Oral sex spreading unstoppable bacteria

KissingImage copyright Getty Images

Oral sex is producing dangerous gonorrhoea and a decline in condom use is helping it to spread, the World Health Organization has said.

It warns that if someone contracts gonorrhoea, it is now much harder to treat, and in some cases impossible.

The sexually transmitted infection is rapidly developing resistance to antibiotics.

Experts said the situation was "fairly grim" with few new drugs on the horizon.

About 78 million people pick up the STI each year and it can cause infertility.

The World Health Organization analysed data from 77 countries which showed gonorrhoea's resistance to antibiotics was widespread.

Dr Teodora Wi, from the WHO, said there had even been three cases - in Japan, France and Spain - where the infection was completely untreatable.

She said:"Gonorrhoea is a very smart bug, every time you introduce a new class of antibiotics to treat gonorrhoea, the bug becomes resistant."

Worryingly, the vast majority of gonorrhoea infections are in poor countries where resistance is harder to detect.

"These cases may just be the tip of the iceberg," she added.

Throat infection

Gonorrhoea can infect the genitals, rectum and throat, but it is the last that is most concerning health officials.

Dr Wi said antibiotics could lead to bacteria in the back of the throat, including relatives of gonorrhoea, developing resistance.

She said:"When you use antibiotics to treat infections like a normal sore throat, this mixes with the Neisseria species in your throat and this results in resistance."

Thrusting gonorrhoea bacteria into this environment through oral sex can lead to super-gonorrhoea.

"In the US, resistance [to an antibiotic] came from men having sex with men because of pharyngeal infection," she added.

A decline in condom use, which had soared because of fears of HIV/Aids, is thought to help the infection spread.


What is gonorrhoea?

Image copyright CAVALLINI JAMES/SCIENCE PHOTO LIBRARY

The disease is caused by the bacterium called Neisseria gonorrhoea.

The infection is spread by unprotected vaginal, oral and anal sex.

Symptoms can include a thick green or yellow discharge from sexual organs, pain when urinating and bleeding between periods.

However, of those infected, about one in 10 heterosexual men and more than three-quarters of women, and gay men, have no easily recognisable symptoms.

Untreated infection can lead to infertility, pelvic inflammatory disease and can be passed on to a child during pregnancy.


The World Health Organization is calling on countries to monitor the spread of resistant gonorrhoea and to invest in new drugs.

Dr Manica Balasegaram, from the Global Antibiotic Research and Development Partnership, said:"The situation is fairly grim.

"There are only three drug candidates in the entire drug [development] pipeline and no guarantee any will make it out."

But ultimately, the WHO said vaccines would be needed to stop gonorrhoea.

Prof Richard Stabler, from the London School of Hygiene &Tropical Medicine, said:"Ever since the introduction of penicillin, hailed as a reliable and quick cure, gonorrhoea has developed resistance to all therapeutic antibiotics.

"In the past 15 years therapy has had to change three times following increasing rates of resistance worldwide.

"We are now at a point where we are using the drugs of last resort, but there are worrying signs as treatment failure due to resistant strains has been documented."

Follow James on Twitter[3].


Is oral sex more common now?By BBC World online

It's hard to say if more people around the world are having more oral sex than they used to, as there isn't much reliable global data available.

Data from the UK and US show it's very common, and has been for years, including among teenagers.

The UK's first National Survey of Sexual Attitudes and Lifestyles, carried out in 1990-1991, found 69.7% of men and 65.6% of women had given oral sex to, or received it from, a partner of the opposite sex in the previous year.

By the time of the second survey during 1999-2001, this had increased to 77.9% for men and 76.8% for women, but hasn't changed much since.

A national survey in the US, meanwhile, has found about two-thirds of 15-24 year olds have ever had oral sex.

Dr Mark Lawton from the British Association for Sexual Health and HIV said people with gonorrhoea in the throat would be unlikely to realise it and thus be more likely to pass it on via oral sex.

He recognises that while condoms would reduce the risk of transmission, many people wouldn't want to use them.

"My message would be to get tested so at least if you've got it you know about it," Dr Lawton said....

References

  1. ^ BBC Radio 1 - Myth-busting STIs (www.bbc.co.uk)
  2. ^ Pubic hair grooming 'STI risk from cuts' (www.bbc.co.uk)
  3. ^ on Twitter (twitter.com)

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Social media firms urged to tackle online body shaming

Harnaam Kaur Image caption Campaigner Harnaam Kaur said she received death threats

Internet companies should do more to tackle body shaming online, social media users have told an inquiry into how body image affects young people.

One told Parliament's annual Youth Select Committee that "so many" young people were suffering from online abuse and feelings of inadequacy.

There should also be greater diversity in the media, the committee heard.

