AUTUMN often sees a surge in the number of cases of sexually-transmitted infections within our community, especially among young people who are a high-risk group.
With more than 10,000 university students coming to Worcester in the coming weeks with freshers’ fairs and parties, I’d like to reach out to our community with advice to keep them safe from a new strain of gonorrhoea.
In 2023, 85,233 cases of gonorrhoea were reported in England which is the highest number since records began.
However, of increasing concern is that in the last two years there has been a small but significant rise in cases of antibiotic-resistant gonorrhoea.
With high-level resistance to the current recommended treatment, which is an injectable antibiotic called ceftriaxone, but also other commonly-used antibiotics, the strains are called gonorrhoea superbugs or super gonorrhoea.
While only nine ceftriaxone-resistant gonorrhoea infections were reported in England from 2015 until 2021, that rose to 15 between June 2022 and May 2024.
Five of those were classed as ‘extensively drug-resistant’ which means they did not respond to both first and second-line treatment options and to other antibiotics.
All drug-resistant cases were among young heterosexual people in their 20s and mainly acquired abroad.
This resistance is caused by a number of factors, including unrestricted access to antibiotics, inappropriate selection and overuse of antibiotics, poor quality antibiotics and genetic mutations within the bacteria.
The emergence of different forms of resistance in gonorrhoea is often followed by a rapid spread of the disease.
Gonorrhoea is a sexually-transmitted infection that is easily passed from person to person through unprotected sex.
Around one in 10 infected men and over half of infected women do not experience any symptoms.
However, in those that do, symptoms of gonorrhoea usually develop within about two weeks of being infected although they sometimes do not appear until many months later.
Symptoms in women may include a thick green or yellow vaginal discharge, pain when passing urine, pelvic pain or bleeding in between periods, bleeding after sex or heavier periods.
Men may report a discharge from the penis, a burning sensation when passing urine, swelling of the foreskin or pain in the testicles.
In patients who engage in unprotected oral or anal sex, gonorrhoea can infect the throat, eyes and anus leading to a sore throat, conjunctivitis presenting as redness and watering of the eyes or pain in the rectum respectively.
The infection can be passed from a pregnant woman to her baby and, without treatment, can cause permanent blindness for a newborn.
Gonorrhoea can cause infertility, inflammation within the pelvis called pelvic inflammatory disease, a five-fold increase of HIV transmission, ectopic pregnancy and an increased risk of miscarriages, especially within the first 12 weeks of pregnancy.
The UK Health Security Agency (UKHSA) is monitoring the situation of super gonorrhoea and is working to process samples from across the country, monitoring different strains and anything individual clinics cannot fully diagnose.
Tackling multi-drug resistant gonorrhoea requires two approaches honed on broad control of drug resistance and control of the infection.
Using condoms and practising safe sex are the best defence.
Additionally, the World Health Organisation is implementing the global action plan to control the spread and impact of antibiotic resistance in gonorrhoea to facilitate effective actions against the spread of the multi-drug resistant infection.
Anyone concerned about gonorrhoea can self-refer to the Aconbury North Sexual Health Clinic in Worcester, the Arrowside Sexual Health Clinic in Redditch or the Kidderminster Health Centre.
Alternatively, you can speak to your GP or visit the NHS SH:24 website to order a free sexual-transmitted infection test kit.
Our columnist Dr Jason Seewoodhary is a former Worcester GP.
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