A virulent and drug-resistant strain of a painful venereal disease is currently spreading through the north of England, now triggering a national alert.
Public Health England (PHE) said it is "concerned" about an outbreak of so-called "super-gonorrhea" — which was first detected in the Yorkshire city of Leeds in March, but has since spread to Macclesfield, Oldham, and Scunthorpe.
Approximately 15 cases have been reported to authorities thus far, according to the British Association for Sexual Health and HIV. All involve heterosexual patients.
Previously, PHE has only rarely reported cases of gonorrhea resistant to the azithromycin drug, which is used to treat the sexually transmitted infection.
Gonorrhea is caused by the Neisseria gonorrhoeae bacteria and is transmitted via unprotected sexual intercourse and oral sex. In many cases, very painful symptoms appear within two weeks of infection.
Women infected with gonorrhea often experience a burning sensation during urination, as well as unusual or discolored vaginal discharge. Irregular bleeding between menstrual cycles and pain in the lower abdomen are less common, according to Britain's National Health Service (NHS). Pregnant women can pass the infection to their offspring during childbirth, and it can cause permanent blindness in newborn babies.
Symptomatic men may experience swelling of the foreskin, irregular and discolored discharge from the penis, or pain while urinating. Tender testicles are another, rarer symptom.
If untreated, gonorrhea can lead to infertility in both sexes and, in the rare cases that it spreads to the blood or joints, the disease can be life-threatening. It may also increase the likelihood of the infected person getting or giving HIV.
Approximately half of infected women, and 1 in 10 infected men, do not show any signs of infection.
According to PHE, an "outbreak control team meeting has been convened" in England. The department's Sexually Transmitted Bacteria Reference Unit has also begun sequencing strains of the new bacteria, "to better understand the molecular epidemiology."
Public heath authorities have also expressed concern about the viability of existing treatment options, should "super-gonorrhea" continue to circulate. A PHE statement read: "PHE is concerned that the effectiveness of current front-line dual therapy for gonorrhea will be threatened if this resistant strain continues to spread unchecked."
Last year, some 35,000 cases of gonorrhea were reported in England, making gonorrhea the second most common bacterial STI in the country after chlamydia. The majority of those infected were under 25 years old.
For decades, new strains of antibiotic-resistant gonorrhea have been cropping up around the globe.
Last year, another drug-resistant strain of gonorrhea was identified in Austria. The STI was reportedly brought to Austria by a European woman who arrived asymptomatic, and then had sexual intercourse with a new partner. A week later, she noticed unusual vaginal discharge — and was discovered to hold a gonorrhea bacteria strain that was resistant to penicillin, ceftriaxone, and ciprofloxacin. It took two months, and a cocktail of drugs, to cure the patient.