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Monday, July 11, 2011

Bad News On the STI Front

Posted by on Mon, Jul 11, 2011 at 3:42 PM

A newly discovered strain of gonorrhea—H041—is "resistant to all known forms of antibiotics." The "untreatable" strain has only been found in Japan so far. But STIs—like people—tend to get around, so it's only a matter of time before the H041 makes its debut here.

I'm the current spokesperson for non-monogamy, thanks to the New York Times, but as was noted in Mark Oppenheimer's piece: I've never endorsed promiscuity. Freaked out monogamists like to portray my nuanced, qualified position on non-monogamy as, "That Dan Savage person thinks that everybody should be fucking everything anytime without any regards for the consequences!" Not true. I think people should be careful and take reasonable precautions. I also think it's possible for a person to have too much sex, and too much much risky sex. And risks—like, oh, drug-resistant strains of various STIs—always have to weighed against rewards, and an honest risk assessment doesn't always favor sex.

The sex-haters on the religious right are going to love this news. They love anything that makes sex seem scarier and deadlier than it actually is or need be. But before religious nuts start celebrating this new strain of gonorrhea—and working into their abstinence-only lesson plans—they should at least have the decency to acknowledge how it got that way:

"This is both an alarming and a predictable discovery," Dr. Magnus Unemo said in a statement about H041. Unemo, based at the Swedish Reference Laboratory for Pathogenic Neisseria, worked with Japanese colleagues to characterize the new H041 multidrug-resistant gonorrhea strain.

Multidrug resistance is "predictable," in Unemo's words, because most gonorrhea strains worldwide are already resistant to at least one major class of antibiotics. Bacteria become resistant to antibiotics through evolution. Some naturally occurring genetic variation exists among Neisseria gonorrhoeae, the bacterial organism that causes gonorrhea, and that means that any one given bacterium may, by chance, be slightly more susceptible to antibiotics than another. When a colony of bacteria first comes in contact with antibiotics, therefore, the antibiotics will kill off the most susceptible bacteria at higher rates. This leaves behind a disproportionately robust batch of surviving bacteria, and when the survivors reproduce, they pass on their more-robust-than-average genes to their offspring. With repeated exposure to antibiotics, and over many generations of bacteria, eventually all the bacteria that are spreading are drug-resistant.

It wasn't a miracle, kids, it was evolution. Darwin, not Jesus.

 

Comments (51) RSS

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Eva Hopkins 1
Indeed, & that's why when my Dr. told me bronchitis wasn't treatable w/ antibiotics, I just sighed, thanked him & left. Because between overprescribing antibiotics, Purell, etc, we are losing our bodies' natural abilities to fight off small germs & the germs are becoming resistant to our over-medicating.

STI's you can't treat. Sigh.
Posted by Eva Hopkins http://www.lunamusestudios.com on July 11, 2011 at 3:46 PM
BEG 2
Yup, TB is also developing lots of drug resistant strains, same deal. I mean, we have people popping antibiotics for VIRUS infections (not the same thing, folks!).

If you are prescribed antibiotics, take them ALL, even when you feel better. Otherwise stopping before you're done means you've left behind the most resistent strains for sure -- lovely job of selection!

Ugh. Let me push condoms & sensibility, once more!
Posted by BEG http://twitter.com/#!/browneyedgirl65 on July 11, 2011 at 3:54 PM
leek 3
If only Japan had followed Kansas's laws:

http://www.theonion.com/articles/kansas-…
Posted by leek on July 11, 2011 at 4:00 PM
4
It's not QUITE that bad, but goodness, it's not good.
The original article is here:
http://www.ncbi.nlm.nih.gov/pmc/articles…
Found in the pharynx of a female Kyoto sex worker, the strain is resistant to all "first-line" antibiotics, i.e. those that are easy to give when the doctor isn't sure what the strain is, before the tests come back (penicillin, cephalexin, tetracycline, cipro, erythromycin, kanamycin, sulfa drugs, and a dozen more).

