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Health officials in Massachusetts confirmed Thursday they have discovered two cases of a new strain of gonorrhea that appears to be drug-resistant and that the U.S. Centers for Disease Control and Prevention (CDC) is investigating.
The state Department of Public Health (DPH) said a novel strain of the bacteria Neisseria gonorrhoeae “showed reduced response to multiple antibiotics,” while another strain was found to have “genetic markers that indicate a similar drug response,” according to a news release.
Both cases, discovered in Massachusetts, were successfully cured with the antibiotic ceftriaxone—the drug that is recommended to treat all forms of gonorrhea. The bacteria is a sexually transmitted infection (STI) that can result in infertility, pelvic inflammatory disease, and a range of other health problems, officials warn.
As the second most commonly reported STI in the United States behind chlamydia, gonorrhea symptoms often do not present or are minor, say officials. CDC and Food and Drug Administration guidelines stipulate that “only ceftriaxone is recommended for treating gonorrhea in the United States” as of now.
The gonorrhea strain recently found in Massachusetts has never been seen before in the United States. Cases have been reported in the Asia-Pacific region and the United Kingdom.
“A genetic marker common to these two Massachusetts residents was also previously seen in a case in Nevada, though that strain retained sensitivity to at least one class of antibiotics. Overall, these cases are an important reminder that strains of gonorrhea in the U.S. are becoming less responsive to a limited arsenal of antibiotics,” the DPH said.
State health investigators are now working with the CDC to collect and test other samples to see whether the drug-resistant strain has spread further, the DPH said in a statement. The state will also carry out contact tracing.
“The discovery of this strain of gonorrhea is a serious public health concern which DPH, the CDC, and other health departments have been vigilant about detecting,” director of the Massachusetts Department of Public Health Margret Cooke said in a statement.
Cooke added that officials urge people to “regularly tested for sexually transmitted infections,” adding that clinicians should “review the clinical alert and assist with our expanded surveillance efforts.”
According to data provided by the CDC, 2.5 million people reported cases of gonorrhea, syphilis, congenital syphilis, and chlamydia across the United States in 2021. Nearly 700,000 people became infected with the disease, preliminary CDC data show, with infections rising by 45 percent between 2016 and 2020.
Meanwhile, researchers and the CDC have signaled that drug-resistant gonorrhea has been studied for years. In 2010, the federal agency changed its treatment regimen to include ceftriaxone and said officials need to continue “to monitor for emergence of ceftriaxone resistance will be essential to ensuring continued efficacy of recommended regimens.”
“We are getting close to an era where [patients] may no longer respond” to ceftriaxone, Dr. Katherine Hsu, medical director at the Massachusetts Department of Public Health, told the Boston Globe.
“We are down to very few–very few–options. The concern is we’ll get to a place where there are no options,” noted Dr. Helen Boucher, chief academic officer of the Tufts Medicine health system, to the outlet. “This is a common infection in young healthy people. … There’s only one thing, and that one thing may not work any more.”
Other doctors told the Boston Globe that if ceftriaxone stops being effective against drug-resistant gonorrhea, there are alternative drugs. But doctors caution that these have worse side effects or aren’t as effective.
“We want to maintain the options we have,” Dr. Ruanne Barnabas, chief of the Division of Infectious Diseases at Massachusetts General Hospital, told the paper, adding that the recent finding is “significant.”
Another antibiotic, azithromycin, can be added as a precaution against the bacteria. And over the years, some people have reported using home remedies including garlic, goldenseal, and apple cider vinegar to treat the infection.
Researchers have pursued new drugs for the infection such as zoliflodacin, which is currently being studied in clinical trials. It’s not currently approved by the FDA.
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