Gonorrhea is like an extremely persistent garden weed. As far as sexually transmitted diseases go, it's relatively easy to get and requires a multipronged offensive to annihilate. And even if you've thwarted it once already, you're still left vulnerable to reinfection.
So far, doctors have been pretty damn good at treating the disease, which is partially why England's public health agency has just sounded the alarm over a rise in "super-gonorrhea" among Brits.
According to an incident response this week from Public Health England, reported cases of an extremely drug-resistant type of gonorrhea have recently spiked. The bacterial strain first emerged in Leeds and the north of England, and has since spread outward, as far as London.
Gonorrhea is caused by an infection of the Neisseria gonorrhoeae bacterium, and is one of the four most common STDs worldwide, next to chlamydia, syphilis, and trichomoniasis. The US Centers for Disease Control and Prevention estimates that 820,000 new gonorrheal infections occur in the United States each year, with 570,000 of those instances appearing in people ages 15 to 24. It affects the cervix, uterus, and fallopian tubes in women, and the urethra, mouth, throat, eyes, and anus of both men and women. Leaving gonorrhea untreated can result in pelvic inflammatory disease, pregnancy complications, infertility, and an increased risk for HIV infection.
Like many other disease epidemics, gonorrhea has been kept under relative control over the years thanks to "wonder drugs," or antibiotics. But as evolutionary theory predicted long ago, the bacteria we suppressed with cocktails of antimicrobial cure-alls have found ways to return, stronger than ever before.
Drug therapy for the disease has evolved from mercury injections straight into the urethra to a dual course of antibiotics that target gonorrhea from different angles, thus increasing the treatment's efficacy. The bacteria first developed a resistance to sulfonamides in the 1940s, followed by penicillin in the 1970s, fluoroquinolones in the 1990s, and most recently, Tetracycline. Now, only a few defenses against gonorrhea currently exist.
Gonorrhea is a tricky organism, and has remained persistent over the decades thanks to its ability to crib DNA from other bacteria and alter its own genetic makeup. If this were a game of poker, one might say that our indiscriminate use of antibiotics has allowed gonorrhea to see our hand and predict our next move, pharmaceutically speaking.
Compared to other resilient bacteria that are usually contracted in contained areas like hospital rooms, such as methicillin-resistant Staphylococcus aureus (MRSA), gonorrhea is everywhere. STDs are a fact of life for anyone who's ever had sex, and they don't discriminate based on age, race, income, or health. You can get them from people you know and trust, in your own home, and even after taking necessary precautions.
Of the few threats that could tip the scales of public concern about antibiotic resistance, "super-STDs" have the potential to make people finally give a shit about the disease future we're facing. The blame for our overuse of antibiotics falls on the shoulders of many, but our expectancy for drugs to cure everything has created a culture of dependency that has us visiting the hospital for a prescription for the common cold.
While a lack of funding for disease research and pharmaceutical companies' disinterest in developing new drugs are also complicit in the epidemic of untreatable bacteria, there are some basic things that everyone else can do to slow the spread.
For starters, we shouldn't be asking doctors for antibiotic quick-fixes when they don't necessarily recommend them. The CDC recommends that patients ask their healthcare practitioners if tests, such as bacterial cultures, will be done to make sure the right treatment is prescribed. If a doctor does end up prescribing drugs, patients should take their dosage as indicated, and never save or share antibiotics.
Think you can get by on a few rounds of antibiotics for the flu every year when you can't really afford to miss those deadlines? Bad idea. Antibiotics have no impact on viruses like influenza or bronchitis. A recent survey from the World Health Organization revealed that 64 percent of people across the world believe that antibiotics can be used to treat the cold and flu. Furthermore, 34 percent of the people surveyed felt they should only stop taking antibiotics once they feel better, and not when they've completed their course of treatment.
Dangerous opinions about the role of antibiotics ultimately contribute to the evolution of superbugs, such as untreatable gonorrhea, because they make us weaker to all types of infections, including STDs. By taking antibiotics for the flu, we're not killing the influenza virus, but we are destroying the hordes of "good" bacteria within our bodies that help to fight off "bad" bacteria like gonorrhea. Our microbiomes are unique to each and every one of us, but it's believed that every time we take antibiotics, those healthy gut flora that are killed off are less likely to repopulate to their original numbers.
If STDs that can't be defeated by modern medicine scare you, then good. They should. And maybe the next time you feel like calling up your doctor for a medicinal miracle, you'll reconsider the benefits of just staying home, hydrating, and sleeping it off.