But the bug is still sensitive to spectinomycin, rifampin, and presumably the antibiotic vancomycin (which must be given intravenously), although spectinomycin is "not suitable for treatment of phayrngeal gonorrhea, nor is it currently available in many countries."
Pharyngeal gonorrhea "probably resolved spontaneously within 3 months," but the lesson is clear: Be careful what you put in your mouth!
Posted by Biologist in the stix on July 11, 2011 at 4:07 PM
ryanayr 5
This is not the first drug-resistant basteriological STI...
Multiple drug-resistant Chlamydia was found in 2000: http://www.ncbi.nlm.nih.gov/pubmed/10762…
And Mycoplasma Genitalium is already becoming resistant to a class of antibacterials:
http://www.ncbi.nlm.nih.gov/pubmed/18990…

Also, keep in mind that syphilis can be easily transmitted via oral sex, and is becoming more common thanks to HIV: http://journals.lww.com/stdjournal/Abstr…

have a nice afternoon!
Posted by ryanayr on July 11, 2011 at 4:08 PM
undead ayn rand 6
Resistant != untreatable/incurable. It just means doctors have to step up their game and for the near future it'll take slightly longer and a slightly larger dose to cure someone.
Posted by undead ayn rand on July 11, 2011 at 4:09 PM
Ophian 7
Depressing news on the health front, but no score for evolution either. The science-illiterate IDers, like the hacks at The Discovery Institute [right there in Seattle] accept micro-evolution.

They make a bullshit arbitrary distinction between how you can get a new breed of dog, but you can't get a new species. So that there STI is just part of their sky-buddy's Intelligent Design.
Posted by Ophian on July 11, 2011 at 4:10 PM
Sargon Bighorn 8
Gay men won't let this stop them from doing what they want. "Don't tell me how to live old man!"
Posted by Sargon Bighorn on July 11, 2011 at 4:29 PM
9
STIs do not mean that sex is bad or wicked - but perhaps people should be working on ways of moderating their sexual behaviour - where is the realistic, concrete advice on how to achieve that?

It seems that - along with the '60s free love movement and everything that has followed, up to and including Dan - there is a great deal of encouragement to explore sexual experience with only the rather weak caveat that one should employ barriers.

Isn't it time to start getting more practical about guiding the population (or at least those who are willing to listen) into ways of coping more strategically about their sexual health?

It seems to me that Dan's focus has always been about giving permission to explore one's sexuality, to challenge conventions and norms without ackowledging that most young people find self regulation difficult. I don't propose a return to the 50s abstinence per se, but without that social taboo - what are young, impulsive and naive folks to do?
Posted by truck on July 11, 2011 at 4:34 PM
Fifty-Two-Eighty 10
What Sargon said.
Posted by Fifty-Two-Eighty http://www.nra.org on July 11, 2011 at 4:48 PM
11
#7 is correct about the quacks/hacks at The Discovery Institute--they make a big deal of the supposed distinction between changes in existing species and micro-evolution (which they accept) and speciation (which they do not).

However, thanks for the blurb Dan. It clearly and concisely explains a very important concept in microbiology--as other posters have already noted, it has broad implications. While most Sloggers are probably already familiar with multiply-resistant infectious agents, it is depressingly likely that much of the general public is not.
Posted by Functional Atheist on July 11, 2011 at 4:57 PM
Sandiai 12
"It wasn't a miracle, kids, it was evolution."

But evolution itself is caused by God (see Intelligent Design).
Posted by Sandiai on July 11, 2011 at 5:12 PM
13
@4 vancomycin has no action against gram negatives, I'd be very surprised if this fancy new strain were susceptible to it.
Posted by family doc on July 11, 2011 at 5:12 PM
14
"I also think it's possible for a person to have too much sex, and too much much risky sex."

