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

Illegal Procedure: How a 1974 Stadium Bill Put Reproductive Rights in the Sidelines

StadiumFans of the University of Arizona football team will arrive by the thousands at Arizona Stadium on September 3, the start of the fall football season, as the UA Wildcats face off against the UTSA Roadrunners, a team they defeated 26 to 23 in San Antonio last September. For fans, the stadium is a place where legends and losses are remembered. For reproductive rights advocates, it represents a devil’s bargain that took place more than 40 years ago and continues to compromise health care to this day.


In 1974, abortion rights were sacrificed to expand Arizona Stadium.


Arizona has long had a unique role in the abortion battle. In 1962, Sherri Finkbine, a Phoenix-area woman, entered the national spotlight after she found out the thalidomide she was taking as a sleep aid could cause severe fetal abnormalities. The early mortality rate among infants who were exposed to the drug was about 40 percent, in large part due to internal defects that commonly affected the kidneys, heart, digestive tract, and reproductive system.

Fearing how thalidomide would affect the development of her own fetus, Finkbine wanted to terminate her pregnancy in a state — and nation — that put legal barriers in the way of abortion. Already known to many as the star of a locally produced children’s show, she became a topic of national debate when she shared her story with a reporter from the Arizona Republic. She spoke to the reporter in the hopes of warning other mothers about thalidomide. An unintended consequence was that the publicity made it harder to quietly seek an abortion; providers who might have otherwise taken a legal risk for her couldn’t escape the attention that followed her. Continue reading

Sherri Finkbine’s Abortion: Its Meaning 50 Years Later

The Finkbines traveling back to Phoenix, en route from London. Image: BBC

In the early 1960s, abortion was illegal in Arizona, as it was in every state after more than a century of anti-abortion legislation. Arizona, like some other states, provided exceptions in limited circumstances, but abortion was otherwise restricted throughout the United States. However, the 1960s also ushered in a change in the public perception of abortion, a change that was conducive to the Supreme Court’s decisions in Roe v. Wade and Doe v. Bolton to overturn many state and federal restrictions on abortion.


Sherri Finkbine’s story reminds us of the devastating impact of abortion restrictions we have since overturned.


The women’s movement played a big part in that change, as well as a rubella epidemic that raised widespread concern about fetal deformities and strengthened support for therapeutic abortions. However, if there was one person whose story had the biggest impact, it was a Phoenix-area woman named Sherri Finkbine. An abortion she had 50 years ago Saturday reminds us of the importance of keeping abortion safe and legal.

Sherri Finkbine was known to thousands of children as Miss Sherri on the local edition of the nationally televised children’s show Romper Room. But Finkbine entered the spotlight for another reason in 1962, when she and her doctor decided she should have a therapeutic abortion. Continue reading