STD Awareness: Will Gonorrhea Be Worse Than AIDS?

Posted on June 3, 2013 by Anna C.

A scanning electron micrograph of a colony of Neisseria gonorrhoeae, the bacteria that cause gonorrhea. Image: Portland State University

If you’ve been reading the news lately, you might have noticed an odd piece of reportage from CNBC, in which a naturopath claimed that antibiotic-resistant gonorrhea “might be a lot worse than AIDS” and might cause cases of sepsis that could kill “in a matter of days.” This quotation, uttered by a single naturopath, was then exaggerated in sources such as the United Kingdom’s Daily Mail, which ran the headline “Doctors warn that antibiotic-resistant strain of gonorrhea could be ‘worse than AIDS.’” In fact, the only person making this claim was one naturopath, not a doctor, and certainly not plural “doctors.”

There’s a lot to unpack here. First is the alarmism in the original CNBC article, and its dependence on an unreliable source. Second is the issue of antibiotic-resistant gonorrhea itself, which is a very serious public health problem. Thirdly, let’s look at the naturopath’s claim, which is that antibiotic-resistant gonorrhea could unleash a plague worse than AIDS and kill its victims in a matter of days.

Claims that antibiotic-resistant gonorrhea will be “worse than AIDS” are greatly exaggerated.

Alan Christianson, the naturopath behind the hyperbolic claims of super-virulent gonorrhea, does not seem to be an actual expert in infectious disease (his website lists “natural endocrinology” and “male menopause” among his specialties), nor is he a medical doctor. The article identifies him as a “doctor of naturopathic medicine,” but what does that mean?

Naturopaths are not medical doctors, and degrees in naturopathic medicine aren’t awarded by institutions accredited by the Association of Medical Colleges, the body that accredits medical schools. Naturopathy is a philosophy that is not generally supported by scientific evidence, but rather is based in “a belief in the healing power of nature,” according to the National Center for Complementary and Alternative Medicine. It was developed in the 1800s and today encompasses many modalities of alternative medicine, including homeopathy and herbalism. For these reasons, it is odd that a journalist quoted a naturopath on the potential of antibiotic-resistant gonorrhea rather than someone more qualified, such as a microbiologist or epidemiologist. Continue reading →

STD Awareness: An Update on Antibiotic-Resistant Gonorrhea

Posted on January 28, 2013 by Anna C.

Last year, we shared the fascinating and frightening story of the emergence of increasingly antibiotic-resistant gonorrhea, an STD caused by the gonococci bacteria. The sexually transmitted scourge, which we only so recently reined in with the development of antibiotics, has been performing some genetic gymnastics to defeat almost every drug we’ve thrown at it. We douse it with certain drugs, and the bacterium literally spits them back out at us, and it inactivates other drugs by snapping the active molecules in half. Sulfa drugs, penicillins, tetracyclines, fluoroquinolones — they all make a gonococcus heave a bored sigh. Luckily, cephalosporins were still an effective treatment, but recently there have been reports of stubborn gonorrhea infections caused by the latest and greatest (and some might say most hated) strain of gonococci.

The bacteria that cause gonorrhea continue to evolve, right under our noses!

Well, the story isn’t over — just like the bacteria that cause gonorrhea, the tale is rapidly evolving. The latest class of antibiotics that the gonococci are chipping away at is the cephalosporin family, which includes several chemically related drugs that work in similar ways — and that can likewise be defeated by microbes in similar ways. Cephalosporin-resistant gonorrhea was first reported in Japan and documented in a few European countries. The Japanese case that inspired the New England Journal of Medicine to declare last year that it was “time to sound the alarm” was an oral gonorrhea infection that was resistant to one member of the cephalosporin family: ceftriaxone.

Earlier this month, the prestigious medical journal JAMA reported the first North American sightings of gonorrhea that failed treatment with another cephalosporin: cefixime. Yeah, I know, you’d rather hear about Big Foot or UFO sightings, not evidence that something as real and unmythical as Gonorrhea 5.0 has landed in your back yard. Luckily, there’s plenty you can do to protect yourself from it, and we’ll tell you all about it toward the end of this article. (Spoiler alert: It involves using condoms!) Continue reading →

Over 90 Percent of What Planned Parenthood Does, Part 11: Diagnosing and Treating Epididymitis

Posted on December 17, 2012 by Anna C.

Welcome to the latest installment of “Over 90 Percent of What Planned Parenthood Does,” a series on Planned Parenthood Advocates of Arizona’s blog that highlights Planned Parenthood’s diverse array of services — the ones Jon Kyl doesn’t know about.

Planned Parenthood Arizona treats epididymitis.This statement might raise a few questions:

Q: What’s epididymitis?
A: Epididymitis is the inflammation, or swelling, of the epididymis, resulting in pain in the scrotum.
Q: That’s great, but what the heck is an epididymis?
A: The epididymis is a tube that is connected to the testicle, and is where sperm are stored before ejaculation. The epididymis is 12 to 15 feet long, but is coiled tightly enough to fit inside the scrotum alongside the testes!

