Because Covid-19 has made this sexually transmitted superbug even worse

Covid-19 has rights Infectious diseases have dominated the news since 2020. However, that doesn’t mean other infectious diseases took a break. In fact, gonorrhea infection rates in the US have increased during the pandemic.

Unlike Covid-19, which is a new virus, gonorrhea is an ancient disease. The first known reports of gonorrhea date back to China in 2600 BC, and the disease has plagued humans ever since. Gonorrhea has long been one of the most common bacterial infections in the US. It is caused by bacteria Neisseria gonorrhoeaewhich can infect the mucous membranes in the genitals, rectum, throat and eyes.

Gonorrhea is usually transmitted through sexual contact. Sometimes referred to as “clap.”

Before the pandemic, there were about 1.6 million new gonorrhea infections each year. More than 50 percent of these cases involved strains of gonorrhea that did not respond to treatment with at least one antibiotic.

In 2020, gonorrhea infections initially dropped by 30 percent, likely due to pandemic lockdowns and social distancing. However, by the end of 2020 — the latest year for which data is available from the Centers for Disease Control and Prevention — reported infections were up 10 percent from 2019.

It is not clear why infections increased, even though some social distancing measures were still in place. However, the CDC notes that reduced access to health care may have led to greater infections and more opportunities for the disease to spread, and sexual activity may have increased when the initial stay-at-home orders were lifted.

As a molecular biologist, I have been studying bacteria and working to develop new antibiotics to treat drug-resistant infections for 20 years. During this time, I saw the problem of antibiotic resistance take on new urgency.

Gonorrhea, in particular, is a major public health concern, but there are specific steps people can take to prevent it from getting worse, and new antibiotics and vaccines may improve care in the future.

How to recognize gonorrhea

About half of gonorrhea infections are asymptomatic and can only be detected through screening. Infected people without symptoms can unknowingly spread gonorrhea to others.

Typical early signs of symptomatic gonorrhea include pain or burning during urination, vaginal or penile discharge or anal itching, bleeding or discharge. If left untreated, gonorrhea can cause blindness and infertility. Antibiotic therapy can cure most cases of gonorrhea, as long as the infection is susceptible to at least one antibiotic.

There is currently only one recommended treatment for gonorrhea in the US — an antibiotic called ceftriaxone — because the bacteria have become resistant to other antibiotics that were previously effective against it. Seven different families of antibiotics have been used to treat gonorrhea in the past, but many strains are now resistant to one or more of these drugs.

The CDC is monitoring the emergence and spread of drug-resistant strains of gonorrhea.

Why is gonorrhea on the rise?

A few factors have contributed to the increase in infections during the Covid-19 pandemic.

Early in the pandemic, most US labs that were able to test for gonorrhea switched to testing for Covid-19. These labs also face the same staffing and supply shortages that are affecting medical facilities across the country.

Many people have avoided clinics and hospitals during the pandemic, which has reduced opportunities to detect and treat gonorrhea infections before they spread. In fact, because of reduced screening over the past two and a half years, health experts don’t know exactly how far antibiotic-resistant gonorrhea has spread.

Also, early in the pandemic, many doctors prescribed antibiotics to patients with Covid-19, even though antibiotics do not work against viruses such as SARS-CoV-2, the virus that causes Covid-19. Inappropriate use of antibiotics can contribute to greater drug resistance, so it’s reasonable to suspect that this is what happened with gonorrhea.

Excessive use of antibiotics

Even before the pandemic, resistance to antibiotic treatment for bacterial infections was a growing problem. In the US, antibiotic-resistant gonorrhea infections increased by more than 70 percent from 2017 to 2019.

Neisseria gonorrhoeae it is an expert at picking up new genes from other pathogens and from “common” or useful bacteria. These helpful bacteria can also become resistant to antibiotics, providing more opportunities for the gonorrhea bacteria to acquire resistance genes.

Strains resistant to ceftriaxone have been seen in other countries, including Japan, Thailand, Australia and the United Kingdom, raising the possibility that some gonorrhea infections may soon be completely untreatable.

Steps for prevention

Currently, behavioral changes are among the best ways to reduce overall gonorrhea infections – especially safer sex and condom use.

However, additional efforts are needed to delay or prevent an era of untreatable gonorrhea.

Scientists can create new antibiotics that are effective against resistant strains. However, reduced investment in this research and development over the past 30 years has slowed the introduction of new antibiotics gradually. No new drugs have been introduced to treat gonorrhea since 2019, although two are in the final stages of clinical trials.

Vaccination against gonorrhea is not currently possible, but could be in the future. Vaccines effective against the meningitis bacterium, a close relative of gonorrhea, can sometimes also provide protection against gonorrhea. This suggests that a gonorrhea vaccine should be possible.

The World Health Organization has launched an initiative to reduce gonorrhea worldwide by 90 percent before 2030. This initiative aims to promote safe sexual practices, increase access to high-quality health care for sexually transmitted diseases, and expand of testing so that asymptomatic infections can be treated before they spread. The initiative also supports increased research into vaccines and new antibiotics to treat gonorrhea.

Setbacks in the fight against drug-resistant gonorrhea during the Covid-19 pandemic make these actions even more urgent.

This article was originally published on The conversation by Kenneth Keiler at Penn State; Read the original article here.

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