Gonorrhea is getting harder and harder — and sometimes even impossible — to treat worldwide, according to a World Health Organization study looking at medical surveillance data from 77 countries released on Thursday.
"The threat of 'untreatable gonorrhea' is real," Carlos del Rio, an infectious disease professor at Emory University who has worked on gonorrhea antimicrobial resistance surveillance, told BuzzFeed News. "The WHO report...highlights that this is a global problem."
Each year, 78 million people are infected with the sexually transmitted bacterium, an estimated 800,000 of whom are in the US.
Gonorrhea has already developed resistance to a slew of antibiotics, including penicillin and tetracycline. Right now, the main treatment regimen is two antibiotics at the same time: a prescription for azithromycin pills, along with a shot of ceftriaxone. But this treatment, too, is slipping in efficacy as the bacteria continues to evolve defenses to evade it.
Currently, there is no alternative treatment for gonorrhea infection.
The new report shows that 81% of the countries reported resistance to azithromycin for at least one year from 2009 to 2014, while 66% of countries reported decreased susceptibility to ceftriaxone.
Doctors in three countries — France, Spain, and Japan — have also reported individual cases where the gonorrhea infections were unable to be cured altogether.
A cluster of seven cases reported in Hawaii last year showed higher levels of resistance to azithromycin than previously seen in the US, alarming health officials.
Because gonorrhea can present without symptoms, it's important to be tested regularly. If left untreated, it can lead to pelvic inflammatory disease, scar tissue, chronic pain, and infertility. It can also increase the risk of HIV infection.
The new report represents just "the tip of the iceberg" when it comes to antibiotic-resistant gonorrhea worldwide, Teodora Wi, medical officer in the WHO’s Department of Reproductive Health and Research, said in a statement. Lower-income countries — especially those in Africa, where an estimated 11.4 million cases of gonorrhea infection occur each year — have fewer resources for diagnosing and reporting untreatable infections. Most countries in Africa did not report for the WHO study.
A second report released on Thursday examined what researchers say is needed to address the growing problem of antibiotic resistance; this includes diagnostic tests for clinics and hospitals to readily identify if a person's strain is resistant to the recommended treatment, and, in the longer term, a vaccine.
The other necessary component, a growing problem with many infections besides gonorrhea, is the urgent need for new drugs to treat it. While three drugs are currently in the pipeline, none have yet made it through all the clinical trials necessary for FDA approval.
"Bottom line, we need new drugs to treat gonorrhea, we need new diagnostic tests and we need a vaccine," Del Rio said.