Chlamydia causes 70 percent of epididymitis cases in young heterosexuals. This STD is easily treated but frequently asymptomatic — and prevented by condoms.

So, basically, epididymitis is a condition that can strike anyone whose reproductive anatomy features an epididymis. It is generally caused by a bacterial infection — which may be sexually transmitted, such as gonorrhea and chlamydia, or may not be sexually transmitted, such as tuberculosis. Very rarely, epididymitis can be caused by other pathogens, such as viruses, fungi, or parasites. Inflammation of the epididymis can also be caused by the heart medication amiodarone (also known as Pacerone).

Epididymitis most commonly affects males between the ages of 14 and 35. Risk factors, regardless of age, include being uncircumcised, a history of prostate or urinary tract infections, having had surgery in the urinary tract, having a history of a neurogenic bladder, an enlarged prostate, regularly using a catheter, and not using condoms during vaginal or anal intercourse.

The symptoms of epididymitis usually develop over one or two days and can include: Continue reading →

STD Awareness: Antibiotic-Resistant Syphilis

Posted on November 20, 2012 by Anna C.

Treponema pallidum under a microscope. Image: Dr. Edwin P. Ewing, Jr., CDC

The image to your right, with lively yellow splotches against a pale green background, is not a long-lost Jackson Pollack piece, and the dark squiggly lines aren’t strands of paint haphazardly splattered onto a canvas. In fact, those squiggly lines are magnified images of the spiral-shaped bacteria species Treponema pallidum. You might not have heard of T. pallidum, but you’ve probably heard of syphilis, the sexually transmitted disease (STD) that these bacteria cause. While syphilis isn’t as common as other STDs, like chlamydia and HPV, it’s still out there, and occasionally communities experience outbreaks. It’s always best for sexually active people to be screened for STDs and practice safer sex.

The evolution of syphilis strains that are resistant to certain antibiotics underscores the need to use antibiotics properly.

Syphilis can inflict serious long-term damage — in fact, before the introduction of antibiotics, syphilis was the worst STD out there! Known as the Great Pox when it descended upon Europe 500 years ago, it could cause large and painful boils. Eventually, natural selection led to T. pallidum’s evolution into a form with milder symptoms, which benefited the bacteria by enabling its less boil-ridden (and presumably more attractive) human hosts to spread it farther and wider. Nevertheless, the symptoms of syphilis, if present, still include infectious sores, and when the disease goes untreated, it can cause severe, possibly fatal, damage to the nervous system.

Back in the day, there were myriad inadequate “treatments” for syphilis, ranging from straight-up quackery to the use of partially effective but toxic chemicals such as mercury. But a century ago, in 1912, a new arsenic-based chemical called Neosalvarsan was hailed as a “magic bullet.” Unfortunately, this treatment took weeks or even more than a year to administer — and had dangerous side effects. Quack treatments continued to flourish, and it wasn’t until the widespread adoption of penicillin in the 1940s that an effective cure with few side effects was available.

But natural selection endures; in fact, by flooding T. pallidum’s habitat with certain antibiotics, we’ve created an environment that favors the organism’s evolution against us. While not as immediately threatening as antibiotic-resistant gonorrhea, syphilis has been quietly evolving resistance to some of the antibiotics we use to treat it. This underscores the importance of using antibiotics correctly and emphasizing safer-sex practices, such as using latex condoms during vaginal or anal intercourse and during oral contact with a penis. Continue reading →

Get Smart About Antibiotics!

Posted on November 12, 2012 by Rebecca

This week we celebrate Get Smart About Antibiotics Week. Antibiotics, or antimicrobials as they are also called, cure bacterial infections by killing bacteria or reducing their ability to reproduce so your own body’s immune system can overcome an infection. Penicillin was the first antibiotic, and was discovered in 1924 by Alexander Fleming. Since its widespread use, beginning in the 1940s, countless lives have been saved from devastating bacterial infections. Talk about a wonder drug!

Improper use of antibiotics can have dangerous consequences.

Since then, different types of antibiotics have been developed to combat many different types of infectious bacteria. Classes of antibiotics include penicillins, cephalosporins, macrolides, fluoroquinolones, aminoglycosides, and others. In each of these classes there are lots of different individual medications. (For example, cephalosporins include the drugs cephalexin, ceftriaxone, cefaclor, and others.) Some antibiotics are broad spectrum, which means they work on many different bacteria. Some are more narrow spectrum, used for specific bacteria.

Antibiotics only work for bacterial infections … not viral infections. They are ineffective at killing viruses. Viral infections include colds, flu, runny noses, most coughs and bronchitis, and sore throats unless they are caused by strep. Sexually transmitted viruses include human papillomavirus (HPV), herpes simplex virus, and HIV. Continue reading →

Over 90 Percent of What Planned Parenthood Does, Part 9: Treating Urinary Tract Infections

Posted on November 5, 2012 by Anna C.

