Canada: Gonorrhea Making Surprising Comeback

Gonorrhea is on the rise in Canada and growing dangerously resistant to even the most potent antibiotics. After 20 years of constant decline, gonorrhea rates have jumped more than 40 percent over the past five years, Health Canada scientists report. Even more worrisome, drug-resistant strains of the disease are being reported across the country.

The National Laboratory for STDs is now receiving up to 5,000 isolates each year that are immune to at least one antibiotic. Moreover, the proportion of samples resistant to ciprofloxacin, one leading treatment, is soaring, jumping more than 200-fold in the past decade. The situation is grimmer in Atlantic Canada, where ciprofloxacin-resistant gonorrhea is double the national number.

Experts are blaming gonorrhea's revival in part on evaporating fears of HIV due to improved drug treatments. In addition, a new generation of sexually active youth never witnessed the early devastation of AIDS, said Dr. Janice Mann, acting manager of Health Canada's sexual health and STD section. Suddenly, the fear factor that once kept gonorrhea under control is vanishing.

In women, untreated gonorrhea can lead to pelvic inflammatory disease and scarring of the fallopian tubes, causing infertility or increasing the chances of ectopic pregnancies. Men can be left infertile from genital tract scarring and, for both sexes, the infection can spread through the blood into the joints, causing gonoccocal arthritis. Further complicating the picture for women is that as many as half do not exhibit symptoms.

Canada's gonorrhea infection rate had fallen from 227 infections per 100,000 people in 1981 to 15.1 per 100,000 in 1997. The trend followed the introduction of safe sex campaigns and changing sexual practices. Preliminary figures show the infection rate was at least 21.9 per 100,000 people in 2002. There were 6,855 cases reported last year, compared with 4,522 in 1997.