How do you define "too much much risky sex," Dan? Just curious.
Posted by My Name Here on July 11, 2011 at 5:38 PM
onion 15
I also want to know what Mr. Nuance's definition of "promiscuous" is.
Posted by onion on July 11, 2011 at 5:49 PM
16
@1+2, overuse of antibiotics in cattle/chicken actually accounts for a much larger reason that bacteria are becoming antibiotic-resistant. People should use antibiotics as directed, and only when directed to, but the truth is that as long as we have factory farming--where animals are packed together so tightly that it is necessary to use antibiotics prophylactically (sp)--we will continue to make bacteria drug-resistant. Unfortunately.
Posted by brokephilosopher on July 11, 2011 at 6:01 PM
I Hate Screen Names 17
Quoth @12:
But evolution itself is caused by God (see Intelligent Design).
Intelligent Design is not the idea that God created evolution. It's actually just a thin coat of paint on Creationism, which was uniformly rejected by federal courts. So the Christian fundamentalists took the same Genesis passages as always, threw in a little Thomas Aquinas, and insisted that they had a different theory that was based on "science" instead of religion. Thus far the courts have not been fooled.

After all, if Intelligent Design consisted of teaching evolution and saying "God did it" at the end, the proponents would not be so opposed to teaching evolution in the first place.
Posted by I Hate Screen Names on July 11, 2011 at 6:07 PM
18
Dream on. This is the same crowd that thinks AIDS is a plague sent to punish the homos and vaccinating girls against HPV is an affront to the Lord because sluts deserve cervical cancer.
Posted by Corydon on July 11, 2011 at 6:53 PM
saxfanatic 19
To "Darwin, not Jesus", I say Nietzsche, not Darwin i.e. what fails to kill the infection outright actually trains it to adapt. As @16 suggests, incorrect administration of antibiotics is the biggest problem.

If you're going to take the meds, follow the doctor's instructions.
Posted by saxfanatic on July 11, 2011 at 7:59 PM
20
Can't treat it, can probably avoid it.

Common sense precautions, consistently applied, and we all know what sort of precautions I mean, can probably reduce the odds of getting this one down to "less risky than crossing the street."

I think that Dan once said "more sex with fewer partners."

Works for me.
Posted by Docme on July 11, 2011 at 9:38 PM
21
@13 Whoopsie, of course you're right. Thanks, doc!
Posted by Biologist in the stix on July 11, 2011 at 9:55 PM
22
You don't *really* think they won't believe wholeheartedly that this is divine intervention at work, do you?

No, I didn't think so.
Posted by gromm on July 11, 2011 at 10:13 PM
23
I'm not religious, right-wing, or a "sex-hater", but I do think sex should be special. A story like this popping up in the news is a nice reminder of how smart it is to limit your sexual partners to people you care about and trust very much.
Posted by Amanda on July 11, 2011 at 10:18 PM
24
@14, 20: I'm more curious to know what Dan thinks is "too much sex" but not "too much risky sex." How can you have too much non-risky sex?
Posted by BlackRose on July 11, 2011 at 10:18 PM
Sandiai 25
Sorry, I should have said "directed," rather than "caused."(*) I argue with ID proponents on a regular basis (And they're scientists too, bah!). This idea is part of the huge, shaky intellectual edifice they've erected in their heads in order to justify working in a scientific field (we're biologists at the patent office). And when I try to pin them down on the science or the "design" or even "how much" is science and how much is the Designer's handiwork, I always get inconsistent gobbledegook and personal opinion. Hell, for all their talk about science and whatnot, I can't even get a testable hypothesis out of them. It's not surprising that they don't even understand their own theory, since there's nothing there to understand. Everything I've read about ID seems to mostly focus on criticising evolution without articulating a counterpoint theory. That's why when they were talking about teaching it in schools, I thought, "teaching WHAT, exactly?"

I agree with everything you said, BTW. I just stated things clumsily (and un-funnily too, apparently).

(*)"It will not be possible to rule out the supposition that the process of evolution may be guided by an intelligent design" (Schiller, who coined the phrase I believe).

Posted by Sandiai on July 11, 2011 at 10:26 PM
Sandiai 26
That was meant for @17, in case it's not obvious.
Posted by Sandiai on July 11, 2011 at 10:27 PM
27
" nuanced, qualified position on non-monogamy"

Danny, are you being funny?

