Public Health

Gonorrhea ‘Super Bug’ Presents Looming Public Health Crisis

by Martha Kempner, RH Reality Check   May 7, 2013


Antibiotic-resistant gonorrhea presents a looming public health crisis that could be prevented.

Public health advocates headed to Congress last week to ask for $53.5 million to help state and local health departments prepare for the impending appearance of antibiotic-resistant gonorrhea in the United States.

Gonorrhea is one of the most common sexually transmitted infections (STIs), with over 700,000 cases in the United States each year. The infection may cause itching, burning, discharge, or pain during urination, but often has no symptoms. If left untreated, however, it can cause pelvic inflammatory disease and lead to infertility in both men and women. Gonorrhea, once known as “the clap,” has long been thought of as minor by many because it can be treated with antibiotics.

However, as I explained in a piece for RH Reality Check last year, Neisseria gonorrhoeae, the official name for this pesky bacterium, has steadily developed resistance to entire classes of antibiotics. As early as the 1940s, it was resistant to sulfanilamides, by the 1980s penicillins and tetracyclines no longer worked, and in 2007 the Centers for Disease Control and Prevention (CDC) stopped recommending the use of fluoroquinolones (the class of drugs that includes Cipro, which we may all remember as the thing to stockpile in case of an anthrax attack). Today, the only class of antibiotics that remains effective is cephalosporins, but the bacterium’s susceptibility to these drugs is rapidly declining.

Last summer, the CDC changed its treatment guidelines for gonorrhea because the bug is becoming resistant to oral ceftriaxone, which had been the recommended drug. Now, the CDC suggests that infection be treated with injectable ceftriaxone in combination with one of two oral antibiotics—doxycycline or azithromycin. The goal of this change is to preserve the effectiveness of ceftriaxone, because it is the last drug that works and there are no others in the pipeline.

The first U.S. case of gonorrhea that’s highly resistant to current antibiotics was discovered recently in Hawaii. Similar cases have been seen in other countries, including Norway and Japan. William Smith, the executive director of the National Coalition of STD Directors (NCSD) and one of the advocates who addressed Congress last week, told the Washington Times that this case was “worrisome.”  He went on to say, “Experts agree that it’s not a matter of if gonorrhea-resistance will hit, it’s a matter of when it will hit.”

Deborah Arrindell, vice president of health policy at the American Sexual Health Association (ASHA), put it more dramatically, telling RH Reality Check, “Gonorrhea is a fighter.  This is one of the most common infectious diseases, and it has an uncanny ability to resist antibiotics. It’s just a matter of time before there’s nothing left behind the pharmacy counter to treat it.”

Both ASHA and NCSD worked with Congress last year on the GAIN (Generating Antibiotic Incentives Now) Act, which was passed as part of the most recent Food and Drug Administration (FDA) User Fee Law. Under this act, the FDA will begin to work with drug companies to encourage the research and development of new antibiotics to combat gonorrhea and other emerging “super bugs.” While advocates


Hooray for Women’s Health Specialists-our Clinic partners!

Today, as the new president of Citizens for Choice, I am honored to have met our clinic staff. These great women were visibly happy and inspired that I had reached out to express my gratitude on behalf of our board.

There were six clients, and I was proud that we — Citizens for Choice –offer Nevada County a SAFE and SHAMELESS space where our community can educate themselves about reproductive health care and sex-ed, and also learn about all UNBIASED birth control options, including abstinence.

You see, we care about our community, especially our youth. Our main goal is to provide resources that empower youth — and this whole community — to be responsible and make healthy choices that promote self-confidence, not fear. When one has the power and the access to make wise choices for themselves, the really hard choices become less.

I had to smile when I saw a couple, probably 17-ish, smiling and walking hand in hand, after leaving our clinic, with a paper bag. I thought, you know, we just may have prevented an unwanted pregnancy or an STI. I was happy to see that these two were responsible and were given the OPPORTUNITY to make a responsible choice. This is one couple who hopefully won’t be on Sixteen and Pregnant.

Please pass along to anyone you know that we are the safe space to go for non-judgmental education materials and counsel regarding reproductive health care options, low cost/free mammograms, annuals, STI checks, birth control.

Thank you for your support of The Clinic! and Citizens for Choice.

Kimberly D’Urso    May 8, 2013


HPV Vaccine & Sexual Promiscuity Not Linked  

Researchers from the Kaiser Permanente Center for Health Research –Southeast released findings this month showing that the availability or use of human pappillomavirus (HPV) vaccine intended to prevent cervical cancer does not cause sexual promiscuity.

Researchers followed the electronic medical records of 1,398 girls ages 11-12 from 2006 to 2007. In comparing those who received the HPV vaccine with those who did not, no major differences were seen in receiving sensitive services like treatment for sexually transmitted diseases (STDs) or seeking birth control.

Although recommended by medical professionals and the Centers for Disease Control and Prevention (CDC), misguided claims linking the HPV vaccine to sexual promiscuity have detracted from the health benefits of the vaccine in preventing cervical cancer.





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