Urinary tract infections occur when certain bacteria invade the urethra.

A urinary tract infection (UTI) affects the urinary system, most notably the urethra. Symptoms might include an increased urge to urinate, accompanied by a burning sensation; urine might be cloudy or bloody. Among adults, UTIs are 50 times more common in people with vaginas than in people with penises, probably due to the shorter distance bacteria travel from the bowel. If you have a vagina, there is more than a 50 percent chance that you’ll have at least one UTI in your lifetime. And, if you’re unlucky enough to be in this group, there’s a 20 percent chance that you’ll develop recurrent UTIs (three or more infections yearly). Annually, UTIs prompt an estimated 8 million visits to health-care providers, costing at least $1 billion.

How can urinary tract infections be prevented?

Although symptoms often recede without medical intervention, it’s important to seek treatment for persistent UTIs because the infection could spread. If you are or have been sexually active, it is also important to ensure you don’t actually have a sexually transmitted disease.

Causes of UTIs

When certain species of fecal bacteria wend their way from the bowel into your urethra, they might initiate an infection. Up to 90 percent of UTIs are caused by certain strains of Escherichia coli; the rest are caused by Staphylococcus saprophyticus, Proteus mirabilis, Klebsiella pneumoniae, and a few other species. Continue reading →

STD Awareness: “What Are the Symptoms of an STD?”

Posted on October 30, 2012 by Anna C.

“I was treated for chlamydia, but my girlfriend feels fine, so she doesn’t need to get tested.”

“The only time I don’t use condoms is for oral sex, and everything’s been OK ‘down there,’ so getting tested for sexually transmitted diseases would be pointless.”

It’s important to be able to recognize the symptoms of a sexually transmitted disease (STD). Being savvy about symptoms can push you to get tested right away if you notice that something is amiss. However, being symptom-free can lull you into a false sense of security, especially if you’ve engaged in sexual activities that could have exposed you to an infectious agent. The fact of the matter is that many people with STDs have no symptoms at all. As they say, “The most common symptom of an STD is … no symptom.” Let’s take a look at some common STDs.

The most common symptom of an STD is no symptom.

Bacterial Infections

Bacterial STDs are curable with antibiotics. They include chlamydia, gonorrhea, and syphilis — all of which can be asymptomatic, and all of which can have severe complications when they are not treated in time.

Chlamydia: Around 3 million Americans are infected with chlamydia annually, and the infection is especially common among young people (less than 25 years of age). Chlamydia can infect the penis, vagina, cervix, anus, urethra, eye, or throat. You can be afflicted with a range of symptoms: pain or a burning feeling while urinating; vaginal, cervical, or penile discharge; swelling around the anus, testicles, or vagina; and more.

However, you’re much more likely not to experience any symptoms at all — most people with chlamydia are unaware they have it. Three out of four women with chlamydia have no symptoms, and half of men with chlamydia have no symptoms. Left untreated, chlamydia can become a serious health threat. Long-term complications might lead to fertility problems and arthritis. Continue reading →

STD Awareness: Gonorrhea of the Throat

Posted on September 28, 2012 by Anna C.

Gonococci can band together to attach themselves to a human cell. Image: Dustin Higashi, University of Arizona

My fellow Generation Xers might remember an episode of Chicago Hope in which a very young Jessica Alba portrays a teenage girl with a gonorrhea infection in her throat — also called pharyngeal gonorrhea. The actress later reported being shunned by members of her church, disillusioning her from the religion she grew up with. It is a testament to the power of taboo that even a fictional association with a sexually transmitted disease (STD) can elicit such negative reactions.

Taboos can affect the ways we relate to one another sexually, as well. Many of us conceptualize of disease as “dirty,” and the flip side to that is to think of people without disease as “clean.” This kind of stigmatizing language can be found in phrases like “She looked clean” and “Don’t worry, I’m clean” — all to describe people who are perceived to be or who claim to be free of STDs. With all the baggage we put on STD status, it can be difficult to ask a partner to use a condom or dental dam during oral sex. Some people might think we don’t trust them or are underhandedly questioning their “cleanliness.” These sorts of fears can cloud our judgment when it comes to protecting our health, but there is nothing wrong with asking your partner to use protection during oral sex — especially if you don’t know one another’s STD status. There are many good reasons to use barrier methods when engaging in oral sex, and pharyngeal gonorrhea is just one of them.

Unprotected oral contact with a penis puts you at the most risk of acquiring pharyngeal gonorrhea.

Gonorrhea is most famous as an infection of the cervix or the urethra. But gonococci, the bacteria that cause gonorrhea, can thrive in other warm, moist areas of your body — not just the reproductive tract, but also the mouth, throat, eyes, and anus. Gonococci can be transmitted to your mouth or throat via oral sex — most likely via unprotected oral sex. Symptoms might include a sore throat, but 90 percent of the time there are no symptoms at all. Continue reading →

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