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Settle down: no 'sex superbug' in the US, despite reports

Reports of a new “sex superbug” threatening the U.S. aren’t true, public health officials say, even as they reiterate worries about the rise of drug-resistant gonorrhea.

“The sky is not falling -- yet,” said Dr. Kimberly Workowski, a professor of infectious disease at Emory University in Atlanta.

Several media outlets, including The Associated Press, last week reported that a rare strain of gonorrhea known as HO41 had been detected in Hawaii. That would have raised alarms nationwide, signaling the first domestic sign of a strain that's been found to be resistant to ceftriaxone, an injectable antibiotic that is the last-resort treatment for the sexually transmitted infection.

But the Hawaii cases, first discovered in May 2011, were actually a different strain, H11S8, resistant to a different drug, the antibiotic azithromycin, state health officials confirmed. That’s been a known problem for a while, Workowski added. The AP later withdrew the inaccurate report.

In fact, the HO41 strain hasn’t been detected anywhere in the world since 2009, when it was found in a Japanese sex worker, said Dr. Robert Kirkcaldy, a medical epidemiologist with the Centers for Disease Control and Prevention.  A handful of other cases that are resistant to ceftriaxone have been detected in other countries, but they’re different isolates, he added.

The false reports have put public health experts in the unusual position of refuting an error while also emphasizing that the threat of untreatable gonorrhea in the U.S. is very real.

“We think that that could be just a matter of a year or two,” said William Smith, executive director of the National Coalition of STD Directors.

Nearly 322,000 cases of gonorrhea were reported in the U.S. in 2011, making it again the second most commonly reported notifiable infection in the nation. Sufferers often show no signs, so the actual number of infections is likely closer to 700,000, according to the CDC.

For decades, gonorrhea was easy to treat with a single dose of antibiotics. But the germ is wily and easily mutable. It developed resistance to successive classes of drugs over the years until the cephalosporins, the current treatment, were all that’s left.

In recent years, though, there have been worrisome signs that the bug is starting to outsmart those drugs, too. Last year, the CDC stopped recommending the oral antibiotic cefixime to treat gonorrhea after surveillance showed it was on the verge of resistance. Now, the recommended treatment is the injectable ceftriaxone along with two other antibiotics, azithromycin or doxycycline.

“The point was to actually preserve the last remaining drug we know is effective,” said Workowski.

The NCSD, led by Smith, has asked Congress for $54 million in emergency appropriations to help bolster the US public health infrastructure that monitors, diagnoses and treats gonorrhea.

“Untreated gonorrhea is a disaster for public health and HIV prevention,” Smith said.

The best prevention against gonorrhea is monogamous sex between uninfected partners, Kirkcaldy said. Diligent use of condoms can also prevent infection, he added.

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