Scientists are raising the alarm after an Austrian man in his fifties contracted a rare strain of gonorrhea after having an unprotected sexual encounter in Cambodia. His case, which was documented in the peer-reviewed medical journal Eurosurveillance on June 16, has researchers concerned “for the future treatment of gonorrhea” and are warning about a looming “major global public health threat.”
In April of this year, the man, after having unprotected sex with a Cambodian sex worker was seen by a urologist in Austria after he started experiencing painful urination and discharge. He was promptly diagnosed with gonorrhea and prescribed the typical treatment of antibiotics, Vice News reported.
After two weeks his symptoms appeared to have abated and swab culture tests on samples obtained by the man returned negative, however a PCR test done on his urethral indicated that he was still positive for the disease, prompting doctors to consider his treatment a possible failure.
Doctors then prescribed amoxicillin-clavulanic acid, another common treatment for the disease and received another negative test result following seven days of treatment. The man did not receive a second PCR test, however scientists concluded that the strain of gonorrhea the man had contracted, commonly referred to as super gonorrhea, was highly resistant to common antibiotic treatments including ceftriaxone and azithromycin.
The first case of super gonorrhea was identified in 2018 in the United Kingdom, followed by two additional cases discovered shortly after in Australia.
“All of these cases also had links to Southeast Asia,” Eurosurveillance reported.
If left untreated, both symptomatic and asymptomatic cases can result in infertility and an increased risk of HIV. In men, symptoms include painful urination, swelling in one testicle and a pus-like discharge from either the penis or rectum. In women, symptoms include painful sensations when urinating, increased vaginal discharge and bleeding between menstrual cycles.
Gonorrhea is the second most common sexually transmitted disease globally after chlamydia and is caused by the bacteria Neisseria gonorrhoeae.
According to the World Health Organization (WHO) some 82 million people caught the disease in 2020 and antimicrobial resistance is a cause for concern.
Experts are warning that a rise in treatment-resistant super gonorrhea may render current treatments ineffective, which could potentially give rise to a global epidemic.
Dr. Magnus Unemo, the head of the World Health Organization’s Collaborating Center for Gonorrhea and Other Sexually Transmitted Infections in Sweden, told the New Yorker in 2012, “The [gonorrhoeae] microbe appears to be emerging as a superbug. This is what we have feared for many years,”
The Cambodian sex worker, believed to be carrying the disease, has been identified and is receiving treatment.
Ann Chhorn, a project manager with Cambodian Women for Peace and Development, who works with sex workers in the country said a lack of contraceptives is a primary issue.
“With the COVID-19 outbreak, we found that sex workers [have difficulties accessing] healthcare. We [also] found that female entertainment workers can’t access condoms,” he told VICE World News.
It’s estimated that approximately 70,000 women work in the entertainment industry in Cambodia, according to 2019 statistics. These women often hail from poor families and migrate to the city to find employment.