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Throats act as a 'silent reservoir' for gonnorrhoea that is driving the drug-resistance crisis, a scientist reveals.
Drug-resistant gonorrhoea can spread from an infected person's throat during oral sex without them even knowing they have the STI, an expert warns.
This comes after a warning from the World Health Organization (WHO) last month that incurable gonorrhoea is on the rise due to oral sex and a decline in condom use as HIV fears lessen.
WHO confirmed three people worldwide have developed 'super gonorrhoea', which is resistant to all forms of treatment.
Globally, gonorrhea infects around 78million people each year. Thirty percent of all new infections in the US are resistant to at least one drug, according to the Centers for Disease Control and Prevention.
Drug-resistant gonorrhoea spreads from an infected person's throat during oral sex (stock)
Gonorrhoea, known as 'the clap', is an STI that can infect the genitals, throat, eyes and rectum.
It spreads through unprotected vaginal, oral or anal sex. The infection can also pass from an infected mother to a child during labour.
Gonorrhoea cannot be spread by kissing even if one person has the infection in their throat.
Symptoms do not always appear, but can include a green or yellow fluid coming out of the penis, a burning sensation when urinating or a rash on the penis.
Women may have increased discharge, and pain in the abdomen or when urinating.
For men, untreated gonorrhoea can cause testicular infections, resulting in pain, swelling and possible infertility.
Some untreated women may develop pelvic inflammatory disease and in serious cases can result in ectopic pregnancy and infertility.
Treatment includes oral or intravenous antibiotics.
Yet, antibiotic resistance is making therapy more difficult.
Source: Sexual Health Scotland
'Transmission is very efficient via oral sex'
Dr Emilie Alirol, head of the sexually transmitted infections program at the Global Antibiotics Research and Development Partnership in Geneva, said: 'The throat infections act as a silent reservoir.
'Transmission is very efficient from someone who has gonorrhea in their throat to their partner via oral sex,' NY Times reported.
Gonorrhoea infections in the throat are frequently overlooked, as the bacteria typically resides there in smaller numbers than in the genitals and is not easily picked up by swabs.
Oral infections are also difficult to treat as antibiotics work in the bloodstream and there are few blood vessels in the throat.
Untreated, oral gonorrhoea can spread to the genitals, causing pelvic and testicular pain in men, and putting women at risk of pelvic inflammatory disease, ectopic pregnancies and even infertility.
Dr Alirol said: 'Women will bear a very high burden if we start having an increasing number of untreatable gonorrhea cases.'
Oral infections driving antibiotic resistance
Oral gonorrhoea is thought to be a key driver in the STI's antibiotic resistance crisis, as bacteria in the throat are exposed to antibiotics when such drugs are taken for any infection.
Due to the throat's confined area, drug-resistant genes from other bacteria can easily transfer across to the STI.
Strains of drug-resistant gonorrhoea have arisen globally, including in regions such as the US and Canada.
Certain strains have developed resistance to all but one treatment, which involves an injection of a specific antibiotic class, known as cephalosporin, alongside the oral antibiotic azithromycin.
Yet, so-called 'super gonorrhoea', which no longer even responds to that therapy, has been reported in Japan, France and Spain.
Doctors are therefore being forced to prescribe high-strength drugs, some of which have not been properly tested in humans and have no evidence of efficacy.