We're not sure.

Some people think their Bullshit is funny....

" too much much risky sex...."?

You do realize,
Danny,
that any sex that falls outside of "abstinence and then monogamy"
(with a partner who is playing the same rules...)
is "risky"

Do you realize that?

And you do realize that any risky sex is too much risky sex?

If you want to be healthy, that is.

Posted by CDC on July 12, 2011 at 2:49 AM
28
Gosh the troll has been telling Danny and Slog forever that new more virulent STDs are inevitable as long as the lifestyle choices remain what they are and what Danny advocates.

We hope this wasn't a surprise to you, Danny.

It won't be the last and isn't the worse you will see......

But rather than confront that reality Danny would rather play snark-asshole and shoot down the fundy strawman that he soooo loves to beat up on.

It must make him feel good....

Posted by should have seen this cuming a mile off.... on July 12, 2011 at 2:51 AM
29
Yeah.
Totally Darwin.
Mother Nature want's you to be abstinent, then monogamous Danny.
AIDS?
HO41?
Her gentle way of reminding you....

Jesus?
He loves you Danny.
And he knows his Darwin.
(he knew Darwin before Darwin knew it....)
He knows that Mother Nature wants you to be abstinent, then monogamous Danny.
So for thousands and thousands of years
He has been telling you not to fornicate
or commit adultery
or lie with mankind.
Cause it wouldn't have been fair to wait for the CDC to figure out the same thing.

Are you listening, Danny?

Tell the Truth, Danny;
you really don't give a Fuck that 20% of homosexuals have HIV.

You won't give a Fuck if 80% of homosexuals get HO41.

Hating on your enemies is WAY more fun.

Right?
Posted by It all cums down to Danny's HATRED of Religion on July 12, 2011 at 3:00 AM
30
The answer to this problem is not "sex should be special" or "they're having too much [risky] sex." That is moralizing, sex-negative bullshit. STIs can and sometimes do happen even when the sex you're having is as loving and special and cautiously done as possible.

The answer to this problem lies with medical and scientific research, which has been telling us for years and years that we depend too much on antibiotics and other medications, and that our sanitation practices encourage the evolution of untreatable diseases.

Another thing that would help: better sex education.
Posted by Skipper Jo on July 12, 2011 at 5:10 AM
31
But of course, Dan knows all this. The post is clearly meant to continue (AGAIN) his defensive stance against Oppenheimer and his ilk. Dan, why are you still going on about this? You've put your message out there already. There's no need to use every news story as an occasion to repeat it.
Posted by Skipper Jo on July 12, 2011 at 5:14 AM
venomlash 32
@27: Actually, it's possible to have perfectly SAFE sex with someone who fucks multiple people (possibly even concurrently). See, there's this magical little thing called an STD test. If you get tested regularly, you can be 100% SURE that you're not spreading anything. Sure, there's time in between tests...but if you make your partners produce a clean bill of health regularly, you're safe in that regard too!
STDs are not caused by sluttiness; they just take advantage of it. We humans, however, can outsmart them.
@28: Yes, you've been going on and on about how we're all going to die of space herpes. But, as it happens, you're entirely wrong.
More virulent? Let's see, "virulent" means "highly infective". This new strain of the clap isn't any more catching, or even more severe than any other strain. It's just harder to treat. If this new strain is cosmic punishment for making whoopie, just about every other drug-resistant bacterium is cosmic punishment for cattle farming.
@29: i'm twelve and what is this?
Posted by venomlash on July 12, 2011 at 6:24 AM
Rob in Baltimore 33
Cars are far more dangerous than sex, and yet I don't hear the Jesus people screaming that cars are evil.
Posted by Rob in Baltimore http://www.wishbookweb.com/ on July 12, 2011 at 7:23 AM
34
33
Yes.
It is well known that 20% of all car owners come down with terrible diseases....
Posted by Sex isn't evil, Bob. You are. hgahahahahahahahahaha on July 12, 2011 at 7:59 AM
Rob in Baltimore 35
Car crashes kill and harm far more people than sex. God must hate drivers, and their passengers!

