Washington, D.C. – Today, the Centers for Disease Control and Prevention (CDC) released a Morbidity and Mortality Weekly Report (MMWR) titled Neisseria gonorrhoeae Antimicrobial Susceptibility Surveillance —The Gonococcal Isolate Surveillance Project, 27 Sites, United States, 2014 which is the first report to present comprehensive data from CDC’s gonorrhea surveillance system and summarize gonorrhea resistance trends over time.  What this report outlines is deeply troubling: This is a 316 percent increase in just one year.

“While no treatment failures have been reported in the United States, this data shows a very troubling trend, one that NCSD has been raising a clarion call on for years: that gonorrhea is steadily outwitting the drugs we have to treat it,” stated William Smith, Executive Director of the National Coalition of STD Directors (NCSD).  “This is shown not only by this data, but also the recent gonorrhea treatment failure in the United Kingdom.  Not only do we need new drugs to fight this infection but we also need additional resources to address our current gonorrhea epidemic, as rates are currently rising across the country,” continued Smith.

The CDC’s most recent STD surveillance data report found that in 2014, gonorrhea increased by 5 percent, driven by a concerning 10 percent increase among men.  In addition, between 2009 and 2013, the gonorrhea rate among men increased 20.3 percent.  The increasing gonorrhea resistance to azithromycin was seen in all regions of the country, but was particularly seen in the Midwest.  In addition, these increases were not just in one population group, but seen among heterosexuals, men who have sex with men (MSM), and men who have sex with women.  This is in contrast to past gonorrhea resistance patterns, which were higher on the West Coast and among MSM.

At the same time, Congress has proposed cuts to the Division of STD Prevention (DSTDP) at the CDC.  Last month, NCSD sent a letter to Congress decrying this proposed cut that is contained in the current Senate fiscal year (FY) 2017 Labor, Health and Human Services, Education, and Related Agencies Appropriations bill.  This proposed cut for FY17 funding comes on the heels of another proposed devastating cut the prior year of 20 percent to DSTDP from the Senate, against which NCSD successfully lead the fight.

While it is too early to know if this increasing resistance is a trend, it is another troubling point in our fight against gonorrhea.  This data shows the troubling fact that gonorrhea can rapidly develop resistance across the country, which has serious implications for treatment of this infection and control of our gonorrhea epidemic.  Azithromycin is not only a part of the CDC recommended gonorrhea treatment, but is also included in every alternative treatment to gonorrhea.  Clinicians should continue to follow the CDC’s gonorrhea treatment guidelines for dual treatment (250 mg of ceftriaxone delivered intramuscularly and 1 g of azithromycin delivered orally).

In order to reduce the gonorrhea disease burden before the arrival of gonorrhea treatment failures here in the United States, notifying and effectively treating partners of those with gonorrhea is also key and expedited partner therapy should be considered for partners unable or unwilling to access health care.  Those who are sexually active should also use condoms consistently and correctly to prevent the transmission of gonorrhea.  Effectively preventing gonorrhea also means providers should screen sexually active women under 25, women older than 25 at increased risk and sexually active MSM at anatomic sites of possible exposure at least annually.

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The National Coalition of STD Directors (NCSD) is a partnership of public health professionals dedicated to promoting sexual health through the prevention of STDs. NCSD provides dynamic leadership that strengthens STD Programs by advocating for effective policies, strategies,and sufficient resources by increasing awareness of the medical and social impacts of STDs. For more information, visit www.NCSDDC.org.