"In the near future, you could be stuck with green discharge and soiled underwear for life."

Earlier this week Junkee reported on the discovery of an extremely aggressive and critically antibiotic-resistant strain of gonorrhoea — a gonorrhoea super-superbug. It’s a story that has continued to both terrify and intrigue this reporter. I mean… a super-super-strain of a common STI? That is bonkers.

So, to help clarify some of the reportage on the super-superbug, and to find out how to avoid it, I approached Dr Brad McKay of Embarrassing Bodies Down Under for the lowdown on all things down low.

Junkee: What exactly is a “superbug” — and a “super-superbug”, for that matter?

Dr Brad McKay: “Superbugs” are multi-resistant bacteria that are able to evade death from the common antibiotics we usually prescribe. “Super-superbugs” are even smarter bacteria that are able to survive any antibiotic known to mankind.

Can you explain why gonorrhoea is evolving so quickly?

Gonorrhoea has a rapid life cycle and evolves quickly; it swaps DNA with other bacteria just as freely as a teenager swaps saliva at a drunken house party. Random exchange of genetic material can serendipitously lead to the formation of super-bacteria resistant to regular antibiotics.

“In the near future you could be stuck with green discharge and soiled underwear for life.”

Is the news of the super-superbug alarming? What does it mean for sexually active Australians?

The way we use antibiotics has changed over the past few decades to match the craftiness of gonorrhoea. In the past we just used a single antibiotic tablet to treat gonorrhoea, then we changed to using an intramuscular injection. A few years ago, we doubled the dose of antibiotics in the injection, and now we routinely use this high-dose injection PLUS tablets.

It’s alarming that we’ve needed to regularly update the way we treat gonorrhoea, but even more alarming that we’re now finding bacteria that’s resistant to all of our available antibiotics. If gonorrhoea continues to outsmart us, in the near future you could be stuck with green discharge and soiled underwear for life.

For sexually active Australians, this means it’s even more important to use barrier protection.

Is it true that there’s been a rise in gonorrhoea cases in Australia recently?

Gonorrhoea has been on the rise in Australia for many years.

Why do you think this is?

This appears to be a combination of doctors getting better at testing and finding it, but also due to falling rates of condom use. There’s also new evidence that suggests gonorrhoea can be spread by passionate kissing.

Many people don’t know that gonorrhoea isn’t just spread by vaginal or anal sex — oral sex will do.

How can you tell if you have gonorrhoea?

Most people know they have gonorrhoea because it stings when you pee and green pus drips from the end of your penis or out of your vagina. However, some people don’t have any symptoms at all.

The only way you can really know if you have gonorrhoea is by seeing your doctor for a sexual health check. If you don’t have symptoms, we’ll just ask for a urine sample and get you to pee in a cup. It’s not scary or painful.

What are the risks if you contract gonorrhoea and leave it untreated?

Untreated gonorrhoea can cause inflammation and scarring of delicate genital pipes, leading to infertility in both men and women. Chronic gonorrhoea causes an infection called epididymo-orchitis, where blokes grow a large, painful, swollen nut. Pelvic Inflammatory Disease (PID) occurs in women when gonorrhoea clogs up the fallopian tubes and oozes into the pelvis, causing high fevers and severe pelvic pain.

It’s not just the penis and vagina that can be affected. Pharyngeal gonorrhoea causes a perpetual sore throat, while rectal gonorrhoea can cause proctitis — a swollen, tender and bleeding anal passage.

What are the best methods to prevent contracting gonorrhoea?

If you’re in the early stage of a relationship, use condoms. See your GP, have a sexual health check, and get the ‘all clear’ before having sex without barrier protection. If you or your partner have multiple sexual partners, then use barrier protection and have a check up every three – six months.

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Matilda Dixon-Smith is Junkee’s Staff Writer. She tweets at @mdixonsmith.