Also, why does God hate Japan? First an earthquake, now drug resistant STDs?
Posted by Rob in Baltimore http://www.wishbookweb.com/ on July 12, 2011 at 8:18 AM
36
@34 Actually, STIs are much more prevalent in the religious areas of the country than the non-religious. The people most likely to get gonorrhea, including presumably this new one, live in the deep south.
http://www.cdc.gov/std/stats09/figures/m…

On the face of it, one could make the argument that religious belief is a strong predictor for STDs.
Posted by Biologist in the stix on July 12, 2011 at 8:43 AM
37
36
You're quite the comodian!

King Co Health Dept.....

"Recently, cases of gonorrhea among gay and bisexual men in King County more than doubled , and chlamydia cases increased by at least 50 percent. The rate of gonorrhea in gay and bisexual men in King County now is at least 10 times higher than in heterosexuals."

"Even more dramatically, the rate of syphilis infection in the gay population has skyrocketed. The rate of syphilis in gay and bisexual men in King County now is 150 times greater than for the heterosexual population."
Posted by Gay=Groinorrhea on July 12, 2011 at 8:58 AM
38
Sharp rise in syphilis cases among local gay/bi men

Friday, March 18, 2011
KING COUNTY, WA -- Syphilis cases in King County reached a 30-year high in 2010, prompting public health officials to call for increased testing and education for high-risk populations, especially men who have sex with men. In 2010, 283 cases of syphilis were reported, an 82 percent increase from 2009. Syphilis had been virtually eliminated in King County in the early-1990s.

Public health officials do not fully understand what is causing the upswing in cases. Rates of syphilis among gay and bisexual men also appear to be increasing in other areas of the U.S.

Gay and bisexual men have the highest rates of syphilis. Ninety percent of cases diagnosed in 2010 were in men who have sex with men, with HIV-positive gay and bisexual men making up 58 percent of those cases.

www.kingcounty.gov/healthservices/health…;
Posted by Who knew Gays were so Religious? on July 12, 2011 at 9:01 AM
Rob in Baltimore 39
37, Again, car crashes kill and injure many more people than sex.

in fact these are all things that kill and injure people more than sex.

1 Diseases of heart
2 Malignant neoplasms
3 Chronic lower respiratory diseases
4 Cerebrovascular diseases
5 Accidents (unintentional injuries)
6 Alzheimer’s disease
7 Diabetes mellitus
8 Influenza and pneumonia
9 Nephritis, nephrotic syndrome and nephrosis
10 Intentional self-harm (suicide)
11 Septicemia
12 Chronic liver disease and cirrhosis
13 Essential hypertension and hypertensive renal disease
14 Parkinson’s disease
15 Assault (homicide)
Posted by Rob in Baltimore http://www.wishbookweb.com/ on July 12, 2011 at 9:02 AM
40
Syphilis and other STDs epidemic in King County among gay and bisexual men

Thurday, October 31,
KING COUNTY, WASHINGTON - Today, the Centers for Disease Control and Prevention (CDC) released a new report citing continued declines in syphilis among African Americans and women of all races, but an alarming resurgence of syphilis among gay and bisexual men (November 1 issue of Morbidity and Mortality Weekly Report). In King County, syphilis was eliminated in the mid-1990s, but reappeared in 1997, and since 1998 this sexually transmitted disease has continued at epidemic rates locally among men who have sex with men.

In King County, there are now between 50 and 60 cases of syphilis each year among gay and bisexual men. "That's 120 to 150 cases per 100,000 gay men each year. The rate in heterosexual county residents is less than one per 100,000," said Dr. Hunter Handsfield, Director of Public Health - Seattle & King County's STD Control Program.

According to Public Health officials, over 60 percent of the gay and bisexual men with syphilis also are infected with HIV, the virus that causes AIDS.

