Headline — 12 July 2017 — by Adele Ramos
Belize alerted that gonorrhea is becoming increasingly untreatable

BELIZE CITY, Mon. July 10, 2017–Gonorrhea is one of the most common sexually transmitted infections (STIs) afflicting almost 80 million people globally, according to data published recently by the World Health Organization (WHO). Whereas there is no official information available to us to indicate how many infections occurred last year in Belize (the last public report of 2013 said there were 13 cases, 12 of them reported in males), it is known that it is also one of the leading STIs in Belize, along with, trichomoniasis, syphilis and chlamydia. So a pattern of increasing drug-resistance in Neisseria gonorrhoeae, the bacteria which causes the infection, is of concern to Belize.

Director of Health Services (DHS), Dr. Marvin Manzanero, told our newspaper today that increased levels of drug-resistance have been noted, particularly in the Americas, to medications usually administered to treat the infection, and this, he said, also has to do with the misuse of antibiotics for treating ailments. However, in Belize, it is often treated with the traditional drug – penicillin.

According to WHO, “Gonococcal resistance to penicillin and tetracycline first emerged in Asia during the 1970s,” and it notes rising resistance to newer drugs.

The Global Antibiotics Research and Development Partnership: Multi-drug-resistant gonorrhea: a research & development roadmap to discover new medicines, cited by WHO, says that while gonorrheal infection in the pharynx (the part of the throat which is behind the mouth) may not cause symptoms, the throat is a favorable site for such resistance to emerge, due to acquisition of resistance traits from other related species that normally exist in the throat. Gonorrheal infections can also affect the rectum or genitalia of males and females.

“Complications of gonorrhea disproportionally affect women, including pelvic inflammatory disease, ectopic pregnancy and infertility, as well as an increased risk of HIV,” WHO said.

In its news release issued on Friday, July 7, WHO said that data from 77 countries show that antibiotic resistance is making gonorrhea much harder, and sometimes impossible, to treat.

El Salvador is the only country from Central America included in the research, and a high level of resistance to the drug ciproflaxocin was reported there, but alternative drugs were more effective, as was also reported for Cuba. WHO also reports widespread resistance to older and cheaper antibiotics.

“Some countries – particularly high-income ones, where surveillance is best – are finding cases of the infection that are untreatable by all known antibiotics,” the report added.

“The bacteria that cause gonorrhea are particularly smart. Every time we use a new class of antibiotics to treat the infection, the bacteria evolve to resist them… These cases may just be the tip of the iceberg, since systems to diagnose and report untreatable infections are lacking in lower-income countries where gonorrhea is actually more common,” said Dr. Teodora Wi, Medical Officer, Human Reproduction, at WHO.

Belize’s DHS said that we do not have any resistant pattern in Belize for the bacteria which causes the STI, and cultures would have to be done to conduct such studies. Still, he said, it is a matter which health authorities here are looking at.

As a side note, the DHS informs that Belize is also on the alert in the wake of an outbreak of the coxsackie virus in neighboring Mexico. The virus is known to cause a contagious illness known as hand-foot-and mouth disease, which has previously been detected in Belize.

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