STD Awareness: Ceftriaxone-Resistant Gonorrhea

syringeNestled in the throat of a Japanese woman was a collection of clones that scientists abducted from their temporary habitat and christened H041 — a humdrum moniker for a strain of bacteria that would burn headlines in medical journals. Though the bacteria never caused symptoms in their host, they lingered in her throat from at least January until April of 2009, when a swab finally tested negative. Rather than succumbing to repeated bombardment by an antibiotic called ceftriaxone, the infection probably just went away on its own — as oral gonorrhea infections tend to do.


Resistance to ceftriaxone, our last good gonorrhea drug, has been reported in Japan, Australia, Sweden, France, and Spain.


The emergence of antibiotic-resistant gonorrhea is considered one of the most pressing problems in infectious disease — just two years ago, the Centers for Disease Control and Prevention named it an “urgent threat.” We have one remaining first-line gonorrhea treatment left: extended-spectrum cephalosporins, which include cefixime, which is taken orally, and ceftriaxone, which is administered as a shot. Resistance to cefixime was first documented in 1999, leaving ceftriaxone as our best remaining option, and the CDC’s first choice for treating gonorrhea. There are no good alternatives to ceftriaxone remaining, which is why reports of ceftriaxone-resistant gonorrhea are so deeply troubling.

What made H041 special was that it was the first extensively drug-resistant strain of Neisseria gonorrhoeae, the bacteria that cause gonorrhea. With an unusually high level of resistance to ceftriaxone — four to eight times higher than the previous record holder — the strain was also resistant to a slew of other antibiotics: penicillin and its relatives, fluoroquinolones, macrolides, tetracycline, trimethoprim-sulfamethoxazole, chloramphenicol, nitrofurantoin, cefpodoxime, cefixime, ciprofloxacin, and levofloxacin — and had reduced susceptibility to azithromycin to boot.

Another thing that made H041 special — as special as clones can be, anyway — is that it never reappeared. After its discovery, researchers in Kyoto and Osaka intensified their surveillance, trying to uncover it again and track its spread through the population. However, their search for H041 turned up empty handed. But other ceftriaxone-resistant strains have been documented around the world. Continue reading

STD Awareness: Why Should You Care About Oral Gonorrhea?

Image: CDC

An illustration of Neisseria gonorrhoeae, the bacteria that cause gonorrhea. Image: CDC

When I say “gonorrhea,” you might think of genitals that feel as though they have been set ablaze, or perhaps a viscous fluid oozing from the urethra. But gonococci, the bacteria that cause gonorrhea, can also set up camp in the pharynx after being transmitted into a mouth and down a throat when its new host gave oral sex to its old host. Indeed, performing oral sex on multiple partners has been found to increase risk for an oral gonorrhea infection (more properly called pharyngeal gonorrhea).

If you read our September 2012 article on gonorrhea of the throat, you might remember these fun facts: Oral gonorrhea goes away within three months, even without treatment! Plus, these infections rarely have symptoms. Why, then, should you care about a gonorrhea infection in your throat? You’re not likely to notice it’s there, and it’ll go away on its own anyway.


Many researchers believe that the throat is an incubator for antibiotic-resistant gonorrhea.


Well, aside from the possibility of transmitting a gonorrhea infection from your throat to someone’s genitals, there’s one other thing to care about: the development of antibiotic resistance.

The emergence of antibiotic-resistant gonorrhea is considered one of the most pressing problems in infectious disease — just two years ago, the Centers for Disease Control and Prevention named it an “urgent threat,” and indeed, gonorrhea seems to be evolving resistance to drugs at quite a rapid clip. If gonorrhea evolves complete resistance to the drugs we use to cure it, we could find ourselves sent back in time, to the days when gonorrhea was untreatable — and responsible for infertility, blindness, and chronic pain. While scientists figure out how to address this emerging threat, you can do your part by avoiding gonorrhea in the first place — and that includes using condoms and dental dams to prevent oral gonorrhea infections.

