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Europe seeing 'constant' increase in gonorrhea rates, study says

Researchers suggest high-risk sexual behavior -- specifically the non-use of condoms -- may be to blame for a 25 percent increase in diagnoses seen from 2013 to 2014.

By Stephen Feller

STOCKHOLM, Sweden, May 31 (UPI) -- Cases of the eminently treatable gonorrhea have increased continuously in Europe during the last decade, raising concerns about prevention and treatment efforts against the sexually transmitted infection's spread.

Researchers at the European Center for Disease Prevention and Control found in a review of data that rates continue to increase possibly because people are not using condoms, threatening to worsen simmering resistance to antibiotics by the pathogen.

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The study showed that, along with increases across the population of most countries in Europe, the infection has become almost as common among men who have sex with men and it is among heterosexual men and women.

The lack of a slowdown in the infection's spread also raises concern that people are not using protection during sex, which may contribute to increases in the transmission of other STIs, including HIV. In Europe, 11 percent of people infected with gonorrhea were co-infected with HIV, according to a press release from the ECDC.

Gonorrhea is a an STI that is relatively easy to spread among men and women that can infect the genitals, rectum and throat. Most public health agencies, including the U.S. Centers for Disease Control and Prevention, suggest people use condoms during sex as the best way to avoid infection.

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For the study, published online by the European Center for Disease Prevention and Control, researchers reviewed surveillance for gonorrhea in 2014 in 27 countries, 23 of which require all new cases of gonorrhea be reported and 4 of which only track diagnoses at certain clinics.

Overall, there were 66,413 cases of gonorrhea reported in 2014 across the 27 nations of the European Union, representing a 25 percent increase from 2013. Of the reported cases, 58 percent were in the United Kingdom. The highest rates in Europe were seen, after the U.K., in Ireland, Denmark and Latvia, with the lowest rates in Croatia, Cyprus, Luxembourg and Romania.

The largest proportion of these cases was among 15- to 24-year-olds, who account for 38 percent of cases, followed by 25- to 34-year-olds, who represent 34 percent of cases. The highest rate among any group of people was men between 20 and 24 who had 145 cases per 100,000 people.

The researchers also note that men who have sex with men were 44 percent of new cases in 2014, slightly lower than the 49 percent of gonorrhea diagnoses made up by the combined number of heterosexual men and women.

Although researchers found no significant increase in resistance to drugs used to treat the infection, small increases in resistance were seen with the drug azythromycin and concerns are raised in the report about resistance to the drugs cefixime and ceftriaxone.

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"The increasing number of cases, particularly among MSM, highlight the need to further strengthen prevention activities which target particular groups by using effective, evidence-based messages and methods," researchers write in the report.

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