The World Health Organization (WHO) is warning that antibiotic-resistant strains of gonorrhea are on the rise, and about 78 million people per year could be at risk for the sexually-transmitted disease (STD). 
In a recent report, the WHO explains how researchers looked at data from gonorrhea cases and antibiotic resistance from 77 countries. Of those countries:
- 97% of those that reported data from 2009 to 2014 had cases that were resistant to ciprofloxacin;
- 81% reported cases were resistant to azithromycin;
- 66% had infections resistant to cephalosporin.
Dr. Teodora Wi, medical officer of human reproduction at the WHO, who co-authored the report, said in a statement:
“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.”
More frightening yet, some countries reported gonorrhea infections that were resistant to every defense doctors threw at 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.”
There has been a global increase in cases of gonorrhea, partly because of unprotected vaginal, anal, and oral sex, as well as the sharing of sex toys.
Antibiotic-resistant gonorrhea has been spreading across Asia, North America, Europe, Latin America, the Caribbean, and Australia, the report states. 
Increased travel, poor gonorrhea-infection detection, and inadequate treatment also contribute to the spread of the infection, according to the researchers. 
Gonorrhea can infect the genitals, rectum, and throat, but the WHO is most concerned about infections of the throat, stating that “thrusting gonorrhea bacteria into this environment through oral sex can lead to super-gonorrhea.”
The report adds:
“Today, lack of public awareness, lack of training of health workers, and stigma around sexually transmitted infections remain barriers to greater and more effective use of these interventions.”
The organization says that gonorrhea infection can be prevented through “safer sexual behaviour, in particular, consistent and correct condom use.”
More women than men suffer serious gonorrhea-related complications, including “pelvic inflammatory disease, ectopic pregnancy and infertility, as well as an increased risk of HIV,” according to the WHO.
Researchers are looking into new drugs to treat the super-STD: solithromycin, zoliflodacin, and gepotidacin. Pharmaceutical companies don’t have much financial incentive to create new antibiotics, because the drugs are only taken for short periods, which makes them less profitable. What’s more, drugs become less effective over time, which feeds the need to constantly develop new antibiotics to treat gonorrhea. 
One of the problems with gonorrhea is that many people who have the disease don’t have any symptoms.
People may have symptoms such as discharge from the urethra or the vagina, but these symptoms may not be caused by other conditions. In turn, doctors sometimes assume the patient has gonorrhea and prescribe antibiotics to treat it, but this only fuels antibiotic misuse and antibiotic resistance.  
Dr. Marc Sprenger, director of antimicrobial resistance at WHO, said in a statement:
“To control gonorrhea, we need new tools and systems for better prevention, treatment, earlier diagnosis, and more complete tracking and reporting of new infections, antibiotic use, resistance and treatment failures.” 
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