So, while it sounds like a blessing that gonorrhea of the throat rarely has symptoms, there’s actually a drawback: An oral gonorrhea infection probably won’t be effectively treated — or even identified in the first place. And these hidden throat infections are likely to be helping to drive the development of antibiotic resistance. Continue reading

From Phoenix to Washington — And the World: A Short History of the Transgender Pride Flag

Monica Helms (right) holding up her Transgender Pride Flag

Monica Helms (right) holding up her Transgender Pride Flag

November is the month for transgender pride and awareness events. In some communities, it’s one day in November: One of the most widespread observations is Transgender Day of Remembrance (TDOR), which is held every November 20. In others, TDOR is part of a longer observation, Transgender Awareness Week. Elsewhere, the whole month is devoted to the theme. Noteworthy, too, have been grassroots efforts organized at TransParentDay.org to make the first Sunday in November a celebration of transgender parents.


Phoenix, Arizona, is the birthplace of the Transgender Pride Flag.


However they’re timed, these events share common themes. They are occasions for transgender people and their allies to remember victims of transphobic violence. They are opportunities to assert rights, dignity, and a place in society — to demand the visibility and respect that transgender people are too often denied.

Transgender visibility has also been strengthened by a powerful symbol that first made its appearance at the Phoenix Pride Parade in 2000. Since the creation in the 1970s of the rainbow flag, a symbol shared broadly by LGBTQ people, several newer flags have appeared, each representing sexual and gender identity groups within the LGBTQ community. In 1999, Michael Page, the creator of the Bisexual Pride Flag, suggested to longtime Phoenix resident Monica Helms that she create a similar flag for the transgender community. Continue reading

Book Club: Woman Rebel – The Margaret Sanger Story

Woman RebelNow that comic books have become the source material for blockbuster movies, the oft-told story of the maligned and misunderstood superhero should be a familiar one, even to many who have never read a comic. Think Professor Xavier’s cohort in the X-Men movies or Christopher Nolan’s take on Batman. They’re extraordinary. They’re also flawed, often unable to shake the ghosts of an uneasy past. But their powers, not their shortcomings, are the reason they’re so maligned. No matter their good intentions, they challenge what is known and established, earning them fear and distrust.


Bagge’s graphic novel is a refreshing contribution to a medium that is often a guilty pleasure at best.


Given that trope, maybe it wasn’t such an odd idea to give the comic book treatment to the life of Margaret Sanger, the reproductive rights pioneer and founder of Planned Parenthood. Writer and illustrator Peter Bagge, a veteran of alternative comics, does just that in Woman Rebel: The Margaret Sanger Story (Drawn & Quarterly, 2013). The outcome is a graphic novel that doesn’t let exaggerated expressions, vivid colors, and terse speech bubbles derail an intelligent and sensitive retelling of Sanger’s life.

Comparing Sanger to a superhero might be hyperbole, but Sanger’s trailblazing work not only created the movement to advocate for birth control but also spurred the development of the oral contraceptive, or “the Pill.” She had the drive and the know-how to contribute to the movement as an author, editor, lecturer, and founder of a reproductive health clinic. Along the way, Sanger helped change the laws that stood in the way of reproductive freedom and bodily autonomy, while rubbing shoulders (and sometimes developing romances) with many luminaries of her time, from novelists to political agitators to wealthy industrialists. March is Women’s History Month, and this year’s theme is Celebrating Women of Character, Courage, and Commitment — a theme perfect for someone of Sanger’s stature. Sanger’s visionary efforts earned her many accolades — as well as a campaign of character assassination that has called her everything from a fascist to a proponent of genocide. Continue reading

Margaret Sanger in Tucson: Reclaiming the Spotlight

Photo credit: Arizona Historical Society

Photo credit: Arizona Historical Society

“The first thing when you opened your eyes, before actual dawn, you beheld the gold and purple and then the entire sky break into color. In the evening the sunsets were reflected on the mountains in pink-lavender shades; sometimes the glow sprayed from the bottom upward, like the footlights of a theater, until the tips were aflame. Sunset vanished as quickly as the sunrise, never lingering long.”
– Margaret Sanger on Tucson, in her autobiography

Margaret Sanger’s more laid-back years in Tucson saw her with the free time to try out new things, such as cooking and painting. Another role in which Sanger indulged was as the hostess of some of Tucson’s most lavish parties. This was partly an attempt to reclaim some of her former celebrity – she missed the attention and sought once again to be in the spotlight, if only locally. Continue reading