If a microorganism, such as bacteria, infects your lungs, you may have pneumonia. If other bacteria infect your eyes, you will have bacterial conjunctivitis. Your heart? an endocarditis. Different bacteria are capable of infecting different parts of our body, different tissues. Some enter us through the air, others through our digestive system. Others, through our genitals.
Diseases that are spread from an infected individual to an uninfected person through sexual contact are known as sexually transmitted diseases (STDs) . Not only bacteria, but also some viruses and parasites can cause STDs. Gonorrhea , genital herpes , human papillomavirus (HPV) infection, HIV (the virus that causes AIDS), chlamydia , and syphilis are some of the more common examples. Because of their catastrophic impact on mothers and newborns, as well as their correlation with HIV, STDs are a top global health priority . Biological interactions and the fact that both diseases affect the same populations link STDs and HIV. That is, some STDs can increase the possibility of contracting and transmitting HIV, as well as affecting the course of the disease.
STDs can also have long-term health consequences, especially in women and children. Pelvic inflammatory disease, infertility, ectopic pregnancy, cervical cancer, and prenatal or congenital infections in babies born to infected mothers are some of the health problems associated with STDs.
Are things by their name
The first term coined for contagious diseases spread primarily through sexual interactions was venereal disease . But, over the last 50 years, ′sexually transmitted diseases′ (STDs) and, more recently, ′sexually transmitted infections′ (STIs) have essentially replaced the earlier ′venereal disease′ terminology. To some people, venereal disease seemed like a limited term and could only be associated with gonorrhea , syphilis , chancroid , lymphogranuloma venereum , and granuloma inguinale . This gave rise to the term “sexually transmitted diseases” .
It more easily encompasses the many recently discovered sexually transmitted agents and disorders. Today, venereology (the study of venereal diseases) includes more than the five traditional venereal diseases. An increasing number of additional diseases are being discovered that can be considered the new generation of sexually transmitted diseases.
What is gonorrhea?
Gonorrhea is one of the most common sexually transmitted diseases, being a highly contagious bacterial infection. Gonorrhea is a disease that causes a strong secretion through the penis or vagina. In addition to infecting the male reproductive organs and female genital tract, it can affect the rectum, throat, eyes, blood, skin, and joints.
As a curiosity, in English it is also known colloquially as “claps”, which translates as “claps”. This is because one of the first treatments for gonorrhea in men involved slapping both sides of the penis at the same time in an attempt to push pus and discharge out of the urethra. That is, clapping with the penis in the middle. Sometimes a penis was also placed between a hard surface and a book to achieve the same results. Not surprisingly, your form of treatment has caused significant damage and done little to clear the infection.
Although this treatment is no longer used, the terminology is still used.
What causes gonorrhea?
The bacterium Neisseria gonorrhoeae is the cause of gonorrhea. It affects the mucous membranes (the mucosal secretory regions) and gives rise to secretion . The mucous membranes of the reproductive tract, including the cervix, uterus, and fallopian tubes in women, and the urethra in both women and men, are infected with N. gonorrhoeae. It can also infect the mucous membranes of the mouth, throat, eyes, and rectum.
How common is gonorrhea?
For most of the 20th century, gonorrhea was the most common STD worldwide, but since the mid-1970s, public health activities in the industrialized world have led to a decline in the incidence of the disease. According to estimates by the World Health Organization, 98 million new cases of gonorrhea occur each year. In 1999, approximately 62 million new cases were registered, compared to 88 million in 2005.
Unfortunately, the problem has increased again. Gonorrhea infection is the second most common notifiable disease in the United States, and case rates have increased since 2009. In 2017, a total of 555,608 cases of gonorrhea were reported in the US alone, the highest number since 1991 and a increase of 18.6% compared to 2016.
Men have been less likely than women to be tested for gonorrhea, at 20.7% vs. 50.9%, respectively. On the other hand, men and women had identical infection rates (105.8 vs. 108.7 cases per 100,000). Although men’s infection rates seem to increase over time.
Around the world, cases of gonorrhea have persistently affected young adults. Without a concerted global effort to mitigate antibiotic resistance, infected people (primarily sexually active young adults, who are usually otherwise healthy) may require extended hospital stays and additional follow-up visits for an infection that is currently treatable on an outpatient basis.
How do you get the disease?
Gonorrhea is transmitted through semen or vaginal fluids. It is mainly transmitted during unprotected sex with a partner who is already infected. Sharing sex toys by contacting body regions with fingers (for example, touching private parts and then eyes), vaginal or anal intercourse with an infected partner, through oral sex, however, this is less common. The bacteria can also be transferred from hand to hand (in very rare cases, if they are in close physical contact), and from a mother to her child at birth.
