WHO warns of rising, worrisome levels of drug-resistant gonorrhea

News brief
Topics
Gonorrhea
Antimicrobial Stewardship
Sexually Transmitted Infections
Illustration of drug-resistant gonorrhea
Alissa Eckert / CDC

New data released today by the World Health Organization (WHO) highlight rising levels of drug-resistant gonorrhea.

The data from the WHO's Enhanced Gonococcal Antimicrobial Surveillance Program (ESGAP) report show that resistance to ceftriaxone and cefixime—the two antibiotics currently recommended for first-line treatment—rose from 0.8% to 5% and from 1.7% to 11%, respectively, from 2022 to 2024. Resistance to azithromycin, which is often used in combination with ceftriaxone and cefixime to ensure successful treatment, rose from 0.5% to 4%, while 95% of Neisseria gonorrhoeae isolates were resistant to ciprofloxacin.

Rising resistant to ceftriaxone and cefixime are especially concerning given that the two antibiotics are the last remaining recommended treatment options for gonorrhea, a sexually transmitted infection (STI) that has quickly developed resistance to every antibiotic that's been used for treatment. But there's hope that two new antibiotics that have shown promise in clinical trials (zoliflodacin and gepotidacin) could soon provide more options. 

The ESGAP data come from 13 countries in five WHO regions. The included countries—Brazil, Cambodia, India, Indonesia, Ivory Coast, Malawi, the Philippines, Qatar, South Africa, Thailand, Uganda, Vietnam, and Zimbabwe—reported 3,615 gonorrhea cases in 2024. The highest resistance rates were in Cambodia and Vietnam.

An urgent public health threat

Gonorrhea is one the four most common STIs globally, with an estimated 82 million cases every year. Because of the limited treatment options, the WHO has labeled drug-resistant gonorrhea a serious and urgent public health threat. If untreated, gonorrhea can cause pelvic inflammatory disease, ectopic pregnancy (implantation of a fertilized egg outside the uterus), and infertility in women.

WHO officials say ESGAP data are critical to efforts to monitor the spread of drug-resistant gonorrhea.

"This global effort is essential to tracking, preventing, and responding to drug-resistant gonorrhoea and to protecting public health worldwide," Tereza Kasaeva, MD, PhD, director of the WHO Department for HIV, TB, Hepatitis & STIs, said in a WHO press release. "WHO calls on all countries to address the rising levels of sexually transmitted infections (STIs) and integrate gonorrhoea surveillance into national STI programmes." 

Editor's note: This article was corrected on December 8 to remove Sweden from the list of countries providing data to the ESGAP report, and add Ivory Coast and Zimbabwe. 

More Indiana poultry operations hit with avian flu

News brief
Topics
Avian Influenza (Bird Flu)
birds
bariskaradeniz / iStock

Today the US Department of Agriculture's Animal and Plant Health Inspection Service (APHIS) reported four more highly pathogenic avian flu outbreaks on Indiana poultry operations. Indiana is currently the epicenter of avian flu activity. 

A commercial duck breeder in Elkhart County reported the virus was detected in an operation with 5,000 birds. And LaGrange County reported that another affected commercial duck meat facility with 5,500 birds was hit. 

Also in LaGrange County, two poultry farms with 28,300 and 8,700 birds, respectively, had confirmed outbreaks. 

Hundreds of wild birds test positive

Over the past week there have been hundreds of detections in US wild birds per APHIS updates. In Grant County, Washington, American wigeons and mallards that had been hunter harvested have been affected. And in Indiana dozens of hunter-harvested wild birds in Greene, LaPorte, and Newton counties tested positive for avian flu virus.

H5N1 avian flu activity is currently high, as wild birds spread the virus during their migration. Over the past 30 days, 88 flocks (38 commercial and 50 backyard) have been confirmed to be hit by avian flu outbreaks, and 1.88 million birds have been affected.

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