Two cases of a novel strain of super-gonorrhea have been reported in the US for the first time. According to the Massachusetts Department of Public Health (DPH) on January 19, the bacteria had picked up potent anti-drug resistance and showed reduced responses to five different antibiotics.

Fortunately, both cases were eventually treated successfully with an injection of high-dose ceftriaxone, the main antibiotic currently recommended to treat gonorrhea, but health authorities say the pair of cases is certainly worrying.

“The discovery of this strain of gonorrhea is a serious public health concern which DPH, the CDC [Centers for Disease Control and Prevention], and other health departments have been vigilant about detecting in the US,” Margret Cooke, Public Health Commissioner of Massachusetts, said in a statement. 

“We urge all sexually active people to be regularly tested for sexually transmitted infections and to consider reducing the number of their sexual partners and increasing their use of condoms when having sex. Clinicians are advised to review the clinical alert and assist with our expanded surveillance efforts,” added Cooke. 

So far, it doesn’t look like there’s any direct connection between the two individuals, indicating there are more unknown cases out there.

Scientists genetically analyzed the strain in an attempt to track its movements and discovered it had a genetic marker previously seen in a case in Nevada, though that strain remained sensitive to at least one class of antibiotics. 

While it’s the first time this strain has been reported in the US, it’s previously been seen in the UK and Asia-Pacific region. 

Gonorrhea is a sexually transmitted infection (STI) caused by bacteria called Neisseria gonorrhoeae or gonococcus. It may present without symptoms, but common symptoms include unusual discharge from the genitals and pain when peeing. Left untreated, it can result in pelvic inflammatory disease, infertility, and other health problems.

It can easily be prevented by practicing safe sex and wearing a condom. Gonorrhea is easily passed between people through unprotected vaginal, oral, or anal sex, as well as sharing sex toys that haven't been washed. The infection can also be passed through pregnancy to newborns and can lead to permanent blindness in babies if not treated. 

In the US, it’s the second most commonly reported STI with 677,769 cases documented in 2020, according to the CDC. Cases appear to be on the up, with rates of gonorrhea increasing 111 percent since the historic low in 2009. 

Globally speaking, it’s clear that drug-resistant super-gonorrhea is also on the rise. Typically, this bacterial infection is treated with two widely used antibiotics – azithromycin and ceftriaxone – but doctors are coming across an increasing number of cases where the bacteria has evolved some level of resistance to these drugs. Lesser-used antibiotics can be used as a last-ditch treatment, but even their days may be numbered.

The issue of super-gonorrhea points to a much bigger threat to humans: the specter of drug-resistant superbugs. For over 70 years, humans have heavily relied on antibiotics and antimicrobial agents to fight bacterial infections. Due to this prolific use, many infectious organisms have adapted and evolved resistance to the drugs, making them less effective.

Considering the world's reliance on these drugs, antibiotic resistance is without doubt one of the biggest threats to global health.