorrhea. 97% of countries reporting in that period found cases of resistance to ciprofloxacin, 81% of countries found resistance to azithromycin, and 66% of countries reported finding strains resistant to the current batch of last-resort antibiotics.
For now, drugs that make up the last line of defense (such as extended-spectrum cephalosporins or injectable ceftriaxone) remain effective in most of the developed world, however, these drugs are not found in great number in the developing world where gonorrhea rates are especially high.
But don’t feel too safe, as the WHO warns that it’s only a matter of time before these drugs start failing in the West, too.
"The bacteria that cause gonorrhea are particularly smart,” says Dr. Teodora Wi, Medical Officer, Human Reproduction, at WHO. “Every time we use a new class of antibiotics to treat the infection, the bacteria evolve to resist them."
Gonorrhea is one of the most common sexually transmitted infections in the world. According to the CDC, there were 395,216 reported cases in the US in 2015, and according to the WHO an estimated 78 million cases annually worldwide. The disease can infect the mouth, rectum, or genitals and can cause pelvic inflammatory disease, ectopic pregnancy and infertility, as well as an increased risk of HIV.
"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 gonorrhea is actually more common," notes Dr. Wi.
Discovering new treatments for gonorrhea is a difficult issue as most companies avoid spending resources on the disease due to a lack of profit. Because the disease evolves to resist new drugs very quickly, as well as the fact that most cases are cured after taking very few pills, it is very difficult for companies to recoup their development costs.
The best way to prevent the spread of gonorrhea is condom use, however, the WHO notes that condom usage is falling worldwide.