WHO warns of danger of untreatable gonorrhoea

News release

MANILA, 29 April 2010—The World Health Organization (WHO) today warned that gonorrhoea may soon become untreatable unless urgent measures are taken to prevent and treat the sexually transmitted infection.

Improper use of antibiotics has resulted in widespread antimicrobial resistance to the disease, with cheaper, first-line antibiotics losing their effectiveness. WHO said that if this continues, it will only be a matter of time before gonorrhoea develops resistance to third-generation cephalosporin. Australia, Hong Kong (China) and Japan have reported treatment failures with oral cephalosporin, which is currently used in the last-line treatment of gonorrhoea.

"We are dealing with a serious issue with the implication that gonorrhoea may become untreatable," said Dr Shin Young-soo, WHO Regional Director for the Western Pacific. "This will have a major impact on our efforts to control the disease and will result in an increase in serious health-related complications," Dr Shin said.

Gonorrhoea is a common sexually transmitted infection caused by the bacterium Neisseria gonorrhoea, also known as Gonococcus. If left untreated, it can result in infertility, pelvic inflammatory disease, ectopic pregnancy, infections in newborn children, urethral strictures and scrotal swelling. Gonorrhoea also increases the likelihood of acquiring and transmitting HIV infection.

The problem is compounded by the fact that the monitoring of gonorrhoea resistance is often insufficient and of poor quality in countries with high rates of the disease. There is also a lack of reliable antimicrobial data for gonorrhoea.

"There is no place for complacency with the possible emergence and spread of multidrug-resistant gonorrhoea," Dr Shin said. "New treatments or alternative treatments for gonorrhoea, improving monitoring for antimicrobial resistance, and strengthening gonorrhoea prevention and management are urgently needed."

International experts from WHO and the United States Centers for Disease Control and Prevention, recently developed an action plan in response to the threat of impending untreatable gonorrhoea and the emergence of cephalosporin resistance in Neisseria gonorrhoea, a bacterium that can grow and multiply easily in the warm, moist areas of the reproductive tract in women, and in the urine canal in women and men. The action plan includes:

  • strengthening antimicrobial resistance monitoring, including gonorrhoea treatment failure monitoring;
  • improving laboratories to detect gonorrhoea resistance;
  • increasing awareness and coordination among health providers and laboratory staff;
  • establishing early and rapid response systems for the emergence of cephalosporin-resistant gonococci;
  • identifying effective alternative treatments for cephalosporin-resistant gonorrhoea and assuring potency and the quality of essential drugs for gonorrhoea; and
  • scaling up gonorrhoea control activities.

For more information, please call Dr Massimo Ghidinelli, WHO Regional Adviser on HIV/AIDS and other sexually transmitted infections: +63 2 528 9714, e-mail: ghidinellim@wpro.who.int