A new study raises concerns about the spread of drug-resistant gonorrhea in Ontario.
A strain of gonorrhea that responds poorly to the last class of drugs available to treat the bacteria is gaining ground among the strains spreading in the province, data presented Tuesday at an infectious diseases conference in Chicago suggest.
The strain wasn't seen in the province in 2005, but by May of this year made up 11 per cent of a representative sample of gonorrhea isolates tested by the provincial laboratory, Dr. Vanessa Allen of Public Health Ontario reported at the Interscience Conference on Antimicrobial Agents and Chemotherapy.
The majority of cases that have been spotted were in men in Toronto. But the strain has been seen elsewhere in the province as well as in other parts of Canada and around the globe, said Allen, a medical microbiologist.
New approaches to treating and controlling the sexually transmitted disease need to be adopted before the bacteria outsmarts all the drugs available to treat the infection, she suggested.
Revised guidelines for tests, treatment
"There's a very imminent threat that there will be nothing left to treat this infection with. And unless we're very careful now, I really think that we're at risk of getting there sooner rather than later."
Public Health Agency of Canada confirmed Tuesday its experts are working on revised guidelines for testing and treating gonorrhea.
"The more aggressive we can be, the more chance we have of eradicating this drug-resistant clone," Allen said in an interview from Chicago.
On Monday, the Canadian Medical Association Journal warned in an editorial that the threat of widespread multi-drug-resistant gonorrhea demands an urgent public response.
"Without action, we are heading back to the pre-antibiotic era, with an escalation in the number of deaths from other multi-resistant organisms as well as rampant gonococcal infections," said the editorial, signed by several editors including journal editor Dr. Paul Hebert.
Doctors often miss signs
Known as "the clap" in bygone days, gonorrhea can be challenging to control because some people who are infected don't have symptoms. Curing the infection does not provide lifetime protection, as is seen with some diseases; a person can be reinfected with gonorrhea.
The bacteria are spread by sexual contact and infection can occur in multiple sites in the body. But doctors often don't look for signs of infection in places like the throat or anus, Allen said, which contributes to the number of cases that are missed.
In women, untreated gonorrhea can cause pelvic inflammatory disease which can lead to chronic pelvic pain and infertility.
Babies born to women with gonorrhea may suffer from blindness or life-threatening blood infections. The bacteria can also cause infertility in men.
If the bacteria move to the blood or joints, infection can be fatal. Infection with gonorrhea increases one's risk of being infected with HIV; and HIV-positive people with gonorrhea can transmit HIV more easily to sexual partners.