Antibiotic resistant gonorrhea could be in Alaska

If you receive an e-mail from a Brazilian website, be cautious before assuming you’ve won a vacation getaway. A government sponsored website in the South American country serves as a convenient, yet cowardly, way to notify a partner that you have contracted a sexually transmitted disease (STD).

UAA students should remain resilient in taking necessary measures before having sexual intercourse.

Recently, there has been an outbreak of gonorrhea across Alaska. In addition, a new strain sweeping across the nation is becoming resistant to treatment and, in effect, becoming incurable.

There is only one remaining class of antibiotics recommended for its treatment. The Center for Disease Control and Prevention’s (CDC) STD guidelines recommend that cephalosporin antibiotics be used to treat all gonococcal infections in the U.S.

Historically, gonorrhea has progressively developed resistance to all antibiotic drugs prescribed to treat it, such as penicillin, tetracyclin, spectinomycin, and ciprofloxacin.

“Any disease has the potential to become incurable. The reason being bacteria and viruses will mutate in response to interference,” Director of the Student Health and Counseling Center Bette Fenn said. “Bacteria are mutating and changing into something else at the threat of being killed. It happened with tuberculosis, as there is now something called multi-drug resistant tuberculosis.”

The top two bacterial infections gaining resistance around the world and causing problems for millions are staph and tuberculosis, according to Fenn. Gonorrhea is not toward the top of that list, yet.

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Gonorrhea is a common sexually transmitted infection. It can cause additional health problems if left untreated. Possible health complications include pelvic inflammatory disease (PID), infertility and ectopic pregnancy, which are abnormal pregnancies that occur outside of the womb, in women.

An increase of gonorrhea in Southwestern Alaska began in 2008, and the infection rate rose statewide in 2009, according to a recent bulletin released by the Alaska Department of Health and Social Services.

“A total of 997 GC (gonorrhea) cases were reported in Alaska in 2009, yielding an incident rate of 144 cases per 100,000 persons, which represents a 69 percent increase from the 2008 rate of 85 per 100,000 persons,” the bulletin read. “The greatest single-year increase in reported GC infection in Alaska since the 1970s.”

Infection rates are on the rise in Alaska, but the reasons for such a steep increase remain elusive.

“The state heath department has ruled out increased rates of testing as being a major factor in the rise, but part of it is better methods of notification,” Fenn said. “The state has individuals in epidemiology whose entire job is calling partner contacts and closing the circle of infection. Partner notification, having partners informed and tested, and the improvement of that process throughout the state is thought to be part of the rise in numbers.”

Treatment methods being used in Alaska appear to be working at the moment. Drug resistance can only be tested with a culture, not simply a urine sample, so it remains unclear whether or not the resistant gonorrhea strain has reached Alaska.

Labs in Alaska have the capability to conduct cultures, but resistance testing is no longer done in the state. Resistance testing was previously funded by a grant that the state received from the CDC. It halted in 2002 after the grant was given up by the state, according to Susan Jones of the state’s Department of Health and Social Services.

“Cultures are more expensive to conduct, they take longer to conduct and the organism has to be viable in order for it to grow,” Jones said. “We have to conduct a certain volume of cultures in order to do resistance testing, so if we’re just doing a test here and there it will not be enough.”

The Gonococcal Isolate Surveillance Project (GISP) conducts research regarding the growing resistance of the bacterial infection.

According to the CDC, 25 to 30 sites and four to five regional laboratories across the U.S. participate in the GISP.

In 2007, 27 percent of the isolates collected from 29 of 30 GISP sites were resistant to penicillin, tetracyclin, ciprofloxacin or some combination of those antibiotics.

There is a distinction between having an organism that is totally resistant to antibiotics and an organism that is not susceptible to antibiotics, according to Jones.

“It’s not true resistance, it’s decreased susceptibility,” Jones said. “It’s always possible (gonorrhea) could become incurable. This is one of the reasons we need to get gonorrhea rates down in the state.”

Pure abstinence is the only method by which people can be guaranteed to never get a STI or STD. Since not having sex is unrealistic for many people, protection such as condoms should always be used before engaging in sexual intercourse. Sex with fewer partners and fewer sexual encounters can help as well.

“If people never had sex they would never get a STD,” Jones said. “If people always used some sort of barrier method, a polyurethane or latex condom, that would decrease the risk, but they have to be used correctly every time.”