A Facebook and Instagram policy manager said the sites were committed to making sure users had positive experiences.

'Mean comments'

The Youth Select Committee, which comprises 11 members aged 13 to 18, chose the topic of body image to consider after nearly one million people voted it as one of the top 10 issues in the UK Youth Parliament's "make your mark" ballot in 2016.

Danny Bowman, who once claimed to be the "world's first selfie addict", told the committee he saw "so many young people who are suffering online" from being bullied or body shamed.

He said his own experiences of social media led him to have a mental health problem over his body image and to him being housebound for six months.

Image caption Danny Bowman told the committee he saw "so many young people" being bullied or body-shamed online

Mr Bowman said he thought Instagram - and the images it has of "six packs left, right and centre" - was "becoming more detrimental, especially to young men".

He added:"I think it translates into the idea of success and failure - a lot of young men are looking at these images and feeling they are inadequate, a failure…

"If we want to solve this problem we have to go directly to social media networks."

Image copyright Paul Michael Hughes/Guinness Wor Image caption Harnaam Kaur is a body positivity campaigner

Harnaam Kaur, a body positivity campaigner, said there was a lack of diversity in the media.

Ms Kaur, who has claimed a Guinness world record for her beard[1], said this had encouraged her to set up an Instagram page.

"That is why Instagram is so important for me, to do photo shoots and show people it is ok to look different.

"I do also feel that companies need to open up their doors to people who do look different and actually stop photo-shopping images…

"The way that women's bodies and men's bodies that are being portrayed are not actually their natural form."

Image caption Stephanie Teboah said it was "difficult to find models of colour"

Stephanie Teboah, a plus-size model, said a "Westernised standard of beauty" dominated the media, and called for a greater variety of ethnicities and body types.

However, she credited Instagram as a site that also hosts "body-positive" content, too, adding that users can curate their feeds to see the content they want to see.

Karim Palant, Facebook and Instagram's UK public policy manager, told the committee Instagram was "absolutely committed" to making sure its community is "as positive as possible".

He added that the companies wanted to make sure policies and tools were in place so that "negatives are dealt with as quickly as possible".

The committee, which next meets on 14 July, will also hear from academics, mental health experts, education professionals, and government officials....

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Charlie Gard case: Great Ormond Street in new court bid

Charlie GardImage copyright PA Image caption Charlie Gard has been in intensive care since October

Great Ormond Street Hospital has applied for a fresh hearing in the case of Charlie Gard following claims of "new evidence relating to potential treatment for his condition".

It comes after seven medical experts suggested unpublished data showed therapy could improve the 11-month-old's brain condition.

Previously, the High Court said it was unlikely a US doctor offering to treat Charlie would be able to cure him.

GOSH said it would "explore" the data.

Charlie's case will be heard by Mr Justice Francis on Monday at 14:00 BST, according to a High Court listing.

Image caption Under a High Court ruling, GOSH is forbidden from allowing Charlie to be transferred for nucleoside therapy anywhere

A hospital spokesman said:"Two international hospitals and their researchers have communicated to us as late as the last 24 hours that they have fresh evidence about their proposed experimental treatment.

"We believe, in common with Charlie's parents, it is right to explore this evidence.

"Great Ormond Street Hospital is giving the High Court the opportunity to objectively assess the claims of fresh evidence.

"It will be for the High Court to make its judgment on the facts.

"Our view has not changed.We believe it is right to seek the High Court's view in light of the claimed new evidence.

"Our priority has always been, and will always be, the best interests of Charlie Gard."

Under a High Court ruling, GOSH is forbidden from allowing Charlie to be transferred for nucleoside therapy anywhere.

'Tested on mice'

Seven clinicians and researchers, including the US doctor, signed a letter explaining that the treatment would be experimental for Charlie's particular condition.

They claim that "ideally" the treatment would first be tested on mice but state that, in Charlie's case, there is not time for such a trial.

Charlie has mitochondrial depletion syndrome, a rare genetic condition which affects the cells responsible for energy production and respiration and has left him unable to move or breathe without a ventilator.

Image copyright PA Image caption Connie Yates and Chris Gard raised more than £1.3m for experimental treatment for Charlie

Doctors at GOSH have said he cannot see, hear, move, cry or swallow and that his life support should be switched off because there is no chance of his condition improving.

Charlie's parents, Connie Yates and Chris Gard, raised £1.3m on a crowdfunding site to pay for experimental nucleoside therapy in the US.[1]

But they lost a legal battle with the hospital last month when judges at the European Court of Human Rights ruled further treatment would "continue to cause Charlie significant harm".[2][3]

Signatories to the new letter include a neurologist and a research fellow from Rome Children's Hospital, a scientist from Cambridge University's Mitochondrial Biology Unit and two researchers from Vall d'Hebron Institut de Recerca in Barcelona.

