'Stealth' gonorrhoea on the rise

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Pastor Dale Morgan

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Mar 11, 2007, 7:05:52 AM3/11/07
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*Plagues, Pestilences and Diseases*

*'Stealth' gonorrhoea on the rise*

* 16:34 09 March 2007
* NewScientist.com news service
* Lisa Hitchen

"Stealth" strains of gonorrhoea that fail to show up in tests are on the
rise across the world, researchers have discovered, because the tests
used by doctors to identify the bacteria look for an enzyme no longer
present in those strains.

The rising prevalence of these strains was found in Australia, New
Zealand, England, Scotland and Denmark. The findings should prompt
clinics to change practice and use at least two tests that work in
different ways to detect the infection, the scientists say.

The prolyliminopeptidase (PIP) enzyme was previously thought to be
present in all strains of gonorrhoea and was therefore used in many
diagnostic tests. However, mutations or deletions in the PIP gene that
prevent the production of this enzyme had been identified in some
strains. Gonorrhoea is known for its ability to mutate throughout its
entire growth phase.

Magnus Unemo, a microbiologist at Orebro University Hospital, Sweden and
colleagues examined a total of 41 samples lacking the PIP enzyme from
patients in Australia, New Zealand and Scotland. The samples were
obtained between 2001 and 2004.

To see how widespread this stealth strain is across the globe, they then
compared these with samples from other studies in England and Denmark.

Widespread dissemination

All the samples from New Zealand and Scotland, and 83% of Australian
samples, were indistinguishable or very similar to the English and
Danish samples and had evolved from a single original strain. The data
show "widespread dissemination" of the strain, the researchers say.

The strain was previously known to be circulating among homosexual men,
but the new work suggests it has become a growing concern within the
heterosexual population as well.

The strain did not appear resistant to the antibiotics typically used to
treat gonorrhoea and all patients were given treatment.

Untreated gonorrhoea infections can cause severe and permanent health
problems and can even be fatal. It can also cause infertility by harming
the testicles or fallopian tubes. These risks mean it is "crucial that a
rapid, highly sensitive and specific confirmation of N. gonorrhoeae is
provided," the authors say.

Journal reference: Sexually Transmitted Infections (vol 83, p 47)

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