Gonorrhea, another STD, also is accelerating in men who have sex with men. Chlamydia rates in gay men also are rising.
Posted by ....that's nasty...... on July 12, 2011 at 9:04 AM
Rob in Baltimore 41
Again, cars kill and injure more people than sex. Just because you can't have sex, doesn't mean that others can't safely have it.
Posted by Rob in Baltimore http://www.wishbookweb.com/ on July 12, 2011 at 9:13 AM
venomlash 42
Alleged, just because male homosexuality correlates to high STD rates doesn't mean that religiosity doesn't.
If you want to think that STDs are divine punishment for immoral behavior, than blessed are the lesbians, for they shall inherit lower rates of STDs than gay men or heterosexuals of either gender.
Posted by venomlash on July 12, 2011 at 9:27 AM
Rob in Baltimore 43
Cars are inherently dangerous, much more so than sex, but there are ways to mitigate the dangers. Drive carefully, no texting, or talking on the phone, wear a seat belt, etc. Too often, gay men have unprotected sex with too many partners. They take too many chances. It's a problem in the community that needs to be addressed. Part of the problem is that society has made them feel unaccepted, and unworthy of protecting themselves (This is according to the CDC) and also because they are men. Straight men would have just as much sex if straight women would let them.

It has been shown in every legitimate psychological study that sexual orientation cannot be changed. (Trying to change it, more often than not, leads to destructive behavior) What people do within their own orientation can. One can be gay, and have gay sex safely. As I've said before, I've never had any kind of STD ever.
Posted by Rob in Baltimore http://www.wishbookweb.com/ on July 12, 2011 at 9:51 AM
44
" It wasn't a miracle, kids, it was evolution. Darwin, not Jesus."

Oh, nice try, but that was a phone-in, Dan, because you know damn well that the kind of person who believes in the Creationist argument is going to go to one of two places LONG before they arrive at "evolution."

The first, and most obvious place, is that God created the new form of gonorrhea. If evidence that evolution resulted in human beings and Republicans isn't convincing, evidence that a sexual disease evolved isn't going to blip their radar.

Second, of course, is that you are leaving out Satan. Obviously, like all this sciency stuff, GOD did the work, but SATAN is in charge of the cover-up, lulling people into believing in things like evolution, to the peril of their immortal souls.

But then, as a minion of Satan, you knew that already.
Posted by Lymis on July 12, 2011 at 9:52 AM
45
@42: "blessed are the lesbians." I laughed. And it's true. Do religious nuts think that lesbians don't count as being really gay or something? cause basically everything they spew vitriol about when confronted with gay men is more true of heteros than of lesbians...
Posted by brokephilosopher on July 12, 2011 at 10:08 AM
46
43 etc

OK Bob, were you molested by a car as a child?
it must have been horrible.
Perhaps counseling can help.....
Posted by perhaps autoerotic therapy would help-get it? "auto"erotic! on July 12, 2011 at 10:16 AM
venomlash 47
@46: By your logic, you must have been molested as a child by someone who has sex. Show me on the doll where they touched you.
Posted by venomlash on July 12, 2011 at 10:39 AM
You Look Like I Need A Drink! 48
Ygyahhhh!!!!! You know this is gonna hit Seattle soon- with all the pac-asian cross-pollinating and all... Rice Queens (and the Dragon Lady Gaysians that prey on them) take note!
Posted by You Look Like I Need A Drink! on July 12, 2011 at 11:16 AM
Rob in Baltimore 49
46, I love driving.
Posted by Rob in Baltimore http://www.wishbookweb.com/ on July 12, 2011 at 12:17 PM
50
@36: Did you really just post a link to a graphic showing that the incidence of gonorrhea in Utah is 0 and then conclude "one could make the argument that religious belief is a strong predictor for STDs"?
Posted by Old Crow on July 12, 2011 at 12:28 PM
51
@50 - I think I remember another thread where we discussed that the hyper-religious also don't believe in modern medicine, so those areas also tend to have these issues underreported (I think it was with the *Amish* guy that was sexting the 12 year old)....
Posted by ariane on July 13, 2011 at 10:28 AM

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