"In light of this new information, reconsideration of treatment for Charlie Gard is respectfully advocated," the group said....

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David Frost cardiac genetic testing service opens

Sir David and his son Miles FrostImage copyright Frost family Image caption Sir David's son Miles Frost died from an inherited heart condition aged just 31

A new genetic testing service is opening at Belfast City Hospital aimed at identifying and supporting those at risk of heart problems.

It is the first service in the UK to benefit from a fund set up in memory of the late broadcaster, David Frost.

It is estimated more than 17,000 people in Northern Ireland are living with a faulty gene putting them at high risk of sudden death or heart attack.

The cash will provide an extra nurse for a specialised unit at the hospital.

Mr Frost's son, Miles Frost, died from a heart condition called hypertrophic cardiomyopathy (HCM) aged just 31.[1]

Image caption Dr Alison Muir said the funding will allow for a new nurse

Although Sir David did not die from HCM, his post mortem found the disease was present.

Miles and his brothers, Wilf and George, were not tested for HCM before his death.

Dr Alison Muir, consultant cardiologist at Belfast City Hospital, said:"In Northern Ireland, HCM affects approximately 1 in 500 individuals, but if you imagine that we have to see their parents, siblings and children, that's a lot of people.

"Our new nurse will help us see a lot more patients each year.

"When someone dies from an inherited heart condition not only will their family be faced with the devastating loss of a loved one, they will also face the possibility that they or another family member could be affected with the condition.

"It is important they are referred to the service so we can carry out this cascade testing.

"It can be a frightening prospect so the care of a specialist inherited cardiac conditions nurse is vital to support them through the process." ...

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Contraception fails in quarter of abortions, say experts

Young woman anxious about her contraceptionImage copyright Getty Images Image caption The pill is the most popular method of contraception among women

One in four women who had an abortion in 2016 were using the most reliable methods of contraception, says the British Pregnancy Advisory Service.

More than 14,000 women, who were treated at BPAS clinics, became pregnant despite using the pill or a long-acting contraceptive.

They often spotted their pregnancy late because they hadn't expected their contraception to fail.

No method of contraception can ever be 100% effective.

But long-acting reversible methods are said to have a very low failure rate (99% effective).

Image copyright Getty Images Image caption Condoms are not as reliable a method as the pill, implants or coils

Oral contraceptive pills are by far the most popular way of protecting against unplanned pregnancy among women, but long-acting methods - known as Larcs - are catching up.

They include contraceptive injections, implants and intra-uterine devices (IUDs) or systems (IUSs).

Contraceptive pills are estimated to be 91% effective while condoms are 82% effective when used typically.

However, BPAS says unplanned pregnancies can occur if the method is not inserted properly, or if it moves or falls out.

It also says hormonal contraception, such as the pill or patch, can mask the symptoms of pregnancy because they may cause light or irregular periods.

This may be why women using these methods have abortions at a later stage than other women.

BPAS said that in 2015, more than 5% of women having abortions past 20 weeks were using Larcs, compared to around 3% of those having one at less than 19 weeks.

The legal limit for abortions is 24 weeks in England, Wales and Scotland.Women in Northern Ireland are now able to get free abortions in England.[1]


What contraception do women use?

  • 45% use oral contraceptive pills
  • 15% use an implant
  • 14% use male condoms
  • 14% use an intra-uterine device (IUD) or intra-uterine system (IUS)
  • 9% use an injectable contraceptive

Further information:NHS contraception guide[2]


Ann Furedi, chief executive of BPAS, said:Our data shows that women cannot control their fertility through contraception alone, even when they are using some of the most effective methods.

"Family planning is contraception and abortion.

"Abortion is birth control that women need when their regular method lets them down."

Out of 60,000 women who had an abortion at BPAS clinics last year, more than half were using at least one form of contraception.

The total number of abortions in England and Wales has been around 185,500 during each of the last few years.

Image copyright Getty Images Image caption Long-acting methods of contraception, like injections, are growing in popularity

Every year, nine in every 100 women using the pill, six in every 100 using the injection and one in every 100 using the IUD become pregnant.

Abortions are only allowed in Northern Ireland if a woman's life is at risk or there is a permanent or serious risk to her physical or mental health.

The sexual health charity FPA said people did not always use contraception consistently or correctly.

It also said some of the most effective methods of contraception were not always made as available as they should be.

"In a survey of GPs, we found that one-fifth don't offer the intrauterine device (IUD), and almost a quarter said they don't offer the contraceptive implant," the FPA said.

GPs told the FPA that this was partly because of a lack of training qualifications and a lack of funding.

But NICE (National Institute for Health and Care Excellence) guidance suggests that long-acting methods of contraception can reduce unintended pregnancy and be cost-effective for the NHS....

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