There are those who think that this is a disease that only occurs in homosexual people. However, it should be mentioned that, although infection by this bacterium is more frequent in some ethnic groups or in homosexual people, heterosexual people are not exempt. In the end, with the spread figures that we are talking about, we cannot limit infections to a single subgroup of the population.
It is important to note that gonorrhea cannot be contracted by simply kissing, or by sharing baths, towels, cups, or toilet seats.
What are the common symptoms of gonorrhea?
Although gonorrhea often shows no symptoms, it can cause significant health problems.
Most women with gonorrhea have no symptoms. Even if a woman does experience symptoms, they are usually minor and can be mistaken for a urinary tract or vaginal infection. Women may experience symptoms such as pain or burning when urinating, increased vaginal discharge, and spotting or irregular periods.
Some of the symptoms that men may experience are a burning sensation or irritability when urinating; colored discharge that may be white, yellow, or green (depending on severity) from the penis; and painful or swollen testicles (although this is less common).
When gonorrhea affects the rectum, you may experience: pain, anal itching, discharge and difficulty defecating or pain during excretion.
treatment options
Antibiotics are commonly used to treat gonorrhea. At the doctor’s office, they are given as an injection. It is essential to retest three months after therapy to ensure that the infection has cleared up (even without symptoms). Even if they show no signs of gonorrhea, all sexual partners of the previous two months should receive therapy.
If a person’s symptoms persist even after treatment, they may need to try another antibiotic. They could also have been reinfected with gonorrhea. After treatment, you and your sexual partner(s) should not have sexual intercourse for at least 7 days after taking the antibiotics. Another criterion is that you and your sexual partner(s) must be free of gonorrhea symptoms before having intercourse again.
Why are we getting worse? Multidrug-resistant gonorrhea
The N. Gonorrhoea bacterium is a living organism, whose life depends on being able to maintain its life cycle, that is, in one way or another, infecting us. We are talking about the life of a microorganism that needs to adapt to the environment to survive. In this aspect, antibiotics, the treatments that we develop to defend ourselves, are stimuli that the bacteria must overcome. Thus, it is a bacterium capable of generating resistance. That is, to make the treatments that once protected us useless. That is why it is important to regulate the correct use of antibiotics. Because, one way or another, we are at war against a multitude of microorganisms.
N. gonorrhoeae is prone to antibiotic resistance, and our ability to control antibiotic susceptibility is limited. So, as the history of this organism has shown, the progression of N. gonorrhoeae resistance is an ever-present concern, and we face the very real danger of multidrug-resistant and nearly untreatable gonorrhea.
There is still no effective preventive vaccine against this organism to help us control the disease. To prevent untreatable cases of this high-incidence infection, we need to advance diagnostic technology and develop treatments with different mechanisms of action. The development of new and effective treatments is also an urgent matter of health priority.
In parallel with ongoing work to develop and approve new drugs, we need to develop point-of-care molecular diagnostics that enable rapid diagnosis of gonorrhea with real-time assessment of antimicrobial susceptibility, to enable targeted therapy in rather than empiric treatment which may be inappropriate in the context of increasing antibiotic resistance.
References:
Anzilotti, A.W. (2021). Gonorrhea. TeensHealth. https://kidshealth.org/en/teens/std-gonorrhea.html
Blank, S., & Daskalakis, D. C. (2018). Neisseria gonorrhoeae — Rising Infection Rates, Dwindling Treatment Options. New England Journal of Medicine, 379(19), 1795–1797. https://doi.org/10.1056/nejmp1812269
Gonorrhea (the clap) (s.f.). STD. https://www.std-gov.org/stds/gonorrhea.htm
Kirkcaldy, R. D., Weston, E., Segurado, A. C., & Hughes, G. (2019). Epidemiology of gonorrhoea: a global perspective. Sexual health, 16(5), 401–411. https://doi.org/10.1071/SH19061
STD Facts – Gonorrhea (s.f.). Centers for Disease Control and Prevention. https://www.cdc.gov/std/gonorrhea/stdfact-gonorrhea.htm
Thappa D. M. (2006). Evolution of venereology in India. Indian journal of dermatology, venereology and leprology, 72(3), 187–197. https://doi.org/10.4103/0378-6323.25777
Thappa, D. M., & Sivaranjini, R. (2011). Venereology in India. Indian journal of dermatology, 56(4), 363–367. https://doi.org/10.4